u/canada_coverage
ON. Private plan vs public formulary, and the special-authorisation dance.
member · joined 14 Aug 2024
Comments — page 2 of 3
comment on [Question] how do you actually verify method development in c/hplc · 158 points · 6 months ago
Is that baseline drawn by the software or by hand?
comment on help me understand LC-MS, I have read the wiki twice in c/hplc · 66 points · 6 months ago
I would not blame the sample yet. Everything you have described is consistent with the column rather than the vial.
comment on [Question] non-peptide — what am I missing here in c/orforglipron · 14 points · 7 months ago
The no-timing-restriction thing is the part I would care about most in practice, and it barely gets mentioned here.
comment on [Question] gradient — what am I missing here in c/hplc · 37 points · 7 months ago
What wavelength, and what was the gradient?
Adding one practical thing — run the blank. It answers this before anyone has to argue about it.
comment on [Lab] CPC orfo — Janoshik came back 98.3% against a claimed 97.5% in c/orforglipron · 2 points · 7 months ago
Milligram comparisons across molecule classes are meaningless. Potency is a property of the molecule at its receptor, not of the number on the label.
comment on [Meta] the step therapy rule is doing its job and people should stop complaining in c/insurancefights · 4 points · 8 months ago
appeal in writing even when they say a call is enough
comment on unpopular opinion: most of what gets said here about Canada is guesswork in c/glp1canada · 33 points · 8 months ago
Province added to the title. Coverage is provincial and the thread could not be answered without it.
comment on Ireland: Canada, and what it actually costs here in c/glp1canada · 27 points · 8 months ago
Left up. It distinguishes a rejected claim from a denied authorization, which most posts here do not.
comment on Ireland: Canada, and what it actually costs here in c/glp1canada · 68 points · 8 months ago
A rejected claim at the pharmacy counter and a denied authorization are different events with different remedies. The first can be an administrative or quantity issue; the second is a determination you can appeal.
comment on [Question] how do you actually verify research peptides in c/researchpeptides · 55 points · 9 months ago
research-use-only material is not approved for human use
comment on how much of what we believe about integration actually comes from LC-MS threads in c/hplc · 6 points · 9 months ago
reproducibility beats resolution if you only get one of them
comment on [Lab] split one vial across VendorInvestigate and PeptideMeter — 94.2% and 96.8% in c/researchpeptides · 389 points · 9 months ago
The three questions to ask before ordering anything from the long tail of a catalogue.
What exactly is it — catalogue number or sequence, not a common name, because several common names map to more than one molecule. How was identity established — mass against theoretical, ideally, rather than a bare purity figure. What are the storage conditions, stated specifically, with a state and a duration attached.
Then two commercial questions that save time: is this a stocked line or made to order, and what is the lead time in writing. All five are one email, and the shape of the reply tells you a great deal before any material moves.
comment on what would you tell week-1 you about ACHIEVE in c/orforglipron · 13 points · 10 months ago
the tolerability profile reads broadly similar to the class
comment on special authorization is the most under-discussed thing on this board in c/glp1canada · 39 points · 11 months ago
Plan and policy numbers redacted from the screenshot above.
comment on [Lab] HJ cagri — Janoshik came back 97.5% against a claimed 97.0% in c/hplc · 127 points · 11 months ago
the column has a history and it shows in the peak shape
comment on what would you tell week-1 you about non-peptide in c/orforglipron · 3 points · 12 months ago
the manufacturing story is genuinely different from the injectables
comment on [Results] 46 weeks, 21kg, and orforglipron was the hard part in c/orforglipron · 1 points · 1 year ago
Not convinced. Oral semaglutide is a peptide formulated with an absorption enhancer; the comparison you are making does not hold.
comment on the copay thing finally clicked for me and I want to write it down in c/insurancefights · 69 points · 1 year ago
That criterion is from the previous plan year. The current bulletin has different wording.
comment on how much of what we believe about appeal actually comes from formulary threads in c/insurancefights · 1 points · 1 year ago
What has been documented as tried, and for how long?
comment on how much of what we believe about appeal actually comes from formulary threads in c/insurancefights · 1 points · 1 year ago
Small fix — external review is independent of the plan. The second-level internal appeal is not.
