I agree that misiu and yourself are likely correct
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Posted On: 03/27/2019 10:11:29 AM
I agree that misiu and yourself are likely correct (especially since this is a rare topic that Fine also agreed with both of you....or maybe she was trying to sell when we discussed this?).
Where I was getting hung up is the insurance paying for it, but maybe they do not look at deep enough to see if the patient is resistant at all and only see HIV patient (R2+ patient coded differently than R1 patients)? That could very well be or even if they do code differently based on the R class, maybe their is no risk to the Dr.'s prescribing off-label as insurance companies do not seek legal action or try to recoup money for off-label use.....if this is true, then the only risk for Dr. prescribing off-label would be malpractice concerns....but this seems unlikely because as you both noted the safety profile of leronlimab and how Dr.'s and patients are waiting for such a drug for easier compliance and patient safety. Your explanation helped me see this more clearly and likely what misiu explained to me previously and I just didn't grasp (sorry misiu for the unnecessary frustration......I can be like talking to a rock sometimes : ).
This would be a welcomed event once sales begin. I likely will not changed my expectations as the company last stated they only expect >$480M revenues in 2020 and if they update these figures, they may even reduce this if combo approval is delayed very much. What I'm not sure is whether these revenue estimates are based on a % of sales due to a license agreement or overall revenue and a very small market penetration which at $70,000/annual per patient is only 6,858 patients (13,716 patients if only 6 months 2020 sales at $35,000). I think your expectations is that they can easily exceed these estimates, which I concur, but for planning purposes I will keep my expectations low and hopefully be pleasantly surprised.
Thank you for enlightening me once again!
Where I was getting hung up is the insurance paying for it, but maybe they do not look at deep enough to see if the patient is resistant at all and only see HIV patient (R2+ patient coded differently than R1 patients)? That could very well be or even if they do code differently based on the R class, maybe their is no risk to the Dr.'s prescribing off-label as insurance companies do not seek legal action or try to recoup money for off-label use.....if this is true, then the only risk for Dr. prescribing off-label would be malpractice concerns....but this seems unlikely because as you both noted the safety profile of leronlimab and how Dr.'s and patients are waiting for such a drug for easier compliance and patient safety. Your explanation helped me see this more clearly and likely what misiu explained to me previously and I just didn't grasp (sorry misiu for the unnecessary frustration......I can be like talking to a rock sometimes : ).
This would be a welcomed event once sales begin. I likely will not changed my expectations as the company last stated they only expect >$480M revenues in 2020 and if they update these figures, they may even reduce this if combo approval is delayed very much. What I'm not sure is whether these revenue estimates are based on a % of sales due to a license agreement or overall revenue and a very small market penetration which at $70,000/annual per patient is only 6,858 patients (13,716 patients if only 6 months 2020 sales at $35,000). I think your expectations is that they can easily exceed these estimates, which I concur, but for planning purposes I will keep my expectations low and hopefully be pleasantly surprised.
Thank you for enlightening me once again!
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