Ask an Account Manager anything...

[RealAM]

Dear Ask an AM, Can you put the price of Hetlioz each year starting in 2014 (2015. 2016, 2017. 2018 and current year 2019).. I was curious on the original price and current price and percent markup. And can you tell me who approves the price increase each year??? How much becomes the burden of the patient and how much is taken on by insurance? I had a Doctor tell (yell) at me about our ever increasing price but I do not remember Management giving us the price or the reasons for the increase. (Has anyone else ever been berated by a Physician because if pricing? How do you handle it?)

I can’t find the price info internally, that is not something the field has ever had access to. Ever. A Google search is the best you can do. I don’t have the exact numbers through the years and it is hard to search for historical data but Hetlioz was approximately 60k a year at launch in 2014. It doubled by 2016 to over 120k a year and is now just about 200k a year for therapy. Handling cost objections is not something the company has ever provided guidance on. HCPs rightfully so are aghast at the price. Most reps avoid that conversation at all cost. Pun intended. Patients bear little burden because who would pay for it? Especially the new patients with the psych initiative, most are bipolar pats with insomnia and a lot are on state plans. So the burden is on the plans, what is the pay responsibility is mitigated by patient assistance so the drug gets billed and patients get an incredibly expensive product for low, if any co-pay that will likely provide little efficacy. Scam.
And yes, been thrown out of offices for price before.

 

[anonymous]

I can’t find the price info internally, that is not something the field has ever had access to. Ever. A Google search is the best you can do. I don’t have the exact numbers through the years and it is hard to search for historical data but Hetlioz was approximately 60k a year at launch in 2014. It doubled by 2016 to over 120k a year and is now just about 200k a year for therapy. Handling cost objections is not something the company has ever provided guidance on. HCPs rightfully so are aghast at the price. Most reps avoid that conversation at all cost. Pun intended. Patients bear little burden because who would pay for it? Especially the new patients with the psych initiative, most are bipolar pats with insomnia and a lot are on state plans. So the burden is on the plans, what is the pay responsibility is mitigated by patient assistance so the drug gets billed and patients get an incredibly expensive product for low, if any co-pay that will likely provide little efficacy. Scam.
And yes, been thrown out of offices for price before.

Hetlioz was 84k at launch

 

[anonymous]

how can reps have over 20 intakes calling on psychs in one quarter? the data shows that there aren’t even more than 100 documented cases of non 24 ever seen by the experts.... wtf

stop selling off label and do the right thing for patients.

 

[anonymous]

how can reps have over 20 intakes calling on psychs in one quarter? the data shows that there aren’t even more than 100 documented cases of non 24 ever seen by the experts.... wtf

stop selling off label and do the right thing for patients.

On label selling at Vanda....ha ha. Dr Mihales would never accept the results of actually following the law. The predicted sales each quarter are completely based on off label sales. The stock would tumble faster than usual if off label promotion stopped.

 

[anonymous]

Can you see dispense rate for the quarter? How is it the financial’s were so high this last quarter yet the sales force didn’t make goals and not many people got product? Also on investor call M said that they are going to do a trial for sighted patients with the 30,000 patients in their database? Is this why they demand sighted patients intakes but don’t care if they dispense?

 

[anonymous]

Can you see dispense rate for the quarter? How is it the financial’s were so high this last quarter yet the sales force didn’t make goals and not many people got product? Also on investor call M said that they are going to do a trial for sighted patients with the 30,000 patients in their database? Is this why they demand sighted patients intakes but don’t care if they dispense?

Don't believe ANYTHING that Dr Pinocchio says on investor calls. His lies will catch up with him sooner rather than later.

 

[anonymous]

This might be a better question for a case manager if you are out there reply please:
How would a doctor office get a
Denial letter faxed over for a prescription that is over 9 months old and was already denied and the patient decided not to go to the appeal
Process. Why 9 months later is the office getting faxed over a new denial like a new claim came in?

 

[anonymous]

Because of the backlog of intakes that never went anywhere. They are still working through intakes that were denied but still resubmit directly to the insurance companies when there is a AR in place. Usually those denials go right to home office since we are the ones submitting them. Sometimes they go to the doctors office which adds to the confusion since it is often months after the original srf was faxed in.

