cowriter is exactly right. The doctors should not use the hemolytic anemia code but rather a chemotherapy code. All the insurance companies are doing is looking for numbers. Use the right number and there is no problem getting the procrit approved.
shanro -- can-do-man's doctor - and he is a leading researcher on behalf of Victrelis - started him on procrit just as soon as his HGB dropped below 11 with the SOC drugs. He knew that the HGB would drop a lot more with the PI and took the precaution for him. My first treatment I started procrit when my HGB dropped to 10.6. This round, my doctor has not mentioned it yet and I am at 10.8.
My liver drs sed if I get 10 or below--procrit. Finally at week 40, got 10, 9.9, 10..., was thinking. "great!" I finally get Procrit the rescue! Was waiting all these months to get it. Nope!!! The Ocologist/Hemotologist disagreed! WHAT?? Dude you gotta be kidding me? Mad... Liver drs sed ok," just reduce RIBA," No. I wont! I will suffer thru the full dosage of my meds.. Even if it kills me to fight this virus and keep it away. The drs just don't wanna pick up the phone and tight for you to get an expensive drug for insurance approval. Forget that Procrit even is in existence if your dr is against it. Just re adjusting RIBA seems like their "cop out!" I won't I won't. I've come this far, in bed for 85-90% what's more agony towards the end? Thanks docs! They havnt been there, peeps. They don't know everything. Hey, how about a shot of interferon for you to try Mr Dr? ..... Just sayin'
I'm feeling awful in the 10s too! I don't know how others are handling being in the 9s!! What was your initial dose reduction/is it still reduced? Did you go below 10 after dose reduction/if so, how long did it take to go below?
My insurance would not cover initial procrit tx until HGB went below 10. I was dose reduced when I dropped very quickly and went below 10. It took 2 weeks for the procrit to really help. Although I didn't like the dose reduction, I felt better. Now I take procrit 1x week and I've been at 10.3 still feel awful. I can't imagine living in the 9s.
my doctor hasn't tried any code yet... she only did the dose reduction... I printed out a couple of studies done on reduction vs procrit to show my doctor, am upping my ribavirin back to 1000 starting tomorrow against doctor orders and calling a hematologist on Monday (who also specializes in ocology so that they can use the chemo code and my insurance doesn't require a referral to see a specialist)
this is the point i'm at right now... i'm too afraid for this not to work and i've already been dropped to 800 for 2 1/2 weeks... who knows what damage that's done already???
i do feel hesitant about going against doctor's orders... so my questions are these... 1. will it really make a difference if i wait two more days to up my ribavirin?; and 2. how risky is procrit???
Usually insurance companies will deny Procrit if your doctor lists a diagnosis of "Hemolytic Anemia"...because Procrit is not FDA approved to be used for the anemia caused by Hep C treatment. A way of getting around that is by using a "chemotherapy" diagnosis code. Interferon is considered "chemotherapy".
Find out what diagnosis your doctor used. He may have used the wrong one.
Co
I'd rather keep my dose up and use procrit. Mine hmg dumped n now I have to transfuse. My dr wanted me to take it, but ins rejected it 2x. Every dr is diff. Und since week 4 n now on week 11 - I want my FULL dose of tx! Nudge ur dr that way cuz it can take a couple of weeks. Most people here have had great success w procrit.. Karen :)
I am with you there WEEK 11 Incevik Doc was talking reduction was down to Hgb 9.6 for a couple of weeks I told them I was feeling a little better and to retest, the test was 2 weeks old came back at 10.0 Hbg they where happy with that and told me to continue on as I have been. I do not feel great but I will make it 12 more days and I drop Incevik and know I will feel better. I did 84 weeks Interferon/Ribavirin and never felt this run down. Been with same Doc so she knows me very well .
My doc feels very strongly that dosage of riba should not be reduced unless as a last resort and doesn't want to start procrit unless my hgb drops below 8.5, I start week 11 of triple tx with incivek tomorrow and for many weeks my hgb has been in the low 9's. I take 1200 mg of riba. I appreciate my doc's aggressive stance......just sayin. Good luck.
I have only 2 months left on tx and have had no problems. But a few weeks ago my hgb went to 9.9 and my hepatologist moved quickly to 1 shot of procrit immediatly and then reduced my riba from 1200 a day to 800. I then had 2 more shots of procrit once a week and after 3 weeks tops everything was good. The procrit stimulates the bone marrow to produce more red blood cell but usually takes a couple weeks for that to happen. he then increased my ribe to 1000 then back to 1200 where i started. I have always maintained between 10.2 and 12 on hgb but they didn't jump till it went below 10. my biggest thing was to get my riba amount back to 1200 as quickly as possible cause i didnt want the virus to have a chance to come back cause my dose was to low. Luckily no transfusion. Good luck to you.