Interviews

fiesta is a joke. no way jose. itz fusion and escape as the choices

 

Your manager will be traveling in your choice several long days per month. Enjoy your pick

 

Stand in front of manager and say Aptiom has an amazing responder rate at the dose many can't tolerate. I know 20% dropped off the 1200mg dose and the 400mg dose was comparable to placebo, but we may have a slight benefit with 800mg dose. You don't have any comparisons to how this compares to generic trileptal, but maybe neuros will take the leap of faith and write for you a script per month. The company is relying on neurologists being scared of generics, but reality is that they are hesitant to SWITCH to a generic from a branded agent. They are not against starting a patient on generic trileptal though. Remember that these patients have to be on many meds. Do you think they are gonna pay $150 out of pocket for a drug not shown to be better than generic trileptal for a $10 copay? Truly think about it. This drug is not going to make it! Don't get sucked into the hype. Companies will tell you that the marketing team surveyed doctors and that they can't wait. Then you get into the field and see reality. Too late then! The company is not going to pay the rebates for better formulary coverage, and there are only 3 studies, one of which shows inconsistent efficacy. I walked away after researching this and urge others to do their homework before getting sucked into a shit storm!

 

I agree! I got weirded out by P1 sending me a thousand emails asking if I'm still interested in pursuing this position. They know that this is a dog and that smart reps will figure out the truth. I get that the managers have to try and rally the troops, but the hiring managers are clueless and can't answer the tough questions. I walked away as well and hope others will be smart enough to realize what they are getting into. This is a decent gig if you are jobless or desperate for a job change. Otherwise, wait for a better opportunity!

 

Sounds like someone who did enough research to get an interview, but not an offer and is bitter about. Remind me what Trileptal's drop out rate is at its highest adjunct dose? Oh, that's right, its 65%. Maybe 20% its so bad after all.

 

Can't compare results from different studies because of different patient populations and study protocols. FDA forbids companies from doing this for a reason. You have a terrible drug that shows no benefit over generics! Company not paying rebates so it will be expensive. Good luck selling your branded snake oil.

 

I agree with the first part of your post but, come on, Aptiom is not snake oil. Honestly, i'll be competing with this drug and did get a call from a recruiter but didn't pursue it because I'm happy with my situation right now. Some friends who are taking offers are excited about getting a monotherapy indication in the fall. The only problem with that is, generic keppra, generic topamax, generic lamictal, generic trileptal, generic depakote, etc....I think you get the point. Good luck getting anybody to cover this for initial mono or even 2nd line mono without deep discounts or concessions.

 

Sunovion paid a high price tag for this "me too" drug. Company can't afford the discounts an concessions.

 

If the results of the below studies are true, I doubt they will have any trouble getting covered. The costs associated with treating break-through seizure far outweigh the cost of even the highest price med.


- Sunovion Pharmaceuticals Inc. Presents Positive Results From Two Phase 3 Studies of Once-Daily Aptiom® (eslicarbazepine acetate) as Monotherapy Treatment for Partial-Onset Seizures

-Patients with partial-onset seizures poorly-controlled on 1-2 AEDs who converted to APTIOM monotherapy had a further 30.9%-47.5% reduction in seizure frequency

- Supplemental new drug application planned for spring 2014

http://finance.yahoo.com/news/sunovion-pharmaceuticals-inc-presents-positive-140000303.html

 

First, what we were talking about was coverage for initial monotherapy NOT adjunctive therapy which is what the study you cited was for. Secondly, the results are in-line with other adjunctive trials with currently marketed or generic anticonvulsants. BTW you are forbidden by the FDA in making any comparative claims so you can't take those results and say that Aptiom is better than X, Y or Z. Everybody in this market - reps, neurologists, pharmacy benefit managers, etc... knows that.

 

Some things to consider.

If you are familiar with this space you will know that the previous conversion to monotherapy studies did not disclose seizure reduction data from the baseline medication(s). Why? Well because the data was unimpressive and showed only maintenance of seizure frequency, at best, from the previous med, never a real improvement. These studies appear to be the first time seizure reduction from baseline has been made available from such a study design and it appears that it was a pre-specified endpoint in the study (frankly, a gamble as it could have showed nothing and Aptiom may have been obligated to disclose that fact).

All the recently completed historical control trials are specifically designed to be comparable to a common historic placebo exit rate and thus, the results are directly comparable to similarly designed studies. This is common practice in other therapeutic areas where historic control studies are used, such as oncology.

 

I agree with post #167 above. It's one thing to get a monotherapy indication but it's quite another to get insurance companies to cover it given all the generics out there. Not gonna happen without deep, deep discounts.

 

I agree in principle, but how exactly will a insurance company be able to distinguish between monotherapy and adjunctive use? Unless its in a truly newly diagnosed patient, which will rarely happen, a switch and adjunctive use will look the same when a patient is initiated.

 

I think you answered your own question. A newly diagnosed patient who has no history of being prescribed anticonvulsants is not as rare as you think. In addition they will continue with the step edits they already have in place. I'm not saying it's impossible, but definitely going to be difficult to get a significant amount of action as a first or second line monotherapy agent in a patient. Also, I'm not so sure a switch and adjunctive use will look the same. You have to remember that branded anticonvulsants are VERY expensive. These insurance companies are getting squeezed big time and they're going to do whatever to try and limit branded use in favor of generics. We'll see..... Bottom line is time will tell.

 

Stop by a pharmacy and ask them about their computer systems. Their computer systems tell them if the prescription doesn't meet step edit or other specifications. Systems are pretty advanced now. They can definitely tell now.

 

If you are familiar with how patients suffering with epilepsy are treated, you will know that switches in this category are done over long periods, as every AED has a warning against abrupt discontinuation. There is no way to distinguish between a mono switch and adjunctive use the day a script is written. And the Dr. might not know themselves what they plan to do until they see how the patient responds to the new med. You would only be able to tell months later when they didn't get a refill of the other med. By then its too late.

 

Managed care companies aren't going to lie down and say " well I guess Sunovion reps figured out a loop hole and I guess we'll just cover this expensive med forever." Somehow I think the MC company will pass the cost on to the patient and that's when the patient calls the doctor bitching. That pisses dr off and say goodbye to your 2 scripts per week.

 

Good thing payers love co-pay cards!!!

 

PrincetonOne is horrible. A quick look up on LinkedIn and you can see their idea of a "recruiter". Most don't have much in the way of an education,=cheep labor, very young. It's a scam. Best look for any other place that doesn't use P1. They are idiots!

 

I guess that the phone screen did not go well. Well if you are looking to work here, by next year you will be happy that you did not make it past the phone screen.

Almost every job now is an employee referral.