My First Afrezza Prescription

[Incognita]

I picked up my first Afrezza prescription from CVS today.  On Friday Feb 26, coincidentally, I had a scheduled appointment with my endo.  In honor of Al Mann's passing, I was resolved to once again request a prescription for myself. I am a recently diagnosed Type 2 but like many others, share personal experience with diabetes as my brother was diagnosed as a Type 1 at age 12 and my father also has Type 2.  I would like to thank so many of you for your contributions to this board.  I have read them all since becoming aware of Afrezza shortly after FDA approval and joining your ranks. This is my first post and while I have remained a viewer rather than a contributor, it is here that I learned so much and am I happy to count myself among the believers in Al Mann's vision for humanity.  

[Deleted]

Congrats.

The most important info for me :

1. What was the endo input when you requested Afrezza
2. Since you were recently diagnosed , didnt the endo push the poison pills?
3. filling up the prescription  in terms of insurance...cost?
4. Is your brother and father on Afrezza as well?

[kc]

Good luck to you. Please keep us advised how things go.

[Incognita]

1) I have a long relationship with this endo and I respect his opinion.  Not, however, regarding Afrezza.  I pledged to myself that I would work to help this good but conservative doctor understand this new drug.  Shortly after Afrezza came on the market, I requested a prescription for Afrezza and like many encountered a lot of resistance.  Despite his refusal, I persisted, I ask for and he gave me a referral to get a spirometry test which I did to remove any future objections. I spent a year trying it his way.
2) I have been on metformin, and then he had me try pills (glipizide  and others etc.) and a Humalog KwikPen.  My most recent A1c is 6.2 but that comes with great effort.  In this last visit, he wanted to add Januvia or Actos.  I rejected both options.  It was a very difficult meeting but I was resolute. 
3) My prescription for 90 doses of 4 units cost me $55.94. I am aware that I might actually need more units per month depending food consumption/snacks, but I wanted to just get started. He was not familiar with the dosing and was afraid of not having the flexibility of the pen for units.  I am his first patient on Afrezza.
4) Perhaps my biggest motivation has been to get my brother on Afrezza. I have been working on him too.  He is a very brittle diabetic and at age 55 we have had many near death hypoglycemic experiences with him.  I don't say that lightly, day to day, moment by moment life is coloured by his diabetes.  He is on Medicaid, not sure about their coverage yet. He does however have a Dexacom CGM which has been a life-saving grace.  He too has had resistance from his endos, but also he is afraid to change his routine.  My father is not yet on Afrezza but is open-minded.  I am hopeful he will see me and try it too.  As we know several other Type 1s that have gone through the difficult journey to gain access to Afrezza and find it has changed their lives miraculously for the better-- our family is hopeful that my brother and father will one day have access to it.

 
 

[centralcoastinvestor]

Mar 2, 2016 17:13:29 GMT -5 Incognita said:

1) I have a long relationship with this endo and I respect his opinion.  Not, however, regarding Afrezza.  I pledged to myself that I would work to help this good but conservative doctor understand this new drug.  Shortly after Afrezza came on the market, I requested a prescription for Afrezza and like many encountered a lot of resistance.  Despite his refusal, I persisted, I ask for and he gave me a referral to get a spirometry test which I did to remove any future objections. I spent a year trying it his way.
2) I have been on metformin, and then he had me try pills (glipizide  and others etc.) and a Humalog KwikPen.  My most recent A1c is 6.2 but that comes with great effort.  In this last visit, he wanted to add Januvia or Actos.  I rejected both options.  It was a very difficult meeting but I was resolute. 
3) My prescription for 90 doses of 4 units cost me $55.94. I am aware that I might actually need more units per month depending food consumption/snacks, but I wanted to just get started. He was not familiar with the dosing and was afraid of not having the flexibility of the pen for units.  I am his first patient on Afrezza.
4) Perhaps my biggest motivation has been to get my brother on Afrezza. I have been working on him too.  He is a very brittle diabetic and at age 55 we have had many near death hypoglycemic experiences with him.  I don't say that lightly, day to day, moment by moment life is coloured by his diabetes.  He is on Medicaid, not sure about their coverage yet. He does however have a Dexacom CGM which has been a life-saving grace.  He too has had resistance from his endos, but also he is afraid to change his routine.  My father is not yet on Afrezza but is open-minded.  I am hopeful he will see me and try it too.  As we know several other Type 1s that have gone through the difficult journey to gain access to Afrezza and find it has changed their lives miraculously for the better-- our family is hopeful that my brother and father will one day have access to it.

