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Post by peppy on Jun 20, 2016 9:55:10 GMT -5
Hi Peppy. The NHS covers everyone, no 'tiers' or whatever. There are no 'co-pays' as such in the NHS but there is a flat fee of £8.40 paid to the pharmacist by the patient per NHS prescription, per medicine, for most medicines (which presumably covers their costs as private companies on the high street). Note that a 'prescription' is unrelated to the number of actual units of the medicine included, so if you have a NHS doctor who writes you (eg) a 4 month long prescription covering multiple repeats of a drug then that is all included in the £8.40. People who are on state benefits or who are old pay no prescription charge. Some drugs have no fee, such as contraceptive pills. The charge never exceeds £8.40 for medicines, irrespective of their cost to the NHS, as far as I know. If a drug is available cheaper than £8.40 over the counter then of course people may decide not to use the NHS prescription (eg if a doctor prescribed aspirin, one would just buy it rather than use the prescription unless one was entitled to free prescriptions). You can also buy reduced price prescriptions by paying a modest annual or three-month cost in advance, if you are a bulk user of multiple drugs, so as to keep the cost down to £2 per week for unlimited prescriptions. One of the factors in the 'Brexit' vote on Thursday this week is that (eg) any EU citizen can come to the UK and get prescriptions at that cost if they are unwell and get a prescription from an NHS doctor. www.nhs.uk/NHSEngland/Healthcosts/Pages/Prescriptioncosts.aspxPS, £16 (=just under $24 USD) is more like 20.65 Euros at the moment if anyone is interested in the Euro equivalent. quote; Some drugs have no fee, such as contraceptive pills. The charge never exceeds £8.40 for medicines, irrespective of their cost to the NHS, as far as I know.
reply; This makes me crazy, In the USA contraceptive is so difficult to get with out health insurance before Obama care and before parent extended health care ages for college students. This best in the world, enlighten society is dumb as dirt at these levels. What a story we have been sold. As a society the dollar amount per prescription more.
Here is a good one to point out the stories sold with out facts or studies; Myths and Facts About Antidepressants | Robert Whitaker and Stefan Molyneux www.youtube.com/watch?v=2hUltqHaGTA I know a 29 year old master degree psychotherapist that bought the story, that there is something wrong with her brain chemistry. Turns old that was/is a made up story. did they say 14 billion dollars a year industry? A marketed to you made up story. How stupid are we.
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Post by madog365 on Jun 20, 2016 10:29:40 GMT -5
Looks like Mike H pretty much confirmed they are reducing the price come July. "Part of the re-launch includes a new NDC (National Drug Code) number that standardizes the Afrezza copay as a single price-point instead of the patient having to pay different copays for varying cartridge concentrations. MannKind won't be releasing that cost until July, but it will be less than the approximate $19 per day it costs the average patient using an injectable mealtime insulin." www.healthline.com/diabetesmine/afrezza-news-updates
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Post by peppy on Jun 20, 2016 10:44:08 GMT -5
Looks like Mike H pretty much confirmed they are reducing the price come July. "Part of the re-launch includes a new NDC (National Drug Code) number that standardizes the Afrezza copay as a single price-point instead of the patient having to pay different copays for varying cartridge concentrations. MannKind won't be releasing that cost until July, but it will be less than the approximate $19 per day it costs the average patient using an injectable mealtime insulin."www.healthline.com/diabetesmine/afrezza-news-updatesmadog, in the kindest way, in the past I have done the math. $125 dollar vial apidra/ 30 days = $4.16 250 dollar 4u/8u 30 day afrezza = 8.33
as I recall I found an article that put fast acting at $3.19/day. afrezza was running 10 to 11 dollars a day.
I have never seen $19 dollars a day for injectable meal time insulin.
Data from some studies showed: •Onset of action within 16 to 21 minutes for Afrezza compared to 45 to 52 minutes for subcutaneous insulin across trials •Afrezza's duration of action at clinically relevant doses was consistently shorter by 2 to 3 hours •Afrezza's labeled dose overestimates its effect, meaning patients need better titration to get the appropriate dose •A 4-unit Afrezza cartridge provides approximately the same insulin exposure as 3.1 units of Humalog. •Lung tests showed PWDs didn't experience any negative lung effects after three months going up to 24 months
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Post by madog365 on Jun 20, 2016 10:54:12 GMT -5
You make a good point. Maybe he meant weekly? I'm not sure but being that MikeH is a diabetic who has tried both types of fast acting insulin i'm sure he is not just pulling that number out of thin air
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Post by Deleted on Jun 20, 2016 10:57:41 GMT -5
Is it me or all his articles back handed?
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Post by kbrion77 on Jun 20, 2016 11:07:59 GMT -5
Looks like Mike H pretty much confirmed they are reducing the price come July. "Part of the re-launch includes a new NDC (National Drug Code) number that standardizes the Afrezza copay as a single price-point instead of the patient having to pay different copays for varying cartridge concentrations. MannKind won't be releasing that cost until July, but it will be less than the approximate $19 per day it costs the average patient using an injectable mealtime insulin." www.healthline.com/diabetesmine/afrezza-news-updatesWhat is the scientific response to him saying others have needed to bump up their dosing (Amy T) over time?
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Post by peppy on Jun 20, 2016 11:25:58 GMT -5
Looks like Mike H pretty much confirmed they are reducing the price come July. "Part of the re-launch includes a new NDC (National Drug Code) number that standardizes the Afrezza copay as a single price-point instead of the patient having to pay different copays for varying cartridge concentrations. MannKind won't be releasing that cost until July, but it will be less than the approximate $19 per day it costs the average patient using an injectable mealtime insulin." www.healthline.com/diabetesmine/afrezza-news-updatesWhat is the scientific response to him saying others have needed to bump up their dosing (Amy T) over time? It may be this •Afrezza's labeled dose overestimates its effect, meaning patients need better titration to get the appropriate dose •A 4-unit Afrezza cartridge provides approximately the same insulin exposure as 3.1 units of Humalog.
