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Author Topic: Auvi-Q relaunch  (Read 5845 times)

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Offline PurpleCat

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Re: Auvi-Q relaunch
« Reply #135 on: May 09, 2017, 01:44:59 PM »
I was told May 8th for our first set.  It arrived today, UPS, in a box, in a silver bubble wrapper with a cold pack!  (it has been in the 50's during the days and 30's at night so the cold pack was not needed but perhaps a standard when they ship?)

DD is going to be thrilled when she gets home from softball!!!!!

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #136 on: May 16, 2017, 06:16:03 AM »
Received in the mail yesterday. Now I can feel no guilt in getting my Auvi-Q fills since the manufacturer will pay for them...


Offline gvmom

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Re: Auvi-Q relaunch
« Reply #137 on: May 16, 2017, 06:02:09 PM »
I don't see where it says the manufacturer will pay for them.  Did Auvi-q come out with a new pricing scheme that doesn't really have someone else paying for them?
"..... who knew that Black History Month was really about an Orange White guy" ~gvmom

".... but HILLARY!" is not ACTUALLY a legal defense in the real world.  ~gvmom

Offline PurpleCat

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Re: Auvi-Q relaunch
« Reply #138 on: May 17, 2017, 07:45:43 AM »
I did not pay for ours and neither did CVS.  When your private insurance won't cover the cost, you qualify for some program.  I can't explain how they are being paid for, just so happy to have some!

Offline gvmom

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Re: Auvi-Q relaunch
« Reply #139 on: May 17, 2017, 10:59:04 AM »
Somebody ends up paying for them though.  Sort of like when someone doesn't have health insurance and they go to an emergency room for help.  If they can't pay, who pays?  Everyone else right? 

Somehow, the ability to make them "free" for some people, really means that other people are going to be paying for them.  Again, and I do wonder, if the makers of Auvi-q are actually running a non-profit or don't have to worry about placating investors?  I am assuming they aren't running their business as a charity, so that means they want to make money.  How do they do that if they are giving Auvi-q's away because you mail in a coupon?
"..... who knew that Black History Month was really about an Orange White guy" ~gvmom

".... but HILLARY!" is not ACTUALLY a legal defense in the real world.  ~gvmom

name

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Re: Auvi-Q relaunch
« Reply #140 on: May 17, 2017, 11:17:21 PM »
Kaleo has the overwhelming success of Evzio to serve as the backbone of their form factor autoinjector proliferation.  This should have been noted upthread, and if not this one then it most certainly was in another.  Assume Auvi-q is a loss until or unless they can get it to perform some time in the next year. 

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #141 on: May 18, 2017, 09:17:10 AM »
I did not pay for ours and neither did CVS.  When your private insurance won't cover the cost, you qualify for some program.  I can't explain how they are being paid for, just so happy to have some!

When insurers like mine paid $9,000 for two kits (2 kits x 2 injectors per kit) then that pays for a loooot of free fills for those with commercial insurance that won't pay for it.. The problem is that this is a short term strategy that can't last. My insurer refuses to pay for it effective June 2017, so then I get it for free still, but kaléo  pays for it instead. There is essentially zero incentive for insurers to be permissive on Auvi-Q because of the extraordinary cost - if the insurer drops the coverage, the insured still gets it for free from the manufacturer:

Quote from: Auvi-Q
If your commercial insurance does not cover AUVI-Q at all, kaléo will pay the total amount so that you have a $0 out-of-pocket cost.

In the end I think the market will fix itself and when all of the major insurers stop covering Auvi-Q altogether, the price will be something much more sane that insurers are willing to pay.

Offline gvmom

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Re: Auvi-Q relaunch
« Reply #142 on: May 18, 2017, 11:34:30 AM »
Kaleo has the overwhelming success of Evzio to serve as the backbone of their form factor autoinjector proliferation.  This should have been noted upthread, and if not this one then it most certainly was in another.  Assume Auvi-q is a loss until or unless they can get it to perform some time in the next year. 

Again, the cost is passed on to those that need Evzio.  If Evzio is the success, or what is paying for Auvi-q, well, they have done the same thing with it:

https://www.wired.com/2017/02/575-life-saving-drug-jump-4500-blame-perverse-system/

So, one can say that Evzio is paying for Auvi-q.... but in the end, the fact that they took and bumped the Evzio price from something in the hundreds to $4500 ..... means that someone else is paying.  And, that is insurance companies or really, guess who..... us!  Insurance companies will pass on the cost to the consumer. 

What I will say is that Evzio has been marketed and placed into use similarly to the Epi-pen, and because of the design of the device, it has become the preferred means of delivery.  The reality is that using a pricing scheme that essentially just backdoor passes costs on to consumers isn't any better than what Mylan did.  Getting free Auvi-q's isn't really the reality.  It may be "free" for some, but eventually those "some" people will still get stuck but just in an indirect way. 

How many $600 cotton balls do you think a hospital has to charge insurance for to cover their supply of Evzio?  And how many "free" Auvi-q's does it cover?  And whose insurance is paying for the cotton balls?

"..... who knew that Black History Month was really about an Orange White guy" ~gvmom

".... but HILLARY!" is not ACTUALLY a legal defense in the real world.  ~gvmom

name

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Re: Auvi-Q relaunch
« Reply #143 on: May 18, 2017, 03:59:34 PM »
"One" isn't saying that.  One is saying naloxone was heavily subsidized by taxpayer dollars and therefore proliferated as opposed to proliferated mainly through insurance.  God speed and God bless with any argument you have, but do realize mechanics don't necessarily come with indictment or endorsement.

