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Post by peppy on Aug 9, 2017 11:16:03 GMT -5
Peppy, I don't know if my insurance would cover if I were disabled. But since I am not, I'm not inclined to bother finding out. I will be going on Medicare next summer. I HOPE I can find a Supplemental policy that allows Afrezza, even on Tier 4. If I could get it for even $150 per month, I would be ecstatic! Brentie, as the Joker said to Batman, "where do you get those wonderful cat videos?" Can the cat on the motorcycle video possibly be genuine? ? It seems in what we have been told is the greatest country in the world, (military?) our health insurance system is poor. Healthcare touting the system as superior?
Inferior food, inferior health care. Plenty of drugs/medication. alrighty then. Good thing we are the best.
Joints on the other hand can be replaced with titanium in an hour. Anyone know these joints only have a ten year warranty?
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Post by alethea on Aug 9, 2017 11:19:46 GMT -5
The U.S. is the ONLY country in the Western world that does NOT have nationalized healthcare. In our country, Corporate Greed is King. The Romans had bread and circuses to keep them appeased. We have cable TV.
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Post by rombic33 on Aug 9, 2017 11:22:25 GMT -5
The insurance is the greatest holds, because people don't want to pay for their health from their pocket. But at the same time they are more then ready to pay for their pleasure - 500,000 preorders for new budget Tesla, (36k-45k) which to wait months if not years.
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Post by sportsrancho on Aug 9, 2017 12:44:04 GMT -5
The insurance is the greatest holds, because people don't want to pay for their health from their pocket. But at the same time they are more then ready to pay for their pleasure - 500,000 preorders for new budget Tesla, (36k-45k) which to wait months if not years. Yep, I have a client who ordered one.
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Post by peppy on Aug 9, 2017 12:50:49 GMT -5
The insurance is the greatest holds, because people don't want to pay for their health from their pocket. But at the same time they are more then ready to pay for their pleasure - 500,000 preorders for new budget Tesla, (36k-45k) which to wait months if not years. 363,000,000 people in the USA.
Some can afford a tesla. I saw a woman at walmart, her credit card would not take the charge. I saw her put the goods in the back of a BMW SUV.
If you make 15 dollars an hour in this country times 2040 work hours in a year, = $30,600 dollars a year income. Some people can not pay for healthcare out of their own pockets.
Are you a survival of the fittest believer? Like our government? Been to a nursing home lately?
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Post by n8 on Aug 9, 2017 13:03:47 GMT -5
The U.S. is the ONLY country in the Western world that does NOT have nationalized healthcare. In our country, Corporate Greed is King. The Romans had bread and circuses to keep them appeased. We have cable TV. And fidget spinners.....
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Post by Actual Investor on Aug 9, 2017 13:13:49 GMT -5
Peppy,
I just talked with a delightful 70 year old man (youngster from my vantage point) who has had both hips and his right knee replaced. I told him what you said about the 10 year warranty and he replied:
"Hell fire, I'd love it if somebody could give me a 10 year warranty. I'm already the oldest member of my family!"
He then, literately, Laughed Out Loud.
There are different attitudes toward time based on your vantage point. I come from a family that dies of boredom in their late 90's so I can look at MNKD as a long term investment. If it doesn't pay off for me, I think it still will benefit PWD and that is good enough for me.
Thanks for all your effort and insight.
AI
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Tinkerbell
Researcher
Watcher of the Skies
Posts: 143
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Post by Tinkerbell on Aug 9, 2017 14:13:28 GMT -5
A couple of thoughts here and the opinions are entirely my own.
When Afrezza's 'first in class' label is awarded, and I am 99% sure that it will be, then insurance companies will not be able to say NO as easily as they are saying it now.
