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Post by sr71 on Feb 12, 2018 13:51:50 GMT -5
twitter.com/castagna2011?lang=en
Mike Castagna @castagna2011 · 11h11 hours ago
"You wonder why AETNA made over $4B in cash flow last year. Easy when you deny care and bill the employer fees not based on any outcomes. United and Blue Shield of CA are even worse. Wait until other medical directors have to put their neck on the line."
This is pretty strong language considering how important third party payers are for Afrezza's future success. Or maybe there is another (better?) plan in the works?
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Post by dreamboatcruise on Feb 12, 2018 13:56:21 GMT -5
Hopefully that was well considered on his part and not impulsive.
Some of Al's criticism about the FDA may well have contributed to problems that were encountered. Having the ability to speak truth to power is an asset, especially when coupled with the wisdom to know when not to do it.
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Post by goyocafe on Feb 12, 2018 14:17:11 GMT -5
How many subscribers would it take to create a Diabetes Advantage program (a lot like supplemental prescription insurance for medicare)? An independent, possibly non-profit organization that enables physicians and patients to get the care they need. I know nothing about how this might work, but the idea came to me while watching re-runs of Deal or No Deal. I figured it had to be a good idea.  |
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Post by celo on Feb 12, 2018 14:35:30 GMT -5
Mike's timing of this shot across the bow, seems to be more than ironic that it occurred after the hiring of Dave. It helps when you have a person with such a large footprint in the world of diabetes all of sudden right behind your back
His anger is justified on many levels, beyond the continual exclusion of Afrezza. Both Dave and Mike, I'm sure share a strong sense they have the tool to control a disease that they have strong personal ties to. They are both probably tired of watching more and more patients with misinformation and poor options not be able to control their diabetes. If you have a lot of money or great insurance, Afrezza is all yours, if not, go get the tired old medications the big pharmas/insurers are pitching.
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Post by dreamboatcruise on Feb 12, 2018 15:11:06 GMT -5
How many subscribers would it take to create a Diabetes Advantage program (a lot like supplemental prescription insurance for medicare)? An independent, possibly non-profit organization that enables physicians and patients to get the care they need. I know nothing about how this might work, but the idea came to me while watching re-runs of Deal or No Deal. I figured it had to be a good idea. That would be a very expensive risk pool so the idea of having it be self funded doesn't seem viable. I'm guessing that you would hope that it would use better standards of care and thus reduce long term costs. That might be true, but there would still be the issue of where to shift money away from in order to subsidize it such that premiums for that risk pool today would be affordable to them. |
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Post by sr71 on Feb 12, 2018 16:09:11 GMT -5
Hopefully that was well considered on his part and not impulsive. Some of Al's criticism about the FDA may well have contributed to problems that were encountered. Having the ability to speak truth to power is an asset, especially when coupled with the wisdom to know when not to do it.Very insightful, DBC.
I can think of 3 things (individually, or in combination) that may have prompted Mike's tweet as worded:
1. The "large insurer" that was to start providing much better coverage for Afrezza in January perhaps didn't. 2. There could be a plan to somehow be less dependent upon the large insurance payers for Afrezza's success. 3. Mike "lost it" and spoke in a way he shouldn't have.
Personally, I discount #3 since Mike has given every indication that he is a thoughtful professional that carefully considers what he says.
Although #1 may well turn out to be true, my gut feeling is that #2 is the real reason. I agree that the timing of Dr. K's hiring is (hopefully) more than just coincidental on this front.
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Post by timri on Feb 12, 2018 16:22:14 GMT -5
Hopefully that was well considered on his part and not impulsive. Some of Al's criticism about the FDA may well have contributed to problems that were encountered. Having the ability to speak truth to power is an asset, especially when coupled with the wisdom to know when not to do it.Very insightful, DBC.
I can think of 3 things (individually, or in combination) that may have prompted Mike's tweet as worded:
1. The "large insurer" that was to start providing much better coverage for Afrezza in January perhaps didn't. 2. There could be a plan to somehow be less dependent upon the large insurance payers for Afrezza's success. 3. Mike "lost it" and spoke in a way he shouldn't have.
Personally, I discount #3 since Mike has given every indication that he is a thoughtful professional that carefully considers what he says.
Although #1 may well turn out to be true, my gut feeling is that #2 is the real reason. I agree that the timing of Dr. K's hiring is (hopefully) more than just coincidental on this front.
I was hoping that one of the big three listed were going to be our new approved large insurer. That’s a pretty ballsy taunt mike threw out there. I’m Hoping he has something to back up the words. |
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Post by dreamboatcruise on Feb 12, 2018 16:26:31 GMT -5
Hopefully that was well considered on his part and not impulsive. Some of Al's criticism about the FDA may well have contributed to problems that were encountered. Having the ability to speak truth to power is an asset, especially when coupled with the wisdom to know when not to do it.Very insightful, DBC.
