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Post by dreamboatcruise on May 3, 2017 9:29:46 GMT -5
Does it usually take a few days, a week, a month? I wonder if this has any effect on the low refill numbers. Yes, it has been cited that some relatively small number of patients in trials and beyond choose to discontinue Afrezza for that reason. I don't think that accounts for the majority of missing refills, however. If someone is coughing and it doesn't go away quickly they probably will discontinue rather than using it for a month.
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Post by peppy on May 3, 2017 9:32:45 GMT -5
Sweedee's Dad is the reason for the missing refills. No insurance coverage. Sweeee's Dad could get Afrezza with the medicare plan available. Poor physician penetration. Hopefully, the ad being in the endo's office will penetrate them?
MattB. Mattdownunder another reason for the missing refills, Cost.
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Post by sportsrancho on May 3, 2017 9:59:09 GMT -5
Sweedee's Dad is the reason for the missing refills. No insurance coverage. Sweeee's Dad could get Afrezza with the medicare plan available. Poor physician penetration. Hopefully, the ad being in the endo's office will penetrate them?
MattB. Mattdownunder another reason for the missing refills, Cost.
I think it's mostly the insurance from the DM's I'm getting.
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Post by dreamboatcruise on May 3, 2017 10:32:54 GMT -5
Sweedee's Dad is the reason for the missing refills. No insurance coverage. Sweeee's Dad could get Afrezza with the medicare plan available. Poor physician penetration. Hopefully, the ad being in the endo's office will penetrate them?
MattB. Mattdownunder another reason for the missing refills, Cost.
I think it's mostly the insurance from the DM's I'm getting. Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM.
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Post by goyocafe on May 3, 2017 10:45:44 GMT -5
I think it's mostly the insurance from the DM's I'm getting. Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM.I do hope a well worded response is forthcoming as well. We should get answers to all of the questions posted, they're all worthy, and we're all deserving of an explanation(s) at this stage of the game.
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Post by peppy on May 3, 2017 11:11:46 GMT -5
I think it's mostly the insurance from the DM's I'm getting. Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM. alethea pays out of pocket. "A bigger reason scripts are not moving up? The 9 boxes shown above in Sam's tweet would cost me $3,150. That's $3,150 dollars or $350 per box. Does not take Albert Einstein to figure out why it is not selling. It would cost me 12 THOUSAND per year to fill Sam's prescription." Read more: mnkd.proboards.com/thread/5513/sams-tweets?page=12#ixzz4g25kJIW0
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Post by sophie on May 3, 2017 11:13:56 GMT -5
Aren't most diabetic plans high deductible? It would seem they would make the switch once they've reached their out of pocket maximum for the year. Was hoping to see a peak at some point throughout the year.
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Post by sportsrancho on May 3, 2017 11:23:09 GMT -5
I think it's mostly the insurance from the DM's I'm getting. Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM. I was under the impression they got the script and then down the road the insurance decides to make a fuss.
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Post by liane on May 3, 2017 11:25:02 GMT -5
Aren't most diabetic plans high deductible? It would seem they would make the switch once they've reached their out of pocket maximum for the year. Was hoping to see a peak at some point throughout the year. Being diabetic has nothing to do with what kind of insurance you have.
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Post by sophie on May 3, 2017 11:38:17 GMT -5
www.nerdwallet.com/blog/health/high-or-low-deductible-health-insurance-plan/This article says a low deductible plan would be better for chronic diseases, so I'm probably wrong. I always thought that it was better for diabetics with families to choose high deductible plans because they ended up being cheaper in the long run- kids typically require more care due to illness, antibiotics, etc. Plus the added benefit of the HSA. Wasn't trying to insinuate anything.
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Post by ssiegel on May 3, 2017 11:41:56 GMT -5
Aren't most diabetic plans high deductible? It would seem they would make the switch once they've reached their out of pocket maximum for the year. Was hoping to see a peak at some point throughout the year. Being diabetic has nothing to do with what kind of insurance you have. No, but I imagine diabetic's insurance has a large impact on how the diabetic manages their condition.
