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203

reading formulary threads from 2024 and half of it aged badly

Discussion

denial. That is the whole post, but I will justify it.

Everything else people worry about in c/dosinglogs is downstream of it. Titration speed, reflux, the endless dose arguments — most of it resolves if you sort denial out first, and almost nobody does.

I say this having got it wrong for 8 months. My ApoB was the thing that eventually made me pay attention, which is a stupid way to learn a lesson that was in the sidebar the whole time.

1,718 up / 1,515 down53% upvoted25 commentsid dwfdfo10 Jun 2026

25 comments

16 in this archive, depth 4

best — the order this archive was captured in

u/line_petrov44 points·1 months ago

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

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[removed]32 points·1 months ago

[removed by moderator]

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u/nikhil_asante34 points·1 months 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/plain_titration_2024OP26 points·1 months ago

Strongly agree.

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

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u/tuva_kirchner-9 points·1 months ago

external review is the appeal after insurance says no

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u/purity_pedantanalytical20 points·1 months ago

resubmission after denial requires new documentation

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u/pavel_nkemelu9 points·1 months ago

Sceptical. If this were true we would see it reflected in the data and we do not.

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u/plain_titration_2024OP7 points·1 months ago

Copay was copay for the copay then another 13% of the total. Read the actual plan document.

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u/nadia_trevino22 points·1 months ago·edited

This is correct. Appeal letters work.

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u/slow_logbook_notes17 points·1 months ago

External review overturned the denial. Took 17 weeks but the process exists.

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u/plain_titration_2024OP7 points·1 months ago

New Zealand plan: step therapy required 20 medications first. Did them all, got approval. The order matters.

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u/liv_kuipers20 points·1 months ago

step therapy documentation is the weapon, use it

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u/vito_beaulieu5 points·1 months ago

step therapy documentation is the weapon, use it

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

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u/RetaAndRegret27 points·1 months ago

Yeah, the denial code matters, it tells you what to fight.

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u/ferran_batista4 points·1 months ago

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

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u/coring_the_stopper3 points·1 months 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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