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Post by savzak on Jan 21, 2015 9:03:57 GMT -5
www.emedny.org/info/fullform.pdf NEW YORK STATE DEPARTMENT OF HEALTH 01/21/2015 PAGE: 7 LIST OF MEDICAID REIMBURSABLE DRUGS RX TYPE: 01 PRICING ERRORS ARE NOT REIMBURSABLE PRICES EFFECTIVE 01/21/2015 LTM BASIS IND NDC CODE MRA COST COST ALTERNATE FORMULARY DESCRIPTION PA CD LABELER OF MRA ------------------------- ----- ------------------ ---------- BND 00024-5882-36 3.08308 AFREZZA 30-4 UNIT + 60-8 UNIT G SANOFI-AVENTIS EA BND 00024-5874-90 2.50171 AFREZZA 4 UNITS CARTRIDGE INH G SANOFI-AVENTIS EA BND 00024-5884-63 2.79248 AFREZZA 60-4 UNIT + 30-8 UNIT G SANOFI-AVENTIS EA I cut and pasted the Humalog and Novolog information into the chart. I have no idea how to equivilate the information in order to compare pricing though.
BND 00024-5882-36 3.08308 AFREZZA 30-4 UNIT + 60-8 UNIT G SANOFI-AVENTIS EA BND 00024-5874-90 2.50171 AFREZZA 4 UNITS CARTRIDGE INH G SANOFI-AVENTIS EA BND 00024-5884-63 2.79248 AFREZZA 60-4 UNIT + 30-8 UNIT G SANOFI-AVENTIS EA
BND 00002-8798-01 25.99560 HUMALOG MIX 50-50 KWIKPEN 0 ELI LILLY & CO. ML BND 00002-8798-59 25.99560 HUMALOG MIX 50-50 KWIKPEN 0 ELI LILLY & CO. ML BND 00002-7512-01 20.91517 HUMALOG MIX 50-50 VIAL 0 ELI LILLY & CO. ML BND 00002-8797-01 25.99560 HUMALOG MIX 75-25 KWIKPEN 0 ELI LILLY & CO. ML BND 00002-7516-01 25.01066 HUMALOG 100 UNITS/ML CARTRIDGE 0 ELI LILLY & CO. ML BND 00002-7516-59 25.00956 HUMALOG 100 UNITS/ML CARTRIDGE 0 ELI LILLY & CO. ML BND 00002-8799-01 25.99560 HUMALOG 100 UNITS/ML KWIKPEN 0 ELI LILLY & CO. ML BND 00002-8799-59 25.99560 HUMALOG 100 UNITS/ML KWIKPEN 0 ELI LILLY & CO. ML BND 00002-7510-01 20.17896 HUMALOG 100 UNITS/ML VIAL 0 ELI LILLY & CO. ML BND 00002-7510-17 20.18006 HUMALOG 100 UNITS/ML VIAL 0 ELI LILLY & CO. ML
BND 00169-3696-19 26.07085 NOVOLOG MIX 70-30 FLEXPEN SYRN 0 NOVO NORDISK ML BND 00169-3685-12 20.99734 NOVOLOG MIX 70-30 VIAL 0 NOVO NORDISK ML BND 00169-3303-12 25.06987 NOVOLOG 100 UNIT/ML CARTRIDGE 0 NOVO NORDISK ML BND 00169-7501-11 20.24287 NOVOLOG 100 UNIT/ML VIAL 0 NOVO NORDISK ML
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Post by Deleted on Jan 21, 2015 9:10:11 GMT -5
Box of novolog pens is $400, each box is 15 mL. Each pen is 3mL. Each mL is $26.
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Post by savzak on Jan 22, 2015 20:09:38 GMT -5
It would seem that enough pricing information has been released to initiate the blogger commentary on the pricing issue. Expecting the first effort any time now. With all the excitement today, I nearly forgot to keep watching for the expected FUD on pricing. Maybe they're accumulating their best arguments and waiting to use them to build a hit piece they can use as soon as they see script data that they can challenge as being disappointing. Maybe so. But I believe that if the pricing had any real weakness, any obvious areas for attack, they'd jump on it from the start and pound, pound, pound like they've done with everything else they've deemed worthy of criticism. The stone cold silence on pricing most likely means they see no obvious problem with it, which is no big surprise given the fact that Sanofi set the price.
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Post by dreamboatcruise on Jan 22, 2015 20:28:03 GMT -5
It would seem that enough pricing information has been released to initiate the blogger commentary on the pricing issue. Expecting the first effort any time now. With all the excitement today, I nearly forgot to keep watching for the expected FUD on pricing. Maybe they're accumulating their best arguments and waiting to use them to build a hit piece they can use as soon as they see script data that they can challenge as being disappointing. Maybe so. But I believe that if the pricing had any real weakness, any obvious areas for attack, they'd jump on it from the start and pound, pound, pound like they've done with everything else they've deemed worthy of criticism. The stone cold silence on pricing most likely means they see no obvious problem with it, which is no big surprise given the fact that Sanofi set the price.
