karuna deal

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anonymous said:
Can you share how you asked 3 different ways ? Genuinely curious lol
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1. Is there a commercial coverage team in place and have they begun working with payers yet?

2. Will KarXT be covered on public aid?

3. How will patients without coverage get access?

9/10 patients with schizophrenia have no job and no insurance. They sure won’t be able to pay out of pocket. How will they get access outside Medicaid in states with no restrictions? It’s important to know going in because if you happen to work in a state without Medicaid coverage for brands, you will have a tough time competing with those who do.
 




anonymous said:
1. Is there a commercial coverage team in place and have they begun working with payers yet?

2. Will KarXT be covered on public aid?

3. How will patients without coverage get access?

9/10 patients with schizophrenia have no job and no insurance. They sure won’t be able to pay out of pocket. How will they get access outside Medicaid in states with no restrictions? It’s important to know going in because if you happen to work in a state without Medicaid coverage for brands, you will have a tough time competing with those who do.
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Sorry. I meant to say how will patients get access if they are in a state where Medicaid restricts branded products. Some states require multiple generic failures before they will consider a PA for a brand.
 




anonymous said:
Sorry. I meant to say how will patients get access if they are in a state where Medicaid restricts branded products. Some states require multiple generic failures before they will consider a PA for a brand.
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How many of those have already failed multiple treatments? Most have. If you’ve launched in the schizophrenia space before, this is nothing new.
 








anonymous said:
How many of those have already failed multiple treatments? Most have. If you’ve launched in the schizophrenia space before, this is nothing new.
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I launched in the space before. You are correct. Many patients have multiple failures by the time they get to a brand. My point is there are states like Tennessee and Michigan where patients can go straight to a brand with no failures. Even newly diagnosed patients naive to treatment can get the newest agents with no PA. If you are competing against reps in those states and you are in a state where patients have to fail multiple generics, you will be in the bottom of the ranking. Especially if the bonus plan is force ranked on volume.
 




Guest666 said:
It’s the Avanir, Alkermes, J&J show. You all hated working there. Leadership sucked. Why would you follow them here?
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Where are most of the leadership people coming in from. I know there are a few from Alkermes and Abbvie. What other organizations? Are they really interviewing reps or just bringing in their former people?
 




Based on the clinicaltrials.gov posting, the pivotal studies enrolled patients who were on monotherapy. They didn't have to fail generic antipsychotics before entering. So the FDA label will probably insist upon the same. But in real life most states will ask that patients fail several other generics before trying the branded.
 




Some good dialog on here about product access. The bells and whistles of a new MOA sounds flashy but this patient population lives on generics due to cost. Flashy won’t mean much to the psych treating low income and no income patient populations.
 




anonymous said:
Some good dialog on here about product access. The bells and whistles of a new MOA sounds flashy but this patient population lives on generics due to cost. Flashy won’t mean much to the psych treating low income and no income patient populations.
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More than 90% of these patients are seen in CMH or public aid settings. Ask any private practice psych MD or APN how many schizophrenic patients they have. Most will say none or a few here and there. I launched another schizophrenia med years ago and it was tough to get these patients because most were on LAI and/or generic. The poster above who said places like Michigan will get out of the gates fast was right. States with mandated mental health access legislation and no restriction or PA for brands will crush. Those without will struggle. If the IC plan is ranked on volume, it will favor reps in those states with open access.

Most managers will tell you anything to try and get you to jump on board. If you really want to know the truth, reach out to reps from Vanda, ITC, Abbvie, etc. and find out what life is like for them in the schizophrenia market. It’s good information to know going into the process.
 








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