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Regional · North America · continued

Telehealth prescribing models in the US posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

LT
l.trevinoTL28 Dec 2024#31
lc_gradient, post #16: Date every claim in this subcategory. Positions here have moved repeatedly and old posts are read as current. Go to post

Following this. I have the same question and no better information than the first post.

20 likes in reply to #16 20mo
HK
h.karlsenTL211 Dec 2024#32
i.boateng, post #24: The arithmetic in post #21 is right; the assumption feeding it is the part to check. Anyone reporting an outcome should give the stated reason rather than the verdict. The reason is the part somebody else can use. Go to post

Reading this telehealth prescribing models thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.

0 likes in reply to #24 20mo
NV
n.vogelTL213 Dec 2024#33

Say which country and which state or province. Regulatory position, availability and practical route can all differ within the same continent and frequently do.

0 likes 19mo
EO
e.okaforTL216 Dec 2024#34

Everything in post #30 holds. The case it does not cover is the one I have.

Telehealth prescribing models was covered in the wiki last year and the page has a review date on it, which is a better starting point than my memory of a thread.

5 likes 19mo
VF
v.fontaineTL219 Dec 2024#35

Building on post #32 rather than restating it.

One caution on telehealth prescribing models: everything above assumes the underlying documentation is what it claims to be. That assumption is doing real work and is rarely stated.

27 likes 19mo
AA
a.aguirreTL221 Dec 2024#36
sharps_bin, post #23: Answering the question post #21 raises rather than the one it answers. On telehealth prescribing models I would separate what is worth knowing from what is worth acting on. The first list is long and the second is short, and conflating them is how threads get heated. Go to post

Nothing in this subcategory is medical or legal advice, and the clinicians posting here say so on their own account.

Two people can read the same figure differently here and both be reasonable.

0 likes in reply to #23 19mo
CA
c.adebayoTL224 Dec 2024#37

On telehealth prescribing models, I would rather understate and be corrected upward than overstate and be quoted. That is a house style here and it is a good one.

2 likes 19mo
ZY
z.yildizTL227 Dec 2024#38

Where a manufacturer runs a direct supply route, that is a commercial arrangement rather than a regulatory change, and it can end.

Written quickly, so the reasoning may be tighter than the wording.

9 likes 19mo
PI
p.iyer_pharmdTL3Pharmacist29 Dec 2024 · edited#39
a.jansen, post #13: Posting my telehealth prescribing models numbers with the method attached so they can be discounted properly. Uncontrolled, unblinded, and collected by someone who wanted a particular answer. Go to post

Picking up post #36: that is the part I would want checked first.

Two things can be true about telehealth prescribing models at once: the mechanism is plausible and the evidence for the size of the effect is thin. Most of the argument here is people defending the first against attacks on the second.

9 likes in reply to #13 19mo
ZO
z.okonkwoTL21 Jan 2025#40

On post #38 — agreed on the reasoning, with one qualification.

Before the thread moves on from telehealth prescribing models — what is the sample size behind the claim? I am not being difficult; I have seen the same figure quoted from an n of four and from an n of four hundred.

21 likes 19mo
NS
n.silvaTL23 Jan 2025 · edited#41

Worth separating two things that post #39 runs together.

Both are useful and different. The account tells you what happens in practice; the criterion tells you what to write.

11 likes 19mo
OB
owen.bradyTL4 Moderator6 Jan 2025#42
Ridgeway, post #9: Post #5 describes the usual case. This is about the unusual one. Appeals succeed more often than people expect when they answer the stated criterion point by point and include nothing else. That is my reading. Someone else read the same page differently and was reasonable. Go to post

United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally.

That is what the documentation says. What happens in practice is usually close.

3 likes in reply to #9 19mo
KD
k.dahlbergTL28 Jan 2025#43
owen.brady, post #42: United States: FDA licenses compounds. Prescribing and pharmacy practice are state-regulated. Compounds are prescription-only. Coverage is decided by individual plans, not nationally. That is what the documentation says. What happens in practice is usually close. Go to post

The practical version of telehealth prescribing models is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached.

