POZ Community Forums
Meds, Mind, Body & Benefits => Questions About Treatment & Side Effects => Topic started by: aztecan on May 20, 2009, 10:33:55 am
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After much discussion, I have in my hot little hand a prescription for new meds.
Surprisingly, my doctor went further than I thought he would.
I am switching from Lexiva/Norvir/Combivir to Isentress and Truvada.
The Truvada was the surprise. I have been on Combivir for a long time - 13 years. But, the doc researched things and decided that, in my case, Truvada would be better.
For those unfamiliar with my situation, I don't have resistance issues, the normal reason to choose Isentress. But I do have hyperlipidemia issues that I can't control with statins because I get severe side effects from statins.
I also have been diagnosed with Non-Alcoholic Steato Hepatitis, an outgrowth of hepatic steatosis, probably caused by many years on meds, so the doc thought the Truvada might be a bit easier on my liver.
So, I will drop this slip off at the pharmacy this morning and will probably pick up the new meds Friday.
Wish me luck folks.
HUGS,
Mark
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That's great! Did your doctor say whether your liver problems were likely to improve on this combination?
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This is the combo I've been on and it's like a walk in the park. (but due to resistance profiles I'm also on Prezista and a Norvir booster).
Best of luck Mark. Don't wait 6 months for your next labs. :)
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Best of luck to you.
You, who's always helping others, deserve a BIG break...
like years and years with no further issues and complications.
Mike
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mark
the truvada isn't too bad. I have gas and i've heard tell by some here it's the truvada that causes it. It can be annoying.
but is sounds to me like your Dr is on to something. let's keep our fingers crossed.
robt
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Thanks BM, Miss Philicia, Mike and Robert.
I am actually rather excited about this change. I don't really know why, outside of going from three to two HIV meds (no more Norvir!).
Best of luck Mark. Don't wait 6 months for your next labs. :)
Don't worry. The doc wants me to have followup labs in a month, then we'll probably go three months as long as things look OK. At some point, we will probably go back to every six months for the HIV labs, which will be fine by me as long as all is working well.
I also am very hopeful I will be able to keep my lipids in better check without the influence of my previous regimen.
That's great! Did your doctor say whether your liver problems were likely to improve on this combination?
No, not directly. But, we did discuss this briefly and, if it causes a drop in my lipids, then it would, as a side effect, be better for my liver, or so we hope
I'll keep you posted.
HUGS,
Mark
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Good luck Mark! This is my number one choice of combos, but until it's approved for first-line therapy, my actual choice will be Reyataz/Norvir/Truvada. I'm hoping to hold out until Isentress is included in first-line.
I really hope this takes care of some of your issues for you. You certainly deserve a break!
Hugs,
Ann
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Wishing you the best Mark !
Ray
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mark
the truvada isn't too bad. I have gas and i've heard tell by some here it's the truvada that causes it. It can be annoying.
Yes, that is truvada that does that. I have found that taking a pancreatic enzyme alleviates most of this, plus it just generally allows for better GI absorption issues.
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Good luck Mark! This is my number one choice of combos, but until it's approved for first-line therapy, my actual choice will be Reyataz/Norvir/Truvada. I'm hoping to hold out until Isentress is included in first-line.
Ann, you've held out very impressively I must say. I've read Isentress will be approved for first-line here in the US in the next few months (one article specifically said July 2009).
Does that mean you're planning on starting meds at that point or that you'll change your choice to Isentress/Truvada (from Reyataz/Norvor/Truvada) for when the time comes for you to start?
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Wow, good luck with that new combo, Mark, and please let us know how it's going. :-*
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I've been on both Isentress and Truvada since MARCH 2006.......Mark, I think the time is right for you, and I think you'll do just fine ;D
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Good luck with the new combo -- hope it will help with the cholesterol.
A
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Ann, you've held out very impressively I must say. I've read Isentress will be approved for first-line here in the US in the next few months (one article specifically said July 2009).
Does that mean you're planning on starting meds at that point or that you'll change your choice to Isentress/Truvada (from Reyataz/Norvor/Truvada) for when the time comes for you to start?
No way am I going to start treatment just because a new combo has been approved. I'm just hoping it's approved in the UK before I need to start - and preferably also approved for once-a-day-dosing. Otherwise, it's the boosted Razamataz and Truvada for me.
Ann
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Mark,
I just wanted to wish you well on your new combo.
I have no complaints taking either one of them although like Philly I have the added joys of Prezista & Norvir.
Hugs,
AA
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I am staring the new regimen today. I don't anticipate any problems.
What was a shocker was when I picked up the new meds and went to pay the copays.
The Truvada was the usual $20. I was curious to see whether the Isentress would be $20 or the higher $40.
I forgot there was another option. Apparently, it is considered a specialty medication for which I must pay 20 percent of the cost.
So, my copay was $177.45. :o That puts the cost of the Isentress at about $888 a month.
Hey, it could have been worse. I could be taking Atripla, which costs about $1,800 a month.
This is going to cause me to rework my budget a bit, at least until my flex account kicks back in July 1.
