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Author Topic: Auvi-Q relaunch  (Read 30500 times)

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name

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Re: Auvi-Q relaunch
« Reply #90 on: February 24, 2017, 10:29:49 AM »
*raises hand*  I'm the nurse's guinea pig CM mentions. 

Used corporate speak with Auvi yesterday to kick it up the chain of command.  I will probably prod the local pharmacist gently (by my standards) by email, give him a little more carrot for confidence.  If after that I see no movement I may put in a request with Auvi to restart the process with Walmart or have a chat with our compounding pharmacy - not to see if they will fulfill but I've noticed they're usually run by industry veterans who love to talk about the system.  Give me a system gives me the keys.

The following is my personal opinion.  I don't see this in the same light as EpiGate although there is a common sticker price shock to consumers on rescue meds.  Auvi is using entrepreneurial disruption to supply logistics.  They clearly want to never partner up with the current dog and pony show ever again after the Sanofi debacle.  Mylan groomed persons of decision making power in nonprofits and government to engage in official acts only possible through their position of public trust (and public dollars) to push contracts with non-compete clauses in public entities.  By massaging influence through "sponsorship" in bloggers, nonprofits, and celebrity ambassadors to reach... whoever it reached (I'm not segment target of those specific demographics) the consumers were lulled and detractors silenced through peer pressure.

Mylan groomed a herd. 
Auvi wants a direct relationship.

Both have ethical issues.  Auvi, so far as I can tell crawling their system, is giving a middle fingers up hold them hands high to existing logistics, admittedly the same crap show that led to Sanofi's hot mess and Mylan's cut throat tactics to control the market through monopoly.  Remember, Bresch's daddy is an elected official and was when Bresch's mommy was high up in the NSBA pushing EpiPens 4 Schools, wearing a willing Mylan-sponsored FARE as their public face.

I don't think I even need to get into the Mylan's $465 settlement for 'overcharging' Medicaid and Medicare. 

Offline CMdeux

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Re: Auvi-Q relaunch
« Reply #91 on: February 24, 2017, 11:55:57 AM »
One thing to bear in mind is that pharmacy, like medical practice-- is regulated BY INDIVIDUAL STATES. 

So some states may permit out-of-state pharmacy mail-ins DTP and others may not.   I suspect that might be what is going on with name and why it hasn't been as smooth as for nyguy.   
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

name

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Re: Auvi-Q relaunch
« Reply #92 on: February 24, 2017, 02:08:35 PM »
Kaleo also had a lock on law enforcement through federal grants for naloxone so arguably our access to Auvi as direct consumers comes on the back of the a de facto Kaleo monopoly in the opioid crisis.  I do think, however, Kaleo has a legitimate form factor competitive advantage.  Law enforcement is still overwhelmingly male and they have to wear vests laden with a crap ton of gear.  If they don't have to carry the giant hot dog-shaped autoinjector they probably won't.  The voice guidance is probably a plus there as well.  One more advantage in a job that requires split-second decisions every moment.

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #93 on: February 24, 2017, 06:47:22 PM »
*raises hand*  I'm the nurse's guinea pig CM mentions. 

Used corporate speak with Auvi yesterday to kick it up the chain of command.  I will probably prod the local pharmacist gently (by my standards) by email, give him a little more carrot for confidence.  If after that I see no movement I may put in a request with Auvi to restart the process with Walmart or have a chat with our compounding pharmacy - not to see if they will fulfill but I've noticed they're usually run by industry veterans who love to talk about the system.  Give me a system gives me the keys.

Kaleo is small and risk averse and it shows. They have tremendous cajones on how they're trying to game the system (in a way that I think that will backfire), I think they had obligations on investments (judging by past press releases and news articles) and the recall of Auvi-Q/disassociation from Sanofi hurt them a lot. They need it to be zero out of pocket for patients to reduce the outrage, but it's all so new and it's a drug that was originally recalled by Sanofi so the logistics are challenging. A lot of pharmacies still show Auvi-Q as discontinued by manufacturer in their databases which makes it ordering it outside direct delivery challenging.

As far as what CMdeux mentions on ease of prescription filling - the entire family is filling at the same address in the state of New York, so while potentially relevant as to filling ease or possibility across forum members, it doesn't apply for my family as law remains the same for all immediate family members at this time.

name

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Re: Auvi-Q relaunch
« Reply #94 on: February 24, 2017, 07:10:59 PM »
They could be going on the old Japanese business model of flood the market subsidizing consumer adoption to create the demand base first.  Tech disruptions have significantly shifted traditional highly regulated markets (e.g., sharing economies).  I agree with you, however, that this will fail because I don't think they are self-aware enough to know their distribution model isn't innovative so much as clunky and mismatched to meet demand.  Their only other home run depends almost exclusively on federal grants appropriated in response to a crisis--completely different fulfillment.  Which means I'm getting what I can before they go away.

Hat tip to your reports and redactions. 

name

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Re: Auvi-Q relaunch
« Reply #95 on: March 01, 2017, 11:32:03 PM »
Summary of today's totals.