This might be a better question for a case manager if you are out there reply please:
How would a doctor office get a
Denial letter faxed over for a prescription that is over 9 months old and was already denied and the patient decided not to go to the appeal
Process. Why 9 months later is the office getting faxed over a new denial like a new claim came in?

 

[anonymous]

Because of the backlog of intakes that never went anywhere. They are still working through intakes that were denied but still resubmit directly to the insurance companies when there is a AR in place. Usually those denials go right to home office since we are the ones submitting them. Sometimes they go to the doctors office which adds to the confusion since it is often months after the original srf was faxed in.

cluster fuck because Dr Mihales, the jerk would rather hire high priced henchmen to keep him out of prison than caring about patents. Oh wait. That's nothing new

 

[anonymous]

Is it possible for other specialty pharmacies to fill Hetlioz? If it is another specialty pharmacy do the AM or ANSR’s get credit for that?

 

[anonymous]

Question: Do ANSR or NSR on fanapt side get credit for intakes that are with a provider that is NOT on their target list, and not in an office with a target?

 

[RealAM]

Question: Do ANSR or NSR on fanapt side get credit for intakes that are with a provider that is NOT on their target list, and not in an office with a target?

You should get credit, those are the rules. Make sure you add the HCP - slow broken process but good luck. Make sure they are at least entered into concur as an attendee at a lunch although that shouldn’t even be necessary. Just check with your AM and ask if anything came over.

 

[RealAM]

Is it possible for other specialty pharmacies to fill Hetlioz? If it is another specialty pharmacy do the AM or ANSR’s get credit for that?

No. If it’s not showing up it is for only two reasons. 1. They wrote it off label, likely wrote in insomnia since that is what they think it’s for anyway. 2. They never wrote it.

 

[anonymous]

The price at Launch was 84 k a year in 2014
2015 went up to about 92,000
2016 148,000
2017-176,000
2018- 200,000
2019 -2020- 208,000
Just an estimate based on what is online for WAC prices not sure what insurance pays because M won’t negotiate with Insurance. This is cash WAC prices that are published yearly with what the price increases are.

 

[anonymous]

The price at Launch was 84 k a year in 2014
2015 went up to about 92,000
2016 148,000
2017-176,000
2018- 200,000
2019 -2020- 208,000
Just an estimate based on what is online for WAC prices not sure what insurance pays because M won’t negotiate with Insurance. This is cash WAC prices that are published yearly with what the price increases are.

CEO says he cares about patients. He is just a large pile of poop! $208K for a placebo he tries to sell as a sleep aid.

 

[anonymous]

I am not sure if this AM is still with the company but can you please explain the foundation and what they do? I have heard they are paying for 3-4 months of medicine for Medicare patients and then telling Medicare that the drug worked to get it paid for. Who is paying for the copay’s? Isn’t it illegal for a foundation to funnel money to Medicare patients? Is PSI the only foundation? Explain this process for the DOJ please.

 

[anonymous]

I am not sure if this AM is still with the company but can you please explain the foundation and what they do? I have heard they are paying for 3-4 months of medicine for Medicare patients and then telling Medicare that the drug worked to get it paid for. Who is paying for the copay’s? Isn’t it illegal for a foundation to funnel money to Medicare patients? Is PSI the only foundation? Explain this process for the DOJ please.

They don’t talk about the foundations.

You would have to get Mihales, Kevin, Jan or Peter to talk.

 

[anonymous]

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.

I was part of the “purge” in June, 2017 and was an early questioner of promotional activity and blatantly dishonest reps ( if you are who I think you are, I’m sure you know who I am).

So tell me, is the rate of Non-24 circadian rhythm sleep disturbance in the blind or nearly blind patient with limited light perception in and around Peoria, Illinois, still running 15,000 - 17,000 % higher than NIH stated incidence rates?

 

[anonymous]

I was part of the “purge” in June, 2017 and was an early questioner of promotional activity and blatantly dishonest reps ( if you are who I think you are, I’m sure you know who I am).

So tell me, is the rate of Non-24 circadian rhythm sleep disturbance in the blind or nearly blind patient with limited light perception in and around Peoria, Illinois, still running 15,000 - 17,000 % higher than NIH stated incidence rates?

You mean Rockford.