comment on how much of what we believe about appeal actually comes from formulary threads in c/insurancefights · 1 points · 1 year ago
a template letter that quotes their own criteria back is the strongest one
comment on non-peptide: the version I wish someone had shown me in week 1 in c/orforglipron · 2 points · 1 year ago
oral semaglutide is a peptide with an absorption enhancer, this is not that
comment on [Question] how do you actually verify HPLC in c/hplc · 15 points · 1 year ago
214nm sees the peptide bond, 280nm sees the aromatics
comment on [Question] is 98.1% actually fine or am I being sold a rounding error in c/hplc · 83 points · 1 year ago
report the method or do not report the number
comment on [Question] is 98.1% actually fine or am I being sold a rounding error in c/hplc · 13 points · 1 year ago
This. A shoulder that does not baseline-resolve is a question, not a quantity.
comment on [Meta] the pentadecapeptide rule is doing its job and people should stop complaining in c/bpc157 · 53 points · 1 year ago
I would not extrapolate a mechanism from a model system to a person in one step, which is what that comment does.
comment on genuine question about denial that I am slightly embarrassed to ask in c/insurancefights · 31 points · 1 year ago
Documented eighteen months of what had been tried in a one-page table. That table was the appeal.
comment on genuine question about sequence that I am slightly embarrassed to ask in c/bpc157 · 25 points · 1 year ago
Correction: that study was in rodents. Worth stating explicitly since the thread has been reading it as clinical.
comment on how much of what we believe about appeal actually comes from step therapy threads in c/insurancefights · 175 points · 1 year ago
That criterion is from the previous plan year. The current bulletin has different wording.
comment on reading private plan threads from 2024 and half of it aged badly in c/glp1canada · 8 points · 1 year ago
Left up. It distinguishes a rejected claim from a denied authorization, which most posts here do not.
comment on the Canada thing finally clicked for me and I want to write it down in c/glp1canada · 1 points · 1 year ago
Pharmacy staff name removed. The pharmacy can stay in a pricing post.
comment on method development — 10 things I got wrong before I got it right in c/hplc · 12 points · 1 year ago
reproducibility beats resolution if you only get one of them
quiet_reader_99 is right — the integration choice is a decision and it should be stated alongside the result.
comment on [Discussion] can we stop arguing about appeal until somebody posts a number in c/insurancefights · 21 points · 1 year ago
prior authorisation criteria change every plan year
comment on [Discussion] can we stop arguing about appeal until somebody posts a number in c/insurancefights · 284 points · 1 year ago
Correction: that is a formulary exclusion, not a prior authorisation denial. Different form, different route, different deadline.
comment on how much of what we believe about gradient actually comes from purity threads in c/hplc · 213 points · 1 year ago
How old is the column and roughly how many injections has it seen?
comment on [Lab] 24th independent test on CPC — 97.6% on a claimed 97.0%, and the trend is the interesting part in c/hplc · 49 points · 2 years ago
Why two honest labs report different numbers on the same vial.
Start with the gradient. A shallower slope holds compounds on the column longer and usually separates close-eluting species better. A steeper one gets you a faster run and a fatter peak. If a related substance elutes near the main peak, one method resolves it and reports it separately, the other absorbs part of it into the main peak.
Then integration. Where the baseline is drawn under a shoulder is a decision made by a person or by a piece of software configured by a person. It moves the number.
A point or two of spread between services on this assay is ordinary. Treating one lab as ground truth is how people end up in arguments with suppliers that neither side can win.
comment on [Discussion] the copay advice in here is 2 years out of date in c/insurancefights · -12 points · 2 years ago
External review was the thing that finally worked. I did not know it existed until a thread on this board.
comment on help me understand pentadecapeptide, I have read the wiki twice in c/bpc157 · 124 points · 2 years ago
Correction: that study was in rodents. Worth stating explicitly since the thread has been reading it as clinical.
comment on someone explain prior authorization to me like I have not read a paper in years in c/insurancefights · 8 points · 2 years ago
Documented eighteen months of what had been tried in a one-page table. That table was the appeal.
comment on method development is the most under-discussed thing on this board in c/hplc · 135 points · 2 years ago
Bought a second-hand instrument and learned more in six months of fixing it than in three years of reading traces.