Replies to post #115408 on Amarin Corp Plc (AMRN)

[bfost]

Ralphey - Have you heard of cost/benefit analysis, number needed to treat etc.? Believe me insures care about cost effectiveness- as we all should as docs. So, yes medical organizations determine things like Quality Adjusted Life Years (usually around $50,000) to see if something is cost effective. Yes, then insurers will look at what is most cost effective to steer providers and patients towards that treatment.
So, the reason your $12K drug is likely to get denied is because it is not cost effective in the population you selected or there may be a better alternative.
Sure, I'm not naive enough to deny that insurers want to make money but we already spend 3x as much money per person than most other countries. We need some criteria to use in selecting treatments that don't brake the bank and Vascepa hopefully will be one of those- and yes insurers will pay for it if it works.

[north40000]

The cynic in me says the insurance company[bean-counter actuary] would rather see you dead immediately[despite losing the insurance premiums you might pay for the next 20 years], rather than bearing the cost of the psck9 for perhaps the next 20 years and continuing to raise its healthcare costs with inevitable additional expenses, reducing profit.

What do you think of the reimbursement system NVS has apparently instituted?
If the treatment works[its CAR-T for cancer] you pay. If it doesn't work[it fails], you pay nothing for the treatment or trial to see if it does work...
a refund of cost.