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Post by joeypotsandpans on Feb 6, 2016 14:57:49 GMT -5
Here are some FACTS: I met with my primary yesterday, young primary from NY with a positive attitude. A little history, I met with a prior PA last January before A was approved and when she said I may need an insulin regimen depending on how I did on "the pills route" I mentioned A and inhalable insulin which should be launched very soon. Her attitude was immediately defensible stating if that's what I wanted she would have to refer me to an Endo. Subsequently, I was introduced to the SNY rep that I've mentioned in the past and in our conversations late spring/early summer the rep told me that the PA had been invited to the educational dinner seminars and no showed. We'll get back to that in a few. I wanted to try the "diet and exercise" route as a first line defense if possible. I did lose close to 20lbs (I was never overly obese but for 5'10" about 205 what I would term the typical overweight middle aged to senior male (55) and managed to get down to 185). I cut out what I term the 3 starches bread, potatoes, and pasta and started on the elliptical. Here's the problem for me, no excuses, but I don't drink or smoke and food is one of life's pleasures that I've always enjoyed. Going into my pizza man's place I could only pass up the garlic knots so many times and eat "the Joey salad" so many times...I could only pass up the baked potato with my filet so many times...etc. Then the holidays came and it was essentially game over. So as I mentioned to my buds on this board who know me on a daily basis, I said I would get my blood tested again (full metabolic, etc) after the holidays passed and set up my appt. one year later. Which brings me to yesterdays appt. In Dec. I had dinner with Spiro and a few others and Spiro left me with one of his dreamboats. I brought that to my visit yesterday in anticipation that the new physician I would be meeting with might not be aware of A. After meeting with the nurse first getting the routine stuff out of the way ie., weight, BP, routine questions answered etc., my new primary came in. After the initial intro and questions, we got into the blood sugar discussion. We talked about the metformin regimen I had been on, and then she started on the "combo" pill she was going to recommend...I stopped her in her tracks and stated "don't bother with the Janumet speech". She seemed a bit taken aback and then I pulled out the dreamboat Spiro gave me (thanks again Spiro, I can't begin to tell you the "mileage" a used dreamboat can get as far as conversation starter with people who are either diabetic or know or are close to one). She had not seen nor heard of it, but to my pleasant surprise was very open minded and receptive. She listened to what I had to say for a few minutes and excused herself with her laptop and stated she would be back in a few. Upon return she started to state "ok, but I have to tell you a few things" and I said go ahead but I already know full well about the "black label" warnings...she said I know but I still have to state them. She then said I would need the spirometry test and the nurse would be in to perform it. I was thrilled that they had it right there and a little surprised that things were moving along so fluidly. Spirometry test completed, she comes back and says you passed so I am going to prescribe but just so you know it might be expensive, and I want to see you back in 90 days. They escripted to my CVS and after finishing up my visit I immediately proceeded to my CVS. On the way to CVS, I called the SNY rep I know and they stated "that great! but now you might encounter the biggest issue/wall we've had, let me know if they state if it was rejected and if so ask them to give you a print out so on Monday I can get with your provider and SPC (Sanofi Patient Connection) to appeal. I've come to learn and appreciate this person (rep) as a proactive and huge supporter of A. So much so, I inquired if they would be willing to talk with Matt and they stated they're always open and mentioned their connection with other "team" members that felt the same way (In my email to Matt, I am highly encouraging him to contact this individual). There is a lot more from that discussion that I can tell you was eye opening and positive. One thing I will say is they did state they did not blame SNY for not doing more advertising in the way of national TV ads as stated before because without the insurance issue being resolved it would have only caused more problems. Again, after our lengthy conversation I can fully appreciate what this rep in particular had done over the past year. One of their last comments to me was "if the price dropped and was competitive with current RAA's this would be flying off the shelves"...nice to hear that from a rep  I actually thought about changing my handle to JoeyFrezza lol, enjoy your superbowl weekend and try not to "carb out" too much... |
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Post by liane on Feb 6, 2016 15:04:19 GMT -5
Yeah! I'm so happy for you! Let us know how you do. Maybe on Afrezza you can carb out once in a while. I think Super Bowl qualifies as an appropriate occasion.
