Rallying the troops.... we need to get together on this

LouLou

New member
Has anyone considered contacting Vertex about this? They are very nice I just hesitate to do it myself because I don't want to take their time away from drug development. I'm just saying it may help to get their perspective before a lot of time is put into this. I personally always have to remind myself that things aren't always as they seem. And as much as we think we know everything, we don't. We have to remember to be appreciative of what Vertex is doing for the cf community. Not in a long time or maybe ever has a company invested in our community like they are. Always remember that from the day that Vertex patented V770, it has only 10 years to recoup its money before it goes generic. Also, the CFF VP who is in charge of legislation, Mary B. Dwight, may be a good perspective too. Perhaps they are endorsing this but have not sent an email blast yet.

Here's a little perspective, when people were discussing why doctors and possibly even Vertex would be discouraging off label use of Kalydeco, I asked my family member why this could possibly be so...wouldn't they want the additional customer, money, good publicity? My family member who works in the pharmaceutical industry told me that the reason was clear. It is because Vertex is so grateful (and that the CF community should be too) for how fast the FDA approved the medication and that to use the medication so quickly off label would be to go against what the FDA had permitted and most importantly the implications that this could have. That's there's a lot of dollars and sense since the process of drug dev is so expensive. That it's important to remember how fast a drug company can decide that development of a drug no longer makes financial sense and to never forget that we are only 70,000 people with regards to recruitment and usage after approval. The FDA approved it with the expectation that specifically DF508 would not use it. It considerably complicates the process when patients breaks the rules and uses a medication even though it is not approved for them. Therefore the FDA raises the bar to include population that wasn't originally designed for because they know that the cf community is likely to break the rules and acquire it anyway. I didn't have much of a response. Thanked the person for sharing their perspective and moved on.

The next week the person went to the American Chemical Society meeting in CA that included a talk by Vertex that said this very same thing.

Additionally, we can't forget that in very recent times CF clinical trials have had issues with recruitment. Hence Beth Sufian went to bat for people on disability to not have income from clinical trials count towards their annual income and disqualify disability payments. Proposing the Ph. 2 participants could stay on drug would disqualify from them from Ph. 3 trials as it is currently set up.

The next weekend I went to a CF education day where I talked with someone from Vertex. I asked the person why they could possibly not be encouraging the use of their medication in off-label-use especially if it was showing good results. The person explained that the process of FDA approval makes or breaks whether a drug gets to market 1) show to the FDA that the cf market still needs another drug that Kalydeco alone isn't enough and 2) that we can listen and follow rules, that Kalydeco was fast tracked and that we can only be hopeful that this could happen again with their future drugs.

The "shall do no harm" argument cannot be directed at this trial alone, since many drugs save lives. I know it's difficult to write without a bias. I just feel it's important when we speak of Vertex to be careful to show no ill will.

As someone who declined from the end of Vertex 770 Ph. 2 and the open label because I was one of the unlucky folks to get placebo in Ph. 3 I feel it was doing my part. Additionally, there was a lot of lag time between Ph. 2 and Ph. 3 for me. This is all part of getting medications to us. I have said I would be willing to lobby against cfers having to do placebo for Ph. 3 but with talking with the above mentioned people about this I realize it is unrealistic to believe that the placebo data could be collected from the patient population who is not taking the drug in as scientific a way to illicit the data the way the trial does. And placebo data IS needed in order to scientifically prove that a medication has a major impact on a person's health. Let's face it medications don't go to market if they only help a little; they need to show clinical significance.

If anyone finds out why the CFF hasn't endorsed Advancing Breakthrough Therapies for Patients Act I'd be interested in finding out. Or maybe they have but haven't sent out an email?

Sadly through having these discussions with my relative who keeps up with all thing cf research related, sees my decline and loves me very much and wants a cure for cf just as much as we all do...says now can understand why pharma. companies may want to shy away from drug dev for the cf market as our righteous behavior can be seen as a stumbling block to the process.

