Any ideas on alternatives to Lantus? Which Canadian pharmacy are price competitive, last time I checked at Northwest ,Lantus was $93 per bottle.
Levemir is the closest product brand-name.
Others do basals with NPH MDI (split 4 times a day it's not too bad, I did that for literally decades) or with fast acting insulin in a pump.
Old thread, but I'm going to try to resurge it since I've been trying to come up with substitutions to Lantus since it's reached over $185/bottle past year. BTW, how could/would someone in the USA obtain insulin from a Canadian pharmacy?
More details: I've done very well on Lantus for about 4 years since off insulin pump (too expensive when paying out-of-pocket for all medical expenses) - I manage same way as when I was on pump 10+ years (basal + boluses) but instead the Lantus is my basal and Humalog insulin pen is my boluses. (Yes, it does get annoying taking so many shots everyday, like when eating often which each time requires a Humalog pen needle injection, but it still works out much cheaper, with the extra bonus of not having an insulin pump hanging on me 24 hrs./day).
Many have suggested switching to NPH (cheaper), instead of Lantus- Has anyone tried this and how did it work out?
NPH has a shorter duration, and is less constant than Lantus or Levemir. That said, many of us used NPH for decades before they came out with Lantus and then Levemir, so it can be done. NPH is cheap at Walmart and some other pharmacies (I've been told), so it wouldn't cost you anything to buy a bottle and experiment.
But I don't have fond memories of NPH, and I'm happy enough with Levemir that I personally would be willing to pay the cost difference.
Recently, a new long term insulin, tresiba has come out from novorapid.
not sure though about availability in the US.
lasts up to 48 hours but needs to be injected once a day.
Thanks for the fast response. "Experiment" (to cut costs) is something I'm so fed-up with. In the old days (1970's-1990's) I took Lente (not NPH) so I have no experience with NPH...I actually found this info (switching from Lantus to NPH) on a government site (disaster assistance).
A few questions, I'm actually not familiar with "Levemir" - How is it different from Lantus? And, cost?
From what I've been told, Lantus to NPH requires 2 shots/day...Not a problem, but I'm most concerned about the peaks and absorption, which I had when on Lente (old days, I'm not even sure if anybody takes "Lente insulin anymore, wasn't that popular back when I was on it)-
What I like the most about Lantus is a steady basal, just like when I was on an insulin pump...
Regarding price, what most pharmacies have told me is NPH is about 1/2 the cost of Lantus---I'm still very (nervous) hesitant to try it.
The many times I've ran out of Lantus over the past year (faced with decisions such as have roof over my head and eat or use the money for Lantus instead),
I tried taking just Humalog (I have plenty of it) and it always was a disaster, even when checking my BS (around the clock) every 2 to 4 hours, it never worked out - I still don't understand why, since I had a pump for 10 years (tried mimicking pump with multiple Humalog injections ATC) - also did extensive calculations (how much Humalog would be needed to mimic the basal action of Lantus dose) - Nothing worked.
I think I tried the switch (from Lantus + Humalog to Humalog only) about 4 times over past year (when forced to because I ran out of Lantus and did not have a prescription renewal and/or money to purchase a bottle), and every time it was a disaster - E.G. Very sick with BS from 30 to ("HIGH"=500-600+) throughout day, depending on meter I checked with.
This is primarily the reason(s) I'm so concerned about trying NPH.
Expect to be faced with the same dilemma next week (when Lantus bottle empty), barring any miracles of course- LOL Thanks for info - look forward to your further response.
BTW, "willing to pay the cost difference" sometimes is not as easy as it sounds. I'm certainly "willing", but if you simply do not have the money (despite working non-stop) no pharmacy will give you the $185+ bottle for free, and as the years go by it's become harder and harder for people to find resources and/or get health insurance, etc.
Same issues arise each month with my B/P pills (3) and strips - Both just as important to me, (only feel well when I can afford them and have them), but certainly not quite as urgent + life threatening as when I run out of Lantus insulin.
ADD: The government information regarding switching insulin and dosages (in a disaster), that I referred to in my prior post, is located here:
http://www.fda.gov/Drugs/EmergencyPreparedness/ucm085213.htm
Plus, I found several sites that describe "LEVEMIR", which I really know nothing about (see Jag1's post above);
Was wondering if anybody knows the cost of Levemir (compared to Lantus) and if cheaper, has anyone been successful (dosing) switching from Lantus to Levemir?
