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Post by traderdennis on Jan 4, 2015 18:03:26 GMT -5
Hi JPG, I went in late November and saw a KP Endocrinologist. I set up the appointment to discuss my D2 treatment options for gaining more control as my A1c had risen. During the conversation I asked about the availability of Afrezza when it would come out during Q1 2015. During the discussion, the doc said they have a regular meeting of the KP endo staff to discuss current and future protocols on treatment. I was told as a department KP socal voted unanimously to not write Afrezza for its patients. I had come into the appointment willing to pay full retail price to get a RX, but my endo will not write it even under those circumstances. His number one concern was placing a hormone into the lungs. The endo also wanted to see a large multi year study before even considering it. The endo also stated that Adcom was too quick in its approval. YMMV. Exubra was not a reason to deny writing scripts. As for myself I will look into different options once I hit open enrollment in spring 2015. I have had other issues with KP Socal, it will come to economics in the end. For those whom are not familiar with KP, there really is very little physician autonomy within the HMO organization. When a company or individual signs up for KP care in exchange for substantially lower premiums, they manage care to very specific standards and protocols. KP Socal does have a decent reputation for being aggressive in preventing and treating ongoing diseases, but extremely conservative with both new meds and non generic meds. KP is one of the largest health care providers in the So Cal area. If it were my choice, I would not be with KP, but my employer has chosen this as the primary care option for its employees and families. At the time I signed up last year it the right choice. My competing plans were very basic in nature so I continued to stay with KP. KP has a very rigid process of not approving non generic drugs in most immediate non life threatening cases. Hi Traderdennis, You said: I am long in MNKD - 30 2016 leaps, but 10 short term Jan 9 contracts. I tried to get them to write a script for me, the endo would not consider it. How would anyone prescribe a medication that isn't even available? I don't get that. I also have not often seen a whole department say that hey will not collectively prescribe something by vote? To me that goes against every principle of physician autonomy I have seen over the years. Again very unusual? JPG |
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Post by jpg on Jan 4, 2015 18:20:09 GMT -5
Hi JPG, I went in late November and saw a KP Endocrinologist. I set up the appointment to discuss my D2 treatment options for gaining more control as my A1c had risen. During the conversation I asked about the availability of Afrezza when it would come out during Q1 2015. During the discussion, the doc said they have a regular meeting of the KP endo staff to discuss current and future protocols on treatment. I was told as a department KP socal voted unanimously to not write Afrezza for its patients. I had come into the appointment willing to pay full retail price to get a RX, but my endo will not write it even under those circumstances. His number one concern was placing a hormone into the lungs. The endo also wanted to see a large multi year study before even considering it. The endo also stated that Adcom was too quick in its approval. YMMV. Exubra was not a reason to deny writing scripts. As for myself I will look into different options once I hit open enrollment in spring 2015. I have had other issues with KP Socal, it will come to economics in the end. For those whom are not familiar with KP, there really is very little physician autonomy within the HMO organization. When a company or individual signs up for KP care in exchange for substantially lower premiums, they manage care to very specific standards and protocols. KP Socal does have a decent reputation for being aggressive in preventing and treating ongoing diseases, but extremely conservative with both new meds and non generic meds. KP is one of the largest health care providers in the So Cal area. If it were my choice, I would not be with KP, but my employer has chosen this as the primary care option for its employees and families. At the time I signed up last year it the right choice. My competing plans were very basic in nature so I continued to stay with KP. KP has a very rigid process of not approving non generic drugs in most immediate non life threatening cases. So I guess it wasn't the endos themselves deciding the policy then? I just can't imagine a large group of MDs ever voting on anything unanimously. We can't even agree on the simplest of things. Never mind something like prescribing a new drug in a binary manner. Even the biggest skeptical endos would occasionally come up with a patient that could do better with Afrezza. It is true that Afrezza could be seen as a very real danger to many endos diabetic management practice. Primary care MDs will start being much more autonomous with initiation of insulin and refer less to endos. I think HMOs will eventually see this as a potential cost saving? Specialists like non generic drugs are often seen as simply a cost burden till proven otherwise. Good luck finding a better way to control your diabetes. JPG |
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Post by Deleted on Jan 4, 2015 18:25:53 GMT -5
I'm not disputing what you were told, Dennis, but I don't believe a word of what that doc was shoveling you. It makes no sense, and when you glance at the list of new drugs recently on the market on their formulary, it makes even less sense.
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Post by rch51 on Jan 4, 2015 19:48:02 GMT -5
I was given a very similar line, virtually word for word, by my Kaiser No. Calif. Endo four months ago - after FDA approval, but before Sanofi partnership announcement. I asked if Afrezza would be available for Kaiser patients and her reply was curt and rather testy, stating that Afrezza hadn't been tested enough and could cause Pulmonary disease and she wouldn't touch the drug for 5 years. She said she would be surprised if Kaiser approved it for prescription. Her words to me were almost verbatim what the shorts have been spewing through their online blogger proxies for months. In other words, pure BS. I assumed she was listening to the sales rep competition and reading SA, MF, etc. BTW - I changed Endos a few weeks later.
