johny
Researcher
Posts: 87
|
Post by johny on Apr 24, 2019 18:53:07 GMT -5
johny You said "The scenario was, KP is monitoring patients who are taking Afrezza, trying to see if it's possible for them to get a better outcome than what their current SOC recommends." If this is true that Kaiser is taking a serious look at Afrezza, it is great. I haven't seen any evidence of this. Getting put on tier 4 or 5 (whatever that is) on a formulary isn't an indication they are taking a serious look at it. It could just mean that they're making it slightly easier for patients who absolutely demand it. Would love evidence they actually are doing as you say. Change does occur within Kaiser like that. Some doctor that really wants to try out new therapy gets approval from the committees to do "mini study" outside of their normal SOC. Sadly what I see, at least of my regional Kaiser, is that their endo department seems particularly stuck in old ways. As for health care financial incentives it gets extremely complicated. In the long run the whole system has incentive to run health care costs up, not down, as they basically are getting a percentage of all costs as profits. Even in the short term there are some perverse incentives that come into play such as "rebates" actually encouraging PBM managers to play along, or encourage, drug price increases. Sadly it seems the cumulative effect of the way the system is set up is to ignore ballooning costs in the long run (I'll avoid being so cynical as to say they encourage it) and provide non-inferior outcomes in the short term while penny pinching to have slightly better margins than your competitors. Long term patient well being certainly isn't the primary driver of decisions. My relative works at Kaiser Permanente. (19+ years, infection control department.) Every month or couple months, they have a meeting, and at this meeting is the " __________" they're name is ____. Over the years, my relative has asked ____ about Afrezza. To be accurate 2-3 times. The first time they said, "never heard of it." That was 1.5 years ago or maybe 2. However, 8-10 weeks ago, my relative asked for an update. ___ said, "were waiting to see if Afrezza can do what they say it can. (3/1/18)I told our CEO this. "Thank you for sharing...Yes we have met with Kaiser and glad to see the tone change. I think once they see what this can do it will be widely adopted, but it takes time for all this come together. Copied my team so they can see this from a third party." On Jan 2019, KP formulary changed, they are now prescribing Afrezza. My relative was an infection control nurse, but every so often, she would go to meetings filled with big wigs in specialized fields.
|
|
|
Post by ktim on Apr 24, 2019 19:11:53 GMT -5
johny You said "The scenario was, KP is monitoring patients who are taking Afrezza, trying to see if it's possible for them to get a better outcome than what their current SOC recommends." If this is true that Kaiser is taking a serious look at Afrezza, it is great. I haven't seen any evidence of this. Getting put on tier 4 or 5 (whatever that is) on a formulary isn't an indication they are taking a serious look at it. It could just mean that they're making it slightly easier for patients who absolutely demand it. Would love evidence they actually are doing as you say. Change does occur within Kaiser like that. Some doctor that really wants to try out new therapy gets approval from the committees to do "mini study" outside of their normal SOC. Sadly what I see, at least of my regional Kaiser, is that their endo department seems particularly stuck in old ways. As for health care financial incentives it gets extremely complicated. In the long run the whole system has incentive to run health care costs up, not down, as they basically are getting a percentage of all costs as profits. Even in the short term there are some perverse incentives that come into play such as "rebates" actually encouraging PBM managers to play along, or encourage, drug price increases. Sadly it seems the cumulative effect of the way the system is set up is to ignore ballooning costs in the long run (I'll avoid being so cynical as to say they encourage it) and provide non-inferior outcomes in the short term while penny pinching to have slightly better margins than your competitors. Long term patient well being certainly isn't the primary driver of decisions. My relative works at Kaiser Permanente. (19+ years, infection control department.) Every month or couple months, they have a meeting, and at this meeting is the " __________" they're name is ____. Over the years, my relative has asked ____ about Afrezza. To be accurate 2-3 times. The first time they said, "never heard of it." That was 1.5 years ago or maybe 2. However, 8-10 weeks ago, my relative asked for an update. ___ said, "were waiting to see if Afrezza can do what they say it can. (3/1/18) I told our CEO this. "Thank you for sharing...Yes we have met with Kaiser and glad to see the tone change. I think once they see what this can do it will be widely adopted, but it takes time for all this come together. Copied my team so they can see this from a third party." On Jan 2019, KP formulary changed, they are now prescribing Afrezza. My relative was an infection control nurse, but every so often, she would go to meetings filled with big wigs in specialized fields. What region? kaisers are very independent one region to another. My inquiries have not yet turned up any activity in SoCal region (the largest one)? I assume you're interpreting "waiting to see if Afrezza can do what they say it can" as proactively prescribing and tracking results? I think another way of interpreting that would be that they are doing what many, many other doctors are doing, simply waiting and seeing. Some real news from Mike on Kaiser would be great. Like how many individual docs are prescribing. Are they new to Afrezza patients or simply ones already on Afrezza coming into Kaiser. How long does he feel it will take for Kaiser to put Afrezza at better formulary position. I really don't expect any answers of that sort, however. I'm certainly eager to see something happening at Kaiser as I know it could tip quickly once moving, but I also know Kaiser, and particularly endo dept there, are slow to break the static friction of status quo and start moving. I guess I'm pessimistic they'll be jumping on board with Afrezza soon given that they are still in the process of accepting RAAs over the prior generation.
