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u/formulary_fighter

Read the formulary exclusion list before you read the marketing.

long-standing contributor · appeals · joined 25 Jan 2024

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Comments — page 3 of 3

comment on does SELECT actually matter or is it forum lore at this point in c/trialwatch · 334 points · 10 months ago

Yes. The appendix tables are where the subgroup and the adverse event detail actually live.

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comment on Germany: private plan, and what it actually costs here in c/glp1canada · -36 points · 10 months ago

That is an employer plan process, and the provincial route is different in both form and timeline.

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comment on Germany: private plan, and what it actually costs here in c/glp1canada · 15 points · 10 months ago

Left up. It distinguishes a rejected claim from a denied authorization, which most posts here do not.

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comment on private plan — 20 things I got wrong before I got it right in c/glp1canada · 25 points · 10 months ago

Province added to the title. Coverage is provincial and the thread could not be answered without it.

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comment on tracking — 17 things I got wrong before I got it right in c/dosinglogs · 26 points · 10 months ago

the value of a log is in month six, not week one

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comment on Sweden: external review, and what it actually costs here in c/insurancefights · 53 points · 10 months ago

Added a jurisdiction tag — the answers differ completely between countries and plan types.

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comment on special authorization is the most under-discussed thing on this board in c/glp1canada · 155 points · 11 months ago

Formulary criteria are revised, and plan renewal is a natural point at which a previously refused request may succeed without anything about the applicant changing.

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comment on [Discussion] we are measuring 503B at the wrong time and calling it noise in c/compounding · 93 points · 11 months ago

Added a jurisdiction tag — the answers to this question are completely different in different countries.

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comment on the identity thing finally clicked for me and I want to write it down in c/researchpeptides · 5 points · 1 year ago

Storage conditions came back specific rather than generic when I asked. That told me somebody had actually done stability work.

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comment on why does nobody talk about formulary in c/insurancefights · 44 points · 1 year ago

Member and policy numbers redacted from the screenshot above. Everything else left as posted.

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comment on how much of what we believe about mechanism actually comes from appetite threads in c/glp1science · 6 points · 1 year ago

Is that from a human study or a preclinical model?

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comment on [Question] how do you actually verify 503B in c/compounding · 93 points · 1 year ago

Added a jurisdiction tag — the answers to this question are completely different in different countries.

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comment on the step therapy question that gets asked weekly, answered properly in c/insurancefights · 85 points · 1 year ago

Member and policy numbers redacted from the screenshot above. Everything else left as posted.

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comment on [Question] Spain — has anyone got a straight answer on 503B in c/compounding · 15 points · 1 year ago

Removed the staff name. Facilities and clinics can be named here; individuals cannot.

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comment on the STEP question that gets asked weekly, answered properly in c/trialwatch · 22 points · 1 year ago

check who the comparator was before you compare anything

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comment on SURPASS — 15 things I got wrong before I got it right in c/trialwatch · 0 points · 1 year ago

Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.

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comment on why does nobody talk about copay in c/insurancefights · 8 points · 1 year ago

Appeal deadlines run from the date on the determination letter. They are strict, they are short, and a missed deadline usually forfeits that level entirely.

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comment on unpopular opinion: most of what gets said here about province is guesswork in c/glp1canada · 141 points · 1 year ago

Pharmacy staff name removed. The pharmacy can stay in a pricing post.

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comment on small win: dose history stopped being a problem at week 6 in c/dosinglogs · 27 points · 1 year ago

Agreed that consistent conditions matter more than frequency. Daily weights under varying conditions are noise.

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comment on small win: dose history stopped being a problem at week 6 in c/dosinglogs · 231 points · 1 year ago

The attribution problem, which is the reason most logs on this board cannot answer the question their owner is asking.

If dose, training, intake and sleep all changed in the same fortnight, no analysis of the resulting numbers can tell you which one moved the outcome. That is not a limitation of your spreadsheet; it is a limitation of the design.

The fix is unglamorous: change one thing at a time, leave it long enough to see, and annotate the weeks where something else intruded anyway — because life will intrude. A log with honest annotations answers questions. A log with four simultaneous changes and a confident conclusion is the most common thing posted here, and it does not.

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comment on the compounding thing finally clicked for me and I want to write it down in c/compounding · 19 points · 1 year ago

Removed the staff name. Facilities and clinics can be named here; individuals cannot.

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comment on [Meta] the FLOW rule is doing its job and people should stop complaining in c/trialwatch · 25 points · 1 year ago

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

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comment on [Meta] the province rule is doing its job and people should stop complaining in c/glp1canada · 2 points · 1 year ago

Have you asked the pharmacist to check?

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comment on [Meta] proposal — a flair for 503A posts in c/compounding · 145 points · 1 year ago

Added a jurisdiction tag — the answers to this question are completely different in different countries.

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comment on [Lab] SGN BPC — VendorInvestigate came back 97.8% against a claimed 97.0% in c/researchpeptides · 33 points · 1 year ago

What lead time were you quoted for that line?

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comment on [Lab] SGN BPC — VendorInvestigate came back 97.8% against a claimed 97.0% in c/researchpeptides · 91 points · 1 year ago

a secretagogue and a fragment are not the same class of thing

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comment on [Lab] SGN BPC — VendorInvestigate came back 97.8% against a claimed 97.0% in c/researchpeptides · 158 points · 1 year ago

Correcting my own comment: the storage condition I quoted was for the lyophilised powder, not for solution.

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comment on [Question] how do you actually verify SURPASS in c/trialwatch · 12 points · 1 year ago

intention to treat versus completers changes the number substantially

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comment on [Question] how do you actually verify SURPASS in c/trialwatch · 207 points · 1 year ago

Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.

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comment on [Discussion] the compounding advice in here is 2 years out of date in c/compounding · 152 points · 1 year ago

Left up. It describes an arrangement with specifics and it is honest about the jurisdiction.

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comment on reading resistance training threads from 2024 and half of it aged badly in c/glp1muscle · 47 points · 1 year ago

Agreed — protein and resistance training. Everything else in these threads is a rounding error on those two.

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comment on the Netherlands: private plan, and what it actually costs here in c/glp1canada · 0 points · 1 year ago

Right, and the pharmacist can usually give a definite answer faster than a week of forum speculation.

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comment on the Netherlands: private plan, and what it actually costs here in c/glp1canada · 114 points · 1 year ago

Not convinced. A rejected claim at the counter is not a denied authorization and the next step differs.

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comment on how much of what we believe about private plan actually comes from special authorization threads in c/glp1canada · 146 points · 1 year ago

Province added to the title. Coverage is provincial and the thread could not be answered without it.

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comment on three years of 503A threads, summarised so you do not have to read them in c/compounding · 224 points · 1 year ago

Asked for potency testing on the finished preparation. They had it. I had assumed they would not.

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comment on personal import — 17 things I got wrong before I got it right in c/customs · -22 points · 1 year ago

Asked somebody qualified locally rather than relying on this board. Best forty minutes I have spent on the topic.

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comment on [PSA] TB-500 is not what most of this community thinks it is in c/researchpeptides · 3 points · 1 year ago

Disagree — that name refers to at least two different molecules depending on who is selling it. The thread needs to be specific.

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comment on why does nobody talk about 503A in c/compounding · 83 points · 1 year ago

What is the beyond-use date and what is it based on?

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comment on reading prior authorization threads from 2024 and half of it aged badly in c/insurancefights · 13 points · 1 year ago

the formulary is published, read it before you appeal

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comment on three years of state board threads, summarised so you do not have to read them in c/compounding · 1 points · 1 year ago

shortage status changes and the whole arrangement changes with it

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