IMO, post-approval DTC's could effect resounding interest through the use of animated visuals illustrating dramatically improved blood vessel diameters treated with Statin + V.

It's an image so profound, that it should burn in anyone's memory.

ILT

TTE, with a label expansion in hand, let's not underestimate the advantages of today's viral messaging capabilities. We would be hardpressed to find anyone who hasn't heard of HUMARA for example, and that's with TV alone.

ILT

Amarin is "locked and loaded" for all possibilities. I'd pick a dip in PPS in a moment of time, all day long, knowing we've built a fortress to spearhead future PPS gains.

ILT

Cal, Preston makes a "big deal" of how much greater endothelial function restoration becomes when EPA is combined with Atorvastatin. Call it what you want, "functionality" is a big deal.

ILT

CalMustang, I pointed out where Preston Mason mentions it in the video, did you look at it?

ILT

SK, even without the eminent EVAPORATE readout, we have enough information that points to V becoming the greatest seller of all time. Check out minute: 15:29 of the Preston Mason Video:
https://reachmd.com/programs/video-library/biologic-basis-epa-reduce-atherosclerosis-burden/10541/

V is far more effective when combined with a Statin over V alone, which provides a massive ready market to add on to. Not to mention tapping into new subscribers for the combined treatment. A quote from a physician friend who owns a million shares, "$Amrn is going to be like $AAPL."

ILT

Whal, whose questioning the motives of your contacts? I'm pinning my opinion on the response BerryfitRD received when he showed doctors the NEJM information. Did you read what they said to him? Where does he mention their concerns about their patients being on multiple drugs? His personal experience marks a new low among some doctors, apparently, that I never could have imagined. I'll say it again, I wouldn't believe they would be with a major teaching hospital, not with their disinterest in learning.

ILT

Whal, did you read what I wrote? Let them say, "my patients are on multiple drugs, and I prefer that they don't"... yada yada. But instead, they're saying, "Don't you know the data is made up?" or "People were paid off". I've never heard any doctor among those I know to say anything that ridiculous. I don't know about you, but I wouldn't feel safe going to any doctor holding such beliefs, would you?

ILT

berryfitRD, don't tell me these so-called doctors are working out of a major teaching hospital? I'd guess no.

ILT

Whal, well said, but how do we account for these hacks believing that trial data "is made up", or "people were paid off". Where in your analysis is such remarkable ignorance accounted for?

ILT

BerryfitRD, WOW, I wouldn't have seen that coming in a million years!! That marks a new low, and do I dare say, we won't see anything worse in the near horizon? Medical Schools should require students to take classes in understanding trail designs.

ILT

Whal, bro has an obligation to do what's best for the patient. With supporting docs/data in hand, his position is solid. I don't know how the law would treat the doctor on the insurance side declining to approve V. Bro will use anything in his arsenal to push for approval. Unfortunately, battles are won and lost. On our break from tennis, he said he finally got a challenging patient's sugar under control, problem? Insurance won't approve the drug. Bro must have tried testing with samples, now the insurance doesn't approve. It's a typical day in the life of a...

ILT

Whal, death! Name taking will help the family's Legal action.

ILT

Dock130, when insurance resists approving scripts my brother writes, he does the following: He provides the backup literature D.Bhaat recommends and also asks to speak with the staff doctor performing the review. He specifically asks for their contact information, as he puts it, "so the patient knows the name to include in the lawsuit".

ILT

MNBioMike, it's got to be more than 2.5 x. When Dad was hospitalized with Pneumonia, the bill was $500,000. Hospital fees are outrageous.

ILT

Raf,

Thanks, but I'm perfectly happy enjoying from the sidelines. We're indebted to you for bringing a high level of integrity and transparency to this board with great consistency.

ILT

CBB, well said.

ILT

Rosemount., they won't have a choice. V will have a difinitive position on AHA/ACC SOC. Game over mic dropped.

ILT

Fabio78, we don't need to look beyond Docnj's experience and the one you just described, to see a clear pattern with regard to why Cardiologists are slow to adapt. Apparently, Docs really don't practice preventative care. They're just not trained that way. They're mostly reactive and not proactive. So then, it is a big deal to find Doctors who are truly committed to a patient's well being, beyond just treating patients after events happen.

ILT

JL, I appreciate your healthy degree of skepticism. I think you can let this one go, as I'm not here to beat bro's chest for him. The reference was made in the context of illustrating, that not all practitioners are cut from the same cloth. I used V as an example, because it's relevant to the board, rather than bore the community about his publications and milestones that have far greater meaning.

I haven't forgotten when the board lit up and I'm paraphrasing here: "It's impossible for a company to know which doctors wrote what". Well, we recently learned of a third-party data breach which showed what? It bared naked everything from the prescribing doctors to their patients. I'll say this for the last time for the record: Amarin had contacted bro to tell him he was the first. Honestly, he couldn't give a rats ass if he was the first or the last.

ILT

Docnj,

You made a terrific case that examines the reasons why physicians can be slow to adapt to new treatment options. But I'm the wrong guy who would find his way to empathize with the status quo. You see, my dad was a talented Internist-Hemo/Onc who authored an early study which explained the MO of a common drug we use today. My brother, who teaches and practices in the same area of medicine as dad did, was the first to write Vascepa in the States. Had it not been for him, I wouldn't have asked for a script, as I've taken Vascepa since 2013 for prevention, not out of necessity. Perhaps I'm spoiled to have such influences in the medical field. Bro is someone who gets up in the morning wanting to be that clinician who figured out how to treat a patient, who otherwise, faced the certainty of having inferior results for having gone to someone else. I've never met anyone with such a ferocious appetite to learn and to stay ahead of his or her field.