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Post by dreamboatcruise on May 3, 2017 12:12:05 GMT -5
Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM. alethea pays out of pocket. "A bigger reason scripts are not moving up? The 9 boxes shown above in Sam's tweet would cost me $3,150. That's $3,150 dollars or $350 per box. Does not take Albert Einstein to figure out why it is not selling. It would cost me 12 THOUSAND per year to fill Sam's prescription." Read more: mnkd.proboards.com/thread/5513/sams-tweets?page=12#ixzz4g25kJIW0
There is the discount card that would knock another $150 off that cost. That is 43% discount for those without insurance formulary coverage. How much more discount do you think would be needed/warranted? It is tough if you're talking about dropping the price so drastically that everyone without coverage could afford to pay out of pocket. Prices charged to insurance companies is negotiated separately from list price. So if Mannkind wanted to lower the price for those without insurance they would likely do it by increasing maximum benefit of discount card rather than lowering list price.
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Post by dreamboatcruise on May 3, 2017 12:16:12 GMT -5
Makes sense that insurance would be a barrier, based on not great coverage that can be seen in formularylookup data. However, I'm surprised that there would be sizable numbers of patients that would fill a NRx and pay out of pocket only to then not refill when they can't get approval. I know when I've been prescribed something that isn't covered I've called doctor to get something else written rather than paying full amount myself for first filling. And with sample packs, I'd be pressing doctors to give more samples until I could sort out insurance. I guess people change insurance fairly often and going from an insurer that covers to one that doesn't could lead to attrition. I do hope a well worded question regarding this is posed at ASM. I was under the impression they got the script and then down the road the insurance decides to make a fuss. I've always been turned down the very first time I tried filling a prescription if the brand drug isn't on formulary, but maybe it happens differently if it is covered but the problem is preauthorization. Maybe that doesn't get caught until later. Interesting question though.
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Post by alethea on May 3, 2017 12:23:49 GMT -5
alethea pays out of pocket. "A bigger reason scripts are not moving up? The 9 boxes shown above in Sam's tweet would cost me $3,150. That's $3,150 dollars or $350 per box. Does not take Albert Einstein to figure out why it is not selling. It would cost me 12 THOUSAND per year to fill Sam's prescription." Read more: mnkd.proboards.com/thread/5513/sams-tweets?page=12#ixzz4g25kJIW0
There is the discount card that would knock another $150 off that cost. That is 43% discount for those without insurance formulary coverage. How much more discount do you think would be needed/warranted? It is tough if you're talking about dropping the price so drastically that everyone without coverage could afford to pay out of pocket. Prices charged to insurance companies is negotiated separately from list price. So if Mannkind wanted to lower the price for those without insurance they would likely do it by increasing maximum benefit of discount card rather than lowering list price. The discount card does NOT work if your insurance "covers" Afrezza while at the same time NOT allowing coverage due to Prior Authorization. I don't know about you but I for one, certainly can Not afford 12 grand a year for the quantity of insulin that Sam, AfrezzaUser currently takes.
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Post by dreamboatcruise on May 3, 2017 12:37:33 GMT -5
There is the discount card that would knock another $150 off that cost. That is 43% discount for those without insurance formulary coverage. How much more discount do you think would be needed/warranted? It is tough if you're talking about dropping the price so drastically that everyone without coverage could afford to pay out of pocket. Prices charged to insurance companies is negotiated separately from list price. So if Mannkind wanted to lower the price for those without insurance they would likely do it by increasing maximum benefit of discount card rather than lowering list price. The discount card does NOT work if your insurance "covers" Afrezza while at the same time NOT allowing coverage due to Prior Authorization. I don't know about you but I for one, certainly can Not afford 12 grand a year for the quantity of insulin that Sam, AfrezzaUser currently takes. Thanks for that info. I did not know that. Not even the fine print I've seen would indicate that. I wonder why MNKD would structure it that way. Fully agree most people couldn't afford $12 grand a year. However, most couldn't really afford half that or a third that. It would dramatically change the potential value of Mannkind if they were to slash the price by 75% or more. For a lot of people more than $100 a month would be prohibitive even for something with real benefit. So that would be slashing price by 90% for that amount of Afrezza. Mannkind can't do that.
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