And, as evidence grows of how well Afrezza helps keep diabetics in superior range, insurers will need to pit the cost of Afrezza against their own historical data. From a purely pharmacoeconomics standpoint, they will need to look at what injectable insulin costs for Type 1 and 2 diabetics and include costs of all anti-hyperglycemic pills for Type 2's as well. That's the first step. Then insurers need to add to drug costs, the costs for complications, ambulance rides, amputations, blindness - any manner of secondary illness which is attributable to diabetes as coded by a physician. If the latter in addition to drug costs exceeds whatever premium Afrezza demands, then it will be compelling and undeniable.
If I put on my insurer's hat, I would start analyzing costs for every single diabetic we've approved for Afrezza for 24 months and look at the total we've paid for the insured in terms of rate of diabetic complications, ambulance rides etc. For those coded to pre-diabetes or Type 2, I would look for any worsening of the condition. In tandem, might I be able to extract data from diabetics being treated with current medications and then do a comparison? Yes. There is simply no other way that any insurance company can see for themselves if Afrezza translates into saving them billions in the long term. This is their main interest aside from collecting premiums. It simply is and they must do the work.
So, a new drug classification will put this in motion. Likewise, PBMs will also need data moving forward and unfortunately, all of this will take time. Next, assuming Afrezza shows it saves insurers substantial monies moving forward, why should MannKind PRICE it's wonder drug equal to / below that of currently available injectables or pills? Simply put, it would be ludicrous for MannKind who having spent 2B (of Al's and investor money) would even consider such. There must be a premium charged for a premium outcome. Insurers won't care if they spend $200 a month more per diabetic on Afrezza if they save $15,000 per diabetic annually in complications - will they? Last I checked, they already pay for complications in addition to drugs. Insurers alone have access to such large datasets as does Medicare/Medicaid who'd also have to do the work.
All I'm saying is consider the big picture and not just the price of Afrezza (as it stands currently). It will be covered in the not too distant future to where it's affordable for everyone who thinks it will work for them. That's my perspective.
Finally, I truly regret if at present there isn't a better answer for people who may have to pay more out of pocket for Afrezza. Mike realizes this which is why the company is is doing what they can to offset it's cost while they wait for the FDA and insurers to come around. That said, I would calculate my medical expenses with Afrezza for the rest of this year and move NOW to take additional deductions from my taxes and some to make up for any taxes I may have already paid.
I REFRAIN from loaning any of my money to the US Goverment except for what I owe. And, I got it down to a science to where I'd rather owe $500 next April 15th than pay $5000 upfront for a refund in May next year. What? I don't think so.
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Post by dreamboatcruise on Aug 9, 2017 14:20:27 GMT -5
Tinkerbell... short term savings such as hospital admissions is what would get the attention of insurers. Sadly it seems most do not have long term horizons with regard to cost savings.
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Post by mydogskip on Aug 9, 2017 14:59:48 GMT -5
A couple of thoughts here and the opinions are entirely my own. When Afrezza's 'first in class' label is awarded, and I am 99% sure that it will be, then insurance companies will not be able to say NO as easily as they are saying it now. And, as evidence grows of how well Afrezza helps keep diabetics in superior range, insurers will need to pit the cost of Afrezza against their own historical data. From a purely pharmacoeconomics standpoint, they will need to look at what injectable insulin costs for Type 1 and 2 diabetics and include costs of all anti-hyperglycemic pills for Type 2's as well. That's the first step. Then insurers need to add to drug costs, the costs for complications, ambulance rides, amputations, blindness - any manner of secondary