Our closeness, and small size makes us unusual - let's make sure all of our plays are smart and not nearsighted.

P.S. Mandi, I trust you won't take this personally. You are a very bright person and I know you appreciate my perspective. I hope it just gives you another side of the coin to consider in your project going forward. Keep us posted!
 

LouLou

New member
Has anyone considered contacting Vertex about this? They are very nice I just hesitate to do it myself because I don't want to take their time away from drug development. I'm just saying it may help to get their perspective before a lot of time is put into this. I personally always have to remind myself that things aren't always as they seem. And as much as we think we know everything, we don't. We have to remember to be appreciative of what Vertex is doing for the cf community. Not in a long time or maybe ever has a company invested in our community like they are. Always remember that from the day that Vertex patented V770, it has only 10 years to recoup its money before it goes generic. Also, the CFF VP who is in charge of legislation, Mary B. Dwight, may be a good perspective too. Perhaps they are endorsing this but have not sent an email blast yet.

Here's a little perspective, when people were discussing why doctors and possibly even Vertex would be discouraging off label use of Kalydeco, I asked my family member why this could possibly be so...wouldn't they want the additional customer, money, good publicity? My family member who works in the pharmaceutical industry told me that the reason was clear. It is because Vertex is so grateful (and that the CF community should be too) for how fast the FDA approved the medication and that to use the medication so quickly off label would be to go against what the FDA had permitted and most importantly the implications that this could have. That's there's a lot of dollars and sense since the process of drug dev is so expensive. That it's important to remember how fast a drug company can decide that development of a drug no longer makes financial sense and to never forget that we are only 70,000 people with regards to recruitment and usage after approval. The FDA approved it with the expectation that specifically DF508 would not use it. It considerably complicates the process when patients breaks the rules and uses a medication even though it is not approved for them. Therefore the FDA raises the bar to include population that wasn't originally designed for because they know that the cf community is likely to break the rules and acquire it anyway. I didn't have much of a response. Thanked the person for sharing their perspective and moved on.

The next week the person went to the American Chemical Society meeting in CA that included a talk by Vertex that said this very same thing.

Additionally, we can't forget that in very recent times CF clinical trials have had issues with recruitment. Hence Beth Sufian went to bat for people on disability to not have income from clinical trials count towards their annual income and disqualify disability payments. Proposing the Ph. 2 participants could stay on drug would disqualify from them from Ph. 3 trials as it is currently set up.

The next weekend I went to a CF education day where I talked with someone from Vertex. I asked the person why they could possibly not be encouraging the use of their medication in off-label-use especially if it was showing good results. The person explained that the process of FDA approval makes or breaks whether a drug gets to market 1) show to the FDA that the cf market still needs another drug that Kalydeco alone isn't enough and 2) that we can listen and follow rules, that Kalydeco was fast tracked and that we can only be hopeful that this could happen again with their future drugs.

The "shall do no harm" argument cannot be directed at this trial alone, since many drugs save lives. I know it's difficult to write without a bias. I just feel it's important when we speak of Vertex to be careful to show no ill will.

As someone who declined from the end of Vertex 770 Ph. 2 and the open label because I was one of the unlucky folks to get placebo in Ph. 3 I feel it was doing my part. Additionally, there was a lot of lag time between Ph. 2 and Ph. 3 for me. This is all part of getting medications to us. I have said I would be willing to lobby against cfers having to do placebo for Ph. 3 but with talking with the above mentioned people about this I realize it is unrealistic to believe that the placebo data could be collected from the patient population who is not taking the drug in as scientific a way to illicit the data the way the trial does. And placebo data IS needed in order to scientifically prove that a medication has a major impact on a person's health. Let's face it medications don't go to market if they only help a little; they need to show clinical significance.

If anyone finds out why the CFF hasn't endorsed Advancing Breakthrough Therapies for Patients Act I'd be interested in finding out. Or maybe they have but haven't sent out an email?

