Glad to see you posting here again! (Even if it is for such an unfortunate reason.)
Can your doctor help you out at all? Either by writing a letter on your behalf or at the very least helping you figure out a dose and schedule if you DO have to go on regular and NPH?
Hi Jen, how are you? I wish my doctor could be of use. She is utterly clueless about diabetes. She refers out anyone who needs more than metformin. I'd be better off getting a seven-year-old type I to help me -- no joke.
I'll have to spend $50 per visit with a "specialist" (really just an internist who is also useless) and the "specialist" will try to put me back on a Neanderthal-era "sliding scale". Her eyes will glaze over if I say "correction factor" or "CGM" -- any innovation in diabetic care that has come up in the past twenty-odd years is foreign to these people.
Diabetic care at Group Health Coop is super scary. These are the folks who had never heard of delayed-onset post-exercise hypoglycemia. One of them actually suggested to me that I crashed from 136 down to 36 in twenty minutes (still fasting in the morning, just sitting at my home-office desk) because of a DIET soda I had consumed the night before.
I try not to rag on them -- but I've already been down this road with them once before. To have to go down it again, from scratch, with all-different insulins, and zero help...it's breaking my spirt. I'm like an old nag just lying down in her traces, refusing to go one more step.
Here there could be helpfull hints: Ask D’Mine: What to Do When You’ve Got No Insurance, No Money
One (remote) hope for the future is for generic humalog and lantus, their patents expire 2014-2015
link 1
link 2
If you could get a pump, even a used one, it would be better.
NPH is very old style, erratic action.
With a pump you would use regular and have a good basal rate, half work done.
Really can't you get any sort of pump, used or low cost (Dana Soil, Cozmo ....) ?
As for regular, it is way slower than novolog.
If you dilute it should get a little faster, in a pump would be more confortable.
I'm looking here fo example (link)
Or read here link
Hi Jean -
I'm so sorry that you have to go through this. Gary Scheiner has a practice that includes an online component. I don't know what the costs are but you might be able to get an effective consult for an affordable price which would make a transition simpler.
You might also try to get at least a couple of samples from your doctors. Humalog has a pen coupon offer that you can google. That would get you a little breathing room if your doc can write a scrip.
Good luck!!!
Maurie
http://www.patientassistance.com/
http://www.lantus.com/hcp/paying-lantus.aspx
http://www.rxassist.org/pap-info/company_detail.cfm?CmpId=33
these sites should be of assistance to you, i did a google search for insulin assistance programs an i am sure there are other ways to search to get other companies assistance or a reference to another program another company may have. the website patient assistance also give information on free clinics or co-pays for your state, i haven't used this but have referred people when i hear that either insurance is changing or someone has lost a job. i was doing some research for my daughter and stumbled on these sites and share them when i can.
i hope they help, god bless and good luck.
Katherine
Hi Laura S.
Thanks for the ideas. I did some research and apparently none of the Patient Assistance Programs will help as I have insurance coverage for medication. The fact that my copays are suddenly utterly unaffordable -- hundreds of dollars that I don't have -- doesn't matter. As I have my own private insurance -- which already costs me hundreds per month -- no dice on getting help from the manufacturer.
Well, that makes sense. Around here you cant get affordable low cost health insurance if you already have health insurance (even if you cant afford it any longer).
I wish you could find a good CDE office (you might look on their national web site). Sometimes they have a way to assist. And I would still hound the doctor for help. Sometimes we have to educate them. Last resort, R isnt the worst thing in the world. It can be used.
You may want to get to the appeals committee at the HMO.
My husband was on a very expensive drug, and went before the committee to get it paid for on a lower copay. They did it. He had to appear for lack of better word, at a hearing by phone. Stated his case, and won.
One thing I am surprised at....my HMO is forever hounding patients about meds etc. Are you having your feet/eyes/etc etc checked on schedule? They dont want to be paying for unhealthy diabetics.
A case manager nurse took up my cause, and though she drove me insane she did accomplish things for me.
I hope you wont give up.
Enlist everyone you can possibly think of to help you. And do price the insulin in single vial purchases with syringes, rather than pre-filled pens. What would that run you? Would it last a month?
Syringes can be reused a time or two.
It just horrifies me that I was balancing on this vile teeter-totter called "diabetes" -- balancing over the abyss -- balancing on a knife's edge -- thinking, "OK. OK. I think I've got this. OK. I can breathe. I'm doing it." Meanwhile, in a room somewhere out of view, a bean counter pressed his enter key. In August. Plink. I wouldn't know it until the following January, until today, but the whole time I thought I was getting my feet under me, that I was maybe going to be OK, finally OK, it was all a lie. He had already set into motion the policy change that was going to destroy me. He started a slow-motion hurricane headed in my direction. Plink. My entire diabetes regimen was about to be completely wiped out. He set into motion his banal and mundane plan to destroy me and then he put on his coat, turned out the lights and headed home for dinner. All these months went by... September... October... November... December... a bureaucrat's hurricane was headed my way and I didn't even know it.
I think that this whole episode is based on a socio-political mandate from the far right ( who have backers funded by Big Pharma in our Republican congresses, throughout the country and in Washington), Their intent, along with other draconian measures, is to slowly put the blame game on Type 