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Post by dreamboatcruise on Sept 18, 2017 13:05:55 GMT -5
There could still be step requirements and prior authorizations, couldn't there? Hopefully that label change would mean the coverage for Afrezza in Medicare would be as good as the best RAA... but I'm waiting to see it in writing before getting too excited. Agreed and those of us who have followed the MNKD/FDA relationship for years know we have to wait until we see it in writing. If we could get coverage as good as the best RAA, that would be a big step forward. YUGE step forward  |
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Post by kball on Sept 18, 2017 13:11:02 GMT -5
dreamboatcruise "Management has basically admitted that retention was a significant problem" Link please Back when Hakan was in charge and SNY still involved the drop out rate was in the 60-70% range from what i remember during a cc. And we were all pretty shocked at that number. Probably threads on that from late 15 early 16. It for sure must have dropped though since with different packages and more effort. I'd like to know about what it is currently, but don't have much skin in the game any more. My guess would be management has these numbers but may or may not be willing to disclose |
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Post by peppy on Sept 18, 2017 13:13:04 GMT -5
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Post by dreamboatcruise on Sept 18, 2017 13:26:17 GMT -5
dreamboatcruise I have listened to numerous calls and cannot recall hearing management saying "retention is a significant problem." In addition to implying I was directly quoting management, which I didn't claim to be, you've actually changed the words and meaning significantly. What I said is that management has stated that retention "was" a problem. Was this rewording by you intentional? |
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Post by qwertqwert on Sept 18, 2017 13:31:25 GMT -5
dreamboatcruise I have listened to numerous calls and cannot recall hearing management saying "retention is a significant problem." I did not put that in quotes. Have you heard management talking about improving retention? Yes, or no? I clearly stated above that my use of the word significant meant that management chose to highlight retention improvement in a call. If the improvement is deemed significant enough to talk about, I would then categorize the problem being addressed as having been significant. If you want to quibble with words then state you are quibbling with words. I'm guessing by you ignoring my last post and putting things in quotes that were not, that you are playing disingenuous games. So sorry... not interested in that sort of game playing. I stand by what I've said and further explained... management has indicated that retention has been a problem, improvements have been made through doc education and patient support, and they are awaiting label change they view as important in further improving this. [none of this is in quotes... my summary of things I've seen stated by management] You're right, they did say that. Early on, just after or close to mnkd taking over from snotanofi. |
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Post by ghochr on Sept 18, 2017 13:38:18 GMT -5
It doesn't matter what the issue is behind retention but by the refill rate it sure is a problem.
It was not enough catridge in a pack - titration pack
Insurance?
Titration- this is still a issue. Go on Facebook Afrezza . A user posted she has been running around 300 all day and she didn't know why
Lots of users pitched in and helping her.
Not every one is on Facebook and Afrezza group.
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Post by peppy on Sept 18, 2017 13:43:34 GMT -5
It doesn't matter what the issue is behind retention but by the refill rate it sure is a problem. It was not enough catridge in a pack - titration pack Insurance? Titration- this is still a issue. Go on Facebook Afrezza . A user posted she has been running around 300 all day and she didn't know why Lots of users pitched in and helping her. Not every one is on Facebook and Afrezza group. wow, it is not that difficult. she needs another dose. she is afraid she will go low like on a rapid acting. it must be difficult to make the shift.
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Post by ghochr on Sept 18, 2017 13:48:13 GMT -5
It doesn't matter what the issue is behind retention but by the refill rate it sure is a problem. It was not enough catridge in a pack - titration pack Insurance? Titration- this is still a issue. Go on Facebook Afrezza . A user posted she has been running around 300 all day and she didn't know why Lots of users pitched in and helping her. Not every one is on Facebook and Afrezza group. wow, it is not that difficult. she needs another dose. she is afraid she will go low like on a rapid acting. it must be difficult to make the shift.
It's not difficult for some one that's been on this board for ever discussing every twitter or Facebook post on Afrezza but for a new user it might be. The right question is what is Mannkind sound to solve this? |
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Post by peppy on Sept 18, 2017 13:54:58 GMT -5
wow, it is not that difficult. she needs another dose. she is afraid she will go low like on a rapid acting. it must be difficult to make the shift.
It's not difficult for some one that's been on this board for ever discussing every twitter or Facebook post on Afrezza but for a new user it might be. The right question is what is Mannkind sound to solve this? www.afrezza.com/hcp/starting-titrating/
dosing:
www.seventhform.com/vdexdownloads/vdex-whitepaper-072817.pdf page 22.
Comments
Afrezza’s speed of action is both a blessing and a curse. Clearly, it is a large factor in the safety of the
product, but for longer meals, you may need more Afrezza to keep the post prandial levels in check. We
recommend follow-on doses. For example, we advise with a standard meal to dose Afrezza 15-20
minutes after the start of the meal, and then another dose of the same size about 45 minutes later.