  • (3) twinpack of EpiPens @ $730.39 each
  • (3) twinpack of Auvi-q @ $5400.09 each

$730.39 * 3 = $2,191.17
$5400.09 * 3 = $16,200.27

Total price = $18,391.44

Out of pocket $0.

I'll write up the resolution of the Auvi-q saga later.  For now let the list price soak in.

Offline Macabre

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Re: Auvi-Q relaunch
« Reply #96 on: March 02, 2017, 06:21:22 AM »
This business model does not make sense.
Me: Sesame, shellfish, chamomile, sage
DS: Peanuts

Offline MaryM

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Re: Auvi-Q relaunch
« Reply #97 on: March 02, 2017, 06:44:39 AM »
I  just scanned and emailed my Auvi-Q forms to the allergist's office yesterday.  I am hopeful that we can get them.  I know that my insurance no longer covers Auvi-Q and now only covers generic Epi....Fingers crossed.
« Last Edit: March 02, 2017, 08:34:48 AM by MaryM »

Online hezzier

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Re: Auvi-Q relaunch
« Reply #98 on: March 02, 2017, 08:17:22 AM »
I'm going to bring the forms on Monday when both kids go for allergy shots.  Worth a try...the worst that can happen is that we don't get them.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

name

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Re: Auvi-Q relaunch
« Reply #99 on: March 02, 2017, 09:47:25 AM »
You should be able to get them.  In the event you reach an impasse at the pharmacy keep polite, steady pressure on the call center in New Jersey.  They are some good people hard at work, and I appreciate each and every one of them that helped roll out this relatively untested logistics.  Where you cannot get direct delivery for whatever reason I believe the preferred pharmacy for fulfillment is either a Walgreens or CVS.  I got the sense one or two of the call center folks were recent transitions to the civilian workforce from military backgrounds.  For those that have experiences going to health care on base it was about like that or similar off base in the CHAMPUS days.

Corporate's role in the US pharmacy system... that I'll get back to later.  For now I'm saving my receipts and will continue to absorb the group experience.

P.S. I was not asked for SS#.

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #100 on: March 02, 2017, 08:21:43 PM »
So my brother (who had insurance who refused to cover Auvi-Q) finally received his from Direct Delivery Free of charge yesterday, or about two weeks from the fill date.

I agree that the pricing model makes no sense. If the patient has commercial insurance that won't pay for Auvi-Q, Kaleo pays for the fill in entirety. It just encourages all PBMs to drop coverage for Auvi-Q so their insured still get it for free AND it isn't passed on to them in the form of increased premium costs.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #101 on: March 02, 2017, 09:32:31 PM »
A friend's aren't due to arrive until April 10 due to high demand.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Offline BensMom

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Re: Auvi-Q relaunch
« Reply #102 on: March 09, 2017, 10:34:45 AM »
DS needs epis this month and will be home for spring break in a couple of weeks. I'm faxing the form to the doctor now to get free auvi-qs delivered. Not sure how long it takes, but maybe we can get these delivered while he's home.  Our insurance doesn't cover it at all. I called auvi-q just to try to figure out how it works. They said the manufacturer will pay. I don't get how they're not going to go out of business. Wouldn't it be better to price it at $100 and have everyone pay for it themselves?

I also asked why they need the last 4 digits of the SSN. They said it's for the insurance company. I said that the insurance company has all the info they need based on name and DOB and she said ok I guess we don't need it then. Makes no sense. I'm just going to leave it blank and if they have a problem, they can call.
« Last Edit: March 09, 2017, 10:43:56 AM by BensMom »

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #103 on: March 11, 2017, 06:53:21 AM »
DS needs epis this month and will be home for spring break in a couple of weeks. I'm faxing the form to the doctor now to get free auvi-qs delivered. Not sure how long it takes, but maybe we can get these delivered while he's home.  Our insurance doesn't cover it at all. I called auvi-q just to try to figure out how it works. They said the manufacturer will pay. I don't get how they're not going to go out of business. Wouldn't it be better to price it at $100 and have everyone pay for it themselves?

I also asked why they need the last 4 digits of the SSN. They said it's for the insurance company. I said that the insurance company has all the info they need based on name and DOB and she said ok I guess we don't need it then. Makes no sense. I'm just going to leave it blank and if they have a problem, they can call.

They charge insurance companies that will pay for it $4,500 and they charge a cash price (makes more than $100K/yr household income/no commercial insurance) of $360 (per pack of two injectors/one trainer)

So when my insurance does cover it, they get $4500 minus $90 plus some cost to dispatch to pharmacy to fill. Result is $4,410 in the black.

Even if we assume it costs them $360 to make them (doubtful), that means they could fill another 12 boxes (12 * $360 = $4,320) with the money they got from my insurer.

The SSN thing is stupid. EMR (eprescription) software doesn't require it and they accepted my faxed form without it. Their online prescriber portal requires an entry into the field and won't proceed without it.

Offline eragon

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Re: Auvi-Q relaunch
« Reply #104 on: March 11, 2017, 12:00:16 PM »
Does anyone know what their needle length is?
I dont think its the same as epi / jext.
could be an issue for woman, and the larger person.
Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.