Hello all am a newbie here, and thanks for the welcome messages!
I have been doing very well on Victoza, and my endo has been giving me pens when I go see him. he finally wrote a prescription for it,but my insurance won’t pay for it. They want me to go onto Byetta firs, before they’ll authorize Victoza. I have been doing really well on Victoza at the 1.2 dosage (the 1.8 made me sick). Now I am stressing out about having to go onto Byetta, which I read has 57% of new users suffering side effects. I don’t want to go through that again. Has anyone here had problems getting their insurance to pay, and have you overcome them?
Thanks
John
Hi John9ten If getting insurance for victoza or insulin is not bad enough try getting it having heart failure as well looks like I will not be leaving the UK for a long while nice to read your article
I have had no problems with my insurance as far as paying for Victoza,I have heard that Byetta has a lot of side effects but not sure for I’ve never been on it,glad to see you can tolerate Victoza at 1.2 I on the other hand am starting all over at .6 to see if I can take it.I’ve been bouncing from .6 to 1.8 since Aug.can’t seem to adjust.I would talk to my Doctor and see if he can write a letter to the insurance company and see if that helps.
Good Luck.Jean
My insurance Aetna PPO also has this requirement. I was on Byetta before so I met the requirement. I would not fear the Byetta side effects, those occur when starting the drug, are basically the same sorts of things you experienced on Victoza. In fact, since I had already become accustomed to Byetta, I did not have any worse side effects with Victoza and accelerated right up to 1.8mg.
In the case of Aetna, you have a step therapy requirement of one month on Byetta. You can request an exception of that by having your doctor request coverage as an exception, but it is likely that he will need a reason for the exception. But realize that the listed reasons from Aetna for an exception are:
Contraindication to preferred alternative – Byetta OR,
Intolerance to preferred alternative– Byetta OR,
Allergy to one preferred alternative– Byetta OR
Failure to an adequate trial of one month of Byetta
So basically, they paint you into the corner. I know that you “stress” over Byetta, but you could give it a try for a month. If you have bad side effects, then you “fail” at Byetta and can move on to Victoza.
But realize, at least in my case Victoza is a third tier drug, it is only covered at 50%, I can only get it through the specialty pharmacy and it costs me $200/month (and that is my co-pay). Compared to Byetta, which was only $40 for a 3 month supply, Victoza is very expensive, even with coverage.
Hey bsc
My doctor wrote a preauth letter to my insurance company and they approved it!!! But my copay is $95 a month…Victoza’s website offers a discount plan with 12 $35 discounts for your first year, so that will help.
Thanks
John
I’m glad that worked out, at least you were able to bypass the Byetta requirement.
In my case, my insurance (Aetna) recognizes Victoza as a covered dryg, but makes it a tier 3 drug, so it is only covered 50%, doctors letter or no. And my attempts to use the discounts all failed. Aetna requires me to fill the Victoza only through their specialty mail order pharmacy which refuses to accept the discount. So all great ideas, perhaps others will be helped, but it all came up “nada” in my case.
Let us know how it works out for you.