|
|
johny
Researcher
Posts: 87
|
Post by johny on Apr 24, 2019 19:27:33 GMT -5
My relative works at Kaiser Permanente. (19+ years, infection control department.) Every month or couple months, they have a meeting, and at this meeting is the " __________" they're name is ____. Over the years, my relative has asked ____ about Afrezza. To be accurate 2-3 times. The first time they said, "never heard of it." That was 1.5 years ago or maybe 2. However, 8-10 weeks ago, my relative asked for an update. ___ said, "were waiting to see if Afrezza can do what they say it can. (3/1/18) I told our CEO this. "Thank you for sharing...Yes we have met with Kaiser and glad to see the tone change. I think once they see what this can do it will be widely adopted, but it takes time for all this come together. Copied my team so they can see this from a third party." On Jan 2019, KP formulary changed, they are now prescribing Afrezza. My relative was an infection control nurse, but every so often, she would go to meetings filled with big wigs in specialized fields. What region? kaisers are very independent one region to another. My inquiries have not yet turned up any activity in SoCal region (the largest one)? I assume you're interpreting "waiting to see if Afrezza can do what they say it can" as proactively prescribing and tracking results? I think another way of interpreting that would be that they are doing what many, many other doctors are doing, simply waiting and seeing. Some real news from Mike on Kaiser would be great. Like how many individual docs are prescribing. Are they new to Afrezza patients or simply ones already on Afrezza coming into Kaiser. How long does he feel it will take for Kaiser to put Afrezza at better formulary position. I really don't expect any answers of that sort, however. I'm certainly eager to see something happening at Kaiser as I know it could tip quickly once moving, but I also know Kaiser, and particularly endo dept there, are slow to break the static friction of status quo and start moving. I guess I'm pessimistic they'll be jumping on board with Afrezza soon given that they are still in the process of accepting RAAs over the prior generation. Ktim, Kaiser is about money, we both agreed on this, Afrezza is expensive, what's the benefit, if not a better outcome? They track all drug outcomes. What region? Southern California. "waiting to see if Afrezza can do what they say it can" This was verbatim. I asked a hundred times.. (my relative)
|
|
|
Post by ktim on Apr 24, 2019 20:17:44 GMT -5
What region? kaisers are very independent one region to another. My inquiries have not yet turned up any activity in SoCal region (the largest one)? I assume you're interpreting "waiting to see if Afrezza can do what they say it can" as proactively prescribing and tracking results? I think another way of interpreting that would be that they are doing what many, many other doctors are doing, simply waiting and seeing. Some real news from Mike on Kaiser would be great. Like how many individual docs are prescribing. Are they new to Afrezza patients or simply ones already on Afrezza coming into Kaiser. How long does he feel it will take for Kaiser to put Afrezza at better formulary position. I really don't expect any answers of that sort, however. I'm certainly eager to see something happening at Kaiser as I know it could tip quickly once moving, but I also know Kaiser, and particularly endo dept there, are slow to break the static friction of status quo and start moving. I guess I'm pessimistic they'll be jumping on board with Afrezza soon given that they are still in the process of accepting RAAs over the prior generation. Ktim, Kaiser is about money, we both agreed on this, Afrezza is expensive, what's the benefit, if not a better outcome? In terms of drugs being effective, patient outcomes financially matters because its a broken record that goes on and on.. the problems never stop. When you introduce a drug that eliminates a continuous pattern of poor outcomes, you use less resources for treatment, because the pattern of poor outcomes has stopped. They track all drug outcomes. Certain outcomes can save KP money. Doctors being called in when their off because they're short staffed. Patients rushing to the ER taking up space, because they stacked their insulin and are now unconscious. The list goes on, there are many ways KP can save money if better outcomes came into play. Diabetes is mismanaged, so there is a lot of cost savings to be done. What region? Southern California. "waiting to see if Afrezza can do what they say it can" This was verbatim. I asked a hundred times.. (my relative) Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry. At least with Kaiser SoCal they review formulary 6 times a year, so if they decide to make Afrezza preferred it wouldn't take long to have that show up in the formulary. We'll know they they are no longer waiting to see when that happens.
