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Author Topic: Auvi-Q relaunch  (Read 30497 times)

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Offline spacecanada

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Re: Auvi-Q relaunch
« Reply #105 on: March 11, 2017, 06:07:39 PM »
I don't know what I'm allergic to anymore... the list keeps growing.

Offline BensMom

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Re: Auvi-Q relaunch
« Reply #106 on: March 14, 2017, 09:42:48 AM »
I filled out the form (with no SSN) and faxed it in. They called DS (because of privacy issues, though they had already confirmed to me that they got the paperwork, so they already told me that my son has a prescription for auvi-q--what more private info could they give me. Shipping time??) Anyway, they told DS it would be 4-6 weeks before we get them. They're backed up. Their website says days.  :disappointed: His epis expire this month, but I'm sure they can last another few weeks. It would have been nice to get the auvi-qs while he was home next week, which is what I expected.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #107 on: March 20, 2017, 02:54:38 PM »
Finally remembered to bring the paperwork to the allergist.  They are going to fax or call it in today.  We will see what happens.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Online hezzier

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Re: Auvi-Q relaunch
« Reply #108 on: March 21, 2017, 01:54:59 PM »
Got a call today from the Auvi-Q people.  I was told that Tricare will not pay for it, but due to their no cost program that we will still get them at $0 delivered to our house on 3/31.  Will update on the 31st.
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 #109 on: March 22, 2017, 07:12:58 AM »
Wow, you got a delivery date? We didn't. I may have to have ds call and ask.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #110 on: March 22, 2017, 02:08:51 PM »
DS just got denied.  They didn't mention DD so I'm going to wait to see if they make a mistake and it goes through.  I called Auvi-Q in Feb to see if we qualified with Tricare and they said we did.  Allergist's office just called say we don't qualify because Tricare will not pay.  So I had to call Auvi-Q and they said because we have insurance through the government we are not eligible for the affordability program. 

There was not mention of the prescription for DD so I let that one stand...maybe it will slip through the cracks and we will get them anyway.

Disappointed to say the least, but I had nothing to lose.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #111 on: March 30, 2017, 08:15:42 AM »
DS just got denied.  They didn't mention DD so I'm going to wait to see if they make a mistake and it goes through.  I called Auvi-Q in Feb to see if we qualified with Tricare and they said we did.  Allergist's office just called say we don't qualify because Tricare will not pay.  So I had to call Auvi-Q and they said because we have insurance through the government we are not eligible for the affordability program. 

There was not mention of the prescription for DD so I let that one stand...maybe it will slip through the cracks and we will get them anyway.

Disappointed to say the least, but I had nothing to lose.

I'd complain to Kaléo at their number and, depending on how much you care, make a fuss over it and see if you might get a manager override. My brother has commercial Medicaid expansion Obamacare insurance in NY (which is technically a commercial plan, but state subsidized) and they refused to pay for it at all, so per Affordability program it was $0 out of pocket still;. Parents had insurance that required prior auth (For visual/hearing defects, which they did not have) and it was covered as well.

It's really unconscionable that they're willing to give it away to everyone or sell it for a reasonable price ($360 cash) if you have commercial insurance that will or won't pay for it, make less than $100K/yr, or make more than $100K with no insurance, but if you have government issued insurance (Medicare/Medicaid/Tricare etc.) you're just screwed. I know that "therapeutic equivalents" exist in Adrenaclick/generic Epi/brand EpiPen, but still. You or a family member serves the country and you get health insurance and, because of that, you shouldn't have access to a drug that you used to have access to? It's insanity.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #112 on: March 30, 2017, 08:42:22 AM »
We have Tricare.  I already called and complained.  They said with luck that they would be able to roll about a program in the future that covers insurance plans through the government.  I really can't complain too much since many are paying huge amounts for epi pens and I can get them for free.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Offline nyguy

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Re: Auvi-Q relaunch
« Reply #113 on: April 02, 2017, 09:40:41 AM »
Kaléo continues to operate under a shroud. I don't know the fill time for Auvi-Q. I know that my brother's prescription (commercial insurance but zero coverage for Auvi-Q) took far longer to fill than my parents (fill with prior auth but prior auth criteria not met?). I suspect there is a very real backlog and that they are prioritizing scrips by how much they get paid: probably permissive insurance billed at full price is first, then cash price people with direct delivery, than commercial insurance with no coverage for Auvi-Q.

