Anyone getting Hep C - Sovaldi from Kaiser in California? Or Kaiser anywhere?

Hi. I got Hep C in 1967, I think, but because I have never drunk alcohol during my whole life my liver seems to be in good shape. I was diagnosed in 1990 with Hep C, and now they call it type 2b. I have never been treated.

I suffer from fatigue, itching and depression and now that Sovaldi is approved my plan is to return to California next month and start Sovaldi/Ribavarin treatment for 12 weeks per my doctors recommendation. I have been getting regular labs every 6 months to one year and the test results have always been in normal range. A recent biopsy showed minor scarring and some inflammation of my liver has also been detected along with some cysts.

My question has to do with Kaiser's policies. I think I have a good doctor. He recommended I start treatment but at the time Sovaldi was not out and I refused to take Interferon at that time.

Now I am experiencing more symptoms and really want to see if this treatment will change my energy and attitude. Kaiser says all patients must go through the Regional HCV Task Force which reviews every member's tx plan to assess risk versus benefit.

I am worried about this screening because my disease is not as serious as some others but I am 63, 64 later this year, and I want to get rid of Hep C. Does anyone have experience with this screening or with Kaiser's treatment process? Can you tell me what happened to you? My concern is that they might say my case is not serious enough and deny treatment due to the cost of Sovaldi.

My AST is 24, ALT is 25 and all of my labs are in the normal range. My viral load of Hep C is about 4 million.
I would really appreciate any information that anyone has in dealing with Kaiser in California or elsewhere.
Thanks

Rob

We are working at a garage sale this morning and I'm not good doing this from my phone.

I went to Google and typed kaiser California and hep c treatment. The articles I read said K was pretty positive about their attitude towards the meds and suggested they had been negotiating the price with manufactures

There was also a very specific example by United Healthcare about their approval process for those with various genotypes. I am hoping the insurance companies understand these new treatments will avoid a whole bunch of medical expense for them and pain etc for the patients down the line.

Excuse typos plz.

ML

Hi Rob,
I live in California, am a Kaiser member and am about to begin treatment with Sovaldi and Ribavirin. I am Geno 2, was diagnosed about 2009, so far no permanent liver damage. The approval took a few months, Kaiser has specific requirements in order for you to be approved (not sure specifically what they are), but my case first had to go before a committee for treatment approval and then another committee for the treatment plan to be approved. I was required to have blood work and a liver biopsy.
I will begin the treatment some time this week. I am told the cost of the treatment is simply what you normally pay for labs, etc., and co-pay for formulary RX. I'm not sure what that will be. My doc told me this treatment is only approved for Genotype 2, so I'm not sure what the decision points are. I heard about the treatment early this year and immediately called my GP who started the process. I'm excited to begin treatment and am anxious to know how it will affect me. I work full+ time and have a pretty stressful job, although I am able to flex my schedule and if necessary, work from home.

Good luck and let me know how it goes! I am going to start my own blog to document my progress.

Hi Aloha,

Welcome to the HW forum. I see you are starting treatment soon and that you don't have permanant liver damage yet...what great news, both that you can get treated and that you have intervention available to you before the horrible symptoms set in!

My partner was not so lucky...cirrhosis, decompensated liver, and liver cancer. He got a transplant. But he has just finished a combo with Sovaldi and Olysio and his Viral Load is undetected and has been for a while now. Next step, the 6 month check up! Unfortuntely Hep C attacked his liver graft agressively and he has Stage 3 fibrosis. We are hoping that can see some reversal with clean living.

Good luck. If you;d like to start your own thread to track your progress you can see how others have done it; Aloha Treatment Blog with Sovaldi and Ribavirin.

Mama Lama

Hi Everyone,
Thanks for the responses.
Thanks to LiveAloha.
Your comments were very relevant.
I'm not happy to hear that it takes so long to get approved by Kaiser.
According to my doc, I have to see him when I return to the US and get the referral, the see the Pharmacist RN for lab screening and then my TX goes to a task force for approval. The task force is supposed to take 7-10 days.

I have been living in China and teaching in a university for the last 3 years. I've already signed a contract for next year but if there will be so many delays it looks like I will have to give up my job.

I was hoping to go back to the US in the summer and get the treatment done quickly but that looks impossible. I guess the insurance bureaucrats have to justify their jobs.

I am type 2b. I had a biopsy back in 97 when they discovered it but their was very little damage. A second biopsy last year showed moderate to low damage but I have a couple of cysts.
Kaiser confirmed that I only pay my normal copays so it is just a question of how long the administration will jerk me around until they approve the treatment. My doc has been tracking me for several years and has said that I am a very good candidate for treatment. So it's just a question of timing.

He wanted me to do Interferon and I told him "no way". Now that Sovaldi is here I'll do it. Probably in another year you won't have to take it with Ribavarin which will really make life easier. I also have doubts that 12 weeks will always be required. Since the virus is eliminated after 4 weeks the 12 week requirement could be reduced if they find efficacy. Everyone wants that as it lowers the cost and the treatment time.

Thanks everyone for your responses. I have googled and read everything I could find about Kaiser but there are not a lot of "facts" available.

I'll start my own thread once I start going through the process.

MamaLama, Can't I just continue this thread?
Thanks all,
Rob in China

OK Mama Lama
I'll think about starting a new thread later.
I've only been to 44 countries so far...

Thanks
Rob

PS, the co-pay of the rx was $25 for the Sovaldi and $5 for the ribavirin. That is great news!