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Post by peppy on May 23, 2018 12:35:17 GMT -5
Medicare yes, but I don't think that is yet true for other insurance for T2s. It should be for all patients needing insulin. The Advantage plans are bit spotty - I *think* Kaiser is the only one that will let you have a CGM at the moment. If you are direct with Medicare then there is a lot less of a problem. Medicare has selection criteria to decide if you get a CGM. stated her physician offered her a CGM. type two. maybe medicare. |
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Post by joeypotsandpans on May 23, 2018 12:38:39 GMT -5
Medicare yes, but I don't think that is yet true for other insurance for T2s. It should be for all patients needing insulin. The Advantage plans are bit spotty - I *think* Kaiser is the only one that will let you have a CGM at the moment. If you are direct with Medicare then there is a lot less of a problem. Medicare has selection criteria to decide if you get a CGM. At the restaurant Mike mentioned he has been in talks with Kaiser towards their better involvement in working with Afrezza...your post reminded me of that part of his conversation with us. |
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Post by agedhippie on May 23, 2018 14:29:32 GMT -5
The Advantage plans are bit spotty - I *think* Kaiser is the only one that will let you have a CGM at the moment. If you are direct with Medicare then there is a lot less of a problem. Medicare has selection criteria to decide if you get a CGM. At the restaurant Mike mentioned he has been in talks with Kaiser towards their better involvement in working with Afrezza...your post reminded me of that part of his conversation with us. Kaiser have a good reputation with CGMs. The Kaiser Foundation funded one of the pivotal studies that forced insurers to cover CGMs for Type 1s. We like Kaiser  |
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Post by agedhippie on May 23, 2018 14:35:20 GMT -5
The Advantage plans are bit spotty - I *think* Kaiser is the only one that will let you have a CGM at the moment. If you are direct with Medicare then there is a lot less of a problem. Medicare has selection criteria to decide if you get a CGM. stated her physician offered her a CGM. type two. maybe medicare. There is an interesting split, and I may be completely wrong, but Abbott got the Libre filed under pharmacy benefits while the Dexcom is filed under Durable Medical Equipment (DME), both are classed as CGMs. It makes it easy to get a Libre and harder to get a Dexcom out of Medicare. |
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Post by dreamboatcruise on May 23, 2018 16:12:04 GMT -5
At the restaurant Mike mentioned he has been in talks with Kaiser towards their better involvement in working with Afrezza...your post reminded me of that part of his conversation with us. Kaiser have a good reputation with CGMs. The Kaiser Foundation funded one of the pivotal studies that forced insurers to cover CGMs for Type 1s. We like Kaiser They don't cover Afrezza, last I checked. |
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Post by akemp3000 on May 23, 2018 17:12:55 GMT -5
My Kaiser covers Afrezza. Seems it varies per plan and per area.
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Post by mango on May 23, 2018 20:18:25 GMT -5
This year is MannKind's rise and the Insulin Cartels' demise.  |
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Post by mango on May 27, 2018 6:33:51 GMT -5
professional.diabetes.org/meeting/scientific-sessions/78th-scientific-sessionsThe STAT. clinicaltrials.gov/ct2/show/NCT03143816This is an investigator-initiated, prospective, randomized, multicenter, parallel, open-label, pilot clinical trial evaluating the efficacy of TI for PPBG, PPGE, and time-in-range on CGM download in patients with T1D. TI is an inhaled ultra-rapid-acting insulin, approved by the FDA for use in patients with diabetes. This is a pilot, real-life study where patients will continue their routine diabetes care and use post-meal correction dosages as deemed necessary for normalizing PPBG as per the protocol. This multi-center study will enroll 60 patients with T1D, A1c values between 6.5 to 10%. The patients will be randomized in 1:1 fashion to either TI or NL. Patients who are randomized into the NL arm will continue using their usual prandial insulin dose before meals. Patients who are randomized into the TI arm will be instructed to dose before the meals and take necessary corrections at 1- and 2-hours after meals to optimize PPBG (Table 1B). There will be a total of 7 study visits (screening visit, randomization visit, 2 clinic, and 3 phone visits). There will be a 4-week treatment comparison between TI and NL and 1-week of post-study follow up. (Phone visit; Figure-1). Standard lab tests (A1c, complete metabolic panel {CMP}, complete blood count {CBC}) will be performed at the screening visit.All patients will use real-time CGM (Dexcom G5®, San Diego, CA), which will be provided at the randomization visit for their day-to-day diabetes care. CGM data will be downloaded at every clinic visit on a secured computer. The data will be analyzed after the study for different primary and secondary end points. All patients will be allowed to keep the CGM after the study is over for their day-to-day diabetes care.  Do you think new poster might be from the Affinity study? Inhaled Technosphere Insulin Compared With Injected Prandial Insulin in Type 1 Diabetes: A Randomized 24-Week TrialReduced Hypoglycemia is Observed with Inhaled Insulin Versus Subcutaneous Insulin Aspart in Patients with Type 1 Diabetes Mellitus |
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Post by sayhey24 on May 27, 2018 8:00:46 GMT -5
It could be or it could be a hybrid including additional data from the old study data and the STAT. The problem with the Affinity was the A1c results.
