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BCBS stalling on Sovaldi/Olysio RX
Just got declined this morning on my RX ( sovaldi/olysio) and seems they are stalling - requesting more "info" from my Dr. . They sounded all good 2 weeks ago when I followed up on my docs RX submission, but seems this is getting bogged down - I am so wanting to get this started and STOP the liver deterioration as soon as possibele... Anyone have this experience or similar with BCBS ? I am sad and fearful I won't get this life saving therapy. TY
Hi
Hope you had a great vacation and you continue to have no side effects.
Here is a link to a MELD score calculator:
http://www.mayoclinic.org/medical-professionals/model-end-stage-liver-disease/meld-model-unos-modification
You just need your test results.
Just wanted to say if you cure hep c unfortunately that won't cure cirrhosis if you have it. We all are hopeful that there can be some recovery for our damaged livers once the hep c is gone but that would be a slow improvement taking years. If you don't have complete cirrhosis (less than F4 fibrosis score) that your chances for improvement are better.
But either way gotta kill the dragon no matter what
Good luck
Lynn
Hope you had a great vacation and you continue to have no side effects.
Here is a link to a MELD score calculator:
http://www.mayoclinic.org/medical-professionals/model-end-stage-liver-disease/meld-model-unos-modification
You just need your test results.
Just wanted to say if you cure hep c unfortunately that won't cure cirrhosis if you have it. We all are hopeful that there can be some recovery for our damaged livers once the hep c is gone but that would be a slow improvement taking years. If you don't have complete cirrhosis (less than F4 fibrosis score) that your chances for improvement are better.
But either way gotta kill the dragon no matter what
Good luck
Lynn
Day 2 since getting back from sun and sand - NO ill effects - weird - like this is too good lol !!! Anyway.... Just a guess at remembering my MELD score - thew bottom line was what I remember , way too low for even listing for translapnt which was great news for me :) 5 other meds are all liver related. Updates to follow....
Hi Harley
From what you just said about meld you probably should be on a transplant list. In Seattle they list you at 15. You won't get one at 15 but you are on the list.
Definately sounds like you are sick enough the get the meds they wouldn't want you on interferon at this point as it sounds likely you have cirrhosis with that high of a MELD score. Interferon could cause you to become completely decompensated.
Just curious what are the 5 rx per month are they related to cirrhosis?
I had varicies banded but only medication I have is Spironolactone for edema and small amount of ascities. Couldn't give me a beta blocker as my heart rate is less than 60 bpm.
Do you get an abdominal ultra sound and an AFP (Alpha-fetoprotein) blood test along with liver function panel every 6 months?
I am MELD 7 Child A and cirrhosis since January 2008.
Yes vacation in the sun now as the warning label for Olysio says stay out of the sun as many patients had strong reactions from sun exposure.
Any way good luck again!
Lynn
From what you just said about meld you probably should be on a transplant list. In Seattle they list you at 15. You won't get one at 15 but you are on the list.
Definately sounds like you are sick enough the get the meds they wouldn't want you on interferon at this point as it sounds likely you have cirrhosis with that high of a MELD score. Interferon could cause you to become completely decompensated.
Just curious what are the 5 rx per month are they related to cirrhosis?
I had varicies banded but only medication I have is Spironolactone for edema and small amount of ascities. Couldn't give me a beta blocker as my heart rate is less than 60 bpm.
Do you get an abdominal ultra sound and an AFP (Alpha-fetoprotein) blood test along with liver function panel every 6 months?
I am MELD 7 Child A and cirrhosis since January 2008.
Yes vacation in the sun now as the warning label for Olysio says stay out of the sun as many patients had strong reactions from sun exposure.
Any way good luck again!
Lynn
I will be receiving my RX tomorrow - vacation in the sun for several days and then start the treatment - I will keep this forum updated on viral load counts etc... . I was alreadt turned down for transplant, MELD score was like 17...wayyyyyy to healthy lol . Passed for many years on alternative chemo injection type treatments...waiting for this . HOWEVER...your feedback is noted, and the varices banding, 5 rx per month for all the blood issues, etc will no longer be needed I believe ( forgot what doc said) and the long term savings for the insurance company is real and true :) ty
Wonderful!! But never forget, this is a great deal for them, too! If you reach SVR, and your liver improves , you won't need transplant, and all those expensive drugs, so they are saving a bundle in the long run.
Never the less. - Great news!!! On to SVR.
Never the less. - Great news!!! On to SVR.
Great news! Good luck on treatment -- it's a very good combo with very good results!
Mark
Mark
WOW !!!!!!!!!!!!!!!!!!!! BCBS has done the deal !!! I am approved and Sovaldi and Olysio are on the way !!!!!!!!!!!!!!!!! Just..........wow !!!!!
Lynn..TY :) I am on pins and needles over this...exhale........... :)
Just got the letters in the mail from BCBS and yes, they are seeking more from Dr - 1( want me to use peginterferon 2) want viral load info from dr 3) METAVIR score of 3-4 needed for liver damage verification. sigh......... I hope this does not mean they want me to be sicker before they approve it :( TY again for the positive feedback :)
Just got the letters in the mail from BCBS and yes, they are seeking more from Dr - 1( want me to use peginterferon 2) want viral load info from dr 3) METAVIR score of 3-4 needed for liver damage verification. sigh......... I hope this does not mean they want me to be sicker before they approve it :( TY again for the positive feedback :)
Hi
I also have BCBS it seems to be the common practice for them. I spent a bit of time on the phone on hold between them and express scripts. It seems Express Scripts was the real hold up for me. There is a form the doctor probably needs to fill out to determine if the treatment is per protocol based on your situation.
Just hang in there maybe be proactive and call to find out what the hang up is. After I called back and forth between BCBS, express scripts and my doctor for about 2 days on the third day I got the paper work all pushed through ( seems some faxed docs never made it originally) and was approved.
Things that help your case are if you have genotype 1 and cirrhosis but I have seen others here who had less liver damage get approved.
Take a breath I am sure it is just the old paperwork shuffle.
Good luck
Lynn
I also have BCBS it seems to be the common practice for them. I spent a bit of time on the phone on hold between them and express scripts. It seems Express Scripts was the real hold up for me. There is a form the doctor probably needs to fill out to determine if the treatment is per protocol based on your situation.
Just hang in there maybe be proactive and call to find out what the hang up is. After I called back and forth between BCBS, express scripts and my doctor for about 2 days on the third day I got the paper work all pushed through ( seems some faxed docs never made it originally) and was approved.
Things that help your case are if you have genotype 1 and cirrhosis but I have seen others here who had less liver damage get approved.
Take a breath I am sure it is just the old paperwork shuffle.
Good luck
Lynn
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