Offline gvmom

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Re: Auvi-Q relaunch
« Reply #144 on: May 18, 2017, 06:46:26 PM »
I guess my real argument, beef, nitpick, gripe, whatever, is that nothing is really free.  Especially when it comes to anything medical in this country.  However, this thread is theoretically about getting free Auvi-q's.  Which I believe is a fallacy.   

Someone pays, and it typically is "us".... taxpayers, people that have insurance, etc.

For me, all of it (sweeping my arm wide) annoys me, and I think that it doesn't make my opinion of the manufacturer of Auvi-q that high when you can look back a year and see what they did with Evzio. 

So, I guess it is just me.  I read this thread and keep wondering if I'm the only one wondering why people keep talking about them being free.  Why it doesn't bother people.... even those receiving these "free" devices.

Whatever though.  I should just stay out of this thread anyway.   :footinmouth:
 

"..... who knew that Black History Month was really about an Orange White guy" ~gvmom

".... but HILLARY!" is not ACTUALLY a legal defense in the real world.  ~gvmom

Offline momma2boys

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Re: Auvi-Q relaunch
« Reply #145 on: May 18, 2017, 08:23:21 PM »
Ya the whole thing bothers me too. We aren't getting them. After the whole Mylan pricing scandal they could've taken a large chunk of the market by being reasonably priced. They went total opposite on that.
peanut, treenut, sesame
Northeast, US

Offline gvmom

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Re: Auvi-Q relaunch
« Reply #146 on: May 18, 2017, 09:08:19 PM »
Okay, see.... I don't feel so crazy now.  That is all I needed. 

I just need to be able to say, "I know, right?!" to move on. 

So..... momma2boys:

Ya the whole thing bothers me too. We aren't getting them. After the whole Mylan pricing scandal they could've taken a large chunk of the market by being reasonably priced. They went total opposite on that.  

I KNOW!  Right?!

 :bye:
"..... who knew that Black History Month was really about an Orange White guy" ~gvmom

".... but HILLARY!" is not ACTUALLY a legal defense in the real world.  ~gvmom

Offline momma2boys

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Re: Auvi-Q relaunch
« Reply #147 on: May 18, 2017, 09:13:50 PM »
I honestly expected an uproar over this after the Mylan ordeal.
peanut, treenut, sesame
Northeast, US

Offline spacecanada

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Re: Auvi-Q relaunch
« Reply #148 on: May 19, 2017, 01:06:49 AM »
(Deleted) I had a rant written about how this whole thing is messed up, though I wouldn't even know where to point the finger of accusation.  Is Kaleó to blame, or is the American medical and pharmaceutical structure as a whole?  It saddens me at a deep level, where ethics meet the greater society.
« Last Edit: May 19, 2017, 01:12:22 AM by spacecanada »
anaphylaxis to tree nuts, peanuts, and potatoes; severe dairy intolerance; vegan (preference)
family members allergic to dairy, egg, peanut, sesame, shellfish

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #149 on: June 20, 2017, 10:23:44 AM »
Parents refilled Auvi-Q while ExpressScripts still paid for it. Shipped and arrived within two days of requesting refill.

I'm now getting a new scrip to ASPN (Direct Delivery) and seeing how much they sit on it now that my PBM (Caremark) will not cover Auvi-Q. Bet it takes weeks.

In the meantime, Express Scripts is suing Kaleo (manufacturer of Auvi-Q and Evzio, an autoinjector for opioid overdose).

A lot of the lawsuit is redacted (sensitive info), but Express Scripts is saying that Kaleo had price protection rebates that they paid to Express Scripts (some of which were sent to customers e.g. insurers, and some of which Express Scripts kept for admin overhead). They say from 2014 up until March 2016, Kaleo paid these price protection rebates as they increased the price of Evzio. Then from that point onward, Express Scripts alleges that they invoiced millions to Kaleo for the price protection rebates as agreed, but Kaleo paid them in part rather than in full (breaching the agreement). A lot of the interesting stuff that spells out the exact terms is redacted in full, but basically on February 1st 2016 they quintupled the wholesale acquisition cost of Evzio from a little over $900 to $4500+, and basically immediately stopped paying the price protection rebates thereafter (they paid barely any of the invoiced amount in May 2016, and stopped paying the price protection rebates at all in June 2016).

What the redacted portions block out is the really interesting part - they are likely specific figures and percentages of the rebate scheme. I suspect the rebates are far in excess of what is normal for a brand name medication (where 50% maybe would be normal), allowing the larger PBMs like Expressscripts to get pricing where they deemed the whole thing worth covering, and allowing Kaleo to negotiate less bargain prices with smaller PBMs or just get wholesale reimbursement of the list from permissive insurance plans.

Considering Kaleo only has two products on market, playing fire with one of the biggest PBMs in the US is pretty gutsy - and judging by ES taking Auvi-Q off the formulary, I expect they are twice burned, once shy. I think the price of Auvi-Q will probably drop substantially in the next year, but time will tell.

EDIT: They got the new scrip from my doctor and called back immediately, they confirmed that they can send me one carton (two injectors/two trainers) in two days, and that they are filling it for me for zero out of pocket since my insurer won't pay. I'll update if it's actually done in a timely fashion as I have heard reports of delays (and when it was re-introduced, my brother's prescription filled when his insurer wouldn't pay took almost three weeks, when they filled it immediately for those of us with insurance who would).

EDIT 2: Shipped from a different pharmacy than the first time a day after filling the scrip with direct delivery. Guess the shortages are over for direct delivery, hear anecdotally that Auvi-Q is still very hard to get at retail.
« Last Edit: June 22, 2017, 08:29:11 AM by nyguy »