Denial for Sovaldi

[thebud1]

my son has GT3, he has no signs of cirrhosis, has had fiber scan done,  his was a 1, he has been approved for Daklinza, has been turned down 5 times for Sovaldi, we were told that you have to be a 3 before they will give you a prescription,  we've heard that in the State of Alabama, after 6 times of denial, they will not hear your case any more, we have tried support groups, had appeals several times, the dr has called the insurance company multiple times, can any one help us with HOW to get approved. its is going  cost us 185,000 for meds. ANY ADVICE would be APPRECIATED!!! We were told that India is cheaper on the medicine

[Dee1956]

Sorry, me again, here is another article about finding funding  It is unconscionable to me that an ins company would want to wait until he has cirrhosis.  Don't they understand the expense to them?
Everyone is right, it is slow moving.  It took me 30 years to get a suspicion of cirrhosis and I was in my 50's.
Oh what about Harvoni?  Sovaldi got some bad publicity for the cost of their medicine so some companies won't pay for Sovaldi but will for Harvoni.

http://www.hepmag.com/articles/2512_20506.shtml

[Dee1956]

From what I have read, you only have to have a prescription. Obviously your sons doctor wants you to have it.  It might take a bit of work or as said above
Gilead was helping people that had been turned down twice by their ins.
There is also a foundation PAN that helps people get grants for financial help.
For a while there Flyinlynn could not get her ins to cover, they finally did.
If it were me I would start telling everyone what this crappy insurance is doing to your son.
Someome will help.
Under my status is a link to financial help.  Sorry, early here and I am desperately trying to think of anything that might help.
Hang in there, Dee

[Dee1956]

Hi everyone has given you excellent advice
I am sending you a link to an article about Greg Jeffrey and how he is helping
people get the medications needed.  It is like the movie about the guy who was getting AIDS drugs and saving lives.  I think Million Dollar Dallas Cub
Well it's in article



http://www.abc.net.au/news/2015-08-20/hepatitis-c-sufferer-imports-life-saving-drugs-from-india/6712990

[Healive]

Thebud1, forget about paying the obscene amount of money for sofosbuvir/daclatasvir in the USA, who can afford them?. The same drugs (which are amazing at healing genotype 3 by the way) will cost you $1500 in India. The Indian generics are of the same quality. Your issue might be in getting a prescription. Going to India might be a solution, get a prescription and buy the meds there, maybe do your teeth cheap and have a break all at the same time. Look at Greg Jefferys blog online, it is easy to find and it's packed with golden info on getting medicine at a cheaper rate than the western world rates.

[patra_]

Lynn was right on.  in addition, have you called Gileas?  I know that they have changed their guidelines some, but it is better to ask and be told he must wait, than not to ask and he would have been able to get the meds.

GILEAD.com, then my support path.

As Lynn said, if not now, then later.  I had the most virulent Gt and I had it for 40 years before Sovaldi/Ribavirin defeated it.  I was at F3, the stage before cirrhosis when treatment worked.  YOur son has time to wait, if he must.  Just impress upon him good, h
Liver friendly eating, drinking LOTS of water, no alcohol, and to get regular exercise, to help his liver as best he can, til he can be treated.

Good luck and blessings to you both.

Pat

[flyinlynn]

Have you looked into a clinical trial?

https://clinicaltrials.gov/ct2/results/map/click?map.x=157&map.y=166&term=hep+c

Just to add I had hep c for 37 years before I was cured and it took me 30 years before I was diagnosed with cirrhosis. Hep c is a very slow acting virus not everyone even develops cirrhosis only about 20% have cirrhosis after 20 years of infection so your son has time on his side

Good luck
Lynn