Medicine Options

[concerned811]

Hello everyone,

I had my tests for Hep B again last week.
My earlier profile is Hepb DNA 4000 copies/ml, HbsAg +ve, HBseAg -ve, HBseAb +ve

I have not got my recent results till now. Doctor says if the liver tests are bad, he might consider treatment by pills.

Now - I looked at my Prescrition Drug Plan and it scares me.

Options that I see are Epivir-HBV, Baraclude and Tyzeka
All of them are in a higher tier cost and they cost from 350 per month to 750 per month.
Also, the plan has a preferred drug list and a non preferred drug list.

Only Epivir-HBV is in the preferred drug list...all the others are nonpreferred. That means higher copayment amout for me - also, mine is a high deductible health plan so I am looking at way too much money going out on meds.

What has been the expereince of others with Insurance companies? do your plans cover these meds at lower cost?
It is surprising to me that the only preferred drug in the list is the one which is known to devlop resistance!!!

[baraclude2009]

hey there-
you should be on therapy. latest studies show that levels of detectable-replicating virus are predictors of people developing hcc-liver cancer down the road. also, if don't want a biopsy yet you can do an ultrasound for now. also, as for cost of therapy: look into: togetherrx program online, also the company's website as well and also, baraclude just started a new copay assistance program that will help you out. finally, your doctor can send a letter to your insurance company asking for a prior authorization to put you on baraclude. your liver and life is not worth the risk of being on a cheap ineffective drug....

[bberry]

also, my doctor is suggesting a liver biopsy which he wants some some time in March . thats when i see him next.

i was for liver biopsy to have a clear cut understanding of where my i stand as far as my health goes but i've been reading that it isnt really needed for my situations and current health . so i am having seconds thoughts which i will discuss with my doctor in a few months

[bberry]

the reason why i asked you is i was in the same boat as you are.
only thing my dna count was  3470 and yours is 4000 . everything else is almost the same reading , and that is why i was curious to know what you decided or what your doctor advised/suggested

also, what liver fuctions test(s) did he do to determine your liver health ?

i opted to go for treatment only because i was new to this hep B **** and i was scared. also he implied he liked to treat everyone specially with HbeAg negative with count over 2000 so i just said yes.
does every doctor think the same way mine does ? let me know what yours says please.

as for treatment options, i am taking Baraclude now. its free to charge with an application you fll out at your doctor's office. they submit it for you to the drug maker / distributors and they give you a year's supply for free. a 3 month-supply at a time for a year. the following year you apply again. main questions on the application is a copy of your W2, the number of members in your household.

good luck

[concerned811]

Thanks for the info Jim.

To bberry, my doctor will suggest treatment if the liver function tests are abnormal...he is suggesting biopsy too, but I am against it....I have not chosen any treatment nor has he suggested any treatment yet.....I just looked at my health plan to find this out and the way insurance companies have stuctured their drugs list is discouraging.....

[bberry]

so i take it your doctor is suggesting treatment rather than monitoring ?


did he say you needed it or did he ive you some options and you chose treatment ?

what tests did he do for your liver ?

thank you

[cajim]

It is surprising to me that the only preferred drug in the list is the one which is known to devlop resistance!!!

--Because it is the cheapest.

What has been the expereince of others with Insurance companies? do your plans cover these meds at lower cost?

--Kaiser in USA provides Baraclude with $10 copay per fill (100 pills).