Hi all. I was diagnosed a few years ago with type 1 (I’m 36) and I’ve been on Medicaid due to a disability that prevented me from working. I’ll be coming off Medicaid in a few days, and I have several other health conditions that are very expensive to treat. I think I can manage to switch medications to get costs down for those, but I am absolutely terrified that I won’t be able to afford my insulin. I’ve looked into savings programs and I don’t qualify for any of them. Have any of you had luck on the cheaper versions that are available through Walmart? I know they have one version of insulin that is $26 per vial, but I don’t know much about it. I think it’s used as a short acting. Are there cheaper versions available for bolus insulins, too?
they have a short-acting and a long-acting
it’s not an ideal situation. I wish the best to you, I understand well having to make difficult compromises with medical decisions.
Walmart offers 2 insulins over the counter, without an RX @ $24.88 each per 10 ml vial. Larger sizes are also available at a slightly higher cost. They offer “Regular” - Novolin R, and “NPH” Novolin N, both made currently by Novo Nordisk. If you use these insulins, do your homework first. The regular takes much more time to “hit” than current short-acting insulins such as Novolog and Humalog. The NPH has a unique curve of it’s own and if you are not careful you will have stack issues, which can be very dangerous. I personally used both for many years due to insurance issues. It takes diligence and frequent testing (relion meter - 100 strips/$17.88) to stay safe.
Have you looked into any support organizations that might be able to help with cost? Also, my endo “helped” me with free (trial) insulin regularly for several years. Many of them keep a stock for this purpose.
Best of luck to you.
I used both mixed, two injections a day morning and before dinner. Takes some practice and strict mealtime planning but I did this for almost 25 years before going on pump. Was able to get low 7-7.4 A1C’s all those years, occasionally breaking into the 6’s. A small amount of R, mixed with roughly 2-3 times the amount of N, would form a mixed curve that would cover about 12 hours. Endo should still be up on how to use this stuff.
As others have suggested, R/NPH is a very different beast from basal-bolus MDI as most of us understand it. Instead of taking a flat-line basal and bolusing with fast-acting for every meal, neither of these is flat OR fast acting. When you take them you’re committing to eating when each effect curve peaks. The result is a much more regimented daily routine. That can be a pretty big mental adjustment. It certainly was for me when I finally got off the regimen after 20 years–like being let out of prison. But it IS doable. Similar to @JC14, I mostly ran low-to-mid 7 A1C’s on it. You’ll want to keep well stocked with glucose tabs and test strips.
I hope you will be able to access what you are currently using. But go to the library and get Bernsteins ‘diabetic solutions’ he covers NPH/R very well.
You may find NPH/R works better on a lower carb diet. (I probably need to say this twice)
google : bernstein nph
here he talks about R and protein
Everything mentioned by other users here is great advice.
I have been in similar shoes, and wanted to offer a piece of advice that SHOULD be common sense but wasn’t for me (which I learned the hard way): When you need help, ask for it. This “game” has really high stakes, and you’re not betting with fake money.
When I was struggling to pay for diabetes, I tried my best to figure out ways to use LESS insulin or how to cut corners on diabetes supplies. And I got really good at it (you will too). I did face a really difficult month where I knew I would not have enough money to refill a Lantus prescription, and I tried to navigate managing my diabetes on fast-acting insulin alone.
Long story short: I almost died. Ended up hospitalized. And the cost of that one hospital visit haunted me for years.
In retrospect, I know that there were people in my life that would have helped me. At the very least, I could have called my doctor’s office and begged for an insulin pen sample or something. But my pride got in the way…and almost killed me.
Your fear is totally understandable. The fact that you’re here and already seeking out ways to make this work and asking questions is great. This community was helpful for me when I was asking questions and trying to figure out what I needed to do while being under-insured…and I hope that it will be as helpful for you. 
Mike, that’s a powerful story. It seems to me that the most influential conversation we have is the one we have every day with ourselves. It sets up our judgments and decisions and opens us to real world consequences. I think stories like yours serves to warn others faced with similar circumstances.
IF you might take Tresiba, there is a coupon you can get from a doctor for only 15 dollars per month for your insulin. Believe it lasts 2 years.
I don’t know where you are posting from, or what you use, but while researching sources for help myself, I stumbled across this, if you are American.
https://www.lantus.com/sign-up/savings-registration
I called them, and confirmed it is a US only program, there is nothing available for Canadian customers.
It sounds like you have a lot of experience using the older styles of insulin. I’m new to diabetes (LADA), and have only had it for four years. I’m terrified to try the older versions because I’m a yoga teacher and I teach up to three classes on a daily basis–not gentle Yoga, but Vinyasa (Flow) yoga where you work up a sweat. I’ve got a pretty good system down with what I’m currently taking (Lantus and Novolog), and I’ve only had two lows during class times. I feel like I’ve gotten pretty lucky so far. I’d continue to stay on my current regimen, but I’ve developed another condition unrelated to my diabetes and the medication costs for that are also out of control. I guess my question is, is it possible to take the older versions of insulin and maintain a very active lifestyle without having lows on a daily basis? I’ve read some horror stories, and yours gave me hope because your A1Cs were in the normal range. Thanks for your help.
