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Post by digger on May 6, 2018 20:19:58 GMT -5
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Post by peppy on May 6, 2018 20:32:19 GMT -5
Mail handlers, do you know what happened to the US postal service? United Mine workers, you mean the coal mines that have been shut down?
hahahaha good ones.
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Post by mnholdem on May 6, 2018 20:50:57 GMT -5
Occam's razor here tells us that it is real. Though someone posted the link to another site to look up formulary coverage that seems to have contradictory info. Simple logic tells us they cannot both be accurate. Belief in formularylookup may be more of confirmation bias than Occam. Occam's razor (also Ockham's razor or Ocham's razor; Latin: lex parsimoniae "law of parsimony") is the problem-solving principle that, when presented with competing hypothetical answers to a problem, one should select the one that makes the fewest assumptions. The idea is attributed to William of Ockham (c. 1287–1347), who was an English Franciscan friar, scholastic philosopher, and theologian.
Source: en.wikipedia.org/wiki/Occam%27s_razor
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Go to that site that supposedly contradicts FormularyLookup.com and you'll quickly discover that you can only select a maximum of 5 plans out of approximatey 4,450 commercial plans listed on FormularyLookup. It would be incredibly complex and would likely take you hundreds of hours to go through all states, five plans at a time, then assimilate to assess and compare national coverage with FormularyLookup.
If you're a perpetual skeptic/naysayer, your solution would be to go with the complex solution but THAT would indicate a true confirmation bias (e.g. "Wow, I've confirmed that there is an opposing viewpoint so, therefore, the original must be wrong). Do you notice that digger is selectively posting only a handful of poor coverages out of the many thousands summarized in the charts? Was he able to quantify the date of the updates s/he's feverishly posting?
Occam's razor would easily favor the FormularyLookup.com numbers and the deceased Franciscan, were he alive to read digger's posts, might suggest that digger go to confession...
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Post by digger on May 6, 2018 20:51:37 GMT -5
Mail handlers, do you know what happened to the US postal service? United Mine workers, you mean the coal mines that have been shut down? hahahaha good ones. Well, first, I was just trying to illustrate the apparent discrepancy between what the online formulary companies report and what actually exists. Second, I would have thought that Akamai and Catepillar at least would have something pretty good -- but what they had didn't cover afrezza. If you have any plans you'd like me to look up, let me know. What I think Mannkind should do is simply start their own afrezza formulary review to document which companies and plans cover afrezza and with what requirements and put that on the new website as well as distribute it to physicians. It's bound to be frustrating to patients to go to all the trouble of getting a prescription only to find out the coverage they were lead to believe exists really doesn't.
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Post by peppy on May 6, 2018 20:54:42 GMT -5
Mail handlers, do you know what happened to the US postal service? United Mine workers, you mean the coal mines that have been shut down? hahahaha good ones. Well, first, I was just trying to illustrate the apparent discrepancy between what the online formulary companies report and what actually exists. Second, I would have thought that Akamai and Catepillar at least would have something pretty good -- but what they had didn't cover afrezza. If you have any plans you'd like me to look up, let me know.
What I think Mannkind should do is simply start their own afrezza formulary review to document which companies and plans cover afrezza and with what requirements and put that on the new website as well as distribute it to physicians. It's bound to be frustrating to patients to go to all the trouble of getting a prescription only to find out the coverage they were lead to believe exists really doesn't. Digger, please look up General Electric. TIA.
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Post by digger on May 6, 2018 21:17:58 GMT -5
Though someone posted the link to another site to look up formulary coverage that seems to have contradictory info. Simple logic tells us they cannot both be accurate. Belief in formularylookup may be more of confirmation bias than Occam. Occam's razor (also Ockham's razor or Ocham's razor; Latin: lex parsimoniae "law of parsimony") is the problem-solving principle that, when presented with competing hypothetical answers to a problem, one should select the one that makes the fewest assumptions. The idea is attributed to William of Ockham (c. 1287–1347), who was an English Franciscan friar, scholastic philosopher, and theologian.
Source: en.wikipedia.org/wiki/Occam%27s_razor
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Go to that site that supposedly contradicts FormularyLookup.com and you'll quickly discover that you can only select a maximum of 5 plans out of approximatey 4,450 commercial plans listed on FormularyLookup. It would be incredibly complex and would likely take you hundreds of hours to go through all states, five plans at a time, then assimilate to assess and compare national coverage with FormularyLookup.
If you're a perpetual skeptic/naysayer, your solution would be to go with the complex solution but THAT would indicate a true confirmation bias (e.g. "Wow, I've confirmed that there is an opposing viewpoint so, therefore, the original must be wrong).
Occam's razor would easily favor the FormularyLookup.com numbers.
And sometimes "buyer beware" is reasonable as well: formularysearch.caremark.com/formularypdf/TuftsByDrug_3.pdfThat officially comes out tomorrow and afrezza is "NC."
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Post by digger on May 6, 2018 21:52:56 GMT -5
Well, first, I was just trying to illustrate the apparent discrepancy between what the online formulary companies report and what actually exists. Second, I would have thought that Akamai and Catepillar at least would have something pretty good -- but what they had didn't cover afrezza. If you have any plans you'd like me to look up, let me know.
