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Post by liane on Jun 27, 2015 18:00:27 GMT -5
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Post by Deleted on Jun 27, 2015 18:22:41 GMT -5
states Prior Auth code is "G" .. hopefully becomes 0 sooner
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Post by jfl on Jun 28, 2015 0:33:31 GMT -5
Sanofi's Toujeo drug is also "G". Seeing that is reassuring.
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Post by abovemyraising on Jun 28, 2015 9:11:26 GMT -5
"Sanofi's Toujeo drug is also "G". Seeing that is reassuring."
"G" means:
"PA[prior approval] required for Non Preferred drugs OR drugs not meeting clinical criteria (FQD, STEP) OR drugs in Clinical Drug Review Program, the Brand Less than Generic Program or the Mandatory Generic Program"
How is toujeo having a "G" as well "reassuring"?
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Post by Deleted on Jun 28, 2015 10:05:59 GMT -5
"Sanofi's Toujeo drug is also "G". Seeing that is reassuring." "G" means: "PA[prior approval] required for Non Preferred drugs OR drugs not meeting clinical criteria (FQD, STEP) OR drugs in Clinical Drug Review Program, the Brand Less than Generic Program or the Mandatory Generic Program" How is toujeo having a "G" as well "reassuring"? Misery seeks company lol |
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Post by jfl on Jun 28, 2015 11:59:01 GMT -5
Even though "G" is unfavorable, it's reassuring that both of Sanofi's newly released diabetic drugs have this same rating. That rules out Sanofi somehow achieving special treatment for it's internally developed drug.
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Post by Chris-C on Jun 28, 2015 12:44:22 GMT -5
states Prior Auth code is "G" .. hopefully becomes 0 sooner There are 3 relevant facts that formulary observers should keep in mind: 1.) It it the nature of health care in the US for insurers to do everything they can to reduce costs, including costs for pharmaceuticals. It is thus becoming the norm for additions to any formulary to be given close scrutiny and placed in prior approval needed status until the economic or clinical benefits are established, especially if the drug is more expensive than generic competitors. Unfortunately, until the next set of studies indicates superiority as a prandial insulin, and label changes are made, Afrezza is likely to experience headwinds in its eventual path to universal acceptance and no questions asked insurance coverage. There is nothing unusual here. 2) Sanofi is helping providers arrange prior approvals with its concierge program. This was just recently launched and should help with increasing script numbers. 3) Sanofi employs specialists who understand the process and have deployed them to facilitate formulary placement. All of this takes time. I, for one, am confident that the clinical results will prevail, and patient/provider adoption will mushroom. This is a slow, steady launch. As time moves on, the adoption process will gain traction. No one at Mannkind or Sanofi is suprised or alarmed by the current state of affairs. If anything, they are pleased with how enthusiastic some of the user responses have been. When was the last time you heard groups of people claiming that a new drug was life changing? |
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Post by mnholdem on Jun 28, 2015 14:48:26 GMT -5
I have found two formularies that already have Toujeo listed as Tier 2. Not surprising, as some payers may consider Toujeo to simply be a souped-up Lantus. Incidentally, that same formulary still has Sanofi's RAA Apidra as Tier 3.
So, even though human insulin has accepted for decades, it's the unique dry formulation, delivery system and the fact that Afrezza launched less than 6 months ago that likely prompted the Tier 3 with restrictions from most 3rd party payers.
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