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Post by robsacher on Mar 27, 2015 14:48:54 GMT -5
I am sorry to place this here because I know it's in the wrong thread but I do not know how to create a thread. Perhaps liane could do this? I read a comment in a SA article in which the commenter states what is happening with his hospital network in regard to Afrezza. It's great news and I posted below. Can someone create a link here of hospital networks as Afrezza becomes part of their therapy procedure? It could be important information.
Thanks.
"Hey Guys - I think this is interesting - I talked to two large hospital networks, both with multiple endocrinologist each, to discuss my referral for Afrezza. My PCP was happy to do it even though it was not really the next step in the established standard of care. I got virtually the same explanation from BOTH of them. I'm paraphrasing: "We are still in the process of training the staff and installing the required equipment. We are booking appointments for Afrezza referrals starting in May. We are on track to start writing prescriptions for Afrezza on May 1" ( the other one said end of April/beginning of May). This is from two large hospital networks in my state. I'm sure there are similar ramp up issues all over. Guys - Goldman and the others are not idiots. They are bashing the stock now while they can drive the price down. It's quite possible that the numbers will surge this summer if my experience is any indication. Just FYI."
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Post by savzak on Mar 27, 2015 15:46:00 GMT -5
I apologize in advance for my ignorance but I don't know what this means or what the ramifications are. I live in a rural state and I'm not even sure what a hospital network is. I assume it's a bunch of hospitals under one ownership or management? Also, since diabetics are prescribed their medications by their personal physicians, what are the ramifications of a hospital network in this context? What does the author mean when he says, that they are booking Afrezza referrals in May? I don't understand what he means by an "afrezza referral".
Again, I'm sorry if I'm the only one here completely uninformed on these matters but I look forward to being educated! |
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Post by Deleted on Mar 27, 2015 16:19:28 GMT -5
hospital networks could be hospital network that has multiple locations and number of physicians.. they might have to come to a conclusion after having their educational conferences/discussion that Afrezza is a better meal time insulin and would have started to prefer prescribing it?
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Post by savzak on Mar 27, 2015 16:41:20 GMT -5
hospital networks could be hospital network that has multiple locations and number of physicians.. they might have to come to a conclusion after having their educational conferences/discussion that Afrezza is a better meal time insulin and would have started to prefer prescribing it? I think almost all diabetics who are admitted to a hospital for any reason would bring and use their own medicines. In the event they forget them or run out of them while they are admitted, I would think that they'd refill their existing prescription at the hospital pharmacy. I don't see too much opportunity or reason for hospitalized diabetics to be changing their diabetic medication while admitted to the hospital. |
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Post by Deleted on Mar 27, 2015 17:02:09 GMT -5
hospital networks could be hospital network that has multiple locations and number of physicians.. they might have to come to a conclusion after having their educational conferences/discussion that Afrezza is a better meal time insulin and would have started to prefer prescribing it? I think almost all diabetics who are admitted to a hospital for any reason would bring and use their own medicines. In the event they forget them or run out of them while they are admitted, I would think that they'd refill their existing prescription at the hospital pharmacy. I don't see too much opportunity or reason for hospitalized diabetics to be changing their diabetic medication while admitted to the hospital. hospital networks are not ONLY inpatient services , but have many out patient clinics.. example : atlanticare.org/index.php/locations-homewww.barnabashealth.org/Our-Locations.aspx |
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Post by lynn on Mar 27, 2015 20:01:12 GMT -5
I work for Kaiser (our Pharmacist has been on vacation ) & prior to that I had a month off . Someone here & I won't name him unless he wants to acknowledge himself informed me of a tip , there was supposed to be a high level meeting sometime this month re: adding Afrezza to formulary . I saw it on our formulary a while back but have seen some here who have Kaiser not being able to get it . I'll do some digging when the opportunity presents itself  They need need member retention & are into preventative health so it's only a matter of time . This is the only time I wish I worked with adults so I'd run into more endocrinologists . Lynn |
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Post by Deleted on Mar 27, 2015 21:27:59 GMT -5
Many hospitals will have diabetes clinics inside them. These are outpatient clinics where the patient can meet with their physician, dietician, diabetes nurse educator etc.
I believe what you are referring to specifically is situations where one healthcare entity has multiple hospitals and clinics all operating under one name. In this case, it would be referred to as an IDN aka: Integrated Delivery Network.
I am not sure as to how ACOs aka:Accountable Care Organizations are evaluated and compensated but in the future, a portion of the money they receive will be based on patient outcomes as opposed to the rapidly dying fee for service model.
Hospitals are also on the hook for patient readmissions if the readmit was due to discharging the patient too early or the hospital not having addressed the patient's medical condition properly the first time. That is, readmitted patients under this scenario are not billed, nor is their insurer billed for the admission, it is on the hospital's dime.