 
 

It is posts like yours that keep me inspired to believe that some day, Afrezza will change how diabetes is treated.  Please continue to share info and thanks for posting.  

[mindovermatter]

Great to hear that your persistence paid off. As for your Endo, hopefully he will see the light assuming you do well while using Afrezza. And as was posted earlier, please keep us informed how you are doing while using it.

[tayl5]

I wish you all the best, Incognita. You'd think MannKind was selling arsenic pills with the level of resistance patients like you are encountering. Please keep us informed as you fight the good fight.

[mpg54]

I recommend getting on Tudiabetes.org and sharing this story.

[elv344800]

Really happy that you decided to push for Afrezza like you chose to do!!! You are living proof of what people have to do for themselves when making decisions about your health. I truly believe its stories like your own that need to be rebroadcast across all diabetic forums and outlets related. You obviously have learned enough through those before you to trust that Afrezza will achieve your goals for improved health in controlling your BG, and highs and lows.
I sincerely hope you will take your message and share your experience with ev1 in the arena. Now is the time!! 
Maybe someone will wake up in the diabetic business and promote this product before its too late.. Time is wasting.

My wife and I are both elderly and now inactive relatively speaking. We are both considered prediabetic for sometime now.
I know we will be facing your level very soon and we dont want to wait and go through the struggles w/drs trying crap we dont want.
Afrezza would head off full blown diabetes condition for prediabetics if we could use it for meals. Al claimed this long ago!! and I want to be able to prove it myself yet in my own llifetime if I get the chance, but, I know we have a battle ahead too.

This is a new paradigm and we cant let the industry bury it just to save their businesses and ties with Pharma.!!

Good Luck and God Bless.

Keep us informed, ok.

[prosper]

As wonderful as A is, please take the time to realize it is not as simple to dose as it seems at first. I strongly suggest you read some of the past posts of the pioneers like Sam and the guy in Australia. Fine tuning dosage amounts and timing seem to me, a non-diabetic, as extremely important.
Good luck

[peppy]

Mar 2, 2016 17:13:29 GMT -5 Incognita said:

1) I have a long relationship with this endo and I respect his opinion.  Not, however, regarding Afrezza.  I pledged to myself that I would work to help this good but conservative doctor understand this new drug.  Shortly after Afrezza came on the market, I requested a prescription for Afrezza and like many encountered a lot of resistance.  Despite his refusal, I persisted, I ask for and he gave me a referral to get a spirometry test which I did to remove any future objections. I spent a year trying it his way.
2) I have been on metformin, and then he had me try pills (glipizide  and others etc.) and a Humalog KwikPen.  My most recent A1c is 6.2 but that comes with great effort.  In this last visit, he wanted to add Januvia or Actos.  I rejected both options.  It was a very difficult meeting but I was resolute. 
3) My prescription for 90 doses of 4 units cost me $55.94. I am aware that I might actually need more units per month depending food consumption/snacks, but I wanted to just get started. He was not familiar with the dosing and was afraid of not having the flexibility of the pen for units.  I am his first patient on Afrezza.
4) Perhaps my biggest motivation has been to get my brother on Afrezza. I have been working on him too.  He is a very brittle diabetic and at age 55 we have had many near death hypoglycemic experiences with him.  I don't say that lightly, day to day, moment by moment life is coloured by his diabetes.  He is on Medicaid, not sure about their coverage yet. He does however have a Dexacom CGM which has been a life-saving grace.  He too has had resistance from his endos, but also he is afraid to change his routine.  My father is not yet on Afrezza but is open-minded.  I am hopeful he will see me and try it too.  As we know several other Type 1s that have gone through the difficult journey to gain access to Afrezza and find it has changed their lives miraculously for the better-- our family is hopeful that my brother and father will one day have access to it.

