A step forward, but a few step back!

[peppy]

Does Medicare and Medicaid cover it?

[kc]

Jun 25, 2015 19:00:26 GMT -5 eddiemoy said:

Looks like the stupid iphone app is wrong, from now on i will be tracking from their website!

formularylookup.com/

Here is what it looks like today:  NOT BAD!!!  look at last line, average is 40% unrestricted access for all of USA!

Commercial	Preferred	Covered	Restricted	Not Covered	# of Plans	% Unrestricted Access
Alabama	4	44	77	36	161	30%
Alaska	3	26	23	12	64	45%
Arizona	3	49	59	54	165	32%
Arkansas	3	38	32	29	102	40%
California	9	145	87	125	366	42%
Colorado	3	42	61	62	168	27%
Connecticut	3	58	48	44	153	40%
Delaware	4	33	41	15	93	40%
Florida	3	74	73	83	233	33%
Georgia	3	73	64	72	212	36%
Guam	2	17	8	9	36	53%
Hawaii	3	33	12	18	66	55%
Idaho	5	31	17	17	70	51%
Illinois	6	107	83	137	333	34%
Indiana	3	56	56	83	198	30%
Iowa	3	38	31	33	105	39%
Kansas	4	38	64	42	148	28%
Kentucky	3	56	51	50	160	37%
Louisiana	3	49	50	39	141	37%
Maine	4	20	48	16	88	27%
Maryland	4	91	45	44	184	52%
Massachusetts	4	50	33	56	143	38%
Michigan	5	127	57	93	282	47%
Minnesota	4	52	21	54	131	43%
Mississippi	3	30	29	22	84	39%
Missouri	4	72	67	46	189	40%
Montana	3	26	20	18	67	43%
Nebraska	3	29	36	26	94	34%
Nevada	3	43	53	36	135	34%
New Hampshire	3	29	41	23	96	33%
New Jersey	5	141	60	52	258	57%
New Mexico	3	29	24	18	74	43%
New York	8	199	78	100	385	54%
North Carolina	5	71	69	54	199	38%
North Dakota	3	20	19	13	55	42%
Ohio	9	156	67	223	455	36%
Oklahoma	3	40	48	32	123	35%
Oregon	4	49	24	23	100	53%
Pennsylvania	10	172	61	98	341	53%
Puerto Rico	3	20	15	14	52	44%
Rhode Island	3	28	14	23	68	46%
South Carolina	3	56	39	42	140	42%
South Dakota	3	28	24	18	73	42%
Tennessee	5	62	53	63	183	37%
Texas	5	145	69	151	370	41%
Utah	4	38	47	30	119	35%
Vermont	3	22	19	12	56	45%
Virginia	3	75	58	57	193	40%
Washington	5	70	33	36	144	52%
Washington DC	3	35	41	39	118	32%
West Virginia	3	31	43	26	103	33%
Wisconsin	6	83	60	72	221	40%
Wyoming	3	25	34	13	75	37%
USA Total	212	3,171	2,386	2,603	8,372	40%

The issue on Formulary is that Sanofi is not in a hurry to give massive discounts on Afrezza until they know they have to in order to expand sales.  You don't roll out the new drug and cut your prices.   So Afrezza enters the market in February 2015 and the formulary plans are adjusted once or twice a year.   The next big round of tier adjustments comes in November for January 2016 plans.   You can bet that Sanofi is calling on and working with the plans to get onto a lower tier but it might still take some time and discounting.  

Sanofi is smart enough to not leave money on the table and they will not cut pricing until they have to do it.   If the sales are not there than they will cut pricing to enhance the sales.   That is their last resort.

[Deleted]

Aug 18, 2015 11:50:28 GMT -5 kc said:

Jun 25, 2015 19:00:26 GMT -5 eddiemoy said:

Looks like the stupid iphone app is wrong, from now on i will be tracking from their website!

formularylookup.com/

Here is what it looks like today:  NOT BAD!!!  look at last line, average is 40% unrestricted access for all of USA!

Commercial	Preferred	Covered	Restricted	Not Covered	# of Plans	% Unrestricted Access
Alabama	4	44	77	36	161	30%
Alaska	3	26	23	12	64	45%
Arizona	3	49	59	54	165	32%
Arkansas	3	38	32	29	102	40%
California	9	145	87	125	366	42%
Colorado	3	42	61	62	168	27%
Connecticut	3	58	48	44	153	40%
Delaware	4	33	41	15	93	40%
Florida	3	74	73	83	233	33%
Georgia	3	73	64	72	212	36%
Guam	2	17	8	9	36	53%
Hawaii	3	33	12	18	66	55%
Idaho	5	31	17	17	70	51%
Illinois	6	107	83	137	333	34%
Indiana	3	56	56	83	198	30%
Iowa	3	38	31	33	105	39%
Kansas	4	38	64	42	148	28%
Kentucky	3	56	51	50	160	37%
Louisiana	3	49	50	39	141	37%
Maine	4	20	48	16	88	27%
Maryland	4	91	45	44	184	52%
Massachusetts	4	50	33	56	143	38%
Michigan	5	127	57	93	282	47%
Minnesota	4	52	21	54	131	43%
Mississippi	3	30	29	22	84	39%
Missouri	4	72	67	46	189	40%
Montana	3	26	20	18	67	43%
Nebraska	3	29	36	26	94	34%
Nevada	3	43	53	36	135	34%
New Hampshire	3	29	41	23	96	33%
New Jersey	5	141	60	52	258	57%
New Mexico	3	29	24	18	74	43%
New York	8	199	78	100	385	54%
North Carolina	5	71	69	54	199	38%
North Dakota	3	20	19	13	55	42%
Ohio	9	156	67	223	455	36%
Oklahoma	3	40	48	32	123	35%
Oregon	4	49	24	23	100	53%
Pennsylvania	10	172	61	98	341	53%
Puerto Rico	3	20	15	14	52	44%
Rhode Island	3	28	14	23	68	46%
South Carolina	3	56	39	42	140	42%
South Dakota	3	28	24	18	73	42%
Tennessee	5	62	53	63	183	37%
Texas	5	145	69	151	370	41%
Utah	4	38	47	30	119	35%
Vermont	3	22	19	12	56	45%
Virginia	3	75	58	57	193	40%
Washington	5	70	33	36	144	52%
Washington DC	3	35	41	39	118	32%
West Virginia	3	31	43	26	103	33%
Wisconsin	6	83	60	72	221	40%
Wyoming	3	25	34	13	75	37%
USA Total	212	3,171	2,386	2,603	8,372	40%

The issue on Formulary is that Sanofi is not in a hurry to give massive discounts on Afrezza until they know they have to in order to expand sales.  You don't roll out the new drug and cut your prices.   So Afrezza enters the market in February 2015 and the formulary plans are adjusted once or twice a year.   The next big round of tier adjustments comes in November for January 2016 plans.   You can bet that Sanofi is calling on and working with the plans to get onto a lower tier but it might still take some time and discounting.  

Sanofi is smart enough to not leave money on the table and they will not cut pricing until they have to do it.   If the sales are not there than they will cut pricing to enhance the sales.   That is their last resort.

SNY should offer up a more aggressive price to the plans and in return, require them to have Afrezza patients get A1c test every 90 days and provide SNY deidentified patient data.  Then a year or two from now, SNY can go back to the plan and raise prices based on patient health, less ER visits.  Plus, you get a large installed base who loves the product, the results and convenience of dosing and needle free life or needle reduced.