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Post by Deleted on Feb 6, 2016 15:19:28 GMT -5
they did state they did not blame SNY for not doing more advertising in the way of national TV ads as stated before because without the insurance issue being resolved it would have only caused more problems. Again, after our lengthy conversation I can fully appreciate what this rep in particular had done over the past year. One of their last comments to me was "i f the price dropped and was competitive with current RAA's this would be flying off the shelves"...nice to hear that from a rep I am not sure if Congratulations is appropriate but atleast you are in good hands of Afrezza . Hope you can maintain better blood sugar range and overall health. If SNY field rep can analyze the road blocks , they would have mentioned this to management. How/what prevented SNY from reducing the price and gain insurance coverage when they has 6 months from the deal signing to launch and then a full year? What prevented them from getting a superiority trial 6 months into the market? and the main Q.. Did you have insurance issues with your prescription getting filled? Did the doc know how to prescribe? Did you get to discuss the benefits of rapid peak and short tail of Afrezza? and hopefully your primary doc now will see the results and Afrezza first hand |
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Post by benyiju on Feb 6, 2016 15:32:38 GMT -5
Good luck, keep us posted on results!
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Post by stevil on Feb 6, 2016 15:39:08 GMT -5
Joey,
nature might be working against you my friend, so keep that in mind. I'm learning all about leptin right now- the hormone that gets secreted by adipose tissue... When you lose weight, there is less adipose mass, thus less leptin in the system. Leptin helps suppress appetite and increase your RMR (resting metabolic rate). So it's going to be challenging for you to keep the weight off, both from a psychological standpoint (saying no to your favorite foods that cause dopamine release- ie. happy foods) as well from a biological standpoint- your body no longer is helping you...
But so glad to hear you're getting your health under control. I hope that Afrezza will help you further meet your health goals!
I just got the crazy idea that we should all get our blood work done right after consuming a pack of Sour Patch Kids so we can all have this talk with our physicians!
P.S. It was really cool that the rep was so helpful and compassionate. But also really bizarre that his opinion was such that the drug would fly off the shelves if they matched the price of other RAAs. Seems to conflict with what he said about not believing SNY wasn't holding back. I wonder what the rationale was for keeping the price high if that was the perceived biggest barrier. I know others have stated they thought SNY was sandbagging the whole time, which is highly likely, but I'm wondering if they just thought they needed to have a set price per unit to meet their expectations for some reason. Still don't get why SNY wouldn't just buy Afrezza from us if they really thought that it would fly off the shelves with a better price point...
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Post by mindovermatter on Feb 6, 2016 15:44:22 GMT -5
My momma always said, "eat the foods you love but always EAT IN MODERATION." So if you haven't, maybe cut down on the portions. Or you could just do what boxers do. Chew the food to get the taste but don't swallow the food. Spit it out!
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Post by Deleted on Feb 6, 2016 15:46:15 GMT -5
Here are some FACTS: I met with my primary yesterday, young primary from NY with a positive attitude. A little history, I met with a prior PA last January before A was approved and when she said I may need an insulin regimen depending on how I did on "the pills route" I mentioned A and inhalable insulin which should be launched very soon. Her attitude was immediately defensible stating if that's what I wanted she would have to refer me to an Endo. Subsequently, I was introduced to the SNY rep that I've mentioned in the past and in our conversations late spring/early summer the rep told me that the PA had been invited to the educational dinner seminars and no showed. We'll get back to that in a few. I wanted to try the "diet and exercise" route as a first line defense if possible. I did lose close to 20lbs (I was never overly obese but for 5'10" about 205 what I would term the typical overweight middle aged to senior male (55) and managed to get down to 185). I cut out what I term the 3 starches bread, potatoes, and pasta and started on the elliptical. Here's the problem for me, no excuses, but I don't drink or smoke and food is one of life's pleasures that I've always enjoyed. Going into my pizza man's place I could only pass up the garlic knots so many times and eat "the Joey salad" so many times...I could only pass up the baked potato with my filet so many times...etc. Then the holidays came and it was essentially game over. So as I mentioned to my buds on this board who know me on a daily basis, I said I would get my blood tested again (full metabolic, etc) after the holidays passed and set up my appt. one year later. Which brings me to yesterdays appt. In Dec. I had dinner with Spiro and a few others and Spiro left me with one of his dreamboats. I brought that to my visit yesterday in anticipation that the new physician I would be meeting with might not be aware of A. After meeting with the nurse first getting the routine stuff out of the way ie., weight, BP, routine questions answered etc., my new primary came in. After the initial intro and questions, we got into the blood sugar discussion. We talked about the metformin regimen I had been on, and then she started on the "combo" pill she was going to recommend...I stopped her in her tracks and stated "don't bother with the Janumet speech". She seemed a bit taken aback and then I pulled out the dreamboat Spiro gave me (thanks again Spiro, I can't begin to tell you the "mileage" a used dreamboat can get as far as conversation starter with people who are either diabetic or know or are close to one). She had not seen nor heard of it, but to my pleasant surprise was very open minded and receptive. She listened to what I had to say for a few minutes and excused herself with her laptop and stated