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Post by mnholdem on Jul 31, 2018 11:42:27 GMT -5
It will be a few days before I update state and national healthcare coverage tables for Afrezza but, for those who think that United Health does not cover Afrezza, it should be noted that most (86%) of United Health's healthcare plans currently cover Afrezza with Pre-Authorization. As you can see, CVS Caremark Rx and Express Scripts PBM have nearly full unrestricted coverage.
So those who are pushing the agenda that patients not getting insurance coverage is the BIGGEST obstacle facing growth in Afrezza prescriptions, that seems not to be the case but for one notable exception.
National Medicare coverage for Afrezza is still at 0% as of this date. What's up with that, MannKind? |
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Post by awesomo on Jul 31, 2018 12:00:42 GMT -5
Have these numbers changed recently or have they been like this for awhile?
Also, if the obstacle is not insurance coverage, isn't this more problematic as it falls squarely on the endos/patients just not adopting it.
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Post by harryx1 on Jul 31, 2018 12:19:12 GMT -5
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Post by peppy on Jul 31, 2018 12:39:03 GMT -5
It will be a few days before I update state and national healthcare coverage tables for Afrezza but, for those who think that United Health does not cover Afrezza, it should be noted that most (86%) of United Health's healthcare plans currently cover Afrezza with Pre-Authorization. As you can see, CVS Caremark Rx and Express Scripts PBM have nearly full unrestricted coverage.
So those who are pushing the agenda that patients not getting insurance coverage is the BIGGEST obstacle facing growth in Afrezza prescriptions, that seems not to be the case but for one notable exception.
National Medicare coverage for Afrezza is still at 0% as of this date. What's up with that, MannKind? United health 101 plans where as CVS, Caremark have over 1000? UNH_ All with pre-authorization? What is wrong with the way the industry is being represented here? How many plans does UNH really have to earn 12.50 a share? Float, 944.41M UNH First half 2018 performance illustrates strong execution on this path. Compared to last year’s first half, revenues of $111.3 billion, increased 12.7% or $12.5 billion. Adjusted cash flows from operations grew to $7.2 billion and adjusted net earnings grew 28.2% to $6.19 per share. For the full-year, our outlook for adjusted net earnings per share is increasing to a new range of $12.50 to $12.75 per share. And we expect cash flows from operations for 2018 to approach $15.5 billion, which is the upper end of our previous guidance. finviz.com/quote.ashx?t=UNH |
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Post by mytakeonit on Jul 31, 2018 14:09:02 GMT -5
Sure seems that Dr. Kendall is working it and the endos are aware of what afrezza can do. But, it takes about a month and a half before the endos start to see the results from their first patients. And yes, it does snow in Hawaii and the snowball will start it's roll by the end of August.
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Post by peppy on Jul 31, 2018 19:03:30 GMT -5
Who does prior approval for medicare? all the rest are step therapy. Thanks Harry.   |
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Post by peppy on Jul 31, 2018 19:20:38 GMT -5
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Post by peppy on Jul 31, 2018 19:31:54 GMT -5
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Post by peppy on Jul 31, 2018 20:10:17 GMT -5
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Post by brotherm1 on Jul 31, 2018 20:12:36 GMT -5
🏒
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Post by pguererro on Jul 31, 2018 21:36:25 GMT -5
Once again I’ll give you reality vs theory. Afrezza coverage is bad. It’s especially bad with UHC/Optum Rx. I wish it was not the case, but UHC will not cover Afrezza even after a PA AND an appeal letter from prescriber. Just dealt with 2 cases today. I have the same formula grids u posted but they aren’t reality. Again, I wish Afrezza was covered by more plans but reality is even after a PA and many times an appeal letter patients still can’t get Afrezza.
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Post by pguererro on Jul 31, 2018 21:43:42 GMT -5
Wait...UHC will cover Afrezza if the patient goes to a psychiatrist and gets clinically diagnosed with needle phobia. I’m not making this up. It is a stipulation in UHC’ s approval guidelines. Again, dealt with a case today where they were requesting that documentation. Reality vs Propoganda.
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Post by pguererro on Jul 31, 2018 21:47:39 GMT -5
MNHOLDEM. Your post might be the most incorrect information I’ve ever seen posted on this board.
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Post by peppy on Jul 31, 2018 22:10:55 GMT -5
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Post by chc on Jul 31, 2018 23:54:02 GMT -5
Pgue said, Once again I’ll give you reality vs theory. Afrezza coverage is bad. It’s especially bad with UHC/Optum Rx. I wish it was not the case, but UHC will not cover Afrezza even after a PA AND an appeal letter from prescriber. Just dealt with 2 cases today. I have the same formula grids u posted but they aren’t reality. Again, I wish Afrezza was covered by more plans but reality is even after a PA and many times an appeal letter patients still can’t get Afrezza.
My Wife is getting Afrezza now in her 2nd year through OptumRx and we have UHC Group Medicare Advantage (PPO) plan. It did require PA but her endocronologist was willing to appeal the initial denial and it was approved. No problem getting it since then.
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