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Post by shawnonafrezza on Jul 10, 2020 8:37:38 GMT -5
Agreed. But in the end someone is paying in most first world countries and it's either private insurance or the government thus they'll have say on what you get. I'm not sure how to get around that unless it's all out of pocket which if it is then Afrezza would be a non started for even the most die hard. Eagle Pharmacy: Cash Pay (no insurance), $99 to $199 per box www.insulinsavings.comIf I was diabetic, I'd be willing to pay that just so I could live a reasonably normal life. That’s a few hundred a month then. Not sure many can afford that. |
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Post by agedhippie on Jul 10, 2020 8:43:26 GMT -5
... And, oh yeah, I meant to say I agree, generally with most everything that’s been said on this thread about Afrezza being superior, but it’s on Mannkind management to prove it and to get insurance companies to cover it. And, I assume they will, just as soon as they can, which is a matter of profit... ^^^This. Insurance companies don't want change. They fought pumps and CGMs tooth and nail. The only reason CGMs are available today is because there was a 6 month 300 person trail funded by the JDRF, and yes it had a control arm so they could prove it was the CGM that was responsible. This changed the SoC and that drove Medicare to start to cover CGMs for Type 1s a year later, the insurers were forced to follow. This is a very simple equation. Without a large scale trial to quantify the improvement do not expect insurers to increase their costs to accommodate Afrezza. |
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Post by agedhippie on Jul 10, 2020 8:50:37 GMT -5
Eagle Pharmacy: Cash Pay (no insurance), $99 to $199 per box www.insulinsavings.comIf I was diabetic, I'd be willing to pay that just so I could live a reasonably normal life. That’s a few hundred a month then. Not sure many can afford that. There is the cost of basal insulin on top of that. Novo Nordisk are providing two packs of pens (Tresiba and Fiasp for example) for $99. That's a month of supplies (two months for me). If you are uninsured that's a good deal. Sanofi and Lilly are doing the same. |
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Post by shawnonafrezza on Jul 10, 2020 9:08:28 GMT -5
Let's actually contextualize all this too as good to see it because saying 99 a month isn't the whole story. It's a cheap shot overlook.
Sam who you all know and love goes through 2 boxes a month per a recent post on FB, he'd like more. That's $200 a month. Many use more, let's put them at 360 cartridges or $400 a month. That's $2400 and $4800 a year respectively. The median US income is $60k, so let's say $45k after taxes. That's 5 to 10% of your income on just Afrezza because to do it best you need a CGM and we still haven't touched getting a basal insulin.
We're not even getting in to dollar pre effective unit. A vial, 1000U, of RAA is now $30 in many places. Afrezza 4U is about 2.5U effective so a 90 pack of 4U is 225 units effective.
sr71, while the comment about what you would spend is nice it's, to me, quite grating because I hope you never have to know. If you think Afrezza puts you to the point of "reasonably normal" then you really don't understand this disease.
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Post by prcgorman2 on Jul 10, 2020 15:30:05 GMT -5
Interesting coments in this thread about insurance, pricing, trials, and greed. I agree that corporations should be more like successful people who generally give back to the community in some form of philanthropic investment of time, labor, and money. It’s one of the reasons I iike Target. Check out their corporate charter. They’ve also been a good investment (and because I’m not as shrewd as many, also a too small proportion of my portfolio). But I do find issue with the generalization of corporations as “greedy”. The profit motive drives competition and innovation which benefit the consumer. Where there is no profit motive there is little incentive to be efficient or produce a quality result. And I think those are the two main reasons why I’m a conservative voter. The government is inherently inept at anything where a corporation based on profit motive can compete with only one obvious exception I can think of which is war and operating a national military. Toll roads and rail roads tend to be much better operated and maintained, generally, than roads and bridges maintained by taxes. The issue there is where there is no profit, people in rural areas are then often underserved, so even my arguement is not unassailable, but in general, people should be very glad of corporations and profit motives and never forget it was the rise of mercantilism which established the New World and gave rise to a middle class. And, oh yeah, I meant to say I agree, generally with most everything that’s been said on this thread about Afrezza being superior, but it’s on Mannkind management to prove it and to get insurance companies to cover it. And, I assume they will, just as soon as they can, which is a matter of profit... I agree with much of what you state, here. BUT, Health Insurance is one of the few industries that I would disagree with you on. Innovation in Insurance comes in the form of earning more for doing less for more people. That means, often, the profit comes at the expense of the consumer, and, not just financially - to their physical and mental health, well being, quality of life, family dynamics, etc. The ramifications of being underserved by insurance are manifold. It's not the same when one gets mistreated by insurance, as when one faces the poor quality involved in part recall or warranty issue on a vehicle. Therefore, the exceeding profit in insurance is undeserved - and, the greater shame is that we all pay for it. This could be one of the reasons Warren Buffet has pledged so much of his wealth to charity upon his death. Maybe, in some cases, he feels the money was too easily earned? I don't know WB, personally, so I won't presume to know his mind, but it is interesting to