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Post by sweedee79 on Nov 11, 2016 17:50:24 GMT -5
IS covering Afrezza .....
I just got off the phone with an Express Scripts rep ... Afrezza is not yet on their formulary .. however the rep told me that with a script and PA they will cover at tier 3 or 4 ... So .. Dad and i proceed with getting him back on Afrezza... we are getting a referral to what seems to be an excellent endo a couple of hours from here who also has a spiro right in his office...... YES .. progress is being made!!!!
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Post by sweedee79 on Nov 11, 2016 18:07:44 GMT -5
I just have to say.... THANK YOU Mike C and Matt P ... you guys are getting it done .. My personal opinion is that the 2017 Express Scripts part D formulary was already done before talks were finished with Mike C , otherwise Afrezza would be on the formulary already... Because the rep basicly said its covered but didn't get on the formulary for the coming year ...
My bet... it will be on the formulary for 2018 ... and it has the same coverage as other meal time insulins ... if we end up with a tier 4 .. we will appeal for tier 3 coverage ..
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Post by Deleted on Nov 11, 2016 18:37:16 GMT -5
IS covering Afrezza .....
I just got off the phone with an Express Scripts rep ... Afrezza is not yet on their formulary .. however the rep told me that with a script and PA they will cover at tier 3 or 4 ... So .. Dad and i proceed with getting him back on Afrezza... we are getting a referral to what seems to be an excellent endo a couple of hours from here who also has a spiro right in his office...... YES .. progress is being made!!!!
Make a call to the endo and ensure he is willing to prescribe Afrezza and not just go by doctor's listed on Afrezza.com as couple of people reported here being shot down after 4 months of wait. also on the formulary, usualy PBM's publish formulary updates if there is any change ( on their website or by mail - i am not sure ), may be they just didnt get to it yet. |
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Post by sweedee79 on Nov 11, 2016 18:42:18 GMT -5
IS covering Afrezza .....
I just got off the phone with an Express Scripts rep ... Afrezza is not yet on their formulary .. however the rep told me that with a script and PA they will cover at tier 3 or 4 ... So .. Dad and i proceed with getting him back on Afrezza... we are getting a referral to what seems to be an excellent endo a couple of hours from here who also has a spiro right in his office...... YES .. progress is being made!!!!
Make a call to the endo and ensure he is willing to prescribe Afrezza and not just go by doctor's listed on Afrezza.com as couple of people reported here being shot down after 4 months of wait. also on the formulary, usualy PBM's publish formulary updates if there is any change ( on their website or by mail - i am not sure ), may be they just didnt get to it yet. Will do ... Mike C asked me to tell the endo clinic what we were coming to see them for when I make the appointment .... also, Mike C has already asked me for the name of the doc and will be contacting that doc before we arrive ...
I also think it will help that my dad has already been on Afrezza and has had wonderful results that we can share with the new endo
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Post by sportsrancho on Nov 11, 2016 18:50:24 GMT -5
Make a call to the endo and ensure he is willing to prescribe Afrezza and not just go by doctor's listed on Afrezza.com as couple of people reported here being shot down after 4 months of wait. also on the formulary, usualy PBM's publish formulary updates if there is any change ( on their website or by mail - i am not sure ), may be they just didnt get to it yet. Will do ... Mike C asked me to tell the endo clinic what we were coming to see them for when I make the appointment .... also, Mike C has already asked me for the name of the doc and will be contacting that doc before we arrive ...
I also think it will help that my dad has already been on Afrezza and has had wonderful results that we can share with the new endo
That is so awesome!! Congrats, and I'm sure this is going to make everyone's day! So glad for your dad and impressed with Mike! |
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Post by dreamboatcruise on Nov 11, 2016 19:06:53 GMT -5
I'm sure there might be a tendency for some to think that someone in Mike's position shouldn't have to be calling individual doctors... but I think this is simply an extension of Al Mann's philosophy of focusing on the patients. I applaud Mike's willingness to jump in and help solve the problems on the ground. There is no better way for him to learn what it will take to make Afrezza the success we know it can be than to talk to patients and doctors directly.
