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Anonymous said:
Your are right regarding MEDICAID patients (indigent patients covered under the federal program administered by the states).

For patients covered under private Rx insurance (and some other groups) G-1 and Clindesses has to be listed in the groups formulary for reimbursement to occur without prior authorization. Even if listed, the products may be subject to a high co-pay. As it turns out today, most groups won't list G-1 or they require a very large co-pay ($30, $60, etc). What KV has planned to do to encourage the filling of G-1 Rx's, like they tried to do with Makena, is to offset the high co-pay with a voucher. For example, if the KV voucher is for $20 and the co-pay is $30 then the patient only has to pay $10.... however the 3rd party payer still has to pay the difference... KV does not eat the difference as with the Medicaid patient. The 3rd party payers don't like these voucher systems since they get stuck paying the difference.... usually what they do to offset the voucher is raise the co-pay very high. They did this with Makena with co-pays being as much as $120 and more, so that patient would have to pay at a level that they would refuse the branded Makena and choose the compounded version which had a small or no co-pay,
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By "...pay the difference" the 3rd party has to pay the price of the product less the co-pay that the patient paid less the voucher amount. The 3rd party still has to pay for the remainder cost of prescribed G-1. This is what happens for MEDICARE patients with Rx drug coverage, and other insurance Rx programs, and group coverage for Rx's.

This is different that what happens for MEDICAID patients. For Medicaid patients a negotiated price is struck between KV and the government, which may include a negotiated co-pay. The negotiated price of prescription products for Medicaid patients is usually very much lower than the price paid by others with Rx insurance. Note that this explanation is regarding Medicaid patients, NOT Medicare patients.
 






Anonymous said:
Got a hit regarding an opening in my territory. I couldn't believe you guys were still around let alone hiring. I've got only 2 yrs of pharma experience but have solid numbers. Looking to make a change and would like the chance to acquire injectable and buy and bill experience. I need to get back to the recruiter by next week. Any feedback on the status of your company would help.
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Makena is not "buy and bill" for the doctor.
 






Anonymous said:
You see 15% I see 85% more to get. It do look good. So what kinda car can I get. Where is the trip I will win president club next year. Ive met many womens with years infections and they say that gynazole is easily the best and that makena is really going to grow by leaps and bounds this year and again. Plus my wife is a pharmacist who will switch for me.
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You are dependent on OB/Gyns to write prescriptions for KV/Therrx products, and most won't even let you in the door, let along write prescriptions, due to the poor reputation of KV/therrx and the predatory pricing of Makena. How do you think you are going to get that 85% of market share? Management fouled any possibility of that happening, in my opinion.
 






I am in TN and looking for opportunities. Is ther-rx a good opportunity ? What are benefits like ? Is there a company car vehicle ? What are chooses for car ? Is there a 401-K and matching at what ? Is salary descent ? I have 7 years experience in industry.
 






Anonymous said:
I am in TN and looking for opportunities. Is ther-rx a good opportunity ? What are benefits like ? Is there a company car vehicle ? What are chooses for car ? Is there a 401-K and matching at what ? Is salary descent ? I have 7 years experience in industry.
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Read some of the posts here a little more closely. Unless you really like pain and uncertainty, I'd scadoodle as far away from this company as you can.
 






Anonymous said:
The 3rd Party payer doesn't even know that a voucher was used, so it doesn't matter if the "stand for it"
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The 3rd party could, and usually does know, if a patient voucher was used to subsidize the co-pay. The voucher causes an inducement for the patient to have the prescription filled, but it does not change the fact that the cost of the drug product, excluding the co-pay and any voucher, still goes to the 3rd party for payment..... and they don't like having to pay for high co-pay (3rd tier) drug products.... the whole idea of the 3rd tier co-pays was to discourage patients from filling such prescriptions and to encourage the use of a lower priced therapy (usually products are listed as third tier when an alternative, equally effective therapy, exists at much lower price).

What 3rd parties can do, and usually will do, is not list the offending product on their formulary, or remove the product from their formulary if it is listed. When this happens, the only way the product is reimbursable to the pharmacy is by special approval (i.e. "requires prior approval") by the 3rd party. And that procedure is cumbersome, requires time, and requires input from the, usually reluctant, physician.
 






You say the 3rd party payer knows that a coupon was used. How could they possibly know? My husband is a pharmacist. When he submits a claim to he insurance company what comes back is what the patient is to pay (the co-pay). He then submits the coupon and the patient pays less. That communication never goes back to the insurance company. This is a fact.
 






Anonymous said:
You say the 3rd party payer knows that a coupon was used. How could they possibly know? My husband is a pharmacist. When he submits a claim to he insurance company what comes back is what the patient is to pay (the co-pay). He then submits the coupon and the patient pays less. That communication never goes back to the insurance company. This is a fact.
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They know when there is an abnormally high number of prescriptions filled...for tier 3 drug products, this is usually due to the presence and use of a co-pay voucher. You are correct that the 3rd party has no DIRECT way to know if a voucher was used.

My point still is that the 3rd party does not like the use of co-pay vouchers, since the 3rd party is still stuck with paying for the drug product minus the co-pay. The reason the co-pay was set so high (Tier 3 for expensive drugs for which there are less expensive alternatives) was to discourage the patient from filling the prescription and to encourage the use of the less expensive, but equally efficacious, drug product(s).
 












Dammit, answer the question!
Company Car? Yes. I drive a 2003 Pontiac Aztek.
Great company. great people. Great products. Docs swing the door open and say "C'mon in, we've been waiting for you in order to advance our care of women!".
Seriously.....Private company now. Profits. New people soon. Could be good.
 












Anonymous said:
Who the hell are you to agree or disagree? Grease the hand that feeds you............it still works!
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Y'know I came into this job with a good sense of honesty and ethics. When I leave this company I'll do so without ever compromising my values, ever! The company needs to know from its employees and the docs that the vouchers are viewed as unethical and probably ultimately illegal..... apparently management sees these vouchers differently. Maybe they should listen to the docs that write the prescriptions, or their own employees.
 






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