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.