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Hep C Discussion Forum -> Hep C News -> Medicaid Restrictions on Sovaldi
Post Info TOPIC: Medicaid Restrictions on Sovaldi
lilbit


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RE: Medicaid Restrictions on Sovaldi
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Thanks Isis, just what I wanted to know. I didn't want the Riba but am doing the best I can. I finally resolved myself to the fact that if it kills the bug it will all be worth it. I think if I was that drug company I would have waited on the AbbVie to get approved then work out price. If the insurance companies are following it at all I would think they will be resistant to approving treatment until they find out. It will be interesting to see it all evolve. Thanks again. Pam

__________________

64 yo Diagnosed in 1991 with Hep C, Genotype 1a, VL close to 16,000,000, Tx Abbvie Topaz II 9/5/14, Wk 2 and 4 und. End of treatment 11/27/14 undetected.  EOT+4 und  EOT+12 und.  EOT+24 und CURED, EOT +52 now I feel really cured.
Isiscat2011


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Hi lilbit:

The Abbvie combo should have similar efficacy to the Harvoni.  It will be harder to tolerate for some patients particularly those who must take Riba with it. It is expected that 1as will need the Riba.  It is still a huge improvement over the Interferon treatments.  

It certainly isn't bad that it will be less expensive but the reason it will be less expensive is because it will be a more difficult tx for some.  Insurance companies will prefer to pay less so they will be likely to select the Abbvie combo over the Sovaldi assuming it costs less.  This payer preference may in turn bring the costs of Sovaldi down which is also a good thing. 

You may not experience significant side effects with Riba; not everyone does.  The things to watch out for are anemia and skin rashes.  Try not to worry; you are on tx now and with a little luck you will get rid of the HCV and your side effects will be moderate.  



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
lilbit


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Isiscat I am so glad to catch you here. You seem like you do a lot of research and know a lot about what is going on. On one of the threads here you were talking about everyone trying to get on Sovaldi now before AbbVie's drugs were approved. There was talk about the Abbvie being less expensive and I cannot understand why that is bad. Is that because the insurance companies won't want to spend the extra money for Sovaldi? I am new to all of this and can't understand why insurance would turn you down period. Seems a transplant would cost a lot more later on. I jumped on the first study I could find because even if insurance covered part of treatment I could never afford the rest. I waited for a year to get something that didn't have interferon. I didn't want the Riba but because I am 1a got it anyway. Will just deal with it. They have got to get the costs down. There are people that will never be able to afford it.

__________________

64 yo Diagnosed in 1991 with Hep C, Genotype 1a, VL close to 16,000,000, Tx Abbvie Topaz II 9/5/14, Wk 2 and 4 und. End of treatment 11/27/14 undetected.  EOT+4 und  EOT+12 und.  EOT+24 und CURED, EOT +52 now I feel really cured.
Isiscat2011


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More states have enacted restrictions on Medicaid coverage of Sovaldi. The count is now up to 70% of states and can be expected to increase.  Below is a state-by-state overview of those that have restrictions to limit the tx to the sickest.  Expect to see similar prior authorization requirements from private insurers.

http://www.mhpa.org/_upload/SovaldiSqueeze-Oct2014.pdf



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
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