Aa
How long is the wait list at the VA for Sovaldi?
Last time we checked, they said it would be about a year before treatment as they are prioritizing by need. Those in worst shape are getting it first. Now, with the shake up in the VA, I am wondering if they are expediting Hep C treatment. Has anyone had experience recently with the VA and know anything about timelines for treatment?
These are my opinions which may or may not be correct or coincide with others. Some may also be the opinions of certain medical organizations and/or providers.
1. Treatment has to be prioritized by need by the VA and other insurance programs
a, There isn't enough new meds already manufactured and available now to treat everyone.
b, There isn't enough medical providers available to treat everyone now.
c. There isn't enough money available right now to treat everyone now at the current pricing.
2. I believe the VA is treating those with GT1 & 3 who need treatment right now. either because of F4 class A close to or class B or other coexisting conditions that require immediate treatment.
ex GT1 SOV PEG RBV, SOV SIM w/wo RBV 12 wks and SOV/RBV 24 wks for those on transplant list. Not using SOV/RBV 24 for others (inferior) They are making other wait until the new meds are approved later this year.
GT3 SOV PEG RBV, those that can tolerate INF and SOV/RBV 24 who need to be treated soon.
GT2 those F3F4 that can tolerate SOV/RBV 12 for those who were non responders to previous tx maybe extend tx to 16 weeks.
NO PEG for F4 Class 2 or 3 or INF intolerable.
___________________________________
If you look at the http://www.hcvguidelines.org/ as of June 30th 2014
excerpts
"This section assumes that a decision to treat has been made and provides guidance regarding optimal treatment. In many instances, however, it may be advisable to delay treatment for some patients with documented early fibrosis stage (F 0-2), because waiting for future highly effective, pangenotypic, DAA combinations in IFN-free regimens may be prudent. Potential advantages of waiting to begin treatment will be provided in a future update to this guidance."
Treatment naive exception GT1 for SOV SIM w/wo RBV 12 wks and SOV/RBV 24
This regimen should be considered only in those patients who require immediate treatment, because it is anticipated that safer and more effective IFN-free regimens will be available by 2015.
____________________________________________________
my opinion
Of course those with F1 to F3/F4 early class A should be monitored for any changes or co existing conditions that may indicate increasing rapid fibrosis or other developing complications that may require immediate or treatment very soon.
Of course some of those in the private sector and/or with connections and or money may somehow get treatment even though they don't have an immediate need.
1. Treatment has to be prioritized by need by the VA and other insurance programs
a, There isn't enough new meds already manufactured and available now to treat everyone.
b, There isn't enough medical providers available to treat everyone now.
c. There isn't enough money available right now to treat everyone now at the current pricing.
2. I believe the VA is treating those with GT1 & 3 who need treatment right now. either because of F4 class A close to or class B or other coexisting conditions that require immediate treatment.
ex GT1 SOV PEG RBV, SOV SIM w/wo RBV 12 wks and SOV/RBV 24 wks for those on transplant list. Not using SOV/RBV 24 for others (inferior) They are making other wait until the new meds are approved later this year.
GT3 SOV PEG RBV, those that can tolerate INF and SOV/RBV 24 who need to be treated soon.
GT2 those F3F4 that can tolerate SOV/RBV 12 for those who were non responders to previous tx maybe extend tx to 16 weeks.
NO PEG for F4 Class 2 or 3 or INF intolerable.
___________________________________
If you look at the http://www.hcvguidelines.org/ as of June 30th 2014
excerpts
"This section assumes that a decision to treat has been made and provides guidance regarding optimal treatment. In many instances, however, it may be advisable to delay treatment for some patients with documented early fibrosis stage (F 0-2), because waiting for future highly effective, pangenotypic, DAA combinations in IFN-free regimens may be prudent. Potential advantages of waiting to begin treatment will be provided in a future update to this guidance."
Treatment naive exception GT1 for SOV SIM w/wo RBV 12 wks and SOV/RBV 24
This regimen should be considered only in those patients who require immediate treatment, because it is anticipated that safer and more effective IFN-free regimens will be available by 2015.
____________________________________________________
my opinion
Of course those with F1 to F3/F4 early class A should be monitored for any changes or co existing conditions that may indicate increasing rapid fibrosis or other developing complications that may require immediate or treatment very soon.
Of course some of those in the private sector and/or with connections and or money may somehow get treatment even though they don't have an immediate need.
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