It's an "off-label" combo. My doc is trying to see if he can get it approved by my insurance. I'm 1B.

Off-label Olysio/Solvadi was approved by Express scripts.

1b's do NOT have the Q80K polymorphism - ever - just 1a's - and half of them seem to have it. For 1a's who might do Sovaldi and Olysio off-label tx, my understanding is that the Sovaldi is SO GOOD that it mitigates the effects of the Q80K polymorphism (that affects Olysio's efficacy) if one has it. But just how much? That's a big question. One wouldn't know until they tried. The 1b's do not have to be concerned about the Q80K thing - they cannot, do not have it.

You've got some apples and oranges and plums going on here :) three different scenarios
LOL

Combining Olysio with Sovaldi is OFF-LABEL tx - i.e., it is not an FDA approved tx. It HAS been very successful in a small study (COSMOS). But getting off-label might be difficult - as far as insurance paying - but maybe not.
Here's an article on this off-label tx about trial results:
http://hepatitiscnewdrugresearch.com/sofosbuvirgs7977simeprevirtmc435.html

I MAY be doing this - but I am a 1a, so I would want to be tested for the Q80K polymorphism before committing to go ahead. I'm pretty sure my insurance will approve this, because they did for RASS, and she has the same prescription coverage that I do.

Okay, moving on.....

FDA approved tx with Olysio: This IS an option for Geno 1-s but - um, not a good one. It is FDA approved for use with Interferon and Riba. The trials were the QUEST trials. Here's a link - SVR rates not as good as we probably want to see - and WHO WANTS INTERFERON anyway? http://www.hepmag.com/articles/Olysio_simeprevir_2501_24839.shtml

Of note: "58 percent of those with genotype 1a who had the Q80K polymorphism achieved an SVR12, compared with 84 percent of those without the polymorphism." THAT is a HUGE difference! So any geno 1a's who are crazy enough to do this FDA approved tx with Interferon and Riba should NOT do it if they have the Q80K.

FDA approved Sovaldi: For Geno 1's, at first it was with Interferon and Riba, then Gilead came out with some out of nowhere 24 weeks with Riba... and not great results IMO. Geno 1's very best tx (again imo) is coming down the pike: Sovaldi and Ledipasvir - combined into one pill, taken once a day, no sides, and AWESOME results in the ION trials with many hundreds of participants.

Did I clear this up? :)

Yes, I am copy/pasting this for my geno 1b dear friend, thanks catmagic, for clearing it up for me~

Well, I hope I cleared it up - ha - it was kinda a "hot mess" of stuff I wrote - just so much going on now it's hard to even keep up.

If your friend is one who can wait just a bit, Gilead's once a day, one pill total HCV assassin for Geno 1: Sovaldi + Ledipasvir - is going to be put in for FDA approval THIS QUARTER. That means - maybe by summer, early fall it will be "on the market." Abbvie has its tx coming out, but it has Riba in it - and that's gonna hurt Abbvie a lot, esp. if GIlead gets that Sova/Led approved around the same time.

I know I'll be treating this year - just not sure when or with what tx. This is a great year for all of us who still have these freaking "bugs." Easier, gentler tx than you and so many others did with triple. Gilead is trialing its "pan genotypic" - as in, across ALL genotypes - GS5816, a nucleotide NS5B inhibitor (whatever that is - Ledipasvir is one too but only works for Geno 1s).

Stayed tuned.... (your doggy is adorbs, as D would say).