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Insurance approval for PIs compared to Ribavirin when it initially was approved for treatment

I keep hearing that insurance companies won't approve the new PIs right away. I am of the opinion that they will look at at the stats and realize that it would less costly to treat with a PI then then treat twice. I also believe the right doctor can often challenge the insurance company and get approval. The pharmaceutical  companies will also be working hard to convince the insurance companies that this is the way to go and they obviously have a lot of money and man power to use towards that end.

Does anyone know how it worked when Riba was first approved for Treatment of HCV. I know riba was on the market for other non-hcv treatment for many years before it was used for HCV tx, but wonder if the insurance companies denied payment when used for HCV initially.
4 Responses
142841 tn?1201978652
The fact is that when the FDA approves the new drugs for treatment of HCV, then when a doctor prescribes it, the insurance will cover it (subject to the usual pre-requisites of pre-approval and dudctables, etc.)

I would think this process will only become streamlined as the HCR (health care reform) becomes implemented.
Avatar universal
you make a good point Dave.  It is cheaper to use a treatment with better outcome then treat twice.  There is no doubt that insurance will cover for those traditional tx didn't work for.  It's just hard to predict insurance, common sense is not always in the  forefront.  In the end a doctor can appeal it and get it approved.  There are ways around get auth and doctors know the ropes.
1118724 tn?1357014191
haha, good one.
Avatar universal
I think you covered it from all angles and that the insurance companies wil cover it.

Andiamo and Susan400 may know from personal experience about the approval of ribavirin back in the mid-nineties. Maybe PM them.

Here's a thread that is a fun read that brings up some interesting takes on the introduction of new drugs but doesn't answer your question :(:


ttyl when i have time and will try to actually be helpful. :)

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