I can think of 3 things (individually, or in combination) that may have prompted Mike's tweet as worded:
1. The "large insurer" that was to start providing much better coverage for Afrezza in January perhaps didn't. 2. There could be a plan to somehow be less dependent upon the large insurance payers for Afrezza's success. 3. Mike "lost it" and spoke in a way he shouldn't have.
Personally, I discount #3 since Mike has given every indication that he is a thoughtful professional that carefully considers what he says.
Although #1 may well turn out to be true, my gut feeling is that #2 is the real reason. I agree that the timing of Dr. K's hiring is (hopefully) more than just coincidental on this front.
It seems that the "large insurer" (or PBM) thing did happen but it wasn't exactly what we had assumed. From Mike's comments it seems some agreement was concluded, but it didn't get Afrezza on their "national" formulary, it merely gave MNKD the ability to now go to individual plan sponsors in various states and try to get Afrezza on each formulary. I really don't know enough about how all of it works to know whether this is what should have been expected or whether this was not the desired outcome but he's just putting the best face on it that he can. It certainly disappointed me. It would seem unlikely that MNKD can be the business success we wish it to be without being dependent on large insurance payers. That is simply where the money is. Very few patients could afford Afrezza for all their meals if not for having insurance that shifts those costs to other healthier patients in the risk pool. That would be true even if MNKD slashed the price in half. |
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Post by peppy on Feb 12, 2018 16:35:40 GMT -5
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Post by barnstormer on Feb 12, 2018 16:51:18 GMT -5
I think Mike's comment was well timed. It's always better to speak up to insurance companies when the light of the state insurance agency is focused on unfair or poor practices. Business as usual for Aetna won't be good enough when the commissioner is breathing down their neck. The reason companies and individuals pay insurance premiums is to get the best care & medications available. If Aetna isn't holding patient care to the highest standard then they need to be called out. Go Mike!
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Post by celo on Feb 12, 2018 16:57:25 GMT -5
Discussions are pushing towards change, but the LA times article shows just how complicated a state created single payer healthcare system would be. www.sacbee.com/opinion/op-ed/soapbox/article190439374.html“Cost containment” was the buzz phrase at the hearing, but let patients beware. Private insurers cut costs by restricting networks of doctors and hospitals, limiting choices of prescription drugs, denying claims and by requiring pre-treatment authorizations and high deductibles to discourage patients from getting the care they need. This is where Afrezza is left out of the loop by many private insurers. Mike might really be in close contact with individuals about reforms coming out of Sacramento and might not be too scared to proclaim his opinion with private insurers demise coming soon in California. |
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Post by tz on Feb 12, 2018 17:12:08 GMT -5
I did not feel frustration from Mike's comment. The only thing I feel is the opportunity for Afrezza.
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Post by pat on Feb 12, 2018 18:02:02 GMT -5
I cannot believe that in today’s world any CEO, even one of a small company such as ours, is firing off tweets that aren’t fully vetted and planned by an internal compliance/marketing team is some kind.
Something is cooking.
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Post by anderson on Feb 12, 2018 18:02:57 GMT -5
twitter.com/castagna2011?lang=en
Mike Castagna @castagna2011 · 11h11 hours ago
"You wonder why AETNA made over $4B in cash flow last year. Easy when you deny care and bill the employer fees not based on any outcomes. United and Blue Shield of CA are even worse. Wait until other medical directors have to put their neck on the line."
This is pretty strong language considering how important third party payers are for Afrezza's future success. Or maybe there is another (better?) plan in the works?
I believe Mike comment was about edition.cnn.com/2018/02/11/health/aetna-california-investigation/index.htmlCNN Exclusive: California launches investigation following stunning admission by Aetna medical director |
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Post by dreamboatcruise on Feb 12, 2018 18:14:12 GMT -5
Discussions are pushing towards change, but the LA times article shows just how complicated a state created single payer healthcare system would be. www.sacbee.com/opinion/op-ed/soapbox/article190439374.html“Cost containment” was the buzz phrase at the hearing, but let patients beware. Private insurers cut costs by restricting networks of doctors and hospitals, limiting choices of prescription drugs, denying claims and by requiring pre-treatment authorizations and high deductibles to discourage patients from getting the care they need. This is where Afrezza is left out of the loop by many private insurers. Mike might really be in close contact with individuals about reforms coming out of Sacramento and might not be too scared to proclaim his opinion with private insurers demise coming soon in California. I know a lot of people in healthcare here in CA, and I don't know of any that really think single payer is going to happen. Perhaps they are in denial, but I tend to think it isn't politically possible. |
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