This is very not good news for me since Express Scripts is my PBM (pharmacy benefits manager). What I just don't get is how they can take this stance when Sovaldi offers the ONLY FDA approved tx on the market right now. In not covering Sovaldi for its patients, ES is forcing them to remain with current SOC - Geno 1: triple horror with Interferon + Riba; Geno 2 & 3: Interferon and Riba. See what I mean? ES is denying Geno 2 and 3's a tx without Interferon, and many patients already suffered and the tx with Intferon and other agents failed them. For us 1's, yes, FDA approved Sovaldi for TWENTY FOUR WEEKS with Riba - but that means twice the cost of the 12 week tx!!! ES will never pay for that.

My expectation to be treating early in 2014 is now out the window. I won't be able to get Sovaldi from ES, so no off-label tx with that and Olysio. I may have to wait for Abbvie's tx to be FDA approved... when? END of 2014 at the earliest. And ES is playing games, so it may not even cover that when the time comes.

I'm not short-changing Gilead, but I sure as hell am pissed off at Express Scripts, my PBM. Other PBMs are already approving use of Sovaldi by their patients - but those of us with ES got ROBBED.

I know, Kramer - maybe ES will change its tune. But I'm betting it won't be anytime soon. No one can force them to approve Sovaldi, and they have thrown down the gauntlet on the price and are waiting to compare it with other pharmas' tx, like Abbvie.

It's just a huge huge disappointment for me - and I HOPE it doesn't mean my liver dives into decompensation before I can treat. I sure can't afford to pay for the stuff out of pocket (and I am sorry you had to, Kramer, only to have it not work).

(p.s. I can't do a trial - I am either too old, not sick enough, wrong genotype, cirrhotics are excluded and with Abbvie, I failed two screenings with them, so no more chances. Also, I don't have the resources to relocate or travel extensively.)

Cat I am in the same boat. Null responder to SOC and compensating cirrhosis. That being said it is only a matter of months before other treatment regimes are approved and the landscape will change drastically.
There is nothing I can do about that, but I can try to live well, avoid anger and stress which we know are proactive things we can do to help our livers, buy more time.
I don't mean to sound indifferent but I;e been on this HCV ride for more than 40 years and all though I (we) and many others are at the 11th hour, well I just gotta continue being patient.

The article was dated today and refers to Friday, yet neglected to mention that they are referring to LAST Friday.

Very poorly written article imo, and certainly NOT a good source for financial information. Gilead was NOT down today, it was UP 1.61%.

I'm in the same boat...the SS Disappointment.

ES is my pharmacy too and I CANNOT do interferon cuz of my RA meds and it's a rare trial that will accept me cuz of those meds. And going off the meds means suicidal pain from head to toe. Not an option.

Hang in there RASS. 2014 is looking to be a whole new story for us .. a good one!

Very salient points from the article. ES is going to be under VERY heavy fire... not that they care about us, the patients, but physicians who are treating us are going to make their voices heard (I hope). (I wish we could FORMAT on here - you know, bold, italicize...)

"When Dr. Miller says, "If the difference in convenience cannot be demonstrated to have a difference in outcomes, we often recommend coverage of the equally effective, less-convenient product," he is actually stepping his bounds as medical insurance person and inserting himself between "the patient" and his or her "physician".

Physician-Patient relationships are bound by the Hippocratic oath not by exuberantly salaried bureaucrats working at extremely profitable insurance companies that have gotten fat on patients' premiums in the first place.

But let us suppose that Dr. Miller is justified in trying to rob the insurance paying patients out of the convenience of receiving the life-saving drug that their physician thinks that they need,...."

Gads, you too, RASS. I've had ES for many years, ever since I got out of the military. It never occurred to me that when I needed a LIFE SAVING treatment, ES would refuse to cover it.

I hear ya, Kramer - 40 years on the ride for me too, just that I didn't know it until 2002. Ah well, yes, what can we do? Wait a bit longer. Live well. Enjoy every moment. Have gratitude for feeling half way decent in spite of the stage of this THING in our livers .... I hear ya.

No sense in getting upset about it - "God grant me the serenity to accept the things I cannot change....."

The price will come down. ES wants to make money too.