ponder the question. Sigh. It’s hard to argue with you because I tend to agree. But I don’t begrudge the insurance companies a profit that the state of over regulation practically guarantees. My health care insurance is pure fecal matter as compared to what I enjoyed 30 years ago. I will not for an instant accept that it simply costs more to provide health care. I agree that it does cost more but not at the level of erosion I’ve experienced. It angers me because I know baked into the current high cost is unregulated greed - by plaintiff seeking attorneys. One of my uncles was a teaching OB-GYN at UCSF. And he told me 20+ years ago that malpractice insurance was killing the medical profession. You could blame the insurance companies again, but malpractice insurance is not health care insurance, it’s business continuity insurance with different risk models. Over-regulation of health insurance by state-run insurance regulators basically guarantees reduced competition. Look at car insurance over the last same 30 years. Intense competition, and reduced costs for improved coverage. So, in my mind, what we need is to end state-level regulation of insurance companies, and torte reform to put limits on liabilities to reduce the egregious profits enjoyed by greedy (and I mean greedy) plaintiff-seeking attorneys. |
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Post by cretin11 on Jul 10, 2020 23:47:45 GMT -5
prc, the malpractice story is propaganda, effectively spun by the insurance lobby. I used to believe it hook, line and sinker. Suffice it to say the evidence doesn’t hold up. Tort reform measures in every state (TX, GA, many others) have clearly proven to NOT reduce malpractice premiums. Rather, they simply increase insurance exec bonus amounts. I know so many doctors who have explained this to me as they too fell for the “litigation problem” hoax.
Like you, I’ve seen the quality of coverage decline. Insurance is an incredibly profitable business, that is a constant.
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Post by prcgorman2 on Jul 11, 2020 11:03:51 GMT -5
prc, the malpractice story is propaganda, effectively spun by the insurance lobby. I used to believe it hook, line and sinker. Suffice it to say the evidence doesn’t hold up. Tort reform measures in every state (TX, GA, many others) have clearly proven to NOT reduce malpractice premiums. Rather, they simply increase insurance exec bonus amounts. I know so many doctors who have explained this to me as they too fell for the “litigation problem” hoax. Like you, I’ve seen the quality of coverage decline. Insurance is an incredibly profitable business, that is a constant. Incredibly profitable businesses tend to invite competition (and sometimes corruption to squelch competition). Where’s the competition? |
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Post by matt on Jul 15, 2020 7:24:47 GMT -5
Incredibly profitable businesses tend to invite competition (and sometimes corruption to squelch competition). Where’s the competition? That is certainly a true statement, but less so in a highly regulated industry. For a competitor to enter the medical malpractice market they would need to have a reasonable expectation that they could make money which in turn is conditioned on having the databases necessary to forecast future loss claims. Those are not easy hurdles to jump over. There used to be many more malpractice carriers and insurance used to be relatively inexpensive. My wife practiced as a dentist and her first year premium after leaving the army was just $75 (this is about 1983) for an unlimited occurrences policy (an occurrence policy covers any event that causes a claim during the terms regardless of when a suit is brought). Over the next few years her initial carrier completely exited the business, all the remaining carriers moved from occurrence policies to claims made policies (which covers only claims made during the policy period, and provides no future protection without a separate and expensive "tail" policy), and her premium increased to $4,000 by 1992 despite zero actual or even threatened claims. A more than 50-fold increase in annual premium in ten years while insurers are exiting the market does not sound like this is a problem based on lack of competition. At the end of 1992 she sold her practice when we moved overseas for a time, but I always wonder what her premiums would be today had she kept practicing. |
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Post by prcgorman2 on Jul 15, 2020 15:48:32 GMT -5
Incredibly profitable businesses tend to invite competition (and sometimes corruption to squelch competition). Where’s the competition? That is certainly a true statement, but less so in a highly regulated industry. For a competitor to enter the medical malpractice market they would need to have a reasonable expectation that they could make money which in turn is conditioned on having the databases necessary to forecast future loss claims. Those are not easy hurdles to jump over. There used to be many more malpractice carriers and insurance used to be relatively inexpensive. My wife practiced as a dentist and her first year premium after leaving the army was just $75 (this is about 1983) for an unlimited occurrences policy (an occurrence policy covers any event that causes a claim during the terms regardless of when a suit is brought). Over the next few years her initial carrier completely exited the business, all the remaining carriers moved from occurrence policies to claims made policies (which covers only claims made during the policy period, and provides no future protection without a separate and expensive "tail" policy), and her premium increased to $4,000 by 1992 despite zero actual or even threatened claims. A more than 50-fold increase in annual premium in ten years while insurers are exiting the market does not sound like this is a problem based on lack of competition. At the end of 1992 she sold her practice when we moved overseas for a time, but I always wonder what her premiums would be today had she kept practicing. Good points Matt. Thank you for sharing. I think you helped underscore the argument for limits on liability. Veternary care would not seem to be a particularly risky business (for humans), but the voluntary exit of insurers and dramatic rise in premiums and reduction in coverage all point to abuse of the legal system from plaintiff-seeking attorneys. |
