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c/insurancefights·posted 8 months ago by u/fabio_kuipers

unpopular opinion: formulary is massively overrated

Discussion Well Actually ×8 Slow Clap ×1

Trying to settle this properly because the thread from last year went in circles.

The claim: formulary matters. The counter-claim: it is measurement error. Both sides have been asserting it confidently for about 11 months without either producing anything.

What would actually settle it is 7 people measuring the same thing the same way. I have started; my numbers are below. They lean one way but not strongly enough for me to declare victory.

If you have data, post the data. If you have an opinion, flair it as an opinion.

7,641 up / 6,733 down53% upvoted61 commentsid au1rpc20 Nov 2025

61 comments

28 in this archive, depth 5

best — the order this archive was captured in

u/plain_titration76 points·8 months ago
appreciate you saying you do not know
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u/hassan_chowdhury69 points·8 months ago

I am going to push back on this slightly.

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u/kian_ferreira-34 points·8 months ago

I am going to push back on this slightly.

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/fabio_kuipersOP1 point·8 months ago

step therapy documentation is the weapon, use it

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u/fabio_kuipersOP1 point·8 months ago

Ireland plan: step therapy required 12 medications first. Did them all, got approval. The order matters.

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u/prior_auth_painMOD39 points·8 months ago

This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.

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u/muscle_cramp_mo20 points·8 months ago

Disagree. What you are describing is consistent with copay, not with what you concluded.

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u/fabio_kuipersOP10 points·8 months ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/pavel_nkemelu3 points·8 months ago·edited

resubmission after denial requires new documentation

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u/marisol_moreau40 points·8 months ago

resubmission after denial requires new documentation

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u/ireland_drugs_pay0 points·8 months ago

Which plan type? step therapy is different.

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u/appeal_letter_al1 point·8 months ago

Which plan type?

Disagree on that part. 98.0% and 98.1% on the same vial is normal.

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u/greta_chukwu1 point·8 months ago

say which country and which plan type

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u/marta_dziedzic29 points·8 months ago·edited

denial reason codes matter, ask for the actual code

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u/sock_puppet_spotter8 points·8 months ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

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u/line_bergstrom5 points·8 months ago

Disagree but this is the good kind of wrong — it is specific enough to be checked.

Yes, exactly this, and it is the bit that took me 66 weeks to accept.

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u/kasper_cabrera22 points·8 months ago

Crossposting this to c/cryptopay because the people who need it are not reading this community.

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u/ireland_drugs_pay11 points·8 months ago

formulary exclusions are negotiable sometimes

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u/ilias_cabrera9 points·8 months ago

resubmission after denial requires new documentation

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u/formulary_fighterappeals7 points·8 months ago·edited

No. This is the kind of confident post that gets copied into a screenshot and repeated for years. Where is the evidence.

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u/amylin_amyamylin4 points·8 months ago

copay is separate from coverage

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u/saskia_rahimi16 points·8 months ago

You have restated the marketing copy. What is the actual substance here.

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u/dose_diary_danalog keeper15 points·8 months ago

Strongly agree. Step therapy is predictable if you have the criteria.

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u/idris_iyer10 points·8 months ago

Inter-lab variance on this kind of assay is routinely 1–2 points. Different column, different gradient, different integration.

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u/solene_eriksen4 points·8 months ago

This is correct. Appeal letters work.

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u/elin_lindqvist3 points·8 months ago

copay is separate from coverage

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About c/insurancefights

The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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