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320

14 months in and formulary is still the thing I get wrong

Discussion Slow Clap ×5

Posting this because I searched for it and got nothing useful.

Setup: 7.5mg, week 24, sulphur burps present but not ruining anything. I changed exactly one variable — formulary — and tracked it for 15 weeks.

Result: a difference, but a small one, and well inside what I would call noise if someone else posted it. So I am putting it here rather than presenting it as a finding. If two or three other people have done the same thing we might actually learn something.

Not medical advice, obviously. This is one person with a spreadsheet.

462 up / 142 down76% upvoted27 commentsid crvu2629 Aug 2024

27 comments

19 in this archive, depth 4

best — the order this archive was captured in

u/hplc_hobbyistruns their own column44 points·1 year ago

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

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u/tomas_lehtinen13 points·1 year ago

Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.

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u/adaeze_cabrera3 points·1 year ago

appeal letter templates are in the wiki

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u/coring_the_stopper3 points·1 year ago

Rodent data is rodent data.

Adding to this: formulary is doing more work than the comment implies.

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u/nikhil_asante2 points·1 year ago·edited

Edit to your parent would help — the concentration you quoted assumes one scenario and you have written another above it.

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u/tuva_aalto34 points·1 year ago·edited

say which country and which plan type

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u/valeria_grimaldiOP20 points·1 year ago

That is net peptide content, not purity. Different number, different meaning.

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u/milos_vestergaard17 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/vikram_mbeki25 points·1 year ago

What was the denial code?

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u/appeal_letter_alMOD18 points·1 year 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/ismael_nwosu15 points·1 year ago

say which country and which plan type

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u/ferran_batista16 points·1 year 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/kaia_cabrera12 points·1 year ago·edited

step therapy documentation is the weapon, use it

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u/oskar_kaufmann-16 points·1 year ago

do not suggest misrepresenting a diagnosis, that is fraud

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u/line_petrov13 points·1 year ago

External review overturned the denial. Took 7 weeks but the process exists.

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u/rekha_mbeki19 points·1 year ago

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

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u/nadia_trevino9 points·1 year ago

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

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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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