illness which is attributable to diabetes as coded by a physician. If the latter in addition to drug costs exceeds whatever premium Afrezza demands, then it will be compelling and undeniable. If I put on my insurer's hat, I would start analyzing costs for every single diabetic we've approved for Afrezza for 24 months and look at the total we've paid for the insured in terms of rate of diabetic complications, ambulance rides etc. For those coded to pre-diabetes or Type 2, I would look for any worsening of the condition. In tandem, might I be able to extract data from diabetics being treated with current medications and then do a comparison? Yes. There is simply no other way that any insurance company can see for themselves if Afrezza translates into saving them billions in the long term. This is their main interest aside from collecting premiums. It simply is and they must do the work. So, a new drug classification will put this in motion. Likewise, PBMs will also need data moving forward and unfortunately, all of this will take time. Next, assuming Afrezza shows it saves insurers substantial monies moving forward, why should MannKind PRICE it's wonder drug equal to / below that of currently available injectables or pills? Simply put, it would be ludicrous for MannKind who having spent 2B (of Al's and investor money) would even consider such. There must be a premium charged for a premium outcome. Insurers won't care if they spend $200 a month more per diabetic on Afrezza if they save $15,000 per diabetic annually in complications - will they? Last I checked, they already pay for complications in addition to drugs. Insurers alone have access to such large datasets as does Medicare/Medicaid who'd also have to do the work. All I'm saying is consider the big picture and not just the price of Afrezza (as it stands currently). It will be covered in the not too distant future to where it's affordable for everyone who thinks it will work for them. That's my perspective. Finally, I truly regret if at present there isn't a better answer for people who may have to pay more out of pocket for Afrezza. Mike realizes this which is why the company is is doing what they can to offset it's cost while they wait for the FDA and insurers to come around. That said, I would calculate my medical expenses with Afrezza for the rest of this year and move NOW to take additional deductions from my taxes and some to make up for any taxes I may have already paid. I REFRAIN from loaning any of my money to the US Goverment except for what I owe. And, I got it down to a science to where I'd rather owe $500 next April 15th than pay $5000 upfront for a refund in May next year. What? I don't think so. You don't know what Insurance companies will do. They say NO a lot to people who they shouldn't say no to. There is another huge elephant in the room that I don't recall seeing anyone addressing and that is the ACA. With its passage and byzantine regulation structure, Insurance companies don't exactly have the flexibility they once had and which, I believe, has hampered the acceptance/approval rate of Afrezza. A new label is great but only if Insurance companies and doctors pay attention to it. There is just no evidence that they will.
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Tinkerbell
Researcher
Watcher of the Skies
Posts: 143
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Post by Tinkerbell on Aug 9, 2017 15:02:12 GMT -5
I agree. Costs associated with hospitalizations if related to diabetes (i.e. severe ketoacidosis) - is covered. We're talking ICU and through the roof. Insurers know this already because how else is it that we know what diabetes costs overall and not just in the US. Everyone is tracking it already. The question will be is it cheaper to provide Afrezza at a premium or just continue and wait for these costs to move even higher. Personally, as a taxpayer, it makes no sense to just let it balloon out of control. Give people Afrezza if it will prevent such. Just my opinion.
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Post by buyitonsale on Aug 9, 2017 15:07:27 GMT -5
I am afraid for exactly the reasons stated above that FDA and all of it's "supporting characters" will not be easily handing out requested label changes.
BP interests are clearly not aligned with insurers.
I hope I am wrong and FDA does the right thing.