Or since you asked, I came across this information, posted it as part of a larger text months ago, and sat on it, thinking it through. Part of what makes afrezza work so well is the phase one response that subq analogue insulin does not allow. subq phase two. IF, some one were so insulin resistant, that their liver cells (phase one) were insulin resistant, less phase 1, or higher dose. ? I wondered what that type of insulin resistance would mean in type two.
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Post by Deleted on Jun 20, 2016 11:32:15 GMT -5
If you google the Italian Dr's name and SNY you can find they have paid him multiple times in the past for "research support"
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Post by sportsrancho on Jun 20, 2016 11:34:33 GMT -5
It's seems like at first people need more than they think they do because the dosing isn't the same. Then less over time. The kids have been using Afrezza now over a year and need less.
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Post by victoria on Jun 20, 2016 11:53:03 GMT -5
Hi Peppy. The NHS covers everyone, no 'tiers' or whatever. There are no 'co-pays' as such in the NHS but there is a flat fee of £8.40 paid to the pharmacist by the patient per NHS prescription, per medicine, for most medicines (which presumably covers their costs as private companies on the high street). Note that a 'prescription' is unrelated to the number of actual units of the medicine included, so if you have a NHS doctor who writes you (eg) a 4 month long prescription covering multiple repeats of a drug then that is all included in the £8.40. People who are on state benefits or who are old pay no prescription charge. Diabetics on drugs or insulin are one of the classes where they will give you a medical exemption certificate. These are worth having as they are permanent and exempt you from all NHS charges and not just diabetes related ones. No more prescription charges (co-pays) ever. Thanks ah, I didn't know that (Im not yet diabetic). Makes sense for it to be free since its essential to life and is a permanent need, so would be discriminatory to make diabetics pay).
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Post by anderson on Jun 20, 2016 12:04:55 GMT -5
What is the scientific response to him saying others have needed to bump up their dosing (Amy T) over time? It may be this •Afrezza's labeled dose overestimates its effect, meaning patients need better titration to get the appropriate dose •A 4-unit Afrezza cartridge provides approximately the same insulin exposure as 3.1 units of Humalog.
Or since you asked, I came across this information, posted it as part of a larger text months ago, and sat on it, thinking it through. Part of what makes afrezza work so well is the phase one response that subq analogue insulin does not allow. subq phase two. IF, some one were so insulin resistant, that their liver cells (phase one) were insulin resistant, less phase 1, or higher dose. ? I wondered what that type of insulin resistance would mean in type two.
Some other questions that need to be asked are: did they cut back on their basal intake so have less of a buffer? What is the timing when they take Afrezza. We just do have enough information about these cases to know right now. Also timing might be everything afrezzadownunder.com/2015/11/simple-sugar-surfing/
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Post by capnbob on Jun 20, 2016 12:37:53 GMT -5
In order for Afrezza to be a success, the price needs to be competitive or discounted with rapid acting insulins. Given its non-inferiority, I don't see how payers, insurance companies and doctors can ignore Afrezza once the price is reduced. The question is, when will MannKind reduce the price? Mike Castagna feel free to chime in. I would argue that the primary underlying problem is that the label says: "AFREZZA provided less HbA1c reduction than insulin aspart, and the difference was statistically significant. More subjects in the insulin aspart group achieved the HbA1c target of ≤7% (Table 4)" Even lowering the price can't overcome that comment. An insurer looking at reimbursing type 1s is bound to ask why should it pay anything at all for something that is less effective; the argument being that long term costs of complications could outweigh short term savings from a cheaper insulin. What is really needed is a study to conclusively demonstrate that afrezza is superior to lispro. That would pretty much solve most of the product's problems.
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Post by seanismorris on Jun 20, 2016 13:26:17 GMT -5
Docs don't seem to care about the PK profile. If MannKind keeps pushing PK in their marketing Afrezza sales aren't going anywhere.
Educating Docs that HbA1c isn't everything is going to be difficult...that's the standard they go by.
MannKind needs to be extremely price aggressive and emphasize less hospital visits, that's the only thing that can counter the HbA1c perception.
For Afrezza to pick up any significant traction, MannKind needs to design a trial to show superiority. Otherwise, Afrezza will almost certainly be a niche product and the company won't survive.
At the ADA I expected/hoped MannKind would wow with some new data, instead we got more of the same. The markets seem to agree, and the stock price has stalled. The volume has been low and earlier in the year institution ownership dived. I recommend keeping an eye on the institutional ownership because the direction it goes (from here) will tell you what to do.
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Post by ilovekauai on Jun 20, 2016 13:38:58 GMT -5
IMO the benefits of Afrezza far outweigh any perceived negs, so often and repeatedly brought up here by some. Time will tell if I'm correct, I stand by the future success of this company which is coming in the years ahead, and look forward to that time with great happiness; not only for the sake of MNKD and my investment, but for all diabetics worldwide who will benefit from this fantastic endeavor. Aloha.
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Post by nylefty on Jun 20, 2016 13:55:42 GMT -5
IMO the benefits of Afrezza far outweigh any perceived negs, so often and repeatedly brought up here by some. Time will tell if I'm correct, I stand by the future success of this company which is coming in the years ahead, and look forward to that time with great happiness; not only for the sake of MNKD and my investment, but for all diabetics worldwide who will benefit from this fantastic endeavor. Aloha. Great response to all the negativity that's being displayed here. Spillover from the Yahoo board?
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