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Post by cretin11 on Jul 15, 2020 18:32:53 GMT -5
That is certainly a true statement, but less so in a highly regulated industry. For a competitor to enter the medical malpractice market they would need to have a reasonable expectation that they could make money which in turn is conditioned on having the databases necessary to forecast future loss claims. Those are not easy hurdles to jump over. There used to be many more malpractice carriers and insurance used to be relatively inexpensive. My wife practiced as a dentist and her first year premium after leaving the army was just $75 (this is about 1983) for an unlimited occurrences policy (an occurrence policy covers any event that causes a claim during the terms regardless of when a suit is brought). Over the next few years her initial carrier completely exited the business, all the remaining carriers moved from occurrence policies to claims made policies (which covers only claims made during the policy period, and provides no future protection without a separate and expensive "tail" policy), and her premium increased to $4,000 by 1992 despite zero actual or even threatened claims. A more than 50-fold increase in annual premium in ten years while insurers are exiting the market does not sound like this is a problem based on lack of competition. At the end of 1992 she sold her practice when we moved overseas for a time, but I always wonder what her premiums would be today had she kept practicing. Good points Matt. Thank you for sharing. I think you helped underscore the argument for limits on liability. Veternary care would not seem to be a particularly risky business (for humans), but the voluntary exit of insurers and dramatic rise in premiums and reduction in coverage all point to abuse of the legal system from plaintiff-seeking attorneys. Incorrect conclusion but you’re not alone in that misconception. I once also believed it. |
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Post by prcgorman2 on Jul 15, 2020 20:56:13 GMT -5
Good points Matt. Thank you for sharing. I think you helped underscore the argument for limits on liability. Veternary care would not seem to be a particularly risky business (for humans), but the voluntary exit of insurers and dramatic rise in premiums and reduction in coverage all point to abuse of the legal system from plaintiff-seeking attorneys. Incorrect conclusion but you’re not alone in that misconception. I once also believed it. I wish I could believe you, but your arguement that insurance companies exited the business because they are greedy seems flawed on the face of it. And your opinion that their absence from the marketplace or high premiums for protection are a “hoax” and that they’re using lobbying to cover their tracks is not persuasive. Given all of the TV, radio, billboard, and other advertising I’m subjected to on a daily basis from lawyers promising to help me get piles of money if I retain them to sue somebody, I’m convinced tort reform has been anemic to non-existent. And why should I expect tort reform would be effective? Who is writing the tort reform legislative proposals? The foxes in the henhouse of course. |
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Post by falconquest on Jul 15, 2020 21:17:04 GMT -5
Please don't tell me that you believe coporations aren't greedy and act in their own interests.
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Post by sellhighdrinklow on Jul 15, 2020 21:29:21 GMT -5
Let's actually contextualize all this too as good to see it because saying 99 a month isn't the whole story. It's a cheap shot overlook. Sam who you all know and love goes through 2 boxes a month per a recent post on FB, he'd like more. That's $200 a month. Many use more, let's put them at 360 cartridges or $400 a month. That's $2400 and $4800 a year respectively. The median US income is $60k, so let's say $45k after taxes. That's 5 to 10% of your income on just Afrezza because to do it best you need a CGM and we still haven't touched getting a basal insulin. We're not even getting in to dollar pre effective unit. A vial, 1000U, of RAA is now $30 in many places. Afrezza 4U is about 2.5U effective so a 90 pack of 4U is 225 units effective. sr71, while the comment about what you would spend is nice it's, to me, quite grating because I hope you never have to know. If you think Afrezza puts you to the point of "reasonably normal" then you really don't understand this disease. Afrezza puts me feeling more reasonably normal than any other insulin therapy I tried in my 43 years of being Type 1. Fact. |
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Post by cretin11 on Jul 15, 2020 21:54:50 GMT -5
Incorrect conclusion but you’re not alone in that misconception. I once also believed it. I wish I could believe you, but your arguement that insurance companies exited the business because they are greedy seems flawed on the face of it. And your opinion that their absence from the marketplace or high premiums for protection are a “hoax” and that they’re using lobbying to cover their tracks is not persuasive. Given all of the TV, radio, billboard, and other advertising I’m subjected to on a daily basis from lawyers promising to help me get piles of money if I retain them to sue somebody, I’m convinced tort reform has been anemic to non-existent. And why should I expect tort reform would be effective? Who is writing the tort reform legislative proposals? The foxes in the henhouse of course. Sorry prc, you’re too far off the mark on this for a quick tutorial. It’s a complicated issue, the info is available if you care to research it. |
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Post by prcgorman2 on Jul 15, 2020 23:17:26 GMT -5
Post a link.
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