RxGuy

Pharmacist sharing insights on the interplay between drug manufacturers, payers, providers, and patients (and all other players in between)

[RxGuy @PharmDGuy]

@SteveEngelberg @charlesornstein @mcuban I am begging @mcuban to actually care about the generics he is selling to the American public. He can save lives by quality testing the drug supply.

No else has an incentive to do it. If he really wants to disrupt healthcare, this is how to do it

[RxGuy @PharmDGuy]

@SteveEngelberg @charlesornstein @mcuban 🚨 please read

[RxGuy @PharmDGuy]

@Willenation @KatherineEban I’ve been begging @mcuban to read this. Hoping someday he will

[RxGuy @PharmDGuy]

@tjparker @BiotechCH Remove all of that rebate money and have patients pay more in premiums.

The money has to come from somewhere.

[RxGuy @PharmDGuy]

@ZacharyBrennan That is ridiculous. The only way to ensure integrity of the inspection is to be unannounced.

[RxGuy @PharmDGuy]

@HaydenDublois I don’t think Medicaid is “focused” on people who can work but chose not to:

[RxGuy @PharmDGuy]

@BertrandBio I would argue payer formulary coverage is more important than health system formularies, with the exception of traditional Medicare FFS part B.

If payers don’t cover Amvuttra, it doesn’t matter if it’s on a health system’s formulary.

[RxGuy @PharmDGuy]

@mcuban Mark,

You still have yet to articulate how drug manufacturers will be held accountable for prices. Removing formulary/access control removes any leverage payers have to negotiate better pricing.

Leaving pharma to increase prices without any counterweight.

[RxGuy @PharmDGuy]

@daphnezohar @elonmusk “For you” page is unusable. Don’t even open it

[RxGuy @PharmDGuy]

@Rosemary100 @ThomasWelch15 @BoesingLoretta @SecKennedy @MartyMakary @BANNONNITES Of course they are

[RxGuy @PharmDGuy]

@GeneInvesting Let’s see how many patients end up getting Amvuttra after being required to “fail” a much cheaper stabilizer, which most ins will require

Spoiler alert - it will be a lot

It isn’t hard to get a prior auth approved for this disease state

[RxGuy @PharmDGuy]

@GeneInvesting Think about it - most candidates for the therapy will already be on stabilizers and silencers

Step therapy doesn’t work for gene therapies

As long as there is patient demand, payers won’t be a barrier

[RxGuy @PharmDGuy]

@Biotech2k1 @GeneInvesting It doesn’t matter. Most patients will already be on these drugs - they are the standard of care

And a “failure” would be any worsening of cardiac function - also not a very high bar to overcome

The unknown is patient demand and ability to supply the market, not ins coverage

[RxGuy @PharmDGuy]

@charlesornstein @AliceOllstein @SheInvestigates @debbiecenziper @MegMcCloskey @mcuban does CPD stock potassium chloride from Glenmark?

Will you commit to stop selling generic drugs that are unsafe for Americans?

You can make a huge impact here with quality testing.

[RxGuy @PharmDGuy]

@charlesornstein @AliceOllstein @SheInvestigates @debbiecenziper @MegMcCloskey When will these issues get the attention they deserve??

A competitive generic supply means nothing if the drugs aren’t safe

[RxGuy @PharmDGuy]

@RNAiAnalyst https://t.co/V1gYIEIWEN

[Bertrand Delsuc @BertrandBio]

$BBIO ATTRUBY label
https://t.co/2rgOJv3LlP

[RxGuy @PharmDGuy]

@matthewherper @UrnovFyodor @nalyticsatwork @adamfeuerstein It boils down to comparative efficacy. If they are the same/similar (I.e. Hemophilia), patients will likely not opt for gene therapy for the sake of convenience. However, if there are potential clinical advantages (I.e SCD), I think the product can succeed commercially.

[RxGuy @PharmDGuy]

@matthewherper @UrnovFyodor @nalyticsatwork @adamfeuerstein In other words, hemophilia gene therapy demand is a terrible predictor for uptake of future gene therapies, IMO.

[RxGuy @PharmDGuy]

@matthewherper @UrnovFyodor @nalyticsatwork @adamfeuerstein Demand is currently low for Hem A/B because it can be managed with alternative therapies and has been for many years.

OTOH, SCD therapies have already been administered to many patients, and will continue. Ex-vivo vs In-vivo will be a huge difference as well.