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Tinkerbell
Researcher
Watcher of the Skies
Posts: 143
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Post by Tinkerbell on Aug 9, 2017 15:08:18 GMT -5
A couple of thoughts here and the opinions are entirely my own. When Afrezza's 'first in class' label is awarded, and I am 99% sure that it will be, then insurance companies will not be able to say NO as easily as they are saying it now. And, as evidence grows of how well Afrezza helps keep diabetics in superior range, insurers will need to pit the cost of Afrezza against their own historical data. From a purely pharmacoeconomics standpoint, they will need to look at what injectable insulin costs for Type 1 and 2 diabetics and include costs of all anti-hyperglycemic pills for Type 2's as well. That's the first step. Then insurers need to add to drug costs, the costs for complications, ambulance rides, amputations, blindness - any manner of secondary illness which is attributable to diabetes as coded by a physician. If the latter in addition to drug costs exceeds whatever premium Afrezza demands, then it will be compelling and undeniable. If I put on my insurer's hat, I would start analyzing costs for every single diabetic we've approved for Afrezza for 24 months and look at the total we've paid for the insured in terms of rate of diabetic complications, ambulance rides etc. For those coded to pre-diabetes or Type 2, I would look for any worsening of the condition. In tandem, might I be able to extract data from diabetics being treated with current medications and then do a comparison? Yes. There is simply no other way that any insurance company can see for themselves if Afrezza translates into saving them billions in the long term. This is their main interest aside from collecting premiums. It simply is and they must do the work. So, a new drug classification will put this in motion. Likewise, PBMs will also need data moving forward and unfortunately, all of this will take time. Next, assuming Afrezza shows it saves insurers substantial monies moving forward, why should MannKind PRICE it's wonder drug equal to / below that of currently available injectables or pills? Simply put, it would be ludicrous for MannKind who having spent 2B (of Al's and investor money) would even consider such. There must be a premium charged for a premium outcome. Insurers won't care if they spend $200 a month more per diabetic on Afrezza if they save $15,000 per diabetic annually in complications - will they? Last I checked, they already pay for complications in addition to drugs. Insurers alone have access to such large datasets as does Medicare/Medicaid who'd also have to do the work. All I'm saying is consider the big picture and not just the price of Afrezza (as it stands currently). It will be covered in the not too distant future to where it's affordable for everyone who thinks it will work for them. That's my perspective. Finally, I truly regret if at present there isn't a better answer for people who may have to pay more out of pocket for Afrezza. Mike realizes this which is why the company is is doing what they can to offset it's cost while they wait for the FDA and insurers to come around. That said, I would calculate my medical expenses with Afrezza for the rest of this year and move NOW to take additional deductions from my taxes and some to make up for any taxes I may have already paid. I REFRAIN from loaning any of my money to the US Goverment except for what I owe. And, I got it down to a science to where I'd rather owe $500 next April 15th than pay $5000 upfront for a refund in May next year. What? I don't think so. You don't know what Insurance companies will do. They say NO a lot to people who they shouldn't say no to. There is another huge elephant in the room that I don't recall seeing anyone addressing and that is the ACA. With its passage and byzantine regulation structure, Insurance companies don't exactly have the flexibility they once had and which, I believe, has hampered the acceptance/approval rate of Afrezza. A new label is great but only if Insurance companies and doctors pay attention to it. There is just no evidence that they will. Sadly, you may be right. Perhaps the ADA, JDRF and diabetics will launch themselves into a larger struggle as HIV patients did. Sometimes it takes a village beyond the one you know to make a difference. We'll just have to wait and see if the label is granted. If not, then my post will be rendered utterly moot.
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Post by lennymnkd on Aug 9, 2017 15:17:07 GMT -5
It's almost as important that the TECHNOLOGY industry pays attention to the label change / 5 minute onset , CGM... practically real time diabetes care ....FROM MNKD CORPORATION. They will get the job done !
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Post by dreamboatcruise on Aug 9, 2017 15:21:14 GMT -5
I am afraid for exactly the reasons stated above that FDA and all of it's "supporting characters" will not be easily handing out requested label changes. BP interests are clearly not aligned with insurers. I hope I am wrong and FDA does the right thing. I'm actually reasonably hopeful they will. I think from a practical standpoint doctors and patients should have it drawn to their attention that the pk/pd is different. As stated by the revered VDex (I'm quoting them so I don't get knocked for FUD), the speed of action is blessing and curse. Saying it is ultra-rapid would emphasize that doctors need to think about its use in a different way than an RAA. I don't think the FDA will be giving a label that says "better", but all involved should want a label that says "this is different from an RAA". Clinicians will then need to decide whether different is good or not. Additionally, Novo is undoubtedly pushing to get a new class as well... and likely have clout ($$$) to make it happen. How could it possibly be justified to deny Afrezza Ultra-rapid and then turn around and give it to a slower insulin some months later? Just my musings and speculations. Take with grain of salt.
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