Hepatitis C Support Group
Hepatitis C is a blood-borne viral disease which can cause liver inflammation, fibrosis, cirrhosis and liver cancer. The hepatitis C virus (HCV) is spread by blood-to-blood contact with an infected person's blood. Many people with HCV infection have no symptoms and are unaware of the need to seek treatment. Hepatitis C infects an estimated 150-200 million people worldwide.
I have been pursuing tx with Harvoni while I am caring for my terminally ill mother in Michigan. I haven't been able to post much but have kept up with news as much as possible. The moment Harvoni was approved by the FDA on October 10th I contacted my doc. He knew my personal situation & is working with me so that I can do my tx here in MI & have any labs drawn & forwarded to him in FL. My doc sent a prescription for 12 wks of Harvoni to Axiom Specialty Pharmacy on Oct. 13. He also submitted a pre-authorization exception letter to my insurer, Blue Cross Blue Shield of MI Medicare Advantage PPO on Oct. 13. Axiom contacted my doc & advised him that the prescription could not be filled as Harvoni was not on my insurer's formulary.
I contacted Support Path at Gilead. The service they provided was exceptional. Support Path advised me that if a patient's household income is less than $100,000 and a patient's ins denies the med the Dr. must submit an appeal. If the insurer denies the appeal as well then Gilead steps in & sends Harvoni to the patient. They also have a few options for patients who have ins as well as grants & coupons for those with no ins or those who might be under insured. Support Path contacted my doc to offer advise on how to proceed to get Harvoni approved for me. My doc was experienced & had already submitted the pre authorization a second time on 10/20. I followed up with my insurer on 10/28 & I was advised that my Doc's requests had just been approved! I could hardly believe my ears. My co-pay is $40.00 per month. The cost to my insurer for 12 wks is $95,000..
Now I am waiting for Axiom to call with a delivery date & to collect my co-pay. I will wait a couple of weeks before I start Harvoni so I can order the next months refill & make sure there are no shortages, interruptions or delivery snafus.
I will be starting my 3rd tx as soon as possible. A little nervous that I could be one of those people who don't clear or relapse with Harvoni. I'm hoping for the best though & I'm starting to believe I'm going to get a decent tx!!! I want to evict this nasty dragon for me & for my husband who didn't get this opportunity. I want to beat it for my mom who is losing her battle with cancer. Things are so difficult right now & this approval is the best news I've had in a very long time. I am blessed to have good insurance & a doctor advocating for me & willing to work with me long-distance.
It is bittersweet to know I'm getting this med when others are struggling to get tx with Harvoni. I encourage anyone who is hoping to tx with this drug to contact Support Path at Gilead. They were the best. Good Luck!
I contacted Support Path at Gilead. The service they provided was exceptional. Support Path advised me that if a patient's household income is less than $100,000 and a patient's ins denies the med the Dr. must submit an appeal. If the insurer denies the appeal as well then Gilead steps in & sends Harvoni to the patient. They also have a few options for patients who have ins as well as grants & coupons for those with no ins or those who might be under insured. Support Path contacted my doc to offer advise on how to proceed to get Harvoni approved for me. My doc was experienced & had already submitted the pre authorization a second time on 10/20. I followed up with my insurer on 10/28 & I was advised that my Doc's requests had just been approved! I could hardly believe my ears. My co-pay is $40.00 per month. The cost to my insurer for 12 wks is $95,000..
Now I am waiting for Axiom to call with a delivery date & to collect my co-pay. I will wait a couple of weeks before I start Harvoni so I can order the next months refill & make sure there are no shortages, interruptions or delivery snafus.
I will be starting my 3rd tx as soon as possible. A little nervous that I could be one of those people who don't clear or relapse with Harvoni. I'm hoping for the best though & I'm starting to believe I'm going to get a decent tx!!! I want to evict this nasty dragon for me & for my husband who didn't get this opportunity. I want to beat it for my mom who is losing her battle with cancer. Things are so difficult right now & this approval is the best news I've had in a very long time. I am blessed to have good insurance & a doctor advocating for me & willing to work with me long-distance.
It is bittersweet to know I'm getting this med when others are struggling to get tx with Harvoni. I encourage anyone who is hoping to tx with this drug to contact Support Path at Gilead. They were the best. Good Luck!
But I am really excited about your news. And the $40 per month co-pay. If the insurance commonly had denied you would they have given you the drug for free?
Now the healing begins.
I am so sorry about your mom.
@TulsaGal. Gilead's Support Path advised me that your insurer would need to deny the original request for Harvoni & your doc would need to file an appeal which also needs to be denied. After those 2 denials they would provide Harvoni free of charge as long as your household income is under $100,000. Great News! They want patients to be treated & they worked quickly to provide help. The squeaky wheel gets the grease. I gave people a couple of days to respond to me and I was probably a pest but I was kind & let them know I was anxious to get tx.
I will follow up tomorrow to check status on when to expect meds. Stay focused & vigilant so you can get tx too!
I did call BCBS of Oklahoma and they didn't seem to think there were any strict criteria for getting the drug. I think someone there has been sleeping???
Anyway, I hope that I get approved since I would not qualify for the Gilead program for free drugs, just the insurance co-pay program. I have already printed that coupon. Can you tell that I am ready to go?
How many weeks will you be doing?
YES YES YES!!!! You have been in need of this medicine for more years and endured more heartache than the insurance co's will ever understand, and at this time in your life, being cured is just what "the doctor ordered".
Doing 12 weeks (with the self delay) would put you right around Valentines Day!!
*Hearts and Hugs* - LEO
is it just 8 weeks??
Can't wait to get started & I'm finding it almost impossible to delay any longer to make sure my 2nd month meds are on their way.
Dawter, we don't know the actual condition of my liver. My doc was unable to get a biopsy & he didn't feel I needed a fibroscan. All labs & CT scans & ultrasounds make my doc think I might have fibrosis 1 or beginning 2 fibrosis. I definitely do not have cirrhosis.
Sadly, my mom's condition is worse every day. Life is beautiful but it can sure be hard at times. That's where faith comes in.