|
|
|
Post by goyocafe on Apr 24, 2019 20:29:43 GMT -5
Ktim, Kaiser is about money, we both agreed on this, Afrezza is expensive, what's the benefit, if not a better outcome? In terms of drugs being effective, patient outcomes financially matters because its a broken record that goes on and on.. the problems never stop. When you introduce a drug that eliminates a continuous pattern of poor outcomes, you use less resources for treatment, because the pattern of poor outcomes has stopped. They track all drug outcomes. Certain outcomes can save KP money. Doctors being called in when their off because they're short staffed. Patients rushing to the ER taking up space, because they stacked their insulin and are now unconscious. The list goes on, there are many ways KP can save money if better outcomes came into play. Diabetes is mismanaged, so there is a lot of cost savings to be done. What region? Southern California. "waiting to see if Afrezza can do what they say it can" This was verbatim. I asked a hundred times.. (my relative) Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry. At least with Kaiser SoCal they review formulary 6 times a year, so if they decide to make Afrezza preferred it wouldn't take long to have that show up in the formulary. We'll know they they are no longer waiting to see when that happens. All this talk about KP makes me wonder about the open req MNKD had on their website for a number of months for a KP rep, which is no longer listed. Did it get filled or cancelled? A lot could be extrapolated from knowing if they actually filled this position.
|
|
johny
Researcher
Posts: 87
|
Post by johny on Apr 24, 2019 20:42:17 GMT -5
Ktim, Kaiser is about money, we both agreed on this, Afrezza is expensive, what's the benefit, if not a better outcome? In terms of drugs being effective, patient outcomes financially matters because its a broken record that goes on and on.. the problems never stop. When you introduce a drug that eliminates a continuous pattern of poor outcomes, you use less resources for treatment, because the pattern of poor outcomes has stopped. They track all drug outcomes. Certain outcomes can save KP money. Doctors being called in when their off because they're short staffed. Patients rushing to the ER taking up space, because they stacked their insulin and are now unconscious. The list goes on, there are many ways KP can save money if better outcomes came into play. Diabetes is mismanaged, so there is a lot of cost savings to be done. What region? Southern California. "waiting to see if Afrezza can do what they say it can" This was verbatim. I asked a hundred times.. (my relative) Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry. At least with Kaiser SoCal they review formulary 6 times a year, so if they decide to make Afrezza preferred it wouldn't take long to have that show up in the formulary. We'll know they they are no longer waiting to see when that happens. Ktim, "Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry." I don't understand what you said above. Sounds like your pessimistic and are worried about my optimism, like it might do more harm than good. My optimism is in check, I've been around this company long enough. As far as Afrezza becoming "preferred", yeah that would be great.
|
|
|
Post by ktim on Apr 25, 2019 3:15:47 GMT -5
Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry. At least with Kaiser SoCal they review formulary 6 times a year, so if they decide to make Afrezza preferred it wouldn't take long to have that show up in the formulary. We'll know they they are no longer waiting to see when that happens. Ktim, "Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry." I don't understand what you said above. Sounds like your pessimistic and are worried about my optimism, like it might do more harm than good. My optimism is in check, I've been around this company long enough. As far as Afrezza becoming "preferred", yeah that would be great. No harm as long as you don't convince your great aunt to invest "gamble" more than she can afford to lose, or at least suffer severe volatility. But, your optimism is in check so that isn't a problem. I just don't think you were presenting realistic version of how Kaiser works. Not necessarily from an intent to mislead. Probably just trying to present Afrezza in a positive light.
|
|
|
Post by rravis1914 on Apr 25, 2019 11:19:16 GMT -5
It seems that there is a lot of interest in KP and its potential. I go back to my original suggestion that MNKD saturate the KP market area with Afrezza ads to drive interest, awareness and patient demand.