she would be back in a few. Upon return she started to state "ok, but I have to tell you a few things" and I said go ahead but I already know full well about the "black label" warnings...she said I know but I still have to state them. She then said I would need the spirometry test and the nurse would be in to perform it. I was thrilled that they had it right there and a little surprised that things were moving along so fluidly. Spirometry test completed, she comes back and says you passed so I am going to prescribe but just so you know it might be expensive, and I want to see you back in 90 days. They escripted to my CVS and after finishing up my visit I immediately proceeded to my CVS. On the way to CVS, I called the SNY rep I know and they stated "that great! but now you might encounter the biggest issue/wall we've had, let me know if they state if it was rejected and if so ask them to give you a print out so on Monday I can get with your provider and SPC (Sanofi Patient Connection) to appeal. I've come to learn and appreciate this person (rep) as a proactive and huge supporter of A. So much so, I inquired if they would be willing to talk with Matt and they stated they're always open and mentioned their connection with other "team" members that felt the same way (In my email to Matt, I am highly encouraging him to contact this individual). There is a lot more from that discussion that I can tell you was eye opening and positive. One thing I will say is they did state they did not blame SNY for not doing more advertising in the way of national TV ads as stated before because without the insurance issue being resolved it would have only caused more problems. Again, after our lengthy conversation I can fully appreciate what this rep in particular had done over the past year. One of their last comments to me was "if the price dropped and was competitive with current RAA's this would be flying off the shelves"...nice to hear that from a rep I actually thought about changing my handle to JoeyFrezza lol, enjoy your superbowl weekend and try not to "carb out" too much... Joey Conrgats on your weight loss. Its gets much harder as you get older as your metabolism slows down- If you ever want help with diet or exercising you can shoot me a pm. I have been training for 18 years. There is nothing wrong with white potatoes or white rice as long as its in moderation. Bread (while I eat 3 slices of pizza for my saturday cheat) is terrible for you and the pre packaged stuff is now a chemical. |
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Post by joeypotsandpans on Feb 6, 2016 15:46:43 GMT -5
they did state they did not blame SNY for not doing more advertising in the way of national TV ads as stated before because without the insurance issue being resolved it would have only caused more problems. Again, after our lengthy conversation I can fully appreciate what this rep in particular had done over the past year. One of their last comments to me was "i f the price dropped and was competitive with current RAA's this would be flying off the shelves"...nice to hear that from a rep I am not sure if Congratulations is appropriate but atleast you are in good hands of Afrezza . Hope you can maintain better blood sugar range and overall health. If SNY field rep can analyze the road blocks , they would have mentioned this to management. How/what prevented SNY from reducing the price and gain insurance coverage when they has 6 months from the deal signing to launch and then a full year? What prevented them from getting a superiority trial 6 months into the market? and the main Q.. Did you have insurance issues with your prescription getting filled? and hopefully your primary doc now will see the results and Afrezza first hand Thanks Liane and "sekc", one big takeaway from the rep is how separated SNY HQ was from SNY US regarding the fact that the rep basically stated to me they found out when we found out....in fact, the very day of announcement they were headed to a care provider with a lead trainer who also found out right then and there, they still proceeded with their visit/meeting and were emotionally spent as they informed the physician and he stated to the trainer "you know who i really feel sorry for is the individual sitting in front of me who has spent the last year working their butt off on this as one day some other rep will get the fruits of their labor". They are now representing Toujeo and are extremely bored and still fully supportive of A. I asked about the price issue and they stated that's back office and they are not privy to the whys and hows of the pricing, etc. They did state they fully understand why Matt would make the statement that they have the research numbers etc., and why they (MNKD) are confident about the information feedback they have gotten going forward, as this rep feels like they played an integral role in providing that feedback to SNY mgmt. Regarding the prescription, it did come back not covered (no surprise there as I didn't expect it to be having already discussed my provider with the rep previously), that is why they offered to visit my primary care individual on Monday and asked for the print out so they can start the appeal process. Btw, I would consider congratulations an appropriate term sekc, to me right now I consider getting the script 50% of the accomplishment (the other 50% getting it covered)....keep in mind when the pancreas becomes challenged, to me this is first in line and best in class and only alternative I personally am willing to consider having done my due diligence (quite a bit more so than Margaret and her flunkies IMO) regarding this SUPERIOR drug/technology again IMO, which I'm confident when the properly designed trials are done will illustrate. |
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Post by nylefty on Feb 6, 2016 16:11:47 GMT -5
Regarding the appeal process, I wonder how much success people have had claiming needle phobia? As I understand it, that can be the basis for getting approval, but how hard is it to prove? I'm not diabetic and therefore have no need for Afrezza, but I HATE getting injections of any kind and can't imagine giving them to myself several times a day. And yes, I know that the needles are supposedly super thin, you can hardly feel them going in, etc., etc., but they still fill me with fear, uncertainty and doubt (hmm..where have I seen that phrase before?).
