Viekira only thing my insurance will approve

[mikejj24]

I am an almost 60 year old with Genotype 1A, supposedly without Cirrhosis. It is quite likely I have had Hep C for 30 years or more and I feel bad almost all the time now, have pains in my liver area, and often low grade nausea.  I have asthma and COPD also so I have been waiting for Harvoni, since it does not use Peg or Ribavirin. All my doctors attempts to get Harvoni approved by BCBS/Express Scripts have failed. I just got the latest nasty letter from them saying basically "it's not covered and that's final".  I do not qualify for Gilead assistance because of my total household income. Now my doctor is asking me if I want to give in to them and go with Viekira with Ribavirin for 12 Weeks. I am terrified to take the treatment and terrified not to. I have no idea if I can tolerate it or not. Any advice you can provide or experience with this drug combination therapy would be greatly appreciated. For instance, if I had to drop the Ribavirin at some point maybe 3-4 weeks into it...would there be any chance of an SVR? What kind of side effects could I expect? Would I be able to still commute/work? Should I let my employer know in case I can't at some point? So many concerns...

[patra_]

Mike:  Is your Dr a hepatologist, gastrointerologist, or infectious disease specialist who treats a LOT of hep C?  I am not trying to disrespect ANY Dr and their training, but from what you have posted, I womder at her knowledge of hepc.  

Is she is thinking about the Ins provider, I would think that she, as a Dr, would be the first to point out that paying for 12 weeks is FAR less expensive than paying for 8 weeks and then having the patient relapse and have to then be treated for 12 or 24 weeks.

Great to hear that you have started tx!  

Good treating and on to SVR!

Pat

[mikejj24]

I bridged the subject of trying to extend to 12 weeks with my doctor and did not get a good response. She was somewhat condescending, saying that she could not justify it because of my biopsy and viral load...and that "I should not believe everything I read on the internet" I was taken aback somewhat over that comment since their office was UNABLE to get Harvoni approved at all and it was my plea to AccredoRxHelp.com that made it happen, which I got the idea from this forum. I don't know how Viral load or biopsy can be the final word as neither of them are all that definitive. I believe the viral load goes up and down depending on your immune system etc. and the biopsy they did was just a small pin prick. They even said that it did not tell the whole story at the time. I will continue to try and see what I can do to convince her. BTW started on the Harvoni last Saturday. So far, nothing to hard to handle. I may have a little more fatigue but not bad. I had trouble sleeping the first night but I think I was just keyed up about it.

[hepcandme]

I would ask for a longer treatment as well only to make sure it gets the job done

For those of us who relapsed on Sovaldi/Olysio, it seems that we may have been cured if we had gone longer? I did a 12 week regimen but now wish I had done 24

The Riba, as Lynn points to, is just one more piece of insurance. My doc ordered it straight away. Lynn had to do some lobbying to add Riba to her treatment but it seems indicated by the new treatment recommendations for those who are difficult to cure

There is a thread that I posted last week I think that contains a link to slides from a recent webinar that summarizes the current recommendations

I can try to find it if you cannot

Good luck on your treatment!

[patra_]

Mike:  I am a conservative person in many ways, not conservative 'take 8 weeks', but conservative 'take 12 weeks', to be sure one time treatment is enough.

Others may not feel that way, but a little extra tx could, IMHO, make the difference between success and relapse.  I would talk to the Dr about choosing 12 wks.

Good luck and good treating, whichever way you go.  On to SVR!!

Pat

[mikejj24]

Since I am now on track to get the Harvoni, I was wondering if I should try and get my treatment extended to 12 weeks instead of the 8 weeks my doctor is suggesting. This would, of course, be depending on how I tolerate the medicine. Like I mentioned before, I likely have had Hep C for ~30 years plus my last sonogram showed what they deemed as fat infiltration in my liver. I want do everything I can to "kill the dragon" on this first attempt.

[flyinlynn]

I was UND at 4 weeks in.

I am a null responder to 3 tries with interferon based treatment. I suspect I was infected in 1978 or 1979. I was dx with Hep C in 1990. I was diagnosed with cirrhosis in 2008 and have since developed edema and a small amount of ascities. I also developed esophageal varicies that went to grade 3 in 2012 so I had 4 sessions of banding. I relapsed on Sovaldi Olysio after 12 weeks of treatment which in November the recommendation was change to 24 weeks for patiientl like my self

Riba Harvoni is recommended for 12 weeks is recommended for GT 1 with decompensated cirrhosis as an example.

So basically based on my treatment history we are pulling out the stops as I amy be running out of time and options.

Lynn