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Post by peppy on Nov 11, 2016 19:16:25 GMT -5
I'm sure there might be a tendency for some to think that someone in Mike's position shouldn't have to be calling individual doctors... but I think this is simply an extension of Al Mann's philosophy of focusing on the patients. I applaud Mike's willingness to jump in and help solve the problems on the ground. There is no better way for him to learn what it will take to make Afrezza the success we know it can be than to talk to patients and doctors directly. it is more impressive like this. no better way to solve the problems on the ground, than to work them and learn how to solve them first hand to show your team what works.
I listened to the conference call once more. point on well spoken plan. Mike/ the team seem to be solving the insurance problem. and really that was the problem.
They look to have the insurance problem solved by TV advertisement time.
Listening to mike, the effectiveness the patient was getting/ they needed more insulin than the prescription. Like adam lasher. Anyway he said the 8 unit /12 unit packs will help.
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Post by compound26 on Nov 11, 2016 19:18:04 GMT -5
I'm sure there might be a tendency for some to think that someone in Mike's position shouldn't have to be calling individual doctors... but I think this is simply an extension of Al Mann's philosophy of focusing on the patients. I applaud Mike's willingness to jump in and help solve the problems on the ground. There is no better way for him to learn what it will take to make Afrezza the success we know it can be than to talk to patients and doctors directly. agree. This is especially the case considering that we are still in the beginning stages of the relaunch and our TRx base is still small. Every patient and his/her satisfaction counts at this stage. |
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Post by grace198 on Nov 11, 2016 19:22:25 GMT -5
IS covering Afrezza .....
I just got off the phone with an Express Scripts rep ... Afrezza is not yet on their formulary .. however the rep told me that with a script and PA they will cover at tier 3 or 4 ... So .. Dad and i proceed with getting him back on Afrezza... we are getting a referral to what seems to be an excellent endo a couple of hours from here who also has a spiro right in his office...... YES .. progress is being made!!!!
You might be able to track its progress on www.goodrx.com/afrezza/medicare-coverage/express-scripts-medicare-value-pdp |
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Post by Deleted on Nov 11, 2016 19:53:46 GMT -5
IS covering Afrezza .....
I just got off the phone with an Express Scripts rep ... Afrezza is not yet on their formulary .. however the rep told me that with a script and PA they will cover at tier 3 or 4 ... So .. Dad and i proceed with getting him back on Afrezza... we are getting a referral to what seems to be an excellent endo a couple of hours from here who also has a spiro right in his office...... YES .. progress is being made!!!!
You might be able to track its progress on www.goodrx.com/afrezza/medicare-coverage/express-scripts-medicare-value-pdpGood RX is not a trusted source. Express scripts is. Good RX doesn't even know titration pack is available even though they are two different variables and sources |
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Post by kball on Nov 11, 2016 20:30:15 GMT -5
So happy for you and your dad Sweedee!
For those of us here who have been following your agonizing story of frustration after such wonderful success he had, we're looking forward to happier posts, less stress, and better health.
For him. And you
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Post by kc on Nov 11, 2016 21:34:16 GMT -5
I'm sure there might be a tendency for some to think that someone in Mike's position shouldn't have to be calling individual doctors... but I think this is simply an extension of Al Mann's philosophy of focusing on the patients. I applaud Mike's willingness to jump in and help solve the problems on the ground. There is no better way for him to learn what it will take to make Afrezza the success we know it can be than to talk to patients and doctors directly. Mike also learned firsthand what it takes to talk to the doctors and get them to prescribe. So it's a teaching moment for him to hear it and pass it on to his staff |
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Post by nadathing on Nov 11, 2016 21:52:22 GMT -5
Went to see if anything changed on my plan. It is through Caremark. Afrezza 8unit(60) Cart Inhal. My copay would be $50 per month. Prior authorization required.
Notes: You pay 4% of the cost.
Your Plan pays $3,579.78 / 3 months
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Post by u1682002 on Nov 12, 2016 0:20:03 GMT -5
Is $50 copayment per month considered average or too high comparing to other choices?
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Post by sportsrancho on Nov 12, 2016 7:49:47 GMT -5
Is $50 copayment per month considered average or too high comparing to other choices? $50 is what my client pays for the kids. He has Health Net. It's $30 for the pens they used to use. But he would pay out of pocket if he had to! Nothing has changed their life like Afrezza. It's freedom! From lows, from carb counting, from being a pen cushion. And from being embarrassed. And it's cool at school:-)) |
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