With very long meals, we have even advised patients to administer two follow-on doses, for very tight
control.
Read more: mnkd.proboards.com/thread/7878/afrezza-starting-titrating#ixzz4t3fVwRT8
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Post by dreamboatcruise on Sept 18, 2017 13:55:21 GMT -5
It doesn't matter what the issue is behind retention but by the refill rate it sure is a problem. It was not enough catridge in a pack - titration pack Insurance? Titration- this is still a issue. Go on Facebook Afrezza . A user posted she has been running around 300 all day and she didn't know why Lots of users pitched in and helping her. Not every one is on Facebook and Afrezza group. wow, it is not that difficult. she needs another dose. she is afraid she will go low like on a rapid acting. it must be difficult to make the shift.
Not that difficult in one way, but it is posing a difficulty for MNKD. Hopefully the OneDrop trials will really highlight what can be accomplished with proper education/coaching. Hopefully we'll get the label changes on dosing. Hopefully as word spreads of successes, practioners when confronted with a problem like the one cited above will know how to guide the patient rather than assuming Afrezza simply doesn't work for some. As I stated I was shocked by a doctor saying Afrezza works for some but doesn't work for many. I felt like saying "Does that really make any sense from what you know about the physiology of insulin?" He hadn't even prescribed Afrezza but just stating opinion from what he'd heard from colleagues. |
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Post by Deleted on Sept 18, 2017 14:14:11 GMT -5
dreamboatcruise "Management has basically admitted that retention was a significant problem... though, true, that doesn't have to mean "most people". That is what you wrote. I simply asked for a link in order for me to determine if / when it was said. Not trying to discredit you; you are doing a fabulous job on your own.
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Post by dreamboatcruise on Sept 18, 2017 14:20:18 GMT -5
I'll let people read what I've said and what you've posted and come to their own judgement about credibility.
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Post by mytakeonit on Sept 18, 2017 14:22:22 GMT -5
Medicare requires insurance companies to approve two drugs within each classification. Some classifications only have one drug. If so, that drug is approved for insurance coverage. Mannkind has basically requested three levels of label change for Afrezza the latter of which is its own classification. If Afrezza gets a new classification relating to ultra-fast acting or inhaled insulin, this will be big...no, very big. BP wouldn't wait on us? Huge mistake ... www.youtube.com/watch?v=Nu3x5SZrMHo |
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Post by zuegirdor on Sept 18, 2017 17:13:25 GMT -5
It's not difficult for some one that's been on this board for ever discussing every twitter or Facebook post on Afrezza but for a new user it might be. The right question is what is Mannkind sound to solve this? www.afrezza.com/hcp/starting-titrating/
dosing:
www.seventhform.com/vdexdownloads/vdex-whitepaper-072817.pdf page 22.
Comments
Afrezza’s speed of action is both a blessing and a curse. Clearly, it is a large factor in the safety of the
product, but for longer meals, you may need more Afrezza to keep the post prandial levels in check. We
recommend follow-on doses. For example, we advise with a standard meal to dose Afrezza 15-20
minutes after the start of the meal, and then another dose of the same size about 45 minutes later.
With very long meals, we have even advised patients to administer two follow-on doses, for very tight
control.
Read more: mnkd.proboards.com/thread/7878/afrezza-starting-titrating#ixzz4t3fVwRT8
We observe in my son (and everyone is different?)that very large meals over 80g carbs tend to delay gastric emptying. So this does complicate the follow up routine, if ther is one, insulin and food being so situational for diabetics. So with a meal like he had last night >150g carbs, you need to keep checking glucose levels for 3 or 5 hours. My son was not wearing a CGM and we forgot to remind him to check after the first follow up. Five hours after eating he was at 340! He had probably been digesting his meal for that long! So as great as Afrezza is (he would never eat that many carbs on injected)some situations can overwhelm you if you forget to pay attention. Not all meals follow the one or even two follow up pattern. |
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Post by dreamboatcruise on Sept 18, 2017 17:39:41 GMT -5
We observe in my son (and everyone is different?)that very large meals over 80g carbs tend to delay gastric emptying. So this does complicate the follow up routine, if ther is one, insulin and food being so situational for diabetics. So with a meal like he had last night >150g carbs, you need to keep checking glucose levels for 3 or 5 hours. My son was not wearing a CGM and we forgot to remind him to check after the first follow up. Five hours after eating he was at 340! He had probably been digesting his meal for that long! So as great as Afrezza is (he would never eat that many carbs on injected)some situations can overwhelm you if you forget to pay attention. Not all meals follow the one or even two follow up pattern. Is the reason for not having a CGM that it is not covered by insurance, or simply not wanting to wear one? Would a non-invasive BG meter help with more frequent follow up testing? If insurance would pay for both an RAA and Afrezza would you use an RAA for meals that you think would be long digesting, or do you think the better/easier solution would be follow up doses of Afrezza? |
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