Anyone know if Insurance will pay for these new drugs?

[GrammyA]

Very exciting news today with my visit to the Hep Dr. - he is going to try to get pre-approval from my insurance company to start me on the 2 new oral drugs (cannot recall the exact names) that you take 1 pill each per day for only 12 weeks with a 90% SVR and minimal side effects.  I have not achieved SVR in 2 prior attempts with the most recent being with triple TX and Incivik which ended last January….am 1b with cirrhosis and 61 years old.  He tells me the plan would cost about $100,000 for the 12 weeks of pills and he is not sure if the insurance companies will approve it.

Anyone else trying this and thinking your insurance might pay?  

[JimmyMose]

I posted to this forum but it was moved to Hepatitis Social Community

Go to this link for more info and link to Formulary Lookup Tool to look up the new Hepatitis drugs to see if they have been added to Medicare-Plans or Non-Medicare-Plans in the USA


http://www.medhelp.org/posts/Hepatitis-Social/Formulary-Lookup-Tool---US-drug-status-for-health-plans/show/2091595

[giska]

Does anyone know aetna covers this new drug solvaldi with co.pination for 12 week regime . My husband is in process of blood test to k ow his IL28 type
Then may start if insurance covers.

[giska]

Does anyone know aetna covers this new drug solvaldi with co.pination for 12 week regime . My husband is in process of blood test to k ow his IL28 type
Then may start if insurance covers.

[NYCMark]

Yes thanks Will, the Cosmos results were the impetus to start this round of treatment -they figured the insurance companies would have to go along with such good results even though not specifically approved for use together.  With or without Riba, the results were excellent using Sof. + Smp.
I'll check back after lab tests are in next week.  

A question - has anyone here on Simeprevir suffered from an elevated bilirubin?  I know that is on the adverse effects list. I can imagine now that I have a slight yellow-ish cast (and I'm usually quite pale).
Mark

[willbb]

Hi mark.
.You doctor is most likely reducing the Riba because he would seem to be well versed in the research(linked below) that shows that  while doing the combination of these two drugs that RIBA is really on no consequence Actually in trials  patients with F3/F4  fibrosis levels did  4 % better without  it and would not want to jeapordize your therapy by  the onsetting anemia

Hope that explains possibly his rational........

Best of luck with your tx.

Will

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/HCV%20Keeping%20Up/Interactive%20Virtual%20Presentation/IVP/Pages/Page%201.aspx

Slide 2 of sect.. 3  discusses use with and without  Riba

[jules2551]

2. It could be from the ribavirin/anemia beginning.  Yes, I would certainly reduce, and then stop, that drug if it turned out to be unmanageable.  I think my doc hoped to maximally increase my chances of SVR this time, since I have relapsed after the last 3 treatment attempts.

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Why on earth would you recommend reducing Riba since you relapsed after 3tx?  I just dont understand