Ok Harvey and Tom here you go, please consider using what is composed here to sell Dr Phil that your going to get what you pay for therefore paying the RSS for refills is important and not to be fucked with:
Constant education to providers related to SHPT disease state as an important chronic condition that should be aggressively managed. Many drs don't understand the disease state as being serious therefore may only manage 25D and not PTH or vice versa, many not look at the CA or Po4 till late stage 4 or early stage 5. They agree to try Rayaldee but are floored by the high cost ($928 per month) but we have to sell them to keep the pt. on Rayaldee and your not going to pay us for that? You are a moron that you think after they put a pt. on something that the refill comes automatically without any hang ups, this is where we really earn our paycheck, dumbass.
Review KDIGO guidelines that recommend analogs and calcitriol not be routinely used to treat SHPT, key word is not but the alternative is very expensive therefore opening the door to alternate RX from calcitriol to Rayaldee and vice versa just to help keep the out of pocket costs down.
Sell Dr that by keeping pts. on Rayaldee with that $155 per month co pay by UHC/AARP will be worth it.
Sell Drs that keeping pts. who have Silver Script insurance who pay 25-33% co insurance is really worth it.
Encourage 501c3 grant monies to help defer the high co-pay cost when those monies are very hard to come by and caregivers hammer us that those funds should be spent on blood pressure, insulin or food and clothing not on a $928 per month V-D analog. 501c3 funds are available if you qualify financially remember?
Sell Dr that treating SHPT is important and should include evaluating 25D, PTH, CA and P04 and that even though you may not get reimbursed for that earlier follow up office visit you should evaluate pts. recently placed on Rayaldee as early as 3 months.
If you not happy with the 30mcg QDHS after 3 months then you have the option to titrate to 60mcgQDHS therefore doubling the co-pay to $310 per month for UHC/AARP or 25-33% for your Silver Script Medicare pts.
Usually chronic conditions prescriptions are written for 12 months, how are you certain the Dr. will keep the pt. on Rayaldee for another 12 months? If we are not going to be paid for those RX then we won't ask for the refill.
Here's the best part, Rayaldee's refill rate is less than 50% after 3 months. In some territories it's less than 30% after 3 months, no pay for refill then no chance the 50% becomes 60% or 30% becomes 50% if we are not following up on existing cases.
God help us all when the newbies who can't even pronounce calcitriol are going to be calling on offices in a few weeks, their job will be to keep your existing pts. on Rayaldee and ask for new business, your bonus depends on it.
This is the most fucked up company I have ever worked for that management would even ponder not paying reps. on TRX, are you stupid or something?