I take 28 units of Lantus a day --- 2 units to prime the pump so to speak, so this is 30 units per day....30 units times 7 days would be 210 units a week. Right? Okay, now four weeks in a month (averaging) means 210 x 4 equals 840 units a month....times three month supply (averaging) means 2520 units for that time frame. This is the amount that is ordered (or should be ordered for me from the clinic)
There are 300 units in a pen, so I use a pen a week. There are five pens in a box which is 1500 units. So a box with my figuring above will last me 5 - 6 weeks. And that's it. So (sarcastically) do I skip every other day or hire a new patient advocate?
I'm so sick of trying to explain to this woman who is herself a diabetic (non insulin dependent) and has a husband who is non insulin dependent, that this is NOT enough (if my math is correct).
I would multiply the 210 units/week by 4.5 rather than 4 weeks to equal a month, so that would be 945/month x 3 months = 2835 total units for 3 months. If there are 5 pens in a box with 1500 units total, they should just send you two boxes. So yes, one box should in theory cover you for 50 days (1500 divided by 30), which as you say is about 7 weeks. I think your math is right on.
Using your current 30 unit a day times 3 months. 30units Times 30 days Times 3 months equals 2700 units. When you divide that by pen volume and pens per box is 1.8 box. Sad to say most prescription plans will not step up and will only drop down so even thou you really need two boxes will only cover one. What you need to do is get your script changed to a higher amount to allow for wastage and your need to be a bit more flexible with your dose, especially as it might change over time.
If you get it rewritten to read inject 40 units a day via pen, dispense 3 months supply then your pharmacy will do the math and you should get at least 2 full boxes if not more. The wording of the script is very important so you get enough to meet your daily needs. Most endo teams understand how to work/play the system so you are not screwed over by insurance, and can do what you need to do to stay healthy. Be very sure to specify how you need the script to read so your insurance will fill it in a way that meets your needs.
If your prescribed does not get this then time for a new one!
I had similar issues with my prescriptions. The pharmacy calculated down to the exact units as then prescribed, even for my fast acting. There was absolutely no accounting for extra boluses, air shots, etc., on the Apidra. With my basal, my dosage is low enough that they sent me three pens for three months. Although I usually average 7 units per day, my endo re-wrote my levemir prescription to say "up to 20 units per day" to make sure I had enough and could change dosages, accommodate pen problems, etc.
Looking at it this way: 30 units per day. 7x30=210 units per week. A pen lasts 28 days out the refrigerator. You should be able to go 10 days on a pen. i.e.: 300 units/30 units per day = 10 days. (Assuming one can get all 300 units out of the pen. Next, on average there are actually 4.33 weeks per month; however 30 days is used by pharmacies. So, you need 3 pens per 30 days. 9 pens per 90 days. They should send two, 5 pen boxes.
Or, 30 units per day x 90 days = 2700 units per 90 days. You get 1500 units per box of 5 pens. You need two boxes which is 3000 units. At minimum, if they insist that you cannot have more then the calculated 2700 units, the must send 9 pens (pulling one pen from one box.
In order to get what you need, calculate in reverse order.
How much insulin do you need, allowing for all contingencies and wastage, for 90 days? Then you take that large number of units of insulin and divide by 90 days. Have your doctor prescribe that number of units per day.
That will keep you healthy and unstressed due to supply concerns. It will also eliminate arguing with you about the quantity of insulin you need to stay alive.
Some people don't consider all the waste in insulin dosing. They haven't lived with it and have no imagination. They live in a world of cut and dried numbers. These kind of people need an exact number with no equivocation. So give them that exact number, even though you know it is not technically correct.
Insulin is our lifeline. Any threat to that supply is an existential threat. Give yourself a buffer so you have one less thing to worry about. It's nice to have a buffer of insulin in the fridge.
So you really need 2 boxes of 5 pens each. Each box contains 1500 units, so you need 3000 units for a 90-day supply.
3000/90 = 33.33 units per day Round up to 34 units per day and the bean counters will calculate 34 x 90 = 3060. They'll round down to 3000.
That will give you the two boxes you need. Don't be shy about asking for this. Most doctors fully understand and will cooperate with you. If they don't, then you need a more compassionate doctor.
I was taking 45 units a day of lantus, u get 300 units per pen so you should be going thru a pen every ten days I go thru a pen every 8 days the dr dropped me 10 units to 35units for my slow acting insulin. So you should be going thru a box roughly every 6 weeks but as I read what others wrote I see there numbers and they are right on target :)