Sadly through having these discussions with my relative who keeps up with all thing cf research related, sees my decline and loves me very much and wants a cure for cf just as much as we all do...says now can understand why pharma. companies may want to shy away from drug dev for the cf market as our righteous behavior can be seen as a stumbling block to the process.

Our closeness, and small size makes us unusual - let's make sure all of our plays are smart and not nearsighted.

P.S. Mandi, I trust you won't take this personally. You are a very bright person and I know you appreciate my perspective. I hope it just gives you another side of the coin to consider in your project going forward. Keep us posted!
 

musclemania70

New member
I think Lauren has some valid points. 770 was created for one mutation. The FDA approved the drug for that ONE mutation. It is hard not to become emotional about these issues but I believe that the FDA can choose to make the approval process longer if we step in and start trying to change the rules now. Vertex has also chosen us as a group to create these drugs and I think its best to allow them to focus on these current studies, rather than diverting energy and time to people who want to change the rules midway through the process.

If you agree to go into the trial and you know the possibility of losing lung function after your trial ends, that is a risk that you have elected to take BUT you are doing it for the greater good of the whole CF community.

I think the best thing to do is sign the letter, and make it known to the REGULATORY agencies what we want accomplished or changed, not Vertex.
 

musclemania70

New member
I think Lauren has some valid points. 770 was created for one mutation. The FDA approved the drug for that ONE mutation. It is hard not to become emotional about these issues but I believe that the FDA can choose to make the approval process longer if we step in and start trying to change the rules now. Vertex has also chosen us as a group to create these drugs and I think its best to allow them to focus on these current studies, rather than diverting energy and time to people who want to change the rules midway through the process.

If you agree to go into the trial and you know the possibility of losing lung function after your trial ends, that is a risk that you have elected to take BUT you are doing it for the greater good of the whole CF community.

I think the best thing to do is sign the letter, and make it known to the REGULATORY agencies what we want accomplished or changed, not Vertex.
 

saveferris2009

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>LouLou</b></i> Here's a little perspective, when people were discussing why doctors and possibly even Vertex would be discouraging off label use of Kalydeco, I asked my family member why this could possibly be so...wouldn't they want the additional customer, money, good publicity? </end quote>

I work in biotech, and the answer is simple. Vertex CANNOT encourage any type of off label use because it's illegal. No drug company, pharmaceutical or biotech, can encourage off label use without being fined hundreds of millions of dollars.
<div class="FTQUOTE"><begin quote>My family member who works in the pharmaceutical industry told me that the reason was clear. It is because Vertex is so grateful (and that the CF community should be too) for how fast the FDA approved the medication and that to use the medication so quickly off label would be to go against what the FDA had permitted and most importantly the implications that this could have. </end quote>
Medications are used off label all the time in the medical commuity. And the FDA knows this.
Do you use zithromax M, W, F? That's off label.
Do you neb colistin? Off label, guys.
Meds are used off label all the time in all disease states. I've worked in this industry for 10 years with all types of specialties and it happens. The FDA knows it and does not "punish" as long as the drug manufacturer isn't promoting the drug off label. Which Vertex is not.
I worked with drugs that are in negotiations for FDA approval - up close. I know the conversations.