Keep in mind that it is not uncommon for people with diabetes to end up in the the emergency room. I am not sure at this point in time if such a patient, who is under the care of an Integrated Delivery Network would be in a situation where their health insurer would try to deny or reduce the reimbursement to the ER because the insurer may be of the belief that had the patient received proper care, they would not have had to go to the ER. I suspect, although I do not know for fact that many people with diabetes who end up in the ER due so because of a hypoglycemic event.
Electronic medical records, big data and tools to monitor patient compliance (continuous glucose monitors made by Dexcom or Medtronic, FitBit to measure activity) will shed much light on the situation.
Should Afrezza prove to reduce A1c and incidencs of hypoglycemia significantly when compared to other Rx therapies currently on the market, rest assured Sanofi will model the economic ramifications and make payors, physicians, hospitals, IDNs, Medicare, Medicaid and the various federal and state players in the healthcare system well aware of the economic and clinical benefits of Afrezza. I suspect this would give Sanofi a bit of pricing power when negotiating with PBMs / payors.
For those of you who are not aware, in 1993 the results for the Diabetes Control & Complications Trial (DCCT) were published. The study wanted to determine if tight control of blood glucose levels resulted in a reduction in long term health complications for people with diabetes. The trial results indicated tight control of blood glucose levels reduced incidences of diabetic retinopathy, neuropathy and nephropathy by over 65%. Reductions in CV I believe were also significant but you would have to review the details of the final report to verify this.
Price is what you talk about when your product has no value. So what is Afrezza worth now?
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Post by robsacher on Mar 27, 2015 21:55:39 GMT -5
So the idea here for this thread is for folks who know of any particular hospital networks in their area who are adding Afrezza to their insulin therapy regiments. Please post their names, locations, state and the approximate number of diabetes patients they serve if you know it. I found this list on Wiki of the total number of networks. It would be great to check them off as each one begins to add Afrezza to their diabetes management programs.
Alameda Health System
Harris Health System - Harris County, Texas - 2 hospitals and 1 specialty hospital
JPS Health Network - Tarrant County, Texas - 1 hospital
Los Angeles County Department of Health Services - 4 hospitals, 2 multi-ambulatory care centers, and 16 primary care sites
Catholic Healthcare West - 42 hospitals; HQ San Francisco, CA ; Now Dignity Health
New York City Health and Hospitals Corporation - 11 hospitals, 4 nursing homes, 70 primary care sites
Parkland Health & Hospital System - Dallas County, Texas - 1 hospital
Private:
Adventist Health System - 45 hospitals
Ascension Health - 100 acute-care hospitals; nation's largest catholic and largest non-profit health system. HQ St. Louis, MO
Aurora Health Care - The system has 13 hospitals, over 100 clinics, and more than 80 community pharmacies. HQ Milwaukee, WI
Carolinas Healthcare System - 19 hospitals
Catholic Health East - 35 hospitals; HQ Newtown Square, PA. Became CHE/Trinity(newly merged with Trinity Health) in 2013.
Catholic Health Initiatives - 81 hospitals in 18 states; 2nd largest faith-based health system, 5th largest US health system overall; HQ Denver, CO
Catholic Health Partners - founded in 1985; HQ Cincinnati, OH
Child Health Corporation of America - 42 pediatric hospitals
CHRISTUS Health - Catholic health system of 40 hospitals; HQ Irving, TX
Continuum Health Partners - 4 hospitals in New York City
Health Management Associates - 66 hospitals; Headquarters: Naples, FL
Hospital Corporation of America (HCA) - 173 hospitals and 107 freestanding surgery centers; Headquarters: Nashville, TN
Kaiser Permanente - 37 hospitals
Kettering Health Network
Mayo Clinic/Mayo Clinic Health System - 70 hospitals and clinics across Minnesota, Iowa, and Wisconsin, with satellite clinics in Jacksonville, Florida, and the Phoenix, Arizona, suburb of Scottsdale. Headquarters: Rochester, MN
Mercy - 32 hospitals, 300 outpatient facilities across Missouri, Oklahoma, Arkansas, and Kansas
McGaw Medical Center of Northwestern University is a consortium of hospitals
NewYork-Presbyterian Healthcare System - 30 hospitals
North Shore Long Island Jewish Health System - 16 hospitals
Partners HealthCare - 11 member hospitals/organizations
Premier Health Partners
Prime Healthcare Services - 13 acute-care hospitals
ProMedica Health System
Providence Health & Services - 29 hospitals of non-for-profit, catholic health system; HQ Renton, WA
Shriners Hospitals for Children - 22 pediatric hospitals
SSM Health Care - 20 hospitals of catholic health system; HQ St. Louis, MO
Sutter Health - 26 hospitals
Tenet Healthcare - 57 hospitals
Texas Health Resources - 12 acute-care hospitals and one long-term care hospital; corporate member or partner in six additional hospitals and surgery centers.