What I think Mannkind should do is simply start their own afrezza formulary review to document which companies and plans cover afrezza and with what requirements and put that on the new website as well as distribute it to physicians. It's bound to be frustrating to patients to go to all the trouble of getting a prescription only to find out the coverage they were lead to believe exists really doesn't. Digger, please look up General Electric. TIA. Decisionresources only provides a link to -- wem.optumrx.com/content/odin/en/ge/public/apps/druglist.html -- but to search I have to select a plan and it won't allow me any choices. I tried a couple of other browsers and got the same. The OptumRx list from January -- learn.optumrx.com/content/dam/orx-rxmicros/documents/Formulary%20List%20Ohio%20Health.pdf -- doesn't show afrezza, but that may be out of date and not apply to GE's specific plan.
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Post by mnholdem on May 6, 2018 21:59:19 GMT -5
As could be many of your links?
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Post by digger on May 6, 2018 22:14:40 GMT -5
As could be many of your links? All of them were dated. Most were current as of May 1st or 2nd. I identified the one that was current as of April 17. I'm pretty sure that none were older than April except the Mail Workers and the one from Optum that I quoted in the previous comment.
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Post by nylefty on May 6, 2018 22:19:09 GMT -5
According to formularylookup.com, CVS Caremark administers 1303 prescription drug plans and 93 percent of the plans cover Afrezza. Which leaves 7 percent that do not. So the Tufts plan, which Formularylookup does not yet list, will be joining the 7 percent, making the Mannkind shorts happy. I'm underwhelmed by Digger's latest negative news.
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Post by digger on May 6, 2018 22:33:10 GMT -5
According to formularylookup.com, CVS Caremark administers 1303 prescription drug plans and 93 percent of the plans cover Afrezza. Which leaves 7 percent that do not. So the Tufts plan, which Formularylookup does not yet list, will be joining the 7 percent, making the Afrezza shorts happy. I'm underwhelmed by Digger's latest negative news. Well, try another. How about CVS/Siemens? Listed as tier 3 covered on formularylookup and on decisionresources as tier 3 non-preferred. The DRG site provides a link to --https://www.caremark.com/portal/asset/caremark_drug_list.pdf -- which indicates the list is current for April, 2018. There's apidra, fiasp, humalog, novolog, humulin, but no mention of afrezza that I can find.
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Post by nylefty on May 6, 2018 22:53:40 GMT -5
According to formularylookup.com, CVS Caremark administers 1303 prescription drug plans and 93 percent of the plans cover Afrezza. Which leaves 7 percent that do not. So the Tufts plan, which Formularylookup does not yet list, will be joining the 7 percent, making the Afrezza shorts happy. I'm underwhelmed by Digger's latest negative news. Well, try another. How about CVS/Siemens? Listed as tier 3 covered on formularylookup and on decisionresources as tier 3 non-preferred. Huh? Tier 3 covered, by definition, MEANS non-preferred. Tier 3 non-preferred doesn't rule out coverage -- it just means that it could be covered if the doc did the proper paperwork. Both sites are saying the same thing. You're really reaching with what you seem to think are negative spins.
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Post by nylefty on May 6, 2018 23:09:26 GMT -5
As could be many of your links? All of them were dated. Most were current as of May 1st or 2nd. I identified the one that was current as of April 17. I'm pretty sure that none were older than April except the Mail Workers and the one from Optum that I quoted in the previous comment. I happen to be a GE retiree and OptumRx administers our prescription drug plan. I'm not a diabetic but every so often I check to see if Afrezza is covered by our plan. It is and has been for the past couple of years. However, I see that if I needed Afrezza I would have to pay $45 for a three month supply, and that's UP 28.5 percent (!) from $35, which it was last year. So that's a bit of negative news that Digger could add to his collection.
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Post by celo on May 6, 2018 23:24:31 GMT -5
Here's my random 5: Anthem BCBS 4 Tier Colorado Anthem BlueCross BlueShield Colorado Commercial Tier 3Non-PreferredPAQL90A BlueCross BlueShield Illinois Enhanced BlueCross BlueShield Illinois Commercial Tier 3Non-PreferredPAQL Boeing Boeing Employer Tier 3Non-Preferred Cigna Value 3-Tier Cigna Commercial NCNot Covered Premera Blue Cross 4-Tier Premera Blue Cross Commercial Tier 3Non-Preferred
80% covered at Tier 3
Then I became picky and tried to pick some of the biggest insurers. Stayed away from individual companies that will eventually fall in line with the bigger insurers:
Aetna Premier Aetna Commercial Tier 3Non-PreferredPA Anthem BlueCross California Anthem BlueCross California Commercial Tier 3Non-PreferredPAQL90A Cigna Legacy 3-Tier Cigna Commercial Tier 3Non-PreferredPA CVS Caremark Advanced Control Specialty CVS/Caremark PBM Tier 3Non-Preferred Humana Rx4 Traditional Humana Commercial Tier 3Non-PreferredPAQL
100% Tier 3 Non preferred
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Post by peppy on May 6, 2018 23:36:42 GMT -5
According to formularylookup.com, CVS Caremark administers 1303 prescription drug plans and 93 percent of the plans cover Afrezza. Which leaves 7 percent that do not. So the Tufts plan, which Formularylookup does not yet list, will be joining the 7 percent, making the Mannkind shorts happy. I'm underwhelmed by Digger's latest negative news. nylefty, you know I was thinking about you when I asked for the GE information. Love ya nylefty.
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