<div class="FTQUOTE"><begin quote>The FDA approved it with the expectation that specifically DF508 would not use it. </end quote>
I competely disagree. The evidence showed that the medication was tested for G551D and worked for G551D, so the FDA approved it for such use. The FDA doesn't make extrapolations from data or assumptions - FDA knows that an innumerable # of drugs are used off label.
In fact, i this unrelated link from the FDA's website, the FDA itself says "<span>FDA recognizes that the public health can be served when health care professionals receive truthful and non-misleading scientific and medical information on unapproved uses of approved or cleared medical products. "
<a href="http://www.fda.gov/regulatoryinformation/guidances/ucm125126.htm">http://www.fda.gov/regulatoryinformation/guidances/ucm125126.htm</a>
The link is an unrelated topic, but it shows that the FDA recognizes that off-label use occures, not just in our small little disease states.
<span>
<div class="FTQUOTE"><begin quote>It considerably complicates the process when patients breaks the rules and uses a medication even though it is not approved for them. Therefore the FDA raises the bar to include population that wasn't originally designed for because they know that the cf community is likely to break the rules and acquire it anyway. </end quote>
I respect what this person says, but it's simply not the case. Drugs are approved for the populations in which they are tested and show efficacy. Are no new antibiotics going to be developed without testing in CF, even if the antibiotics don't treat CF bacteria, because so many CFer's use zithromax off label? Or do all new IV antibiotics need to be tested in neb form because those darn CFer's nebulize so many antibiotics?
The FDA has no way of tracking who uses which medication, in addition. Unless a physician is enrolled in a tracking program, where patient info is collected, the FDA has no idea what my mutation is since I'm using Kaly off label. There's no tracking - there probably would be in single payor medical systems where the gov't tracks all meds and associated patients, but we don't have that here in the US....yet.

<div class="FTQUOTE"><begin quote>I asked the person why they could possibly not be encouraging the use of their medication in off-label-use especially if it was showing good results. </end quote>
BECAUSE IT'S AGAINST FEDERAL LAW TO PROMOTE A DRUG OFF LABEL. THEY WILL BE FINED MILLIONS OF DOLLARS. I'll give you a bunch of links here.... it's ILLEGAL.
<ul>
<li>Merck fined $322 million for off label drug promotion<a href="http://news.consumerreports.org/health/2012/04/merck-fined-322-million-for-illegal-off-label-vioxx-promotion.html">http://news.consumerreports.org/health/2012/04/merck-fined-322-million-for-illegal-off-label-vioxx-promotion.html</a></li>
<li>Abbott fined $1.5 billion for off label drug marketing<a href="http://medcitynews.com/2012/05/1-5-billion-abbott-fine-shows-government-more-serious-about-penalizing-off-label-promotion/">http://medcitynews.com/2012/05/1-5-billion-abbott-fine-shows-government-more-serious-about-penalizing-off-label-promotion/</a></li>
<li>Pfizer fined $430 million for off label marketing<a href="http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a4yV1nYxCGoA">http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a4yV1nYxCGoA</a></li>
</ul>

<div class="FTQUOTE"><begin quote>
The person explained that the process of FDA approval makes or breaks whether a drug gets to market 1) show to the FDA that the cf market still needs another drug that Kalydeco alone isn't enough and 2) that we can listen and follow rules, that Kalydeco was fast tracked and that we can only be hopeful that this could happen again with their future drugs. The "shall do no harm" argument cannot be directed at this trial alone, since many drugs save lives.
</end quote>

I'm curious what the person's title was that you spoke with.....because it could have easily been a sales rep who has never been invovled with clinical trial design, regulatory relations, or the FDA approval process. CF drugs are fast tracked due to our orphan drug status. Not that we followed some rules regarding on or off label use. You reference "we can follow rules"....well, what rules, specifically, did they outline? I think it's vague language that doesn't necessarily relate to off label use.

<div class="FTQUOTE"><begin quote> As someone who declined from the end of Vertex 770 Ph. 2 and the open label because I was one of the unlucky folks to get placebo in Ph. 3 I feel it was doing my part. Additionally, there was a lot of lag time between Ph. 2 and Ph. 3 for me. This is all part of getting medications to us. </end quote>
And we have expressed our gratitude for your amazing sacrifice. None of us would have Kaly without you. We thank you! <img src="i/expressions/face-icon-small-smile.gif" border="0">
<div class="FTQUOTE"><begin quote> companies may want to shy away from drug dev for the cf market as our righteous behavior can be seen as a stumbling block to the process. </end quote>