Katie
An A1c of 7 - 7.4 isn’t in “the normal range”.
Let’s put it this way: my daughter has refused to wear her Dexcom CGM for the past two months. At her endo appt. 4 months ago, her A1c was 6.0. On Monday, it was 7.0, the highest it’s ever been since her diagnosis. Saying that I am unhappy is a gross understatement.
Keeping my fingers crossed that you can find a way to afford your “modern” analog insulin!
You’re right, it is higher than I would like as well. I’m keeping my fingers crossed as well that I can afford the “modern” versions that I’m currently taking, but it’s not looking that way. The problem is that I’m a very active person, teaching three exercise classes per day, and I can’t afford to have lows while I’m teaching. I’ve heard mixed reviews about the older versions–some people saying that they developed more lows and others more highs. I wondering if anyone has had experience and success with using the Regular/NPH versions with a somewhat irregular schedule and lots of physical activity during the day. I know it peaks at different times than the current versions I’m taking. My endos haven’t been much help…
Make sure you always, always have glucose tabs/gels available when you’re teaching a class. As others have said, the struggle with NPH is that it essentially locks you into an eating schedule.
When reading that you are teaching 3 classes/day, I might even consider skipping NPH during the day and just dose with R every 4 hours.
Oh and make sure you always have glucose tabs/gels available (did I mention that?)!
The way I managed before I got my insulin pump (which has revolutionized my life!) was by eating a high protein, relatively high fat, super low carbohydrate diet so that Lantus maintained my blood sugar 24 hours a day (and I monitored frequently). I had the Lantus levels to where it covered my “basal” well. My A1C’s were in the low 6’s. In my case my aim was to take as little insulin as possible period since it is such a nasty hormone. I was lucky enough to be able to have access to Novolog Pens in case I needed to cover a meal with the wrong foods if that was what came my way in the course of my day (a meeting or conference where I didn’t have choices). Using regular insulin might be a little trickier, but I am sure it could be done, especially if any carbs were eaten with an amount of fat to slow down the absorption. The diet and insulin régime I followed was fully supported by my Doctor. I did this for over 14 years.
@Kbuzzic Where are you located in the USA? Do you see an endo or a family practice doctor for your diabetes related needs? This provider may be able to give you insulin samples which can last you a month or two to help stretch out costs. Also if you’re on Facebook find me: “Asha Brown” and I’l add you to some diabetic facebook groups where you may be able to find more local support. The DOC is amazing and we take care of our own. If we can find other people near you they may know of local resources, free clinics etc where you can get reduced priced supplies or financial assistance.
I think using an R / NPH regimen is workable, but with a longer lasting basal like Lantus or Tresiba, it becomes much easier.
If you don’t mind my asking, what is your total daily dose? It sounds like you are active, in which case it is possible you would not require a lot of Lantus. It sounds expensive when you look at a cost per vial, but cost per day actually seems much better.
I’d get it from a canadian phamracy. You’ll save some bucks. There are a lot of these, so this is just an example, not a recommendation on any particular web site. I’d reach out to Jen who is from Canada, she might know better.
I called this site. They sound legit. They DO sell to people in the US, you just need a dr’s script. It’s actually pretty easy. And relatively cheap!
https://www.canadianinsulin.com/buy_lantus_vials
https://www.canadianinsulin.com/humalog-insulin-lispro
Also, the expiration date? Trust me on this. Insulin will last way past that. Use every drop from your vials. Don’t toss it! Keep it refrigerated if you can.
If you still have a problem with the costs, let me know. I’ll pay you for some yoga advice.
Great ideas, Eric!
Katie, some thoughts:
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Basaglar is a brand new introduction on the US market, it’s more or less the same as Lantus, and it’s a lot cheaper (you may also be able to get it in Canada pharmacy).
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It’s much cheaper to get Lantus in vials than in pens. And you can refill your lantus pen cartridges with it if you want.
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Your endo should be able to get you samples, rougly one month supply at a time, at least for some time. You can also get free pens from them any time. Your GP might not though, the endo is the person to go to.
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As @jack16 mentioned, going on the Bernstein diet shrinks your bolus insulin needs like crazy. It’s not an easy diet to be on I think, if you like carbs, but considering the alternatives, it might not be a bad thing to do until you can get good insurance again. If you combine that with a cheap long acting insulin through a Canada pharm, you might be able to afford the minimal bolus needs?
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you say you already tried the discount programs. Did you try different manufacturers? You don’t have to be married to Lantus, for instance. You could check levemir or basaglar - or Tresiba - see above, great option if you can get it for $15/ month.
Please get a hold of @Asha1, she is the best. Check her post above.
Keeping my fingers crossed for you. I know you must be worried:( Hopefully, you are maxing out your supplies while you are still on Medicaid.
Trust me, in the days of R/NPH, no CGM those were not near a normal person’s BG but for the times was more than acceptable for type 1. Yes the modern stuff is way better but she may have no choice but to use the oldies. She is also going to have to work around the exercise she is doing which is another hard to control variable when using “the mix” as I used to call it.
I agree R/NPH is better than no insulin.