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Hepatitis C Community
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1635208 tn?1300807160

off label & insurance

what does that mean regarding new drugs Oly. & Solvaid (sorry mis-spelled)  Also have questions re insurance.  Am hoping to start treatment in Sep., but have medicare part D--AARP Medicare RX Preferred (PDP) in Ill.--& tho I can call, was wondering if anyone else was able to successfully navigate the many hoops I'm sure one has to jump thru??  Also what co-pay?
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2 Responses
683231 tn?1467323017
Hi welcome to the Hepatitis C community

Olysio per the prescribing information sheet is intended to be used with interferon and Ribavirin. The same applies to Sovaldi. Per prescription they are not used together.

However there have been clinical trials using them together "off label" and they have been shown to be highly effective when used together. You can web search for Cosmos clinical trial cohort 1 and cohort 2 to see study results. The AASLD American Association for the Study of Liver Disease has posted treatment guidelines and recommends this off label combo also for specific classes of patients depending on whether the patient is treatment naive or has been treated before. If they have cirrhosis and if it compensated or decompensated. And many other scenarios.  

I have insurance through my employment and am taking Olysio Solvaldi but I don't know about Medicaid. I have seen people here on medicaid getting approved.

See your doctor find out what treatment is recommended for you they can help getting you approved. Also contact your insurance to find out how to get covered. Also the makers of Olysio and of Sovaldi are also offering assistance in getting your prescription they can also provide information. Web search Olysio to see their site and search for Sovaldi.

Whatever your doctor prescribes you might have to make a few frustrating phone calls (I did) but eventually you should be able to get help getting you medications. Be your own advocate!

Good luck
Lynn

218926 tn?1398016246
Olysio/Sovaldi (often with ribavirin) are prescribed off-label for those who are interferon-intolerant and/or previously treated responding relapsers or (in my case) both. I had to navigate through several private insurance hoops,but know nothing of Medicare. It's important to find a knowledgeable Hepatologist, rather than relying on an internist. Liver clinics at research institutions such as UCSF are also good resources. A hepatology specialist will be most likely to have experience prescribing advanced treatments (read: Sovaldi+Olysio) to other patients, and will be therefore most likely to be able to help you navigate the Medicare maze.

Hope this helps!

-- Allan
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