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Post by mnholdem on May 4, 2018 11:09:59 GMT -5
This week, I posted some excerpts of the negative cost effects of REMS to the various distribution channels. Well, with the lifting of the REMS, commercial coverage for Afrezza just exploded. I'll update Medicare and other channels on Sunday (I have to leave town in a few minutes).
See more details in Formulary Coverage in the members-only section. Congrats to all you Afrezza/MNKD believers!
Good fortune all!  |
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Post by brotherm1 on May 4, 2018 11:26:50 GMT -5
💪🏻💥🌈⭐️☀️🍺🍹🥃💰🍻🗝💣🚀🎼
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Post by dreamboatcruise on May 4, 2018 11:39:00 GMT -5
This week, I posted some excerpts of the negative cost effects of REMS to the various distribution channels. Well, with the lifting of the REMS, commercial coverage for Afrezza just exploded. I'll update Medicare and other channels on Sunday (I have to leave town in a few minutes).
See more details in Formulary Coverage in the members-only section. Congrats to all you Afrezza/MNKD believers!
Good fortune all! Do you have any evidence that this has anything to do with REMS or is that simply an assertion you are making based on your own guess? From my understanding of the way these work, there are review boards that meet (often no more than once a quarter) to make formulary changes. The chance that MNKD rushed out and presented review boards with the REMS change, the review boards made a decision and a new formulary updated to hit formularylookup.com all since the REMS changed seems to stretch logic. If this huge jump is real (hoping it is, but also would like to verify such as United Health now having 89% coverage), seems unlikely this is related to REMS. Based on lack of share price movement, I'm worried this may be a formularylookup glitch. |
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Post by mnkdfann on May 4, 2018 11:42:16 GMT -5
Do you have any evidence that this has anything to do with REMS or is that simply an assertion you are making based on your own guess? From my understanding of the way these work, there are review boards that meet (often no more than once a quarter) to make formulary changes. The chance that MNKD rushed out and presented review boards with the REMS change, the review boards made a decision and a new formulary updated to hit formularylookup.com all since the REMS changed seems to stretch logic. That is what I am wondering. Are the two really connected? BUT if the increase in coverages has nothing to do with the REMS being removed, and was just due to increased acceptance of Afrezza that was happening before the REMS removal was known, that would be even BETTER news. |
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Post by mannmade on May 4, 2018 11:45:13 GMT -5
Either way this is great news!!! Thx MN!
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Post by wiscdh on May 4, 2018 11:58:14 GMT -5
This news got me wondering what my health plan coverage is for Afrezza. I have United Healthcare for my insurance. I looked up the cost and here is what I found:
4(60) & 8(30) Unit NDC: 47918088463
90 day supply
Plan pays $764.79
Employee pays $100.00
I cannot recall what the cost was in the past because I am not a user of Afrezza. The out of pocket cost seems very reasonable for a 3 month supply.
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Post by brotherm1 on May 4, 2018 12:09:12 GMT -5
UnitedHealth Group Inc. is an American for-profit managed health care company based in Minnetonka, Minnesota. It is sixth in the United States on the Fortune 500.[3] UnitedHealth Group offers health care products and insurance services. UnitedHealth Group is the largest healthcare company in the world by revenue $184 billion in 2016. UnitedHealth Group subsidiaries companies together serves approximately 115 million individuals in 2016. en.m.wikipedia.org/wiki/UnitedHealth_Group |
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Post by sportsrancho on May 4, 2018 12:19:05 GMT -5
UnitedHealth Group Inc. is an American for-profit managed health care company based in Minnetonka, Minnesota. It is sixth in the United States on the Fortune 500.[3] UnitedHealth Group offers health care products and insurance services. UnitedHealth Group is the largest healthcare company in the world by revenue $184 billion in 2016. UnitedHealth Group subsidiaries companies together serves approximately 115 million individuals in 2016. en.m.wikipedia.org/wiki/UnitedHealth_Group And they were the ones that were giving us the hardest time! Better book that flight out to California:-)) |
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Post by dreamboatcruise on May 4, 2018 12:21:20 GMT -5
If memory serves there was one previous time when formularylookup had a glitch and radically incorrect numbers were posted for awhile. I'm certainly hoping these are real.
I just looked on my CA Blue Shield plan and they update formularies once a quarter, but have not yet released the new formulary for this quarter. Though given last update was Feb it seems it would hit this month. Right now the February formulary doesn't include Afrezza at all though formularylookup.com is currently showing CA Blue Shield as 100% covered. Is it possible formularylookup.com got some advance notice before Blue Shield posted changes to members... I suppose.
I'm crossing my fingers.
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Post by lojothehus on May 4, 2018 12:41:06 GMT -5
Good news taste much better without skepticism. I am going to take this and run with it! Thank you, more good things to come.
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Post by nylefty on May 4, 2018 12:44:53 GMT -5
This news got me wondering what my health plan coverage is for Afrezza. I have United Healthcare for my insurance. I looked up the cost and here is what I found: 4(60) & 8(30) Unit NDC: 47918088463 90 day supply Plan pays $764.79 Employee pays $100.00 I cannot recall what the cost was in the past because I am not a user of Afrezza. The out of pocket cost seems very reasonable for a 3 month supply. There is not just one UnitedHealthCare plan. According to FormularyLookup.com, UHC administers 101 different commercial plans and when it comes to Afrezza those collective plans cover 89 percent of "lives," with PA/ST required. |
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Post by cjm18 on May 4, 2018 12:46:19 GMT -5
Big jumps in unrestricted coverage in ny, md, ar, and pa.
4 of the 10 states where there is opening for a rep.
Coincidence?
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Post by peppy on May 4, 2018 12:47:39 GMT -5
This is good news. MNKD is going to hit the market with a one two punch.
The STAT study, we know will be epic.
Thank you MN for the news.
Here is the one two punch. 1 the continuous glucose monitors/ afrezza bringing down the HbA1c. The dosing instructions were perfect.
We know a commercial was spotted on Hulu.
Now Insurance. Thank you MN.
April 2 Commercial Coverage for Afrezza - ALL LOCATIONS
Commercial Plans: 4,350
Unrestricted Access: 25%
Covered (PA/ST):42%
Not Covered: 33%
May 4 Commercial Coverage for Afrezza - ALL LOCATIONS
Commercial Plans: 4,350
Unrestricted Access: 47% (+7%)
Covered (PA/ST):47% (+45%)
Not Covered: 6% (-27%)
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Post by awesomo on May 4, 2018 12:51:45 GMT -5
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Post by mnkdfann on May 4, 2018 12:51:53 GMT -5
New article out by Spencer Osborne at SA, (unless I misread something) he attributes the big rise in coverage to the recent deal with CVS.
"A bit over a month ago, MannKind (NASDAQ:MNKD) CEO Mike Castagna announced that the company had reached a deal with CVS Caremark (NYSE:CVS) in regard to gaining insurance access for its diabetes treatment Afrezza. The deal made access available to numerous plans that previously excluded Afrezza from any form of coverage."
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