I respectfully, but vehemently, disagree in this assessment. Companies aren't shying away because we are "righteous behavior"..... it's about dollars and cents. If money can be made, it will be made.
No disrepect to you, Lauren. Just my perspective working in the trenches in this industry in many areas such as Oncology, Endo, Rheum, Gyn, etc.
 

saveferris2009

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>LouLou</b></i> Here's a little perspective, when people were discussing why doctors and possibly even Vertex would be discouraging off label use of Kalydeco, I asked my family member why this could possibly be so...wouldn't they want the additional customer, money, good publicity? </end quote>

I work in biotech, and the answer is simple. Vertex CANNOT encourage any type of off label use because it's illegal. No drug company, pharmaceutical or biotech, can encourage off label use without being fined hundreds of millions of dollars.
<div class="FTQUOTE"><begin quote>My family member who works in the pharmaceutical industry told me that the reason was clear. It is because Vertex is so grateful (and that the CF community should be too) for how fast the FDA approved the medication and that to use the medication so quickly off label would be to go against what the FDA had permitted and most importantly the implications that this could have. </end quote>
Medications are used off label all the time in the medical commuity. And the FDA knows this.
Do you use zithromax M, W, F? That's off label.
Do you neb colistin? Off label, guys.
Meds are used off label all the time in all disease states. I've worked in this industry for 10 years with all types of specialties and it happens. The FDA knows it and does not "punish" as long as the drug manufacturer isn't promoting the drug off label. Which Vertex is not.
I worked with drugs that are in negotiations for FDA approval - up close. I know the conversations.

<div class="FTQUOTE"><begin quote>The FDA approved it with the expectation that specifically DF508 would not use it. </end quote>
I competely disagree. The evidence showed that the medication was tested for G551D and worked for G551D, so the FDA approved it for such use. The FDA doesn't make extrapolations from data or assumptions - FDA knows that an innumerable # of drugs are used off label.
In fact, i this unrelated link from the FDA's website, the FDA itself says "<span>FDA recognizes that the public health can be served when health care professionals receive truthful and non-misleading scientific and medical information on unapproved uses of approved or cleared medical products. "
<a href="http://www.fda.gov/regulatoryinformation/guidances/ucm125126.htm">http://www.fda.gov/regulatoryinformation/guidances/ucm125126.htm</a>
The link is an unrelated topic, but it shows that the FDA recognizes that off-label use occures, not just in our small little disease states.
<span>
<div class="FTQUOTE"><begin quote>It considerably complicates the process when patients breaks the rules and uses a medication even though it is not approved for them. Therefore the FDA raises the bar to include population that wasn't originally designed for because they know that the cf community is likely to break the rules and acquire it anyway. </end quote>
I respect what this person says, but it's simply not the case. Drugs are approved for the populations in which they are tested and show efficacy. Are no new antibiotics going to be developed without testing in CF, even if the antibiotics don't treat CF bacteria, because so many CFer's use zithromax off label? Or do all new IV antibiotics need to be tested in neb form because those darn CFer's nebulize so many antibiotics?
The FDA has no way of tracking who uses which medication, in addition. Unless a physician is enrolled in a tracking program, where patient info is collected, the FDA has no idea what my mutation is since I'm using Kaly off label. There's no tracking - there probably would be in single payor medical systems where the gov't tracks all meds and associated patients, but we don't have that here in the US....yet.