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Post by Deleted on Jan 4, 2015 20:17:35 GMT -5
I changed Endos a few weeks later. Hopefully the new endo doesnt belong to Kaiser No. Calif......change in insurance plan? |
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Post by robsacher on Jan 4, 2015 21:08:34 GMT -5
I suppose with any new paradigm there will always be those early adopters and those who choose to wait and see.
I have a feeling that the public demand for Afrezza will eventually outweigh many endocrinologist's wait and see attitude. But, it may take longer for Afrezza to gain market share, maybe an additional year or two.
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Post by dreamboatcruise on Jan 5, 2015 3:53:08 GMT -5
I am long in MNKD - 30 2016 leaps, but 10 short term Jan 9 contracts. I tried to get them to write a script for me, the endo would not consider it. Why did he say he wouldn't consider it? |
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Post by pmikeks on Jan 5, 2015 9:19:53 GMT -5
It appears to me we have a couple new posters that are shorts trying to throw a bunch of they told me this or that. AF wannabes if you will. I'm type 2 and if a moron doctor was that emphatic that they wouldn't write scripts I'd tell them they are morons followed by "go forth and multiply" then find a new doctor. Interesting the new naysayers just now show up. It appears their comments have others liking them but when you look, those are newbies too. People making stuff up is getting irritating although shorts have been doing it for years. Soon they can choke on it.
Until they come out with actual pricing and not speculation I don't see insurance companies committing to more favorable tiers of coverage.
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Post by liane on Jan 5, 2015 9:31:42 GMT -5
pmikeks,
I don't get that sense. Kaiser is known to be a tightly run HMO in terms of cost-containing. They may want to put their collective heads in the sand for now and think it's cheaper (they'll say safer) not to prescribe Afrezza. But that will prove foolhardy if they see the diabetics are better managed and more compliant if they take Afrezza.
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Post by traderdennis on Jan 5, 2015 11:04:37 GMT -5
Bottom line was my endo was vehemently against placing a hormone into the lungs. Injection discomfort < potential damage to lungs.
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Post by gamblerjag on Jan 5, 2015 11:11:33 GMT -5
My Endo said your Endo got his license revoked; Go MNKD... 2015 should be a great year; however I believe the bigger increase in pps will be 2016.
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Post by traderdennis on Jan 5, 2015 11:15:03 GMT -5
Hi PM, Yes I am new to MNKD boards, but I post on stocktwits under the same name trader_dennis. I have been very positive up to November 2014 about Mannkind if you would like to go back in the history. I am more neutral today and do plan to scale out if this breaks over $7.00 in the next month or two. I am long 5 5's 5 5.50's Jan 9th. 30 7's and 10's Jan 2016 and a 100 shares in a third account. As I said, long FUD is just as bad as short fud. Not to mention KP released its 2015 today and Afrezza is not on the list. I posted the approved diabetic drugs today.  Not sure how to post images. URL postimg.org/image/meuvrp0y3/Attachment Deleted |
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Post by traderdennis on Jan 5, 2015 11:16:21 GMT -5
The thread turned into KP approving Afrezza on their formulary and that is not true.
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Post by rch51 on Jan 5, 2015 11:26:20 GMT -5
Well, I had no choice and chose another No Calif Kaiser Endo but have decided to go with my newly selected PCP and skip the Endo altogether.
Unclear as to what he'll do, but he doesn't have the pre-judgment or clear bias that my Endo had. In fact he really liked what he has heard so far about Afrezza.
My Diabetes is in early stages and thus far I've been able to control it reasonably well with lifestyle changes. My A1c has slowly climbed to close to 7, which is the threshold for pharmaceutical treatment at Kaiser. It's not clear if I'm ready to take the next step, which in my case is Metformin. My desire to try Afrezza has to do with my post-meal excursions. I do experience those, but not severe. If I were to control those excursions with Afrezza I'm sure my overall Diabetic health would be excellent and perhaps close to normal physiology.
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Post by suebeeee1 on Jan 5, 2015 11:47:25 GMT -5
I also have Kaiser. While they DO have a limited Formulary and they want all prescriptions filled within their own pharmacies, it is possible to get physicians to write scripts for drugs not on thier formulary. You will have to pay full price for it at an alternative pharmacy. This will be a major stumbling block for most people. I have a prescription that falls into this category so I know they will do it. As a long term vegetarian, I do not want drugs that are made from animal products. For one of the meds I take on a regular basis, the only one that Kaiser stocked in their pharmacy was one that fell into this category. After explaining this to my doc, he wrote the script and I now pay full price on the outside.
Clearly, I am very sorry to see that they will not be covering Afrezza this year. My husband is a diabetic, and while he is well controled with oral meds alone, we all know what happens over time. If injectible insulin becomes part of his maintenance routine, we will ask for the script anyway or find a doc that will prescribe it and pay for both the doc and the script on the outside. He does not want to inject if there is an option. And, there IS an option.
Most people, unfortunately, do not have the resources to do this.
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Hi Traderdennis,
