The Lead-In for Victrelis Explained

[Magnum]

Just got back from my Gastro. As some may know, He applied for Bocepravir (Victrelis) for me. Something weird to report...

Two of his patients were denied Victrelis and were approved for Telaprevir instead, which cost more. As for the Victrelis lead-in with four weeks of standard therapy. His studies showed that in more than a few cases, when Telaprevir was administered, there was a significant drop in the viral count almost right away or at least within 7 days. However... the virus hopped right back soon after.

So... The reason for the lead-in with Victrelis is to weaken the virus for a month with traditional therapy only, and let it drop to a point when it is then bombarded with Victrelis, so it will lose its battle. Die, die die die....

So in my case, the insurance company called and said they need more info before approving the Victrelis. I have my fingers, arms and legs crossed that they won't deny me. If they do, I will then ask for a supplement co-pay by Blue Shied. This is not the last of it if denied again. I will still fight it all the way to a Medicare judge in court if necessary. Remember, insurance companies didn't build skyscrapers by giving away money. At times you have to force them submission by trapping them into a corner. They don’t want to hear the words "court" "judge" "more appeals if necessary" and so on. That’s called “rocking the boat”, and they’re too busy trying to save money rather than sending attorneys to court... Stay tuned...

Magnum

[Magnum]

I spoke to my Gastro regarding the Anemia factor with Victrelis. He said it was no big deal and readily controlled with Procrit. He's had a lot of success with Procrit and his patients. I've been fortunate to not have the Anemia problem through four tries, but if we face that problem, then Procrit.

The rash on the other hand is not easily controlled and in his opinion is a big factor with Incevik. How your insurance company deals with switching PI's is another consideration. Will they allow you to switch if you get the rash with Incevik? that's an important question. At any rate, whatever you choose, good luck in clearing...

Magnum

[ShortLaura]

Hi.  Hope you get what you want. I wanted BOC, but at first my GI said no because of my anemia.  I was NOT looking forward to any more itch or rash than I've had with SOC.  Then he changed his mind and said I would go on Procrit quickly. Of corse BCBS denied it but once the anemia kicks in, I should be OK.
I will do whatever I have to.  There's no dropout from this girl.

[coeric]

hi magnum,
spoke with a hepatologist this week, who was an investigator in the incevik trials but not victrellis.  the doc said they will be using both PIs in their clinic.   their first patient they are treating after approval is receiving victrelis.  
eric

[temmi]

It will be at least 6 weeks before I tx and I am planning to request Victrelis instead of  Incevik because of the severe skin rash probability. I already have sensitive skin problems and I can't imagine what Incevik would do... I hope my insurance plan won't try to insist on which drug to approve.

[brianmo]

My doctor, who I am trying to work all this out with, also suggest not adding the 3rd drug and staying with SOC because of the horrendous rash. She stated 58% drop out rate because of it. She wants to do the lead in then add the Teaprevir if needed. I decided to go with that decision. My gene is CC, genotype 1a, HIGH VL, female, small.

[Magnum]

I can only relay my Gastro's take on Victrelis after studies he's seen. The other reason he wants me on it is the absence (hopefully) of the horrendous rash, in which studies he’s seen showed that 30% have dropped out of therapy because of rash intolerance and suffering beyond reason. To him, that’s too high of a rate of drop-outs. You're right to run this by your Hepatologist, as my doctor has yet to catch up on the final studies of Telaprevir. Best of luck to you...

Mag

[frijole]

Very interesting, indeed.

First, I wonder where this information is coming from that with the Incevik(Telaprevir) the virus comes back after the intial drop.  Any ideas?  Seen that in any studies? The only reason I can think of for denying Vitrelis and approving the Incevik is that the SVR rates are slightly higher.

I am going to see if I can get any kind of info from my insurance company before I go to see the heppo next Friday.

What additional info do they want from you?

frijole

[can-do-man]

If denied why not apply for Mercks Patient Assistance Program???

Good luck guy,
cando

[mike716]

Hi, Magnum. I got a lot of pleasure from reading your post, since the only thing I hate as much as pharmaceutical companies and the AMA is insurance companies. Maybe it's time for a class-action lawsuit (like170 million HCV infectees in the class!), to force the insurance companies to sell their skyscrapers and give triple therapy to us all?

Mike

[babs824]

i have had battles with insurance that make my blood boil. i sure wish u success this time.
best to u! babs