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Stalking Byetta

by  David Mendosa
Friday, February 17, 2006

Taking Byetta is a lot easier than getting it. At least for me.

Byetta (pronounced bye-A-tuh)
has been an interest of mine for years. I learned about it eight years ago this month in an interview with Richard Krawiec, who was then Amylin’s spokesman. Then four years ago I wrote what I think was the first article about Byetta for my column on American Diabetes Association’s website.

But it wasn’t until I read and reviewed the new book by Dr. Joe Prendergast, The Uncommon Doctor, that I was inspired to take Byetta myself. I knew that Byetta helps to control blood glucose, but my A1C is already below 7. I also knew that people on Byetta typically lose weight, but the official prescribing information documented an average weight loss of no more than 2.8 kg (a little more than six pounds) after 30 weeks with people who also used metformin.

Dr. Joe’s enthusiasm for Byetta opened my eyes. “My patients have done so well on Byetta,” he wrote in his book, “that I think it could be the next miracle drug.”

He told me a few days ago that 200 of his patients are using Byetta. Their average weight loss since the first of them started in May is 35 pounds.

How could Dr. Joe have so much better results? I don’t really know, but it must be in his selection of patients.

If it weren’t for Dr. Joe and my persistence, I never would have got started on Byetta. I don’t have any issues with Byetta or with its manufacturer, Amylin Pharmaceuticals. In fact, I am such a believer in Byetta that recently I bought 100 shares in the company.

I fault my health insurance company and my former doctor.

It’s hard for me to believe even now the amount of misinformation that so-called customer service representatives gave me. Like a diligent consumer, the first thing that I did was to check with my health insurance company to see if I could afford it. It took at least a half dozen calls.

At first they told me that the 5 mcg Byetta pen that we use for the first month would cost me a $35 copay and $1098 against my Medicare cap. Then, each month after the first we use a 10 mcg pen, which they said would cost $645 a month. Even without considering my other medications that would have meant that this year I would have fallen into the Medicare Part D donut hole, the coverage gap after total drug costs reach $2,250 each year.

It didn’t make sense that the smaller pen would cost more than the bigger one. I had also compared prices with an online drugstore, where Byetta would be much less expensive.

Still, in repeated phone calls the customer service representatives insisted they were correct. I finally demanded to speak to the health insurance company’s pharmacist.

It turns out that the 5 mcg pen would cost me $159.97 against my Medicare cap, and the 10 mcg pen would count as $187.07 each month. So it would fit within the Medicare cap, and I could therefore afford to go on Byetta.

Meanwhile, I had asked people at Amylin’s reimbursement hotline at 800-330-7647 to intercede for me. When they got back to me, it was with a message that my health insurance company doesn’t yet cover Byetta at all. A different customer service representative told Amylin that the insurance company’s “PNT committee” (whatever that is) was still reviewing Byetta, so it wasn’t in the formulary.

That took still more calls to convince me that my health insurance company will cover Byetta.
That issue resolved, I next made an appointment with my doctor to get a prescription.

Unfortunately, he had never heard of Byetta. And even after researching it, he declined to give me a prescription.

Byetta is new. It has only been generally available since last summer. So it is understandable that the medical profession isn’t familiar with it.

Since I understand that, I did the only reasonable thing when my doctor wouldn’t prescribe Byetta. I fired him.

Next, I set up appointments to see another primary care physician and an endocrinologist. But neither could see me for more than six weeks.

I hated to wait that long to start on Byetta, but there didn’t seem to be any choice. Then my salvation came in the form of an email from Jeffry N. Gerber, M.D.

He wrote to tell me that he is a family doctor located south of Denver and that he had just linked my website on his. Later, he wrote that he had just met with the Byetta rep because he was anxious to start many of his patients on it. He wrote, “You can be the first, if you wish.”

I wished. Even though his office is almost an hour away on the far side of Denver from my home in Boulder, I made an appointment to see him the next weekday. I not only got my prescription but a free 5 mcg pen that the Byetta rep had left with him. I took my first shot of Byetta on Monday night.

It’s only a few days that I have been using Byetta, so I don’t know yet if I will be the thin young man I once was. But I do know that it’s much easier to inject it than to do a fingerstick test, and I hardly feel it. My blood glucose levels, often in the 80s and 90s, are better than they ever were. And while the only real nausea I felt was for the first three hours after my first shot of Byetta, my appetite is satisfied on much less food.

People talk about going on a particular medicine. But I have gone to Byetta, a drug that I believe will change my life. So don’t be surprised if you see more about Byetta here.