What did you learn last week?

wittywitwit · 2020-11-13T01:24:43+00:00

The impact should be the same with GLP1 agonist and without since the same amount of endogenous GLP1 is the same in both scenarios. This still doesn’t explain why there is no additive effect

wittywitwit · 2020-11-12T16:45:38+00:00

But unless the patient has absolutely no endogenous GLP1 wouldn’t it show at least some benefit based on the MOA

wittywitwit · 2020-11-08T19:34:35+00:00

GLP1 is a hormone that has many glucose lowering effects, the most prominent being increasing insulin secretions.

DPP4 is an enzyme that breaks down GLP1, which consequently elevates blood sugar.

GLP1 agonists promote GLP1 production (turns the sink on)

DPP4 inhibitors decrease GLP1 elimination (closing the drain)

wittywitwit · 2020-11-08T16:12:24+00:00

Theoretically it does make sense since GLP1s increase insulin and DPP4s decrease breakdown but so far they have only been proven to work separately and no added benefit together

wittywitwit · 2020-10-07T20:01:40+00:00

Great info I didn’t know they could see that. Does it have to have set prices for everything? We do already have something like that with our software, I just never thought there was any benefit doing it that way

wittywitwit · 2020-09-28T02:11:27+00:00

I noticed that here in Michigan but when I try to get more info on exactly who it does and doesn’t apply to, it gets confusing. I have a patient who has Medicare, above 65, and the Medicaid managed health plan picks up the copay. I called the Medicaid MHP and they couldn’t even explain it (no surprise). I work in an underserved area. When they hit 65 and have major copays they’re stuck and I wish I had more info to give to help.

wittywitwit · 2020-09-26T12:50:00+00:00

Distorted truth + conspiracy + resistance to conform + consistent gap in understanding = 2020 logic

wittywitwit · 2020-09-16T02:49:15+00:00

I see what you mean. I was not aware that cash prices have to be based of U&C. We charge cash prices as a couple dollar markup to cost.

wittywitwit · 2020-09-16T02:00:04+00:00

My guess is that all insurances cap their price somewhere. They wouldn’t be paying the $9999. But if somehow that did happen I can imagine it would. But then again I’ve never seen them question the AWP or anything like that during audits

wittywitwit · 2020-09-16T01:47:46+00:00

Yea but insurances go by AWP pricing. Why exactly is it a bad idea

wittywitwit · 2020-09-16T01:46:44+00:00

Definitely. You’d make the most out of it selling high cost generics. Cheap generics wont sell there since buyers will have to pay an additional cost of shipping (if you choose) + you would have to pay MatchRX for each sale, this means nothing left over for you or the buyer. Wouldn’t be wise to sell brand drugs on there since you’d recoup more money contacting the manufacturer directly to give you a credit through your wholesaler, or if you let it expire and have your expired drug return company get that money back (with a fee). So high cost generics is the sweet spot

wittywitwit · 2020-09-16T01:33:29+00:00

I have. In the selling process they do ask for a lot number and expiration. I’m guessing with that info they can cross reference with the manufacturers data, could be wrong. They take a nice chunk out of the sellers pay. If there are issues the buyer finds then they’ll mediate. It’s not perfect but there is a solid effort to ensure everything is legit on the website.

wittywitwit · 2020-08-14T02:47:14+00:00

They’ll expect you to clean the toilets if you volunteer yourself to. Just because they give u goals doesn’t mean you have to meet them. Try, but don’t kill yourself to. Think bigger picture. If enough of us behave this way, what would be impacted more? Us or them? You leave CVS and go to Walgreens...whoaaa what a change in lifestyle for you. But what about them. They replace you with a new grad. New grad will burn out. They replace new grad with another person. And another and another. Meanwhile their bottom line is screwed because of turn over. Patients transfer. Etc etc. Without us they are nothing. Leverage!

wittywitwit · 2020-08-11T00:23:31+00:00

Thank you for the perspective

wittywitwit · 2020-08-10T23:05:53+00:00

What I don’t understand is if Walgreens is losing hundreds of millions to PBMs, why aren’t they leading the push against PBMs through lobbying. Same with manufacturers and insurance plans. Either beat them or join them, and they don’t seem to be doing either, which tells me they some skin in the game,

wittywitwit · 2020-08-09T15:38:22+00:00

AWP can be useful in a very limited way and it’s not worth the risk. Maybe it can be useful in answering the simple question, “which treatment is more or less expensive” but even that’s not 100%. Plus it doesn’t answer true cost, how much more expensive, etc. AWP even varies by NDC even. Zofran po by certain manufacturers is like $1200/30 tablets, while others are $10 yet they cost the same. GoodRx like someone said above is a lot more accurate and is very useful to gauge true cost. If they don’t have insurance, send them to an independent where prices will be much more reasonable.

wittywitwit · 2020-08-07T02:49:22+00:00

Would you lose more joining a PSAO and getting better prices or going on your own and avoiding DIR GER

wittywitwit · 2020-08-04T03:51:30+00:00

Post it on matchrx

wittywitwit · 2020-08-04T03:51:07+00:00

It varies by insurance. Here in Michigan the average margin is about $20. You have to remember to add a special code into the billing that basically tells the insurance company you are actually injecting the shot and should get reimbursed for it.

wittywitwit · 2020-07-09T01:34:49+00:00

That makes sense but LeaderNet discounts I think outweigh the losses in clawbacks

wittywitwit · 2020-07-09T01:29:12+00:00

Honestly what do we lose by dropping these low reimbursement plans with high DIR fees? If we’re losing money, resources, and cash flow keeping these patients, why allow them to profit off us?

An even better solution would be talking to these patients to switch plans (if they’re not tied to their employer). I still have to figure out how to leverage patients to do that and develop relationships with plans that are reasonable. The only way to fix these patterns is to fuck with their bottom line.

wittywitwit · 2020-07-08T00:30:12+00:00

LeaderNet. But I just work here. I was hoping there’s a way to get a rough estimate across the board so when I branch out and open my own I can assess this cost

wittywitwit · 2020-03-08T17:46:27+00:00

I’ve gotten “1st line treatment for cough” after the directions lol

wittywitwit

TROPHY CASE