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Post by joeypotsandpans on Feb 6, 2016 16:21:13 GMT -5
Joey, nature might be working against you my friend, so keep that in mind. I'm learning all about leptin right now- the hormone that gets secreted by adipose tissue... When you lose weight, there is less adipose mass, thus less leptin in the system. Leptin helps suppress appetite and increase your RMR (resting metabolic rate). So it's going to be challenging for you to keep the weight off, both from a psychological standpoint (saying no to your favorite foods that cause dopamine release- ie. happy foods) as well from a biological standpoint- your body no longer is helping you... But so glad to hear you're getting your health under control. I hope that Afrezza will help you further meet your health goals! I just got the crazy idea that we should all get our blood work done right after consuming a pack of Sour Patch Kids so we can all have this talk with our physicians! P.S. It was really cool that the rep was so helpful and compassionate. But also really bizarre that his opinion was such that the drug would fly off the shelves if they matched the price of other RAAs. Seems to conflict with what he said about not believing SNY wasn't holding back. I wonder what the rationale was for keeping the price high if that was the perceived biggest barrier. I know others have stated they thought SNY was sandbagging the whole time, which is highly likely, but I'm wondering if they just thought they needed to have a set price per unit to meet their expectations for some reason. Still don't get why SNY wouldn't just buy Afrezza from us if they really thought that it would fly off the shelves with a better price point... Stevil, I have read a fair amount of your posts, I get where you're coming from as my oldest is a first year resident and has a seven year fellowship path in HEMONC, my youngest is first year PHARMD student and had his first paper for one of his courses on Janumet (why I knew where my PC provider was going so fast) and finally my wife has been an ICU RN for the past 30yrs. So trust me when I tell you I have gotten the speeches regarding my medical situation more than I care to say lol. Even though they are aboard of the benefits of A. they get first hand how difficult the obstacles are between insurance and fundamental economics surrounding the situation. For example, the particular county hospital my son works at as first year resident, when i asked if he has had the opportunity to prescribe A. he stated the following, "dad, you have to understand how indigent the patients I see are, I'm fairly limited on what I can prescribe etc." ...to which I responded I get it. I also get why he is destined to continue down the research path as opposed to clinical for that matter. Regarding your statement about what seemed to be a bizarre contradiction regarding the price statement and not holding back, see my response to sekc regarding same. My guess is at 65% and what may have been agreed upon initially they didn't expect as much push back from getting it accepted on Tier 2, and economically for them (SNY) they weren't willing to drop for whatever "net net" reasons. Again, the reps aren't privy to the back office number crunching, etc. |
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Post by stevil on Feb 6, 2016 16:29:55 GMT -5
Sorry if my post sounded kinda "preachy" just in crazy study mode right now and I was excited to share some of what I was learning while also hoping to encourage you to keep on keeping on. Hope I didn't offend you. Best of luck on your health goals!
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Post by mnholdem on Feb 6, 2016 16:30:54 GMT -5
Joey, why do I have a feeling that you will be buying a CGM next? If the disease is early enough in its progression, perhaps it's not to late for your insulin therapy to restore normal insulin production. It would be fantastic to have a documented case where Afrezza led to remission of this disease.
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Post by kball on Feb 6, 2016 17:09:31 GMT -5
Good luck Joey. Hoping the wait isn't long, but keep us posted as we KNOW the stuff works, just that the whole Rx process can sometimes be the biggest challenge.
Once you get things dialed in, is that the end of Joey Salads?
