Who is Paying for Duexis??

I am confused

The major PBM's are not covering Duexis, yet their sales continue to climb. If the PBM doesn't pay for the drug from where does the PME get reimbursed? Who is the one that is paying for this drug? Is it Medicare? Is it ObamaCare? The high revenues are NOT being generated by the $35 Co-Pay through the PME. Where is the money coming from?

 

There are apps out there like finger tip formulary that will help you understand coverage. There are in fact.a large number of plans or parts of plans that cover duexis as well as the other products. Do your leg work and figure it out.

 

It's the specialty pharmacy scam, you silly fool!!!

 

Basically they have to go through the specialty pharmacy so that they can bill it as a necessary medicine and force the insurance company to pay for it. It's a super shady way to do business...

 

See express scripts lawsuit against horizon that just cane out. Basically a lot of what horizon does is super dubious

 

Nope not at all, only half my scripts go through a specialty pharmacy. The other half that are being approved and filled are going through local retail. Some require a PA but are still being filled which means the plans are approving them. Do your homework and check out some of the formulary apps like the poster who you cAlled a silly fool told you to do.

 

Lol so only half go through the specialty pharmacy. So only half your scripts are a scam?

Ps I hear that $1800 ibuprofen is good stuff

 

Thanks - I actually did some work and it seems that insurance companies will reimburse (with a huge co-pay - e.g., my insurance requires a $350 co-pay, which of course will be covered by Horizon) only with a Doctors Note that says that this is a "necessary medicine".........

hmmmmm...............

So that leads me to the next few questions
1) which doctor would prescribe this medication and then "write a letter" saying that it is a necessary medicine - how is this medicine any more necessary than taking 4 advils and a pepcid?

2) why wont the doctor write a letter to my local CVS pharmacy and it will only work through a specialty pharmacy?

 

Because the doctor is a speaker numnuts!

 

These guys are a bunch of shady douchebags

 

Takes one to know one

 

my question is why are there so many non Horizon employees on our threads all the time? Why are you people so interested in what is going on here at Horizon?
Is it because a rep pulled in over 1million dollars in under 2 years, or how more than 10% of the sales force will break 250K this year? shut the fuck up and get a life and be happy with your bullshit paying job you LOSERS!!! Next time you visit, think of your children and know what a loser parent you are!

 

Ummm because Horizon isn't paying your local CVS pharmacy to run the insurance scam, fill without the "dispense as written" note, and skip the PA...the specialty pharmacies. Have been partnered with and incentivized to skip all the red tape!

 

Hahaha...you mean the rep who was fired for insurance fraud?! Yeah she was a shining example, along with most of the other 10% you are referring to who benefited from a shady PME pharmacy that was also "fired" but of course not until after they contributed to most of your q3 earnings! My math may be a little hazy but I guess the remains 90% fit into the bs paying job then? Regardless, I'll earn my money with a clean conscious and not as a shady, no talent hack...good luck when ship sinks you fuck!

 

No... this is pme's job