I'll guess Levemir, like Lantus requires a prescription (?)
Another reason NPH recommended (by pharmacist) to me since apparently it does not require a prescription.
I'm unsure if "prescription requirement" for buying certain types of insulin varies by state or country? I'm currently in NJ, have lived in several other states over past decade...And surprisingly, all too often the pharmacists are unsure of which insulin types REQUIRE a prescription, and which do not; Which I've learned to use to my advantage (when necessary) when I did not have any (Lantus) renewals available...
Having to pay a doctor, sometimes every month, to get a renewal for Lantus insulin is also a huge and difficult expense to afford...
Several (shocking) stories come to mind (of extreme measures I've gone to obtain my medicines, including insulin, I require every day) -
E.G. When unable to (afford) to visit doctor for renewal for Lantus, visit local pharmacy on Sunday (early) morning or (late) night with empty bottle that has label with details of prior refill,in hand, and many pharmacists will refill, with expectation of getting renewal approved by phone on Monday.
Obviously, prior to my "Sunday trick" I called and begged the doctor/clinic to renew prescription without an $$$ office visit, and they refused...
And, while I understand the clinic's (doctor or nurses) reasoning of why they want you to come back every month or 2 before they'll refill your prescriptions, still seems outrageous to me to refuse to renew insulin (that I've been on for almost 40 years) unless I can afford the office visit too! Interesting too, that when I had insurance doctors wrote prescription renewals for 3, 6 months, and even a year with no hesitation whatsoever.---Sorry I keep going off topic (healthcare politics instead of use/switching) -Maybe I'll start a thread on that topic (cost and extreme measures people go through to obtain insulin and other life-sustaining medications) later on.
I actually have never taken "Levemir", take Lantus, and yes I am aware of MANY prescription programs available that I may be eligible for (E.G. Lilly Cares, which I received insulin from a couple times over the years), BUT all of these programs REQUIRE time + physician's office to complete paperwork, and if "clinic" unwilling to sign forms (E.G. They say they're too busy or you must come back and meet with social worker, etc. etc.),
there is no way to get the free or low-cost medicines from any of these programs, "without cooperation from your healthcare provider's office" AND a permanent address.
I think "Lilly Cares" changed since the last time (years ago) I got insulin from them, quick search shows program details here: http://www.lillytruassist.com/Pages/AboutLillyCares.aspx
Either way, referral to programs was not what I urgently was looking for right now. Just needed some help finding a cheaper, appropriate substitute for Lantus insulin (if it exists), and advice on how to make dosage adjustments necessary.
BTW, my fault for mentioning details of "cost" issues, etc. I kind of expected suggestions on "programs" etc. for low income, uninsured to enter thread -
But, I was looking more for concrete information on dosage, effects, problems, etc. when/if cost lower so I could switch myself...
While I certainly would love the advice of a qualified physician who knows my medical history, it's not something I can obtain unless I can afford to pay them for the visit(s), including all the expensive lab work, etc. they all want you to have as a condition of accepting you as a patient.
In other words, not taking insulin, while battling through our RIDICULOUS healthcare systems is not an option - -I could write a book on all the measures I've taken to try to get assistance for medicines, insurance, and the most basic medical care (a long, complicated, ugly story)- And yes, I expect I am very eligible for all, and have been for some time, but still doesn't change the fact (outcome) that I'm still on my own to pay for all care and costs, UNTIL I get through all the red-tape and nonsense.
BTW, using an "emergency room" as my primary care provider is not a choice I would make easily, just like MANY OTHER ACTIONS uninsured, self-employed, low income people are forced to make every day...
I'll be really mad at myself for posting here if this turns into a political Obamacare discussion and/or the failures of Medicaid and state programs, discussion.
I'll end my rant (on the lack of basic human rights for the uninsured) by saying, while I'm consumed trying to work these things out MYSELF, it's like being hit with a dagger every time you turn on a news channel these days and listen to all the growing nonsense (battling) that's going on with "Obamacare", which has existed in the USA for decades (long before Obama took office)-- The only thing that's changed for the uninsured (recently) seems to be the SKYROCKETING COSTS OF ALL MEDICINES, with a growing reluctance by doctors and pharmacies to care for anybody who does not have health insurance.
