Replies to post #124441 on Biotech Values

[AlpineBV_Miller]

You’re still mixing two issues: 1) the risk of not being paid; and 2) how long it takes to get paid.

According to DNDN, the only problem is #2; claims for Provenge reimbursement are getting paid by all third-party payers.

According to DNDN, it is #1. They have Mckesson out there fading the cash flow problem (#2).

All 3rd party payers are paying VALID claims. Have been for months. The risk is in submitting a patient that a MAC decides is INvalid. With other drugs, you know that 10% of the way in and are therefore only exposed to 10% of the cost. With Provenge you don't know this until the practice is on the hook for 100%.

Truth said, the issue is both #1 and #2. Even though McKesson is fading the cash flow timing issue, that AP still is on the practice books taking up space in a practice's credit line calculation. This is why speedier payment will help even though this is not really a speed of reimbursement issue.

Also, the faster the reimbursement the faster urologists get comfortable with the fact they will be reimbursed. So speed helps with #1, too.

(And if that all sounds a little circular, welcome to my life over the last three months.)