New member hep c geno 1a stage 2 cirrhosis

[Rdnation]

I am new to this group but have been reading frequently. My husband will be 30 this week and about 1.5 years ago after donating blood we received a letter stating he was positive for hep c. After having blood work that confirmed genotype 1a hep c viral load I belive 3million we came to the conclusion he got it during childbirth. His mother found out she was positive 10 years ago. She has done 3 ribrovion treatments and last year received a liver transplant. After many complications she is now almost nor al minus all her medications. My husbands doctor decided to start harvoni but we just found out today he was denied. I Was only able to speak with a front desk staff so didn't get much info. She said they would approve another drug that started with a B? We have two small (4&18months) children and both work intense 40-50 hours a week. I was just wondering if anyone knows what are the next steps we could do to get harvoni approved? We have Cigna.

[Ekkiemom]

Hi Rd,  welcome to the community! Very sorry you are having a tough time right now. I have the same GT as you, today I finished my 24wk Tx. I was taking Sov/Riba and it was more doable than you think, if it this is what ur Hepa decides as Tx.
I wish you luck and remember the community is always here to help and walk you thru this, you aren't alone ok.
Keep us updated on your progress
Peace&Good Karma
Deb

[Dee1956]

Hi could the doctor have said AbbieV? Viekra Pak?  Here is some news about insurance companies that are making deals with Gilead to use their medications effectively taking the decision out of the doctors hands.

The only drug I know with a B is Boceprevir which is going by Victrellis now and is taken with Peg-interferon and Riba.

There are a lot of choices right now which makes it confusing

http://www.modernhealthcare.com/article/20150112/NEWS/301129971

[Dee1956]

Hi there, I was trying to find out what Cigna is paying for, I see that there are different types of Cigna.  I looked on one for Medicare Advantage just to see what they are covering, I did not see Harvoni but did see Sovaldi and Olysio
I think you will have to log in to your particular Cigna account to look up what is being covered.  It is possible they are a bit behind since it was just approved in October.  Good luck Dee

[flyinlynn]

Just noticed Stage 2 in your question. Could you mean F2?

There is a scale of degree of fibrosis I have copied below

A 5-point scale is used in grading the degree of liver fibrosis:

    F0= no fibrosis

    F1= minimal fibrosis

    F2= fibrosis has occurred and spread inside the areas of the liver including blood vessels

    F3= fibrosis is spreading and connecting to other liver areas that contain fibrosis

    F4= cirrhosis or advance liver fibrosis

So as an F2 he does not have cirrhosis which is most likely why your prescription drug insurance denied coverage.

As I mentioned you can appeal and if denied twice you can go to My Support path Harvoni and they can try to help you get approved and if you still can't get Harvoni from your they may if you qualify for Gilead to provide Harvoni for you. I believe they require a household income less than $100,000/year if you decide you want to go that route.

http://www.mysupportpath.com/

Providers and patients can call 1-855-7-MYPATH (1-855-769-7284) for assistance

[flyinlynn]

Hi and welcome

Sorry about all the difficulties you have experienced.

Your doctor can appeal the denial but some insurance companies and prescription drug providers will only provide Harvoni if the patient has F3 scarring or F4 cirrhosis specifically express scriptsI know has that policy.

They will however provide VieKira Pak for genotype 1 patients unless there is a reason they cannot take that medicine.

That is the only medicine I think they may have said I cannot think of one that starts with a "B".

You said have Cigna do you know who provides your prescription drugs?

So if you can't get Harvoni,Viekira Pak is a very good alternative. It has very good results.

The main difference is Harvoni is one pill a day vs Viekira Pak is a package containing 4 pills 3 in the morning and one in the evening. Also as he has Genotype 1 he will have to take an additional medicine called ribavirin which can lower hemoglobin and make him feel tired also he will need more frequent blood tests to monitor his hemoglobin levels. But unless he has cirrhosis he will only need to be on treatment for 12 weeks.

Here is a link to the prescribing information sheet for Viekira Pak:

http://www.rxabbvie.com/pdf/viekirapak_pi.pdf

Good luck to you and your family

Lynn