And, as the costs rise, and profits (reimbursement) decreases, I expect the ability for anyone to obtain care "out-of-pocket" will only worsen in the future - The new outcome (choices) for those who pay out-of-pocket (working uninsured) likely will become (assuming you don't die) get sick or sicker permanently to obtain Medicare (disabled) or give-up your profession/career and become another government-supported statistic.
THE END, I hope, on discussions about "programs available" (please, not now or here, if possible).
If it was available, do you expect it would be cheaper and a good substitute for Lantus?
(I never heard of "Tresiba" before your post today).
I actually really like Lantus insulin, and although I started taking it "by default" about 4 years ago, while trying to get a replacement for my Disetronic insulin pump, that was too old to be serviced anymore, now, I prefer taking Lantus daily INSTEAD of a pump, and probably would not want to go back on a pump, even if I had insurance willing to pay for it and the supplies...
Levemir and Lantus are both developed under patent (i.e. the insulin molecule was modified and patented), so probably both about the same cost. Humalog is also under patent; so its good you have a supply of that because I believe that is also very expensive.
Regular Humulin and NPH Humulin are the actual human insulin molecule and not modified and therefore not as expensive. Also no prescription is required. The cost of it at Walmart is much less than half the cost of the patented insulins - I think its only $25 per bottle: read this thread with the information: LINKHERE
Costco (no membership needed) is also a good place to try for better prescription prices.
When I was using NPH I definitely needed it at least twice a day. I also need Lantus and Levemir twice a day. If you take three or four injections of NPH per day you can probably smooth the basal rate out as much as possible (I was taking three injections of NPH per day, 8 hours apart, before I switched to Lantus and later Levemir). Tim recommended four injections a day, but that would make them only 6 hours apart which would be difficult if you wanted to get any sleep.
Your goal for any of the Lantus Levemir and NPH insulins is to provide basal coverage, so approximately the same number of units of these should be taken per day (i.e. if you take 30 units of Lantus in one shot per day now, you would start with 15 units of Levemir twice a day, or 10 units of NPH three times a day). Of course it would be smart to lower the dose a bit to start while you're tuning the amount that really works best for you.
I'll not gum this up with politics, but I will say that I find it criminal that the Repubs and the Dems both agree that we should not have universal health care in this country. The Repubs and Dems and Obama himself failed to provide a public option that would have actually given us healthcare worth caring about. (In my view all Repubs, and many Dems with Obama and Joe Lieberman in particular are most responsible for the pathetic non-public-option health insurance company plan we are rolling out now).
See the reply I added above.
Sanofi - the maker of Lantus - has an patient assistance program which might drastically cut the cost. Here is the web address: http://www.sanofiservices.us/
Maurie
Alex, my doctors office never gives me any headaches like that whatsoever. Sounds like a lot of your frustrations come from lack of support you need and expect from your doctors office— maybe it’s time to find a new doctor? Also the many chain pharmacies that have a “minute clinic” are decent affordable options when a new rx has to be written. My doctors office would write any rx I genuinely needed within hours of me requesting it and send it anywhere in the world I asked them to-- yours should do the same-- if they won’t then they don’t deserve your business
Jag-- interesting to note though that the patent on humalog is about to expire. I’m not aware of any plans for generic brands to start producing it but I’d sure be thrilled if they do.
Hello again - A few posts I wrote yesterday are not here (I expect it was my mistake, by not entering them correctly), but in
SUMMARY:
I'm looking for cheaper alternatives to Lantus insulin (now costs $185.00 bottle);
I am considering switching to NPH (or other cheaper insulins), temporarily until I have insurance or more money;
NPH apparently is about 1/2 the price and does not require a prescription.
(I've never taken NPH in my life but am considering this now, since only possible alternative left that I've found-
In 70's-90's (pre-insulin pump and before Humalog was around)) I took Lente insulin (which I don't think is even around anymore).
+
I've tried switching to only Humalog several times over past year, (when I did not have the money to buy Lantus and/or did not have a prescription renewal), with disastrous results. I still can't figure out why?
Any advice (dosage, side effects, problems, etc.) on switching (to NPH, only Humalog or some other "cheaper insulin" would be appreciated.
Approximate current dosing (past 4 years):
Lantus 35 units once a day +
Humalog for meals/snacks (carb counting) and for coverage of BS above 150.
Note: For me, 1 unit Humalog covers 15 GM carbs + 1 unit drops BS about 75 mg/dl (depending on time of day), except when experiencing insulin resistance if BS 300 or higher, then it takes at least twice amt. of Humalog to bring BS down.