Trinity Health (Novi, Michigan) - 44 hospitals; one of the largest catholic health system; HQ Novi, MI. Became CHE/Trinity(newly merged with Catholic Health East) in 2013.
University of Pittsburgh Medical Center - 19 hospitals western Pennsylvania
Vanguard Health Systems
Wheaton Franciscan Healthcare - 16 hospitals of catholic health system; HQ Glendale, WI
Yale-New Haven Health System - 4 acute care hospitals, 1 psychiatric hospital and multiple outpatient centers providing Surgical Services, Urgent Care, Diagnostic Radiology & Clinical Labwork in Connecticut
US government networks[edit]
Indian Health Service - 33 hospitals
Military medicine - United States Department of Defense - See Category:United States military hospitals
Air Force Medical Service
Army Medical Department
Navy Bureau of Medicine and Surgery
Veterans Health Administration
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Post by robsacher on Mar 27, 2015 22:28:18 GMT -5
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Post by rak5555 on Mar 28, 2015 8:11:04 GMT -5
Rob, I'm happy to assist with this task while I am waiting for scripts to explode. By far, Mercy is the largest hospital network in St. Louis MO. I would assume that with regard to formulary, it is managed independent of Mercy Grand Rapids. When I call the care center who should we ask for to answer questions about Afrezza?
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Post by robsacher on Mar 28, 2015 10:44:49 GMT -5
rak, I guess you could call the department that is in charge of diabetes outpatient treatment and ask them if they have any plans of adding Afrezza to their diabetes treatment programs. Thanks for giving it a try and let us know what they say. Thanks. RS  |
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Post by Deleted on Mar 28, 2015 11:43:23 GMT -5
Rob, Any chance you can tell us how you found out about this and how reliable the source is. If they move forward & have success, other big players in the state would take note. Especially University of Michigan medical center which given their reputation likes to be on the cutting edge. Falling in line after them could be Wm Beaumont and Henry Ford. U of M I think was one of the trial sights for Al Mann's bionic eye product, the Argus II prosthetic eye made by Second Sight, NASDAQ: EYES. Nice of you to offer to collect all of this information. In the diabetes space, if you get this type of info for the larger states, you will have most of it covered. N. Dakota, etc due to minimal population won't skew the numbers much. CA, AZ, TX, IL, OH, PA, NY, NJ, MA, FL, NC, GA along with large populations have big numbers of people with diabetes. Secondary is IN, TN, MO, WI, MN, CO |
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Post by robsacher on Mar 28, 2015 22:22:05 GMT -5
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Post by dreamboatcruise on Mar 28, 2015 22:50:21 GMT -5
I work for Kaiser (our Pharmacist has been on vacation ) & prior to that I had a month off . Someone here & I won't name him unless he wants to acknowledge himself informed me of a tip , there was supposed to be a high level meeting sometime this month re: adding Afrezza to formulary . I saw it on our formulary a while back but have seen some here who have Kaiser not being able to get it . I'll do some digging when the opportunity presents itself They need need member retention & are into preventative health so it's only a matter of time . This is the only time I wish I worked with adults so I'd run into more endocrinologists . Lynn I've asked for a follow up from my friend at Kaiser. The way I understand it is that the meeting to evaluate new drugs for formulary occurs on regular schedule and the one that should have already occurred this month would likely have Afrezza on the agenda. Hopefully that was the case and it got thumbs up. |
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Post by lynn on Mar 29, 2015 0:08:11 GMT -5
DBC, I hope that in this meeting some of the early adopters , tweets , blogs ect have been shared . Kaiser loves generics , but no expense is spared in the NICU world I work in . The outcomes I see ( at least where I am which is a level 3 NICU ) are night & day from the previous hospital I worked at ( also a level 3 & I loved that job so won't say anything bad about it) . The majority of Ex 24 weekers eventually go home healthy . It's a Priceless job that I'm blessed to have <3 ( & in case you didn't know a full term infant is 40 weeks ) . But even for myself I've asked for tests that they've given me , tho I think that has a lot to do with me saying " I'm a nurse" & having a justification for the test . Sorry, I got off track ( those who know me are used to it ,) ) but my final point is patients have to be their own advocates . As a Nurse who cares for lil ones who don't have a voice , I also advocate for myself & everyone should do the same .We are all all Unique & NOONE knows You better than you know Yourself . This is exactly what we're witnessing on social media , type 1's have been battling their disease for years if not decades , type 2's can hang in denial for years but when the word gets out .. It'll be Game On !! & We are on the Winning Team But I can't stress enough how much people need to look out for their own well being .. We don't all fit in perfect lil boxes, we are all individual's & respond differently to different tx. K I'm done Lynn |
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