Medicare Eases Restrictions On Pricey Hepatitis C Treatment
Cinnamon Girl said
May 19, 2014
Hi Wayne, thanks for posting this very significant news item! This new ruling by Medicare will have a huge impact for many people in the US who are in need of non-interferon based treatment who would otherwise not be able to access the Sovaldi/Olysio combo.
Well done Walter Bianco, just shows what can be done when people are determined enough to fight for their health and survival.
Matt Chris said
May 16, 2014
This is really really important news and it will make a lot of very happy folks that have been forgotten. I hope all the doctors are hearing this and calling their patients to re-apply for the combo.
matt
suziq said
May 16, 2014
When I did the "A Year Ago" post a few days ago--this had not changed yet or I had not heard about it yet. Just in a few days time, things change for us now. It was only nine months ago that I started my trial. Nothing was approved yet except the old SOC or a few newer drugs--but still with interferon and long treatment times. And the rates of success were so much lower.
It is such wonderful news for the "older group" (actually the younger group from my standpoint LOL) needing treatment now. And for those approaching 65 and those on Medicaid.
Great information Oldenslow, Thanks for posting it.
SuziQ
Isiscat2011 said
May 16, 2014
Yay! Good for Walter Bianco. The treatment guidelines really do rule what must be paid for. As new drugs are approved, and tx guidelines are updated, insurance companies and medicare/medicaid will have no choice but to pay. Whatever the SOC is will be what they must pay for, and SOC is determined by tx guidelines.
The problem with payment for the S/O has been that the first line SOC for genotype 1s (as determined by tx guidelines) has included Interferon and Riba. Off-label S/O is only SOC as a secondary line of tx that does not apply to everyone. That will all be changing soon. Hard not to get excited seeing all the changes unfold right before our eyes.
Thanks for posting this.
patiently_waiting said
May 16, 2014
I just heard this on the radio as I was driving too. Glad to hear people with Medicare will be getting their meds now.
OldenSlow said
May 16, 2014
"The shift has come about because of an Arizona man named Walter Bianco who was twice denied Medicare coverage for two new drugs that together cost about $150,000. But those denials were reversed this week after Shots and NPR's Morning Edition reported on Bianco's case. Bianco has been infected with hepatitis C for 40 years, and the virus has taken a toll on his liver.
In a statement late Wednesday, Sean Cavanaugh, deputy administrator of the Centers for Medicare and Medicaid Services, said the reversal resulted from updated treatment guidelines that recommend the use of the new drugs Sovaldi and Olysio for patients in Bianco's case -- even though the combination treatment hasn't been approved by the Food and Drug Administration.
Before now, Medicare hadn't explicitly embraced the treatment guidelines that were issued in January by the Infectious Disease Society of America and the American Association for the Study of Liver Diseases."
Hi Wayne, thanks for posting this very significant news item! This new ruling by Medicare will have a huge impact for many people in the US who are in need of non-interferon based treatment who would otherwise not be able to access the Sovaldi/Olysio combo.
Well done Walter Bianco, just shows what can be done when people are determined enough to fight for their health and survival.
This is really really important news and it will make a lot of very happy folks that have been forgotten. I hope all the doctors are hearing this and calling their patients to re-apply for the combo.
matt
When I did the "A Year Ago" post a few days ago--this had not changed yet or I had not heard about it yet. Just in a few days time, things change for us now. It was only nine months ago that I started my trial. Nothing was approved yet except the old SOC or a few newer drugs--but still with interferon and long treatment times. And the rates of success were so much lower.
It is such wonderful news for the "older group" (actually the younger group from my standpoint LOL) needing treatment now. And for those approaching 65 and those on Medicaid.
Great information Oldenslow, Thanks for posting it.
SuziQ
Yay! Good for Walter Bianco. The treatment guidelines really do rule what must be paid for. As new drugs are approved, and tx guidelines are updated, insurance companies and medicare/medicaid will have no choice but to pay. Whatever the SOC is will be what they must pay for, and SOC is determined by tx guidelines.
The problem with payment for the S/O has been that the first line SOC for genotype 1s (as determined by tx guidelines) has included Interferon and Riba. Off-label S/O is only SOC as a secondary line of tx that does not apply to everyone. That will all be changing soon. Hard not to get excited seeing all the changes unfold right before our eyes.
Thanks for posting this.
"The shift has come about because of an Arizona man named Walter Bianco who was twice denied Medicare coverage for two new drugs that together cost about $150,000. But those denials were reversed this week after Shots and NPR's Morning Edition reported on Bianco's case. Bianco has been infected with hepatitis C for 40 years, and the virus has taken a toll on his liver.
In a statement late Wednesday, Sean Cavanaugh, deputy administrator of the Centers for Medicare and Medicaid Services, said the reversal resulted from updated treatment guidelines that recommend the use of the new drugs Sovaldi and Olysio for patients in Bianco's case -- even though the combination treatment hasn't been approved by the Food and Drug Administration.
Before now, Medicare hadn't explicitly embraced the treatment guidelines that were issued in January by the Infectious Disease Society of America and the American Association for the Study of Liver Diseases."
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