Aa
A
A
A
Close
Hepatitis C Community
13.4k Members
Avatar universal

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 :(:

http://www.medhelp.org/posts/Hepatitis-C/Alinia-undergoing-trials-for-Hep-C/show/307461

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

susan
Have an Answer?
Top Hepatitis Answerers
317787 tn?1473362051
DC
683231 tn?1467326617
Auburn, WA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Answer a few simple questions about your Hep C treatment journey.

Those who qualify may receive up to $100 for their time.
Explore More In Our Hep C Learning Center
image description
Learn about this treatable virus.
image description
Getting tested for this viral infection.
image description
3 key steps to getting on treatment.
image description
4 steps to getting on therapy.
image description
What you need to know about Hep C drugs.
image description
How the drugs might affect you.
image description
These tips may up your chances of a cure.
Popular Resources
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.
These common ADD/ADHD myths could already be hurting your child
This article will tell you more about strength training at home, giving you some options that require little to no equipment.
In You Can Prevent a Stroke, Dr. Joshua Yamamoto and Dr. Kristin Thomas help us understand what we can do to prevent a stroke.
Smoking substitute may not provide such a healthy swap, after all.