One thing you must admit, when it comes to HIV care and treatment, there are always surpirses.
HUGS,
Mark
(Who is poorer but wiser this weekend.)
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I wonder why it's considered a "specialty" medication and Truvada, which is for the same thing (i.e. HIV) is not?
Merck does have an assistance program for co-pays, you might want to check out their website.
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I'm going to check, but I think the reason is it wasn't on my insurer's formulary.
Since Isentress was only approved about 18 months ago, it may not have made it onto the formulary yet. It is weird, since it is still considerably cheaper than some of the other meds.
I am going to try to get a copy of the formulary to see what's what.
Aside from that, no problems with it as yet.
HUGS,
Mark
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I'm going to check, but I think the reason is it wasn't on my insurer's formulary.
Since Isentress was only approved about 18 months ago, it may not have made it onto the formulary yet. It is weird, since it is still considerably cheaper than some of the other meds.
I am going to try to get a copy of the formulary to see what's what.
Aside from that, no problems with it as yet.
HUGS,
Mark
Mark, I have Medicare Part "D" and it's been covered for the last 3 yrs. I've been on it since 2007, not sure about any New Mexico State Formulary, as that doesn't apply to me...........I haven't been on State ADAP since March 2006, due to the New Medicare part "D" taking affect......in a way I'm greatfull for Part "D" as, I wasn't able to get anything other than what was State Formulary, back then.......
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Wow, Mark. That co-pay is like a whole month's worth of groceries. Geesh.
I'm glad things seem to be going alright with the meds. When do you see your doc again?
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Mark,
Glad to hear a meds change is in tow for you ... sorry that it comes with a new cost to ya. Here's hoping it's a breeze and does the trick to better overall health. Keep us abreast. -YaKa
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Thanks all. Yep, that copay took me aback for a bit. I even asked the pharmacist to make sure they had run it through my insurance, even though I knew the cost would be too low for them to not have.
Wow, Mark. That co-pay is like a whole month's worth of groceries. Geesh.
I'm glad things seem to be going alright with the meds. When do you see your doc again?
Hey Betty,
I will see the doc at the end of June. Well, I actually saw him today, but you know what I mean.
He wants to give it a month to see if there is any change in the lipids. I will continue to take 500 mg Niaspan and 6,000 mgs of fish oil.
I also will stick to my new way of eating. I have found that I rather like it and that fatty foods don't really attract me any more - with the exception of cheese and the occasional beef steak or pork chop. ;)
So, in other words, so far, so good. ;D
HUGS,
Mark
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Most drug plans have a formal appeals process, where you can challenge a decision to put a drug into the highest copay tier. It might be worthwhile to call the 800 line for your plan, ask how to file an appeal and to draft a letter and ask your doc to send one as well. All it costs is some time and a few stamps.
I'd include a summary of your lipid issues and trial of various statins and exercise, that you are treatment experienced and the lower cost versus other antiretrovirals.
Even if it doesn't work retroactively, it will serve as a prod for them to add it to the formulary in the future.
If this is a self insured plan, and you are comfortable sharing the info with the human resources staff, ask your benefits rep how they protect HIPAA privacy rights and then copy them (in the approved HIPAA format as well ) But this is a large employer play, if your employer is small and only buying insurance for a few people this may not actually do anything for you.
Good luck
A
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Mark: I was wondering, is your Isentress dose 400 mg. twice a day?
I have not yet filled my Rx for it but I went online to check my insurance coverage and they consider 30 qty. 400 mg as "one month's supply" which it clearly isn't since it needs to be taken twice a day so one month's supply would be 60 qty. I hope I don't have a hard time getting 60 pills instead of the 30 that they consider to be one month's supply.......we'll see.
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Mark: I was wondering, is your Isentress dose 400 mg. twice a day?
I have not yet filled my Rx for it but I went online to check my insurance coverage and they consider 30 qty. 400 mg as "one month's supply" which it clearly isn't since it needs to be taken twice a day so one month's supply would be 60 qty. I hope I don't have a hard time getting 60 pills instead of the 30 that they consider to be one month's supply.......we'll see.
Yes, I take a 400 mg tablet of Isentress twice a day, so you will indeed need 60 tablets.
HUGS,
Mark
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Mark: I was wondering, is your Isentress dose 400 mg. twice a day?
I have not yet filled my Rx for it but I went online to check my insurance coverage and they consider 30 qty. 400 mg as "one month's supply" which it clearly isn't since it needs to be taken twice a day so one month's supply would be 60 qty. I hope I don't have a hard time getting 60 pills instead of the 30 that they consider to be one month's supply.......we'll see.
I'd have to consider that some sort of error on their website. If you are overly concerned, ask the pharmacy to check before they fill it. I know they'll do that were I go, but then the place I go to caters to HIV folks (specialty pharmacy).
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Mark, how's it going?
:)
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Mark, how's it going?
:)
So far, so good. No noticeable side effects from either the Truvada or Isentress.
I will go for labs at the end of the month, or thereabouts, to see how things are going both with the CD4/viral load and the lipids.
Thanks for asking.
HUGS,
Mark