0 likes in reply to #42 19mo
AR
a.reyesTL4 Admin11 Jan 2025#44

Post #43 answers the question as asked. The question underneath it is different.

Two questions I would want answered before drawing anything from the telehealth prescribing models data above: how were the cases selected, and what happened to the ones that dropped out.

24 likes 19mo
SG
s.grimaldiTL213 Jan 2025#45

Helpful, and easy to find again, which is half of what a good reply is.

16 likes 18mo
DV
dr.villanuevaTL3Physician16 Jan 2025#46
r.zielinski, post #15: Thank you for taking the time. That was more work than a reply usually is. Go to post

The public assessment documents published at approval are free, detailed and largely unread here.

I would put a moderate confidence on that and no more.

6 likes in reply to #15 18mo
EI
e.iyerTL218 Jan 2025#47

Coming back to post #43, because the follow-up matters more than the original answer.

Telehealth prescribing: widespread in the US and varying in quality. Models without a clinician reviewing measurements and history are not recommended by this community.

0 likes 18mo
MH
ms_hollowayTL4Mass spectrometrist21 Jan 2025#48

Post #47 is right about the mechanism and I think understates the practical bit.

Telehealth prescribing models looks different depending on whether you are reading the primary literature or the summaries of it, and the difference is not in our favour.

32 likes 18mo
MR
m.radichTL223 Jan 2025#49

I would keep telehealth prescribing models and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.

4 likes 18mo
HO
h.oyelowoTL2Regular26 Jan 2025#50

Adding the measurement that post #47 says would settle it.

Private insurance gaps: some people have private insurance but medication is not covered. Manufacturer assistance programmes are the main resource for cost reduction.

The step people skip is the one I have spelled out.

0 likes 18mo
M
MSaarinenTL3Regular28 Jan 2025#51

Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.

Marking that as an opinion rather than a finding.

18 likes 18mo
IR
i.rasmussenTL231 Jan 2025#52
V
VThorvaldsenTL3Regular2 Feb 2025#53

Practical note on telehealth prescribing models: write down what you expect before you look. The number of times I have found what I went looking for is higher than chance would allow.

1 like 18mo
IB
i.brobergTL24 Feb 2025#54

Compounded preparations and authorised products are different regulatory categories with different oversight, and conflating them produces most of the confusion here.

I would put the burden of proof on the interesting explanation, not the dull one.

7 likes 18mo
K
KnowltonTL3Regular7 Feb 2025 · edited#55

This follows post #54 rather than contradicting it.

For anyone finding this later: the short answer on telehealth prescribing models is that it depends on one thing, and the rest of the thread is people identifying which thing.

12 likes 18mo
EK
e.kimaniTL29 Feb 2025#56
titration_diary, post #14: Careful with the language on telehealth prescribing models. "Not detected" and "not present" are different findings and the first is a statement about the method. Go to post

Worth separating two things that post #53 runs together.

I keep a log for telehealth prescribing models specifically because my memory of it turned out to be systematically wrong in one direction. Six weeks of notes cost nothing and settled it.

26 likes in reply to #14 18mo
SS
s.silvaTL211 Feb 2025#57

The denial letter is the specification for the appeal. It states a criterion and the job is to demonstrate that criterion in the letter's own language.

That is one dataset and I would not build a rule on it.

0 likes 17mo
EF
e.ferrariTL214 Feb 2025#58

Nothing to add, except that this is the answer I would give if asked.

4 likes 17mo
AW
a.weissTL216 Feb 2025#59
KR
k.roosTL219 Feb 2025#60

The arithmetic on telehealth prescribing models is the easy part and it is where the errors are, which is an uncomfortable combination. Show your working and someone will catch it.

19 likes 17mo