You would think if afrezza does reduce the risk of hypos even if the A1c is the same the insurance companies would be jumping up and down to get their PWDs on it. Add in the STAT with improved A1c and TIR and it looks like a home run. Maybe even the standard of care as the insurance companies should be able to save a ton of money in hospital costs.
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Post by mango on May 27, 2018 9:31:14 GMT -5
It could be or it could be a hybrid including additional data from the old study data and the STAT. The problem with the Affinity was the A1c results. You would think if afrezza does reduce the risk of hypos even if the A1c is the same the insurance companies would be jumping up and down to get their PWDs on it. Add in the STAT with improved A1c and TIR and it looks like a home run. Maybe even the standard of care as the insurance companies should be able to save a ton of money in hospital costs. What about saving money by avoiding lawsuits? |
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Post by agedhippie on May 27, 2018 9:36:49 GMT -5
It could be or it could be a hybrid including additional data from the old study data and the STAT. The problem with the Affinity was the A1c results. You would think if afrezza does reduce the risk of hypos even if the A1c is the same the insurance companies would be jumping up and down to get their PWDs on it. Add in the STAT with improved A1c and TIR and it looks like a home run. Maybe even the standard of care as the insurance companies should be able to save a ton of money in hospital costs. I think mango is correct and it's the 171 study. It would be hard use the STAT study in conjunction because it was far smaller and shorter - it's not like for like. We have been over cost before. Insurers do not care about long term cost, only the next few years, so hospital costs don't come into it if you mean long term complications. Additionally Afrezza would increase their drug costs both directly, and indirectly (a reduction in total spend rebates with pharmas). If this is about hypoglycemia then this is a lot more complicated than it looks. For example hypoglycemia increases in the last week of the month because people don't have enough to eat (from 2009 - 2013 this effect disappeared when the federal nutrition program benefits increased, after it was discontinued the effect returned). Education dramatically reduces incidence as well, after a how to spot a hypo course about 60% experienced fewer severe hypos. CGM use reduces the hypo rate by about the same amount as Afrezza (I wonder if that effect stacks...) Interestingly Novolog reduced both hypos and severe hypos by half over it's predecessor (buffered Regular insulin). |
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Post by mango on May 27, 2018 9:41:31 GMT -5
The new Afrezza website talks about the studies for both T2D and T1D (guessing it is the same data being used for ADA).
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Post by mango on May 27, 2018 9:51:42 GMT -5
It could be or it could be a hybrid including additional data from the old study data and the STAT. The problem with the Affinity was the A1c results. You would think if afrezza does reduce the risk of hypos even if the A1c is the same the insurance companies would be jumping up and down to get their PWDs on it. Add in the STAT with improved A1c and TIR and it looks like a home run. Maybe even the standard of care as the insurance companies should be able to save a ton of money in hospital costs. I think mango is correct and it's the 171 study. It would be hard use the STAT study in conjunction because it was far smaller and shorter - it's not like for like. We have been over cost before. Insurers do not care about long term cost, only the next few years, so hospital costs don't come into it if you mean long term complications. Additionally Afrezza would increase their drug costs both directly, and indirectly (a reduction in total spend rebates with pharmas). If this is about hypoglycemia then this is a lot more complicated than it looks. For example hypoglycemia increases in the last week of the month because people don't have enough to eat (from 2009 - 2013 this effect disappeared when the federal nutrition program benefits increased, after it was discontinued the effect returned). Education dramatically reduces incidence as well, after a how to spot a hypo course about 60% experienced fewer severe hypos. CGM use reduces the hypo rate by about the same amount as Afrezza (I wonder if that effect stacks...) Interestingly Novolog reduced both hypos and severe hypos by half over it's predecessor (buffered Regular insulin). What happens when people start being held liable for their actions? Insurers can't deprive someone from receiving medical care, it is a constitutional right. When Afrezza becomes the Standard of Care... |
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Post by liane on May 27, 2018 10:04:50 GMT -5
mango - You're posting a lot of extreme comments this morning. Please - this is supposed to be a fact-based board. Medical care is not a constitutional right.
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Post by mango on May 27, 2018 10:32:39 GMT -5
mango - You're posting a lot of extreme comments this morning. Please - this is supposed to be a fact-based board. Medical care is not a constitutional right. At his change of plea hearing, Barnes admitted that he was made aware between June 16 and June 19, 2013, that K.W. had been booked into the McClain County Jail, and that K.W. represented that he was a Type-1 diabetic who required insulin. Barnes further admitted that he failed to obtain medical care for K.W. and that, in doing so, he willfully denied K.W.’s Constitutional right to medical care. Barnes also admitted that his failure to obtain the required medical care resulted in K.W.’s death. “Every law enforcement officer in this country takes an oath to uphold the United States Constitution,” said Acting Assistant Attorney General Gore. “ The Constitution ensures that persons detained pending the adjudication of charges against them are entitled to necessary medical care. This sentence affirms the importance of that right and underscores the continuing commitment of the Civil Rights Division to hold officers accountable to their oaths.” “Inmates deserve and the law requires that adequate medical care be provided by penal institutions,” said U.S. Attorney Yancey. “ Denying necessary medical treatment is inhuman and unconstitutional.” www.justice.gov/opa/pr/former-jail-administrator-sentenced-depriving-inmate-medical-care |
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