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Post by dreamboatcruise on May 7, 2018 0:14:10 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. Well then what’s stopping you from giving us the URL and telling us what the contradictions are. I did earlier in this very thread.
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Post by dreamboatcruise on May 7, 2018 0:30:22 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). 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...
You can sort the plans by their size. And pretty simple to search for a given name like UnitedHealth. So if one selects the top 5 largest UnitedHealth plans and get very different results from the 89% "covered" of formularylookup... it seems there is a discrepancy. I won't claim to know WHY there is. I'm just pointing out that one might want to take this with caution. There is that discrepancy, there is the fact that people (including myself) have formularies on their health plan sites that are inconsistent with it and there is the fact that formularylookup previously had major erroneous data that went up and was then corrected. You can believe whatever you wish. Lord knows most here have been believing in things for years upon years that turn out to not be true. Perhaps your "faith" will finely come through. I wish it to be true this time... as I always do. I simply separate wishes from factual evidence. I'd give it a 40/60 probability. You of course feel you have to 100% believe it, lest you blaspheme your MNKD religion.
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Post by digger on May 7, 2018 7:26:36 GMT -5
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. Yes, I know that both sites say the same thing, and both sites appear to be wrong. That's why I included the link to the most recent updated list which shows CVS/Siemens listing every diabetic drug except afrezza -- to show that you cannot trust either formulary site.
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Post by golfeveryday on May 7, 2018 7:38:30 GMT -5
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. Yes, I know that both sites say the same thing, and both sites appear to be wrong. That's why I included the link to the most recent updated list which shows CVS/Siemens listing every diabetic drug except afrezza -- to show that you cannot trust either formulary site. Must still be a ‘glitch’ on formularylookup. 👍🏻 Appears the Covered Unrestricted Access has gone up to 48%. Only glitches cause coverage to go up. 😜 Covered Restricted is 46% and Not Covered is 6%. Enjoy your weeks ahead.
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Post by brotherm1 on May 7, 2018 8:02:10 GMT -5
I wonder if MNKD is now working with these companies to help keep their websites updated
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Post by digger on May 7, 2018 8:08:21 GMT -5
I wonder if MNKD is now working with these companies to help keep their websites updated I think my own idea is best -- Mannkind should start monitoring insurance coverage and start putting it on the afrezza website with regular updating. It would give patients immediate feedback on their situation and prevent the frustration of going to the trouble of getting a prescription and then finding out they can't afford it.
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Post by dh4mizzou on May 7, 2018 8:41:42 GMT -5
I wonder if MNKD is now working with these companies to help keep their websites updated I think my own idea is best -- Mannkind should start monitoring insurance coverage and start putting it on the afrezza website with regular updating. It would give patients immediate feedback on their situation and prevent the frustration of going to the trouble of getting a prescription and then finding out they can't afford it.
Based on what you've posted in the thread I think you should offer your services to MNKD. I'm sure they'd be happy to have you go through EVERY Plan in the U.S. and document Afrezza coverage.
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Post by digger on May 7, 2018 9:26:40 GMT -5
I think my own idea is best -- Mannkind should start monitoring insurance coverage and start putting it on the afrezza website with regular updating. It would give patients immediate feedback on their situation and prevent the frustration of going to the trouble of getting a prescription and then finding out they can't afford it.
Based on what you've posted in the thread I think you should offer your services to MNKD. I'm sure they'd be happy to have you go through EVERY Plan in the U.S. and document Afrezza coverage.
There's only about 4,500 or less. One person could easily do 25 an hour or a complete run in about 3 weeks. And then everyone would know for certain exactly who covers what and under what conditions and no one would have to depend on websites of questionable accuracy. Physicians, patients and and investors would benefit. I see no down side, in fact.
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Post by mytakeonit on May 7, 2018 15:09:51 GMT -5
Told my wife that HMSA Akamai was listed on proboards as not listing Afrezza on their formulary. She said that they use CVS's formulary and sales of Afrezza is low right now. When sales pick up then it'll show up. So ... next week isn't too long to wait
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Post by agedhippie on May 7, 2018 15:17:13 GMT -5
I think my own idea is best -- Mannkind should start monitoring insurance coverage and start putting it on the afrezza website with regular updating. It would give patients immediate feedback on their situation and prevent the frustration of going to the trouble of getting a prescription and then finding out they can't afford it.
Based on what you've posted in the thread I think you should offer your services to MNKD. I'm sure they'd be happy to have you go through EVERY Plan in the U.S. and document Afrezza coverage.
Isn't that what you have interns for?
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Post by dreamboatcruise on May 8, 2018 8:58:08 GMT -5
Formularylookup is now showing Medicare as 100% not covered.
Still think something doesn't seem right with this site's data.
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Post by bill on May 9, 2018 12:48:26 GMT -5
Formularylookup is now showing Medicare as 100% not covered. Still think something doesn't seem right with this site's data. dreamboatcruise This site may be useful for sussing out Afrezza Medicare coverage: 2018 PDP Drug Finder
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Post by mango on May 9, 2018 13:09:38 GMT -5
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...
You can sort the plans by their size. And pretty simple to search for a given name like UnitedHealth. So if one selects the top 5 largest UnitedHealth plans and get very different results from the 89% "covered" of formularylookup... it seems there is a discrepancy. I won't claim to know WHY there is. I'm just pointing out that one might want to take this with caution. There is that discrepancy, there is the fact that people (including myself) have formularies on their health plan sites that are inconsistent with it and there is the fact that formularylookup previously had major erroneous data that went up and was then corrected. You can believe whatever you wish. Lord knows most here have been believing in things for years upon years that turn out to not be true. Perhaps your "faith" will finely come through. I wish it to be true this time... as I always do. I simply separate wishes from factual evidence. I'd give it a 40/60 probability. You of course feel you have to 100% believe it, lest you blaspheme your MNKD religion. I am of no religion and I do not worship because what I believe in does not require those things. I believe in love and it is the truth and I know this because I understand it and I can't give up on it. If I give up on love I give up on hope and I give up on life. I had to experience having this for myself and through that I understood what it means to believe. It means not giving up on the love you believe in because you know it is true, even when those you love give up on you.
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