I was on an insulin pump for over 10 years, prior to taking Lantus (past 4 years) so I am familiar with Humalog dosing (more reason why I still can't figure out why I've always failed at taking only Humalog injections around the clock, when I had no Lantus available). ???
----------------Please do not post insurance/financial assistance program suggestions (here + now), instead please focus responses on "switching insulin":
Also, please do not make "assumptions" on why I've had to battle to get ANY basic medical care and prescriptions filled, (does not help me to get my urgent questions answered on how to switch),
I'll START a different THREAD LATER today for that.
Obviously I've already tried and failed to get any assistance, which is the sole reason I've been resorting to drastic measures (switching medicines on my own) - and I expect the problems preventing me from having basic things (insulin) I need to stay alive over past 1+ year will eventually resolve (some day, hopefully soon).
-----------------------
To Jag1 - Thanks for the great info and link yesterday (on lower cost of insulin + strips at Walmart)- I'm going to research that further - When I've had RX for Lantus filled at Walmart (several times) was only a couple dollars cheaper, and they (like all other pharmacies) say the prescription savings cards I use (which offer huge discounts for my B/P medicines) do not apply to Lantus (and other insulins) since there is no generic version.
I started a NEW THREAD
https://forum.tudiabetes.org/topics/2014-assistance-programs-to-help-afford-insulin-diabetic-supplies
FOR INFORMATION ON FINANCIAL, patient assistance programs etc.
in hopes that this thread will focus ONLY on concrete MEDICAL advice, suggestions, experience, etc. regarding switching from Lantus to another (cheaper) insulin type.
Thanks!
PLEASE POST ONLY MEDICAL ADVICE HERE (not financial):
Since I only have a couple of days of Lantus insulin left, and do not have the $185 or a prescription refill required to get another bottle I'm hoping others can help me to either switch to NPH (cheaper and no prescription required) or switch to Humalog only which I have plenty of right now -(I've tired about 4 times over past year and failed at keeping BS normal + stable on Humalog only). Failed (Humalog only) for reasons I could never figure out why...
My current insulin regimen (Lantus + Humalog) listed in my prior post.
Maurie, I copied/pasted your post here:
https://forum.tudiabetes.org/topics/2014-assistance-programs-to-help-afford-insulin-diabetic-supplies
Please add details there (such as website address for application to obtain Lantus insulin, and other program requirements).
Thanks!
I sent you a pm, but I want to post here too, since "I Give up!"-
While I can think of numerous good reasons why people post "clueless" responses here (when post reply has nothing to do with question(s) the person's asking), but instead gives details on "something else", based on very wrong assumptions...
You said, "Expect from YOUR doctors office...don't deserve YOUR business" blah, blah, blah
------A low income, uninsured person is lucky to have access to ANY provider whatsoever, choosing a supportive, competent doctor is not an OPTION or CHOICE, unless they have a lot of cash on hand.
"Minute clinics"? "Affordable"? Is this something you have personally used for primary care? Not likely or you would realize that somebody struggling to pay-out of pocket for medicines does not have the extra $500-$1000 it will cost them after they complete all the "routine testing" etc. the "minute clinic" (ambulatory care center) will demand as a condition to follow/treat their care.
In the Northeast, most "minute clinics" charge about $200 just to walk in the door...
Emergency rooms also not the answer, (for many reasons) including unless you are willing or able to pay the $2000-$3000 bill you'll receive for a few prescriptions written.
If I had an extra $200+, I would buy the Lantus bottle, and not even try again (now) to switch to something else.
Next you'll probably (wrongly) "assume" there are free or low cost clinics everywhere, willing and able to appropriately take care of the medical needs of everyone, whenever they need it, (including filling out the lengthy applications + procedures required by all patient prescription assistance programs)--->Wrong again!
I give-up...
While I personally and professionally (I am a RN) KNOW there are others in my position, I likely won't find them here, since they are too busy working (like I usually am) to try as hard as I have (past 2 days) to get some free, useful medical advice (suggestions) on how to switch off Lantus.
When I'm in a better position, and not as easily offended or frustrated by remarks such as "find a NEW doctor", when I obviously don't even have the "basic human right" to have ANY doctor...I'll stop by again.
* Thanks to the few here that did post concrete information on switching. It was very helpful. Bye!
You are clearly a victim of a cruel society and an unfair world. None of the rest of us have ever had to make difficult choices in life, so I’m not sure we can help you.