What could be the harm? and what could be the benefit? Thoughts?
|
|
|
Post by ktim on Apr 25, 2019 14:02:05 GMT -5
It seems that there is a lot of interest in KP and its potential. I go back to my original suggestion that MNKD saturate the KP market area with Afrezza ads to drive interest, awareness and patient demand.
What could be the harm? and what could be the benefit? Thoughts?
Not that targeting CA where Kaiser is biggest would be bad, but it is costly and that isn't the way to get into Kaiser. They play by the book. If the book says to use humulin and novolin as first line and RAA as second, then the docs do that. It wouldn't matter if more patients are coming in asking about Afrezza. The only exception to that is likely for patients coming into Kaiser as new members who have already been on Afrezza. The way that Kaiser works is that the committees that make treatment decisions would need to decide to evaluate Afrezza with an internal mini trial and then it would be made preferred on formulary before any widespread use starts. We don't know whether they are doing such an evaluation, but we do know it has not been completed with positive outcome because Afrezza is highest tier on formulary, at least the one I found for this region.
|
|
johny
Researcher
Posts: 87
|
Post by johny on Apr 25, 2019 14:55:57 GMT -5
Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry. At least with Kaiser SoCal they review formulary 6 times a year, so if they decide to make Afrezza preferred it wouldn't take long to have that show up in the formulary. We'll know they they are no longer waiting to see when that happens. All this talk about KP makes me wonder about the open req MNKD had on their website for a number of months for a KP rep, which is no longer listed. Did it get filled or cancelled? A lot could be extrapolated from knowing if they actually filled this position. "We hired someone who just started a few weeks ago to lead Kaiser full time." "Afrezza is perfect for them bc they care about total cost of care but are also evidenced based so we need to generate the evidence in their own population."
|
|
|
Post by cretin11 on Apr 25, 2019 15:26:17 GMT -5
Who/when are those quotes from?
|
|
johny
Researcher
Posts: 87
|
Post by johny on Apr 25, 2019 15:50:07 GMT -5
Ktim, "Well, what you say could have been true for medicine in general for years, yet patient centered improvements largely aren't happening. Hope your optimism comes to pass. It would be great for all of us not in healthcare industry." I don't understand what you said above. Sounds like your pessimistic and are worried about my optimism, like it might do more harm than good. My optimism is in check, I've been around this company long enough. As far as Afrezza becoming "preferred", yeah that would be great. No harm as long as you don't convince your great aunt to invest "gamble" more than she can afford to lose, or at least suffer severe volatility. But, your optimism is in check so that isn't a problem. I just don't think you were presenting realistic version of how Kaiser works. Not necessarily from an intent to mislead. Probably just trying to present Afrezza in a positive light. Ktim, How about you mind your own business, and I'll never talk about your wife (or boyfriend.) Good? Great.
|
|
|
Post by ktim on Apr 25, 2019 15:57:48 GMT -5
No harm as long as you don't convince your great aunt to invest "gamble" more than she can afford to lose, or at least suffer severe volatility. But, your optimism is in check so that isn't a problem. I just don't think you were presenting realistic version of how Kaiser works. Not necessarily from an intent to mislead. Probably just trying to present Afrezza in a positive light. Ktim, How about you mind your own business, and I'll never talk about your wife (or boyfriend.) Good? Great. Apologies. It was simply a figure of speech, not intended to refer to any specific real person. Just don't tell my wife about my boyfriend or vice versa
|
|
|
Post by rockstarrick on Apr 25, 2019 23:27:31 GMT -5
Ktim, How about you mind your own business, and I'll never talk about your wife (or boyfriend.) Good? Great. Apologies. It was simply a figure of speech, not intended to refer to any specific real person. Just don't tell my wife about my boyfriend or vice versa Before this thread gets locked,,,,, 😂😂😂😂😂😂😂😂😂😂😂😂 you two crack me up 😆 👏🏻👏🏻👏🏻👏🏻👏🏻🤘🏻🤘🏻✌🏻✌🏻😎
|
|
|
Post by ltta on Nov 9, 2019 11:06:27 GMT -5
2020 formularies for Kaiser California
California Marketplace: No Afrezza
Self Funded Formulary: No Afrezza
Medi-Cal Formulary: No Afrezza
Medicare Part D formulary: Afrezza Available Tier 4 and 5
Federal Employees: No Afrezza
Kaiser Permanete Insurance Company Formulary: Afrezza Available Tier 3
Use these formularies if you have a KPIC point-of-service (POS), preferred provider organization (PPO), or out-of-area (OOA) indemnity plan.
|
|