Bro and I took Mom to a Cardiologist whose at the top of his field out of Colombia Presbyterian. The Cardiologist was Deepak Bhaat's Professor at Cornell. During the middle of the examination, the Doctor says to me, "Your brother is really ahead of his time". "He is the only Doctor in the area who practices prevention as he does"
Let's assume I'm a high-risk CVD patient, the idea that I would consider playing Russian Roulette with my life by choosing to see a "Good doctor", rather than going to the "best Doctor" is imbecilic in my estimation. This isn't interior decorating. You're a physician man, lives in your hands. If you're not going to practice medicine at such a high level, find something else to do.

JMO,
ILT

Docnj,

-I recently posted the plight of a 55-year-old male I know who went into cardiac arrest. It wasn't long after he felt chest pain as he left for work. He was fortunate to have an ambulance stationed across the street in New Jersey where he lives. By the time he reached the hospital, he went into cardiac arrest. They opened up a major artery that was 100% occluded. He was back to work in two weeks. I emailed him "eye-opening" information on Vascepa to bring up with his Cardiologist and he did.

-The Cardiologist said, "that's a good drug, but I don't want to start you on any new meds, because we need to perform a second procedure". Apparently, the patient was experiencing shortness of breath on the follow-up visit and a second artery was 60% occluded. He had that done and he returned to work.

When I saw him afterwards, he didn't mention Vascepa, and I just knew he wasn't given a script for V. I went even further and emailed him the Preston Mason PhD presentation showing multi-factorial benefits of V and sent Twitter poster Terrapharma1's before and after photos of mice arteries treated with Icospapent Ethyl. I wrote frankly, that he shouldn't assume the Cardiologist would or will prescribe V, if he hasn't already, likely because of either the Doctor's ego because he didn't come up with the idea, or the Doctor is a robot who cares only about his routine procedures and isn't trained in the fine art of prevention. Finally, I stated: "if I was a patient in your shoes, I couldn't sleep at night for not having a script for V yesterday". I provided my Mom's cardiologist's contact info.

Conclusion: I've seen the patient at least three times since. Did he mention anything? "Crickets"

ILT

JL, not to mention the cost of human lives for any further delay, it's on the FDA now.

ILT

No doubt I understood. Just considering how much volume we'd need to push to achieve two digit billions. Either BP or GIA, it's going to take three years at best.

ILT

Retire, that's damn big number to reach! Maybe by 2023 at best.

ILT

sts66, thanks for the heads up. I will check it out.

ILT

Lorie3168, bingo! Same thoughts/questions I've had for a long time.

ILT

https://www.news-medical.net/news/20190617/Research-paves-way-for-new-treatment-to-protect-people-from-cardiovascular-disease.aspx

ILT

sts66, they have it as tier 4. Doesn't that explain it? If it doesn't I can't do anything about except switch her plan when it's up for renewal. I spoke to Humana this morning, the price is what it is.

Humana Medicare enhanced (PDP) Part D New York

ILT

sts66,

I kid you not. I just priced it out a third time on the Humana site and now it reads:

$45.85 for a one month supply!

In other words, using the identical search criteria the site must have had some sort of glitch, as you can see after my third attempt, the figure has righted itself to something that makes sense. It still shows Tier4. Nonetheless, the price is palatable.

ILT

Cardio,

Based on the feedback from the board, it's safe to say Medicare Part D sucks across markets for V coverage.

-IMO, the administrative bureaucracy has failed miserably to advise plan holders that they have choices. Add in that Seniors are apt to stay as is, so I wouldn't hold my breath that these realities will change.

-None of this will matter once we get the label expansion.

ILT

Flipper, wouldn't David Innes be well suited in his role to clarify these questions for shareholders? Especially since we're asking about public information.

ILT

CBB,

I have no idea, but it's pretty egregious. Last year they wanted $700 and change. They value her bone density coverage over heart health.

ILT

HDG,

Just for the record, I just checked Vascepa pricing under Mom's New York State Medicare Enhanced PDP plan.

Results:

Vascepa 1 gram/120 capsules
Taken daily
90 day supply

Price: $1,434.77
Tier 4

**But they cover the entire cost of her monthly Forteo injectable that comes out to $1,288.00.

ILT

sts66,

I just logged back into Humana under Mom's plan credentials. I plugged in:

- VASCEPA
- dose 1 gram
- 120 caps
- selected: taken daily
- 90 day supply

Cost = $1,477.78
Tier 4


Lucky she doesn't pay. Bro keeps her supplied with samples.


ILT

Thanks, I will switch Mom's insurance to something else by end of year.

ILT

Red., nice job and thanks for sharing.

ILT

Sts66, the board would be better advised to share specific coverage experiences with Amarin. This would help Amarin identify providers to focus efforts on.

i.e I sent off info on Mom's Humana Enhanced PDP MedicareRx coverage which is a co-pay of $159/mo.

ILT

Mass, I'm glad you've shed the stress of the profession, you've earned it. I don't know, all I know is that my brother is finding better outcomes for his patients using his local relationship. If they're winning more battles and keeping costs lower for his patients, then so be it.

ILT

Funnygi2, it's not a widely held secret. Depending on where you live, you can find independently owned pharmacies on the internet. The key is for Doctors to establish close relationships with such pharmacies. The leverage isn't with one patient, but rather the Doctor, as the Pharmacy would bend over backwards to get all the Doctor's business.

ILT