<div class="FTQUOTE"><begin quote>I asked the person why they could possibly not be encouraging the use of their medication in off-label-use especially if it was showing good results. </end quote>
BECAUSE IT'S AGAINST FEDERAL LAW TO PROMOTE A DRUG OFF LABEL. THEY WILL BE FINED MILLIONS OF DOLLARS. I'll give you a bunch of links here.... it's ILLEGAL.
<ul>
<li>Merck fined $322 million for off label drug promotion<a href="http://news.consumerreports.org/health/2012/04/merck-fined-322-million-for-illegal-off-label-vioxx-promotion.html">http://news.consumerreports.org/health/2012/04/merck-fined-322-million-for-illegal-off-label-vioxx-promotion.html</a></li>
<li>Abbott fined $1.5 billion for off label drug marketing<a href="http://medcitynews.com/2012/05/1-5-billion-abbott-fine-shows-government-more-serious-about-penalizing-off-label-promotion/">http://medcitynews.com/2012/05/1-5-billion-abbott-fine-shows-government-more-serious-about-penalizing-off-label-promotion/</a></li>
<li>Pfizer fined $430 million for off label marketing<a href="http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a4yV1nYxCGoA">http://www.bloomberg.com/apps/news?pid=newsarchive&sid=a4yV1nYxCGoA</a></li>
</ul>

<div class="FTQUOTE"><begin quote>
The person explained that the process of FDA approval makes or breaks whether a drug gets to market 1) show to the FDA that the cf market still needs another drug that Kalydeco alone isn't enough and 2) that we can listen and follow rules, that Kalydeco was fast tracked and that we can only be hopeful that this could happen again with their future drugs. The "shall do no harm" argument cannot be directed at this trial alone, since many drugs save lives.
</end quote>

I'm curious what the person's title was that you spoke with.....because it could have easily been a sales rep who has never been invovled with clinical trial design, regulatory relations, or the FDA approval process. CF drugs are fast tracked due to our orphan drug status. Not that we followed some rules regarding on or off label use. You reference "we can follow rules"....well, what rules, specifically, did they outline? I think it's vague language that doesn't necessarily relate to off label use.

<div class="FTQUOTE"><begin quote> As someone who declined from the end of Vertex 770 Ph. 2 and the open label because I was one of the unlucky folks to get placebo in Ph. 3 I feel it was doing my part. Additionally, there was a lot of lag time between Ph. 2 and Ph. 3 for me. This is all part of getting medications to us. </end quote>
And we have expressed our gratitude for your amazing sacrifice. None of us would have Kaly without you. We thank you! <img src="i/expressions/face-icon-small-smile.gif" border="0">
<div class="FTQUOTE"><begin quote> companies may want to shy away from drug dev for the cf market as our righteous behavior can be seen as a stumbling block to the process. </end quote>

I respectfully, but vehemently, disagree in this assessment. Companies aren't shying away because we are "righteous behavior"..... it's about dollars and cents. If money can be made, it will be made.
No disrepect to you, Lauren. Just my perspective working in the trenches in this industry in many areas such as Oncology, Endo, Rheum, Gyn, etc.
 

LouLou

New member
Great perspective Amy. I have no further comment just wanted to share those two perspectives. You helped to jog my memory that the Vertex person did mention the fact that they can't recommend it off label because it is illegal and at the time it was fresh in my head because you had explained that in a post days before.
 

LouLou

New member
Great perspective Amy. I have no further comment just wanted to share those two perspectives. You helped to jog my memory that the Vertex person did mention the fact that they can't recommend it off label because it is illegal and at the time it was fresh in my head because you had explained that in a post days before.
 

musclemania70

New member
when insurance companies start backpedaling and stop covering drugs that people have already taken and showed benefit from....this is what concerns me.

why is there no regulation to allow patients to keep taking medication if there has been significant improvement? why can the insurance company decide not to cover a drug and change the rules as they go? if off-label use is legal, then why are insurance companies denying coverage?
 

musclemania70

New member
when insurance companies start backpedaling and stop covering drugs that people have already taken and showed benefit from....this is what concerns me.

why is there no regulation to allow patients to keep taking medication if there has been significant improvement? why can the insurance company decide not to cover a drug and change the rules as they go? if off-label use is legal, then why are insurance companies denying coverage?
 