I wouldn't think pricing can really be attacked solely on its own merits. It really comes down to where it lands on formularies... how many hoops doctors do or don't have to jump through to prescribe and amount of copay patients face. If we get good formulary coverage... the higher the price the better... for pps. [Note: despite being a lizard with cold blood, I do realize that many in the U.S. don't have insurance coverage for drugs, so higher price for Afrezza could hurt some people suffering from diabetes... but Sanofi is likely to take the cold calculating approach of maximizing profits]
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Post by savzak on Jan 22, 2015 20:40:25 GMT -5
"the cold calculating approach of maximizing profits"
It's hard to imagine such a thing in this day and age.
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Post by Deleted on Jan 22, 2015 20:54:51 GMT -5
The problem with the pricing argument on the short side will be to establish the case by which afrezza is significantly more expensive. The problem is, however that it all depends on what the individual dose is just how much "more" afrezza is vs novolog pens.
I'm a bit suprised we haven't seen any negative spin on pricing, because Unit vs unit, afrezza is more expensive. And on the surface, the difference is fairly significant.
However, pricing is moot if it's covered (even in tier 3). But that's wiithout looking at waste as a significant issue
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Post by mannmade on Jan 22, 2015 22:39:35 GMT -5
I don't believe you can compare unit to unit for Afrezza vs Pens etc as Afrezza Units are not a 1:1 comparison to RAA insulins
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Post by Deleted on Jan 22, 2015 22:50:15 GMT -5
I don't believe you can compare unit to unit for Afrezza vs Pens etc as Afrezza Units are not a 1:1 comparison to RAA insulins Ya I believe it's more afrezza units to RAA units though, which makes pricing look worse
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Post by ezrasfund on Jan 22, 2015 23:00:09 GMT -5
I don't believe you can compare unit to unit for Afrezza vs Pens etc as Afrezza Units are not a 1:1 comparison to RAA insulins Ya I believe it's more afrezza units to RAA units though, which makes pricing look worse This is incorrect. Look at the pictures of the packaging. "Each blue cartridge approximates 4 units of injected insulin" "Each green cartridge approximates 8 units of injected insulin" You can be sure that MannKind learned from the dosing confusion of Exubera. It is true that to approximate 4 units of injected insulin Afrezza must use more insulin in the dose, but the conversion is built into the product so it is 1:1 dosing.
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Post by Deleted on Jan 22, 2015 23:17:13 GMT -5
In study 171, afrezza performed at a 1:4 ratio to novolog. So I don't think I'm wrong.
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Post by Deleted on Jan 22, 2015 23:22:16 GMT -5
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Post by Deleted on Jan 22, 2015 23:26:32 GMT -5
Ok I get that, but in the trial they concluded that the ratio was 1:4. Are you telling me they changed what a "unit" meant in that trial to account for the efficacy difference when equal dosages of aspart and afrezza were given?
I'm not trying to be difficult, but it's an important distinction that I'm unclear on.
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Post by ezrasfund on Jan 22, 2015 23:30:59 GMT -5
In study 171, afrezza performed at a 1:4 ratio to novolog. So I don't think I'm wrong. Just read the box. It couldn't be any clearer. mnkd.proboards.com/attachment/download/284As I mentioned, you are correct that Afrezza requires more insulin than Novolog to deliver the same dose, and this is the 1:4 ratio you cite. The packaging of Afrezza takes care of this so that "each dose approximates X units of injected insulin." In fact the Afrezza package does not say how many units a cartridge contains, but only how many units of injected insulin it "approximates." If you took 8 units of injected you use the cartridge that approximates 8 units of injected insulin to get the same dose.
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Post by Deleted on Jan 22, 2015 23:32:06 GMT -5
Ok I get that, but in the trial they concluded that the ratio was 1:4. Are you telling me they changed what a "unit" meant in that trial to account for the efficacy difference when equal dosages of aspart and afrezza were given? I'm not trying to be difficult, but it's an important distinction that I'm unclear on. i would accept the fda label with out second thoughts to keep it simple and easy rather than 1 trial unless you have followed all the trials
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Post by Deleted on Jan 22, 2015 23:41:41 GMT -5
Good point about the box not saying how many units is in a 4/8 injected equiv unit dose, I hadn't considered that.
It also sort of ties up the tweet that was floated out there in the jpm Q&a that afrezza contained 2.5 x more insulin than RAAs
It also makes mannmades point earlier a bit more clear.
i guess I could still argue that on an equivalent unit to unit basis, afrezza is more expensive, milligram to milligram
For example, the Max unit equivalents in a box of afrezza is 600. A box of pens is 1500. Cost difference is like $400 for pens and $275 for afrezza. Assuming even 20% loss with owns still puts equivalent units at costing $550 for afrezza and $400 for novolog. Seems signifcant to me and a most likely point of contention of shorts
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