 
 

Incognita, thank you for your story. I hope you find using afrezza a positive. It will be interesting to see if you can come off one of the two orals (Glipizide), or if the amount of long acting you are on can be reduced.

Your co pay seems good.

[Incognita]

Thanks to all for comments and suggestions to my previous posts a while ago. Here's an update. And yes, getting dosing correct does take time -- you may remember I picked up my first prescription for Afrezza on 2/2/2016. Well I picked up my 3rd prescription from CVS on 7/22/16 after seeing my endo on 7/20. I feel much better. As a Type 2, I found that 4 units of Afrezza brought my BG down about 50 points. I talked with my doctor and we agreed that the prescription dosing could be increased to up to 8 units per meal plus 1 extra 4 unit dose per day (so in fact the new prescription only covers 75 days: with 540 4 units now rather than previous prescription of 270 4 unit cartidges for 90 days). CVS received the prescription order on 7/20 and was able to get 4 boxes 90 cartridges of 4 units the next day (Sanofi expire date 12/16) and the additional 2 boxes of 90 cartridges of 4 units from Mannkind with 04/2018 expire date on 7/22. VERY QUICK no problems at all and they called me throughout process to let me know what they could get by when. I now enjoy the freedom and great control Afrezza brings each day including the amazing convenience when travelling. Regarding cost -- I asked what the co-pay was and it came back $0! CVS submitted cost to my private prescription plan of $1,630.62 which was discounted to $1,335.95 that they paid. Apparently, I have met the out of pocket annual cost (ouch) and now am in the 100% coverage zone for the rest of the year. I am planning on visiting my Type 1 brother and Type 2 father next week to share my experience and push them along to join the Afrezza journey. Hope everyone enjoys their summer and Mannkind 2.0.

[mnholdem]

If so, that would be $2.47 average per 4-unit cartridge (discounted).  It's my understanding that one 8-unit cartridge is cheaper than using two 4-unit cartridges. It seems odd that your doc didn't prescribe some 8-unit packs to save you (or your payer) some $$$.

[Deleted]

Aug 1, 2016 11:36:08 GMT -5 Incognita said:

Thanks to all for comments and suggestions to my previous posts a while ago. Here's an update. And yes, getting dosing correct does take time -- you may remember I picked up my first prescription for Afrezza on 2/2/2016. Well I picked up my 3rd prescription from CVS on 7/22/16 after seeing my endo on 7/20. I feel much better. As a Type 2, I found that 4 units of Afrezza brought my BG down about 50 points. I talked with my doctor and we agreed that the prescription dosing could be increased to up to 8 units per meal plus 1 extra 4 unit dose per day (so in fact the new prescription only covers 75 days: with 540 4 units now rather than previous prescription of 270 4 unit cartidges for 90 days). CVS received the prescription order on 7/20 and was able to get 4 boxes 90 cartridges of 4 units the next day (Sanofi expire date 12/16) and the additional 2 boxes of 90 cartridges of 4 units from Mannkind with 04/2018 expire date on 7/22. VERY QUICK no problems at all and they called me throughout process to let me know what they could get by when. I now enjoy the freedom and great control Afrezza brings each day including the amazing convenience when travelling. Regarding cost -- I asked what the co-pay was and it came back $0! CVS submitted cost to my private prescription plan of $1,630.62 which was discounted to $1,335.95 that they paid. Apparently, I have met the out of pocket annual cost (ouch) and now am in the 100% coverage zone for the rest of the year. I am planning on visiting my Type 1 brother and Type 2 father next week to share my experience and push them along to join the Afrezza journey. Hope everyone enjoys their summer and Mannkind 2.0.

does your doc has any one else on Afrezza?

[Incognita]

Actually, he was going to order some 8 units, but as I am just starting, I asked for 4 units to give me more flexibility until I get used to the larger amount.  There are times when I will split the dose.