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Re: HinduKush post# 313998

Tuesday, 12/08/2020 9:53:40 PM

Tuesday, December 08, 2020 9:53:40 PM

Post# of 447552
Bingo. And agreed- most people have "some" level of atherosclerotic plaque especially if they are required to take a statin, but like you said you would have to go through imaging studies to confirm it.

To your second point- from my understanding a clinical Peer to Peer review with BCBS requires a lengthy process. The request to fill Vascepa at the pharmacy must be denied- then the initial prior authorization (done by the dr's office) must be denied. Afterwards a written appeal (also done by the dr's office) must be denied and only then will the insurance agree to a clinical Peer to Peer with your doctor. That could take weeks and the success rate of a peer to peer are generally low which is why most doctors don't consider doing them.

This was a bigger blow to Amarin's profits than most people are aware.
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