When the combo isn't covered in the US for the reasons I listed, what's Amarin even gonna do? They cant force insurers to cover it. There has to be a financial incentive for them to do so. A combo label being specific to reduce it wont sell if it's only available out of pocket to people. Amarin cant stop selling plain V. If they do, they're abandoning the Brand label and that gives insurers free reign to substitute. No alternative exists works both ways. Everyone's operating under the assumption that Insurers are going to stumble over themselves to adopt a combo into their formularies and tier it better than V and gV. Not gonna happen unless it is cheaper. At that point, it isnt the combo that's winning in the market. It's price competition and Amarin can always do that without a combo.
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