formulary is the most under-discussed thing in c/cagrilintide
Posting this because I searched for it and got nothing useful.
Setup: 10mg, week 62, injection-site soreness present but not ruining anything. I changed exactly one variable — appeal — and tracked it for 22 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.
best — the order this archive was captured in
the carve-out clause varies by employer
the carve-out clause varies by employer
Yes, exactly this, and it is the bit that took me 58 weeks to accept.
Strongly agree. Step therapy is predictable if you have the criteria.
The evidence standard in c/vendorvetting gets called too strict about once a month, and every time, the thread ends with the complainant agreeing.
This is correct. Appeal letters work.
Did you get step therapy or outright denial?
say which country and which plan type
The confident tone is doing a lot of work that the evidence is not.
appeal letter templates are in the wiki
Tracking number removed. It identifies both ends of a shipment.
Disagree. What you are describing is consistent with denial, not with what you concluded.
Disagree.
Disagree on that part. 99.2% and 96.2% on the same vial is normal.
Yeah, the denial code matters, it tells you what to fight.
Disagree.
Yes, exactly this, and it is the bit that took me 8 weeks to accept.
do not suggest misrepresenting a diagnosis, that is fraud
Rodent data is rodent data. Dose scaling is not linear and the models tell you what to investigate, not what to expect.
formulary exclusions are negotiable sometimes
Yeah, the denial code matters, it tells you what to fight.
Strongly agree. Step therapy is predictable if you have the criteria.
appeal letter templates are in the wiki
- 1say which country and which plan type10 comments in this branch · started by u/plain_titration_2024
- 2Yeah, the denial code matters, it tells you what to fight.4 comments in this branch · started by u/ferritin_low