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Post by pantaloons on Dec 6, 2017 7:48:12 GMT -5
I'm surprised there aren't more stock analysis articles that cover/follow trends in insurance coverage. There are ample articles about weekly scripts and revenue, but insurance coverage is fundamentally way more impactful.
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Post by boca1girl on Dec 6, 2017 9:01:23 GMT -5
Nice to see but this only applies Utah? No info given about tier level or out of pocket cost.
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Post by akemp3000 on Dec 6, 2017 9:09:48 GMT -5
Afrezza is covered by Kaiser Permanente.
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Post by sportsrancho on Dec 6, 2017 9:13:20 GMT -5
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Post by traderdennis on Dec 6, 2017 10:52:09 GMT -5
Afrezza is covered by Kaiser Permanente. It may be on the formulary. Kaiser’s medical protocols are always to use generic medicine first and foremost. Only a specialist can write non generic meds and most type twos are seen by a family doctor and not a kp Endo.
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Post by zuegirdor on Dec 6, 2017 11:54:04 GMT -5
Afrezza is covered by Kaiser Permanente. My son will soon turn 18. My wife currently has same Kaiser Adult Endo that my son will see beginning in March. In an appointment with him yesterday, she broached Afrezza for my son. His reply was encouraging without being pre-decisional. Almost more important to me, lets see what tier coverage Kaiser may give us!
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Post by zuegirdor on Dec 6, 2017 12:20:29 GMT -5
Afrezza is covered by Kaiser Permanente. My son will soon turn 18. My wife currently has same Kaiser Adult Endo that my son will see beginning in March. In an appointment with him yesterday, she broached Afrezza for my son. His reply was encouraging without being pre-decisional. Almost more important to me, lets see what tier coverage Kaiser may give us! ...to add to the last post about what Kaiser will cover. Right after they let my son get Afrezza we go straight to work on getting Kaiser to cover Tresiba for his basal insulin. My son is unfortunate in being afflicted by the evil twins nighttime hypoglycemia and dawn phenomenon. In other words, there is no "correct dose" of Lantus. If you experience this, and I cannot imagine most T1Ds not experiencing something similar given the clamor for Tresiba among the "activist diabetics" (you know-the ones who demand Afrezzza!), then you know how much room for improvement over Lantus there is. For more on that see the recent study results here: www.epgonline.org/global/news/eu-treat-study-shows-benefits-of-switching-to-tresiba-for-type-1-and-2-diabetes-patients---.html . You better believe we are prinitng a copy of this out to bring to his new endo in March. I am pretty sure if we had all the Afrezza my son needs AND Tresiba for his basal, that his A1Cs would be in the 5's and his hypos non existent. By the way, he ran out of Afrezza this week and its been rough going back. Last night after dinner he underestimated the dinner dose. He took 12 u humalog for 70 g carb meal a full half hour before the meal. That was on top of a 2unit humalog correction he took an hour earlier. That did seem to block the liver; and heis BG barely rose over the nest two hours. But then began the creep up to 270 over the next two hours. He took 2 units correction when he hit 180 and another 2 units an hour later when he hit 240. He was still rising when he went to bed at 10:30 but unlike Afrezza you can't just take more insulin and go to sleep-too dangerous. We had no idea when or if he would start coming down. He did come down below 180 at about 2am. That was 5 hours after the last correction. Then over the next two hours he came down to 92, which we recognize as the old Lantus night time Hypglycemia pattern-this time working in our favor. Upshot is that he had 18 units of humalog prior to bed, 14 before the meal, 2 + 2 after. He spent 6 hours out of range peaking at 272. We were grateful for the CGM, but it was a stressful evening. A 12 unit correction with Afrezza at 9:30 and he would have been in range for bedtime with less than two hours out of range and very little chance of a hypo thereafter.
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Post by kimi on Dec 7, 2017 5:28:10 GMT -5
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Post by nadathing on Dec 7, 2017 6:45:54 GMT -5
My BCBS plan covers Afrezza $150 copay for 3 months. Prior authorixation needed.
Note on site: You pay 3% of the cost. Your Plan pays $4,800.62 / 3 months
Almost $15,000 a year? Wow.
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Post by casualinvestor on Dec 7, 2017 12:54:08 GMT -5
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Post by bosephe on Jan 24, 2018 1:59:08 GMT -5
Any ideas if this would also apply to Afrezza? CMS Clarifies Part D Coverage for Newer Insulin Delivery Devices "CMS has now clarified that these more sophisticated devices may be covered under Part D if they are directly associated with delivering insulin into the body, and do not otherwise meet coverage requirements for durable medical equipment under Part B." www.lexology.com/library/detail.aspx?g=44adf828-1bed-48a4-9e6d-6ea07b6ce0dd
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Post by tchalaa on Jan 24, 2018 2:29:30 GMT -5
Insulin Delivery Devices -> Technosphere, but let's hope that the lung test will fall thought here it is about the form of insulin "Inhaled insulin"
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Post by kite on Jan 24, 2018 9:38:50 GMT -5
This is great Kimi. Thank you I like seeing Afrezza at the top of the list
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Post by dreamboatcruise on Jan 24, 2018 16:32:05 GMT -5
Any ideas if this would also apply to Afrezza? CMS Clarifies Part D Coverage for Newer Insulin Delivery Devices "CMS has now clarified that these more sophisticated devices may be covered under Part D if they are directly associated with delivering insulin into the body, and do not otherwise meet coverage requirements for durable medical equipment under Part B." www.lexology.com/library/detail.aspx?g=44adf828-1bed-48a4-9e6d-6ea07b6ce0ddNo, this is about things like pumps. Even before this ruling, the plan sponsors had the ability to include Afrezza on part D formularies, though not many have so far.
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