saveferris2009

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>musclemania70</b></i> why is there no regulation to allow patients to keep taking medication if there has been significant improvement? </end quote>
There is for medicare part D patients, and to my knowledge, in the state of California. I would always appeal a denial to a state insurance commissioner and not just let the insurance company tell me what to do.
<div class="FTQUOTE"><begin quote>why can the insurance company decide not to cover a drug and change the rules as they go? </end quote>
A lot of them can't..... there is a pretty uninformed public when it comes to the rules of insurance, especially in the state in which the patient resides. Insurance companies do very well with these patients because, like we've seen on this board, <b>patients won't even try to get a drug in the 1st place </b>because some doc tells them a drug won't be covered, or, if there is a denial, a patient doesn't appeal or reach out to the insurance commisioner.

<div class="FTQUOTE"><begin quote>if off-label use is legal, then why are insurance companies denying coverage?</end quote>

Because they have formularies and can cover whatever they want. Most people get their health insurance through their employer. and each employer contracts with a health insurance provider based on what the employer wants to pay and the insurance provider covers services & medications according to the $$$ the employer pays. The more $$ the employer pays, generally, the more liberal the formulary.... and this is scaled by the size of the company as well.
 

saveferris2009

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>musclemania70</b></i> why is there no regulation to allow patients to keep taking medication if there has been significant improvement? </end quote>
There is for medicare part D patients, and to my knowledge, in the state of California. I would always appeal a denial to a state insurance commissioner and not just let the insurance company tell me what to do.
<div class="FTQUOTE"><begin quote>why can the insurance company decide not to cover a drug and change the rules as they go? </end quote>
A lot of them can't..... there is a pretty uninformed public when it comes to the rules of insurance, especially in the state in which the patient resides. Insurance companies do very well with these patients because, like we've seen on this board, <b>patients won't even try to get a drug in the 1st place </b>because some doc tells them a drug won't be covered, or, if there is a denial, a patient doesn't appeal or reach out to the insurance commisioner.

<div class="FTQUOTE"><begin quote>if off-label use is legal, then why are insurance companies denying coverage?</end quote>

Because they have formularies and can cover whatever they want. Most people get their health insurance through their employer. and each employer contracts with a health insurance provider based on what the employer wants to pay and the insurance provider covers services & medications according to the $$$ the employer pays. The more $$ the employer pays, generally, the more liberal the formulary.... and this is scaled by the size of the company as well.
 

JoyousMom

New member
Ok...let's clear the smoke a bit and look at what the rest of of us who aren't so smart can do about this problem. First, I signed up with Open Congress, and I sent the letter supporting the current bill. Second...what do you all suggest? Call Vertex? Call my CF Clinic? Sit around and do nothing? Seriously...like all of you, I am ready to get in the game and DO something, even if it's just phone calls or letters. I have a beautiful 16 year old daughter with CF, and I want to do all I can for her and others like her. Next move for the average person like me?
 

JoyousMom

New member
Ok...let's clear the smoke a bit and look at what the rest of of us who aren't so smart can do about this problem. First, I signed up with Open Congress, and I sent the letter supporting the current bill. Second...what do you all suggest? Call Vertex? Call my CF Clinic? Sit around and do nothing? Seriously...like all of you, I am ready to get in the game and DO something, even if it's just phone calls or letters. I have a beautiful 16 year old daughter with CF, and I want to do all I can for her and others like her. Next move for the average person like me?
 

dramamama

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>CyrilCrodius</b></i> Wait, are you the one with Df508/621+1G->T who tried Kalydeco?</end quote>
yes <img src="i/expressions/face-icon-small-smile.gif" border="0">
 

CyrilCrodius

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>dramamama</b></i> <div class="FTQUOTE"><begin quote><i>Originally posted by: <b>CyrilCrodius</b></i> Wait, are you the one with Df508/621+1G->T who tried Kalydeco?</end quote> yes <img src=""></end quote>
This is awesome. I have your blog bookmarked and I hope to see an update if you ever get Kalydeco back.
 
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