edit: And if you change your handle...maybe go with joeypuffsandpees
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Post by slugworth008 on Feb 6, 2016 17:49:35 GMT -5
Here are some FACTS: I met with my primary yesterday, young primary from NY with a positive attitude. A little history, I met with a prior PA last January before A was approved and when she said I may need an insulin regimen depending on how I did on "the pills route" I mentioned A and inhalable insulin which should be launched very soon. Her attitude was immediately defensible stating if that's what I wanted she would have to refer me to an Endo. Subsequently, I was introduced to the SNY rep that I've mentioned in the past and in our conversations late spring/early summer the rep told me that the PA had been invited to the educational dinner seminars and no showed. We'll get back to that in a few. I wanted to try the "diet and exercise" route as a first line defense if possible. I did lose close to 20lbs (I was never overly obese but for 5'10" about 205 what I would term the typical overweight middle aged to senior male (55) and managed to get down to 185). I cut out what I term the 3 starches bread, potatoes, and pasta and started on the elliptical. Here's the problem for me, no excuses, but I don't drink or smoke and food is one of life's pleasures that I've always enjoyed. Going into my pizza man's place I could only pass up the garlic knots so many times and eat "the Joey salad" so many times...I could only pass up the baked potato with my filet so many times...etc. Then the holidays came and it was essentially game over. So as I mentioned to my buds on this board who know me on a daily basis, I said I would get my blood tested again (full metabolic, etc) after the holidays passed and set up my appt. one year later. Which brings me to yesterdays appt. In Dec. I had dinner with Spiro and a few others and Spiro left me with one of his dreamboats. I brought that to my visit yesterday in anticipation that the new physician I would be meeting with might not be aware of A. After meeting with the nurse first getting the routine stuff out of the way ie., weight, BP, routine questions answered etc., my new primary came in. After the initial intro and questions, we got into the blood sugar discussion. We talked about the metformin regimen I had been on, and then she started on the "combo" pill she was going to recommend...I stopped her in her tracks and stated "don't bother with the Janumet speech". She seemed a bit taken aback and then I pulled out the dreamboat Spiro gave me (thanks again Spiro, I can't begin to tell you the "mileage" a used dreamboat can get as far as conversation starter with people who are either diabetic or know or are close to one). She had not seen nor heard of it, but to my pleasant surprise was very open minded and receptive. She listened to what I had to say for a few minutes and excused herself with her laptop and stated she would be back in a few. Upon return she started to state "ok, but I have to tell you a few things" and I said go ahead but I already know full well about the "black label" warnings...she said I know but I still have to state them. She then said I would need the spirometry test and the nurse would be in to perform it. I was thrilled that they had it right there and a little surprised that things were moving along so fluidly. Spirometry test completed, she comes back and says you passed so I am going to prescribe but just so you know it might be expensive, and I want to see you back in 90 days. They escripted to my CVS and after finishing up my visit I immediately proceeded to my CVS. On the way to CVS, I called the SNY rep I know and they stated "that great! but now you might encounter the biggest issue/wall we've had, let me know if they state if it was rejected and if so ask them to give you a print out so on Monday I can get with your provider and SPC (Sanofi Patient Connection) to appeal. I've come to learn and appreciate this person (rep) as a proactive and huge supporter of A. So much so, I inquired if they would be willing to talk with Matt and they stated they're always open and mentioned their connection with other "team" members that felt the same way (In my email to Matt, I am highly encouraging him to contact this individual). There is a lot more from that discussion that I can tell you was eye opening and positive. One thing I will say is they did state they did not blame SNY for not doing more advertising in the way of national TV ads as stated before because without the insurance issue being resolved it would have only caused more problems. Again, after our lengthy conversation I can fully appreciate what this rep in particular had done over the past year. One of their last comments to me was "if the price dropped and was competitive with current RAA's this would be flying off the shelves"...nice to hear that from a rep I actually thought about changing my handle to JoeyFrezza lol, enjoy your superbowl weekend and try not to "carb out" too much... Best of luck to you! And thank you for the uplifting post. Hopefully once MNKD has control of A - The first order of business will be pricing which I believe will greatly help with insurance and get A "flying off the shelves". |
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Post by suebeeee1 on Feb 6, 2016 18:11:29 GMT -5
Regarding the appeal process, I wonder how much success people have had claiming needle phobia? As I understand it, that can be the basis for getting approval, but how hard is it to prove? I'm not diabetic and therefore have no need for Afrezza, but I HATE getting injections of any kind and can't imagine giving them to myself several times a day. And yes, I know that the needles are supposedly super thin, you can hardly feel them going in, etc., etc., but they still fill me with fear, uncertainty and doubt (hmm..where have I seen that phrase before?). Needle phobia doesn't seem to cut it. Unfortunately, we ask just can't change insurance companies like we did. The cost is oppressive for most working people. I can't even imagine how bad it would be for someone on a fixed income to try to pay for out of pocket. joeypotsandpans , you are about to discover that, with a tad bit of practice, you will be able to eat just about anything you wish to eat. Just don't get carried away. Eating well for the sake of all the OTHER reasons is good too. Welcome to the club. Looking forward to pre-Afrezza and 3 month post commencement A1c s.. |
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