Not an “anonymous” thread, although I won’t disclose or answer anything that hints at my identity, location or the identity of others. Responses by me will be under the username RealAM.
I will field questions from colleagues, investors and investigators to the best of my ability. Fire away.
Not really. Easy enough to guesstimate looking at Thebe. What I can see is around a 6%-7% dispense rate, ie. approval rate.Are any intakes getting covered. I mean WTF????
Are any intakes getting covered. I mean WTF????
Not sure why they don’t say it. Best guess is that even though the indication does not specify blind or sighted, they know they are skating on thin ice with targeting non-circadian rhythm specialists. It also could be that the criteria for orphan drug status is pretty specific. If we are expanding beyond the totally blind, no light perception patient the perhaps we are jeopardizing that orphan drug designation.Why do the CEO and CFO both refuse to answer the simple question on quarterly calls of the breakdown of sighted Hetlioz patients versus blind? It makes them look like they are hiding something and is why the stock price is in the toilet.
Lol. You are kidding right? The vast majority of scripts do not refill. I have a handful of patients that have continued for years but they are the exception. They are also totally blind and likely truly have non-24. I don’t believe I have ever had a sighted patient refill. As far as the NSR scripts that have come in from territory or my even my own HPI scripts, NONE HAVE REFILLED. Reason being generally given by the HCP is that it doesn’t work. That makes sense. If you don’t have free running circadian issues it’s not going to work for you. Not sure if the company really cares about the drop off though since three months shipped costs about 52k anyway. That makes the pitiful amount we get in IC seem even more pathetic.Is there a big drop off rate of prescription refills? How long is an average patient actually on the medicine?
Not really. Easy enough to guesstimate looking at Thebe. What I can see is around a 6%-7% dispense rate, ie. approval rate.
Now who remembers what the dispense rate was before the “Vanda Benefits” clusterfuck? It hovered around 25%. Before the NSR team started promoting Hetlioz it was around 40%. That drop probably had to do with more sighted patients thrown into the mix.
How did you see this? I looked on THEBE and it looks like it has more than 40% approved across the blind and sighted
My guess is you are looking at Date Sent to SP instead of Date of First Shipment. You must be an associate since all AMs know this. “Triage” used to mean dispense because when a case was usually sent to SP when it was approved and ready to ship. Now what they call “Triaged” is vastly different. If they can’t get in touch with a patient, if they can’t get authorized rep from patient, if it’s denied and Vanda benefits can’t proceed for any reason the case is passed off to specialty pharmacy and ends up in cold storage there.How did you see this? I looked on THEBE and it looks like it has more than 40% approved across the blind and sighted
Does anyone know what “Payer Approved Pending Triage” means? My case manager is always saying how Frances is constantly on them about these and whatever contest she has Pulled out of her ass for the week.
I just want some new PDPs that aren’t 4 years old and uninterested.
My guess is you are looking at Date Sent to SP instead of Date of First Shipment. You must be an associate since all AMs know this. “Triage” used to mean dispense because when a case was usually sent to SP when it was approved and ready to ship. Now what they call “Triaged” is vastly different. If they can’t get in touch with a patient, if they can’t get authorized rep from patient, if it’s denied and Vanda benefits can’t proceed for any reason the case is passed off to specialty pharmacy and ends up in cold storage there.
Again, Vanda Benefits is a joke. When they rolled that out Feb 2018 they said it was because of a backlog of 700 cases. They partly blamed that backlog on the AMs not being responsive enough in getting out to the offices and helping the approval process along. Well how did that work out? LOLOLOL My case manager says the backlog is now well over 3000 cases that they can’t do anything with. Mostly because the PA was denied and health plan stated as reason that Vanda is an inappropriate party to serve as authorized rep. Hmm, who didn’t see that coming? Managed Care Plans saying the company who will profit 200k from their approving the product can’t be the ones completing and submitting a prior authorization. Go figure.
This is wrong.
You are talking about reimbursement assistance. For these, they do not mark date sent to current spp. My CM said these are the prescriptions that are off label, and there is nothing they can do. They won’t call the patient or anything.
Just ask your CM and they will tell you everything.
If a prescription triages (date sent to current spp), then that means it is approved by the insurance, the patient did their stuff with the cm, and the prescription was sent to the pharmacy. This also makes it automatically “complete” for IC. She said they get an email whenever one of their prescriptions is approved and can see all prescriptions, including off label.
My CM and I went through all my prescriptions for Q4 because they won’t tell us which prescriptions they paid ic for. I will ask her about the first ship date thing, but she was very clear that if the date sent to current spp is set, that the insurer approved the prescription and the patient had done all of the things they have to do. She said they have a CM dedicated to following up with every triage to make sure it is filled.
When we compared the prescriptions that triaged, or had been marked complete, it added up to my ic.
She said they have to mark something confirming every triage that it is done or it shows up for their managers.
It is bad enough here without misinformation.
Bro, I call bullshit. In your earlier post #8 you said you had access to Thebe. If you did have access you could see First Ship Date for yourself and would not have to even ask your CM. None of those things, triage or dispense has anything to do with reimbursement assistance which is not even noted in Thebe. So you are either an NSR trying to pretend you know what you are talking about regarding Thebe and what info the CMs have or you are Tom or some other dumbass in senior management trying to muddy the waters of confusion.This is wrong.
You are talking about reimbursement assistance. For these, they do not mark date sent to current spp. My CM said these are the prescriptions that are off label, and there is nothing they can do. They won’t call the patient or anything.
Just ask your CM and they will tell you everything.
If a prescription triages (date sent to current spp), then that means it is approved by the insurance, the patient did their stuff with the cm, and the prescription was sent to the pharmacy. This also makes it automatically “complete” for IC. She said they get an email whenever one of their prescriptions is approved and can see all prescriptions, including off label.
My CM and I went through all my prescriptions for Q4 because they won’t tell us which prescriptions they paid ic for. I will ask her about the first ship date thing, but she was very clear that if the date sent to current spp is set, that the insurer approved the prescription and the patient had done all of the things they have to do. She said they have a CM dedicated to following up with every triage to make sure it is filled.
When we compared the prescriptions that triaged, or had been marked complete, it added up to my ic.
She said they have to mark something confirming every triage that it is done or it shows up for their managers.
It is bad enough here without misinformation.
So if this is all true, would it be safe to say that a NSR/ANSR is only being paid on triaged prescriptions?
Is this why self reported intakes never match for IC? Some people who had 6-8 in 4 th quarter were not paid anything for H bonus because they said you only had 1. Which, when you go back to your accounts and you know they wrote one and have to take your manager in to prove they wrote one, but still no credit given. Basically if it goes through Vanda benefits then you might get credit, but if another Sp picks it up then you do not get credit?? Does this sound right?
They pay on what they WANT to pay on. They have robbed me and my team mates and then we are berated by district and regional manager even though we HAVE the intakes. youNo, they pay on complete, on-label prescriptions.
But if a prescription is in-complete, but they get it triaged, that makes it complete automatically.
The difference in self-reported is generally complete vs in-complete
