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Post by straightly on Oct 6, 2016 19:28:40 GMT -5
Gonetotown said "The ultimate test of whether spirometry is a "minimal barrier" is the number of endos doing them to prescribe afrezza. However, posted here when talking about the shareholder lawsuit was some testimony by a former afrezza rep saying that spirometry was a major barrier to getting endos to write scripts. Has anything changed? If it was a "major" barrier a year ago, why would it not be a major barrier now? And if it's so "simple," then why exactly is it a major barrier? "
I don't believe what this former Afrezza rep said... The spirometry test is not a barrier... the true barriers are the attitudes of docs.. lack of insurance coverage.. trust me... the first walls we ran up against were docs not wanting to change what they are doing ... the spiro was a snap.. a slight inconvenience .. no big deal and certainly not what has caused all of the problems.. Mike talked about docs having a small spiro machine right in the office and I would think that would be sufficient.. if not they can still order a test from lab and x-ray using the bigger machine.. NO BIG DEAL ..
Every single doc we have had contact with while trying to get a script for Afrezza had an attitude about it .. and said the insurance wont cover it anyway.. blah blah blah or they don't want to hassle with pre authorization.. etc etc etc .. Afrezza isn't established... that is the barrier we need to break.. anything we can do now to streamline the process and make it easier will help.. but the big problems are with insurance and docs.. particularly general practitioners.. docs order labs and x-rays everyday .. why would a spiro be such a big deal.??.. ITS NOT ..
"the true barriers are the attitudes of docs..."? You are EXACTLY correct. Spirometry is likely a "red herring" which makes a good excuse to refuse to use afrezza. Like everyone else, physicians develop "grooves" -- routines that they feel comfortble with. Lispro has a very, very deep groove with endos. It doesn't require worrying about spirometry or pulmonary function tests. It doesn't require dealing with insurance companies prior authorization forms and filing appeals. They know lispro's physiology inside out, have memorized every medication interaction, and could recite appropriate dosing for any patient backwards and forwards. Mannkind could make spirometry as cheap and easy as taking a drink of water and odds are endos will still use it as an excuse not to prescribe afrezza. Forget spirometry reimbursement as a carrot since endos rake in more than enough loot with lispro and with fewer headaches. Indeed, like it or not, from the endo's perspective, afrezza has nothing going for it except that it doesn't require an injection. For the endo, the "rapid in/out" that so many treasure just creates management complications that he/she would just as soon not deal with. And the patient can threaten to go elsewhere, but since practically every endo in the country has a waiting list several pages long, it's simple enough for him/her to say, "go ahead." The only way to overcome this is a clinical trial clearly demonstrating that afrezza produces superior clinical benefits -- superior A1cs, fewer ER visits, less complications, etc. Aman. The only hope for Afrezza is the patients. We HAVE to re move or ease the obstacles as mentioned, but need the patients sUchiha as Sweenee-Dad to get the water start to flow. |
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Post by Deleted on Oct 6, 2016 19:37:42 GMT -5
gonetotown , You don't say that you actually practice medicine. Indeed, residency trained, board certified, licensed in two states -- just another pathetic example of American medicine going to hell in a hand basket, I suppose. Thanks for reminding me of a great song. Here is a snipit for you. You analyze me, tend to despise me You laugh when I stumble and fall There may come a say when I'll dance on your grave Unable to dance I'll still crawl across it Unable to dance I'll still crawl Unable to dance I'll still crawl Unable to dance I'll crawl. You must really consider the circus It just might be your kind of zoo I can't think of a place that's more perfect For a person as perfect as you. And it's not like I'm leaving you lonely 'Cause I wouldn't know where to begin Well I know you wake up here only When the snakes come marching in. You imagine me sipping champagne from your boot For taste of your elegant pride I may be going to hell in a bucket, babe But at least I'm enjoying the ride, at least I'll enjoy the ride. |
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Post by sweedee79 on Oct 6, 2016 20:24:35 GMT -5
Gonetotown said "The ultimate test of whether spirometry is a "minimal barrier" is the number of endos doing them to prescribe afrezza. However, posted here when talking about the shareholder lawsuit was some testimony by a former afrezza rep saying that spirometry was a major barrier to getting endos to write scripts. Has anything changed? If it was a "major" barrier a year ago, why would it not be a major barrier now? And if it's so "simple," then why exactly is it a major barrier? "
I don't believe what this former Afrezza rep said... The spirometry test is not a barrier... the true barriers are the attitudes of docs.. lack of insurance coverage.. trust me... the first walls we ran up against were docs not wanting to change what they are doing ... the spiro was a snap.. a slight inconvenience .. no big deal and certainly not what has caused all of the problems.. Mike talked about docs having a small spiro machine right in the office and I would think that would be sufficient.. if not they can still order a test from lab and x-ray using the bigger machine.. NO BIG DEAL ..
Every single doc we have had contact with while trying to get a script for Afrezza had an attitude about it .. and said the insurance wont cover it anyway.. blah blah blah or they don't want to hassle with pre authorization.. etc etc etc .. Afrezza isn't established... that is the barrier we need to break.. anything we can do now to streamline the process and make it easier will help.. but the big problems are with insurance and docs.. particularly general practitioners.. docs order labs and x-rays everyday .. why would a spiro be such a big deal.??.. ITS NOT ..
"the true barriers are the attitudes of docs..."? You are EXACTLY correct. Spirometry is likely a "red herring" which makes a good excuse to refuse to use afrezza. Like everyone else, physicians develop "grooves" -- routines that they feel comfortble with. Lispro has a very, very deep groove with endos. It doesn't require worrying about spirometry or pulmonary function tests. It doesn't require dealing with insurance companies prior authorization forms and filing appeals. They know lispro's physiology inside out, have memorized every medication interaction, and could recite appropriate dosing for any patient backwards and forwards. Mannkind could make spirometry as cheap and easy as taking a drink of water and odds are endos will still use it as an excuse not to prescribe afrezza. Forget spirometry reimbursement as a carrot since endos rake in more than enough loot with lispro and with fewer headaches. Indeed, like it or not, from the endo's perspective, afrezza has nothing going for it except that it doesn't require an injection. For the endo, the "rapid in/out" that so many treasure just creates management complications that he/she would just as soon not deal with. And the patient can threaten to go elsewhere, but since practically every endo in the country has a waiting list several pages long, it's simple enough for him/her to say, "go ahead." The only way to overcome this is a clinical trial clearly demonstrating that afrezza produces superior clinical benefits -- superior A1cs, fewer ER visits, less complications, etc. what you are saying paints a very dismal picture of our health care in this country... docs are putting themselves before patients..? I don't believe that is completely the case.. also it doesn't take that long to get connected with an endo.. just a few weeks.. the endos now have specially trained nurse practitioners working under them in order to carry the case load... fast in and fast out is important and any competent endo will know this.. you would think they would want to stay ahead of the game rather than fall behind prescribing the same old same old... docs will not be sued for a side effect of the medicine as long as they follow recommended procedure. And no place does it state that a certain kind of spiro has to be used... from what I have read it takes time before any new medicine is acknowledged.. I believe we have made some good headway in every state even without advertising.. and also, if a patient requests Afrezza and their is insurance coverage, most docs even the GPs will try to get it for them .. SO .. our biggest problem is the insurance coverage.. not all of the other things you speak of .. we have met with receptive attitudes in the endo office... it is the GPs that have been reluctant.. and if there was insurance coverage it more than likely wouldn't be that big of a problem.. |
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