April 1st has come meaning most insurers have updated their formularies for the quarter. Express Scripts on my parent's plans already tier 3'd it with prior auth required as of Jan 1st. I have no idea how Kaléo filled the scrip. The PA criteria required that either the patient had a visual or hearing impairment requiring visual/spoken directions from the injector, or a total inability of the patient to self administer and the caretaker having a visual/hearing impairment. My parents met none of those criteria and the allergist did not fill a PA form to insurer. This makes me wonder whether ExpressScripts waived their own criteria for PA or... well, the alternative would be more troubling to consider.

My plan paid, whatever, my brother's obamacare commercial insurance did not and they filled it...after much prodding on the fill date via the phone number. (I think that definitely filtered in).

The end problem is I don't see how this strategy succeeds, between senate/public outrage and the fact that Kaléo will fill on commercial insurance if they don't cover it, there is literally zero incentive for permissive insurance to cover it. The only possible scenario I can think of is if Kaléo has negotiated some massive rebate with the largest PBMs where they can charge plans (e.g. large groups) huge amounts for the drug and then get it back. Large companies aren't stupid though and shenanigans like this would likely result in a threat to switch providers.

The biggest victims are those on government insurance who used to get Auvi-Q for a reasonable price. With the much better branded EpiPen in greater public consciousness I think it's a tough battle to fight for awareness on this. I think Kaléo will eventually change their tune though, I think they're trying to get as much as they can while they can.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #114 on: April 03, 2017, 01:09:30 PM »
Holy cow, I don't know what happened but we got the Auvi-Qs in the mail today for DD.  I'm in shock, seriously cannot believe it.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Offline PurpleCat

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Re: Auvi-Q relaunch
« Reply #115 on: April 03, 2017, 02:34:07 PM »
That's great!  I start the process tomorrow to get some for DD.

Offline BensMom

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Re: Auvi-Q relaunch
« Reply #116 on: April 05, 2017, 04:14:06 PM »
My son texted today that his have been delayed until April 21st. They were supposed to come today. Then my friend emailed and said hers arrived today. She ordered after we did. Wth? I may call them tomorrow to see what's going on. DS's epis have expired (as of end of March, or beginning of March--not sure how that works.) I'm not too worried about it, but I think it bothers him that they've expired.

Online hezzier

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Re: Auvi-Q relaunch
« Reply #117 on: April 05, 2017, 05:52:58 PM »
When I talked to them on the phone, they asked when our epis expired, I didn't know so he put down that they expired in two weeks and gave us an arrival date of 3/31.  They arrived on 4/3.
DS (15 yrs) TN
DD (17 yrs) cat, wasps and yellow jackets

NH, USA

Offline PurpleCat

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Re: Auvi-Q relaunch
« Reply #118 on: April 06, 2017, 02:55:34 PM »
So, the process continues with a giggle and smooth sailing (so far)

Allergist can now use escript to send in the prescription, we did not have to fill out any forms.  The company\ny then called me today to reconfirm my address and other details, and to say the escript converts the prescription to epi pens barbecue auvi q is not in the system yet, but...they will call doctor to explain how to change.  My CVS Caremark does not cover it so it will be covered under the affordability program.  I will have 2 refills.  And because they are back logged a bit, we will receive them on May 8th.

Very efficient, very nice, easy, pleasant.  I don't mind waiting!  With refills which we will space out every 30 days, DD will have enough for college.

 :coffee:

Now to see if it really happens as planned.

Offline MaryM

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Re: Auvi-Q relaunch
« Reply #119 on: April 17, 2017, 06:22:14 PM »
My allergist sent the script in back in February but I never received a call.  After our appointment today she resent it.  When we got home I had a message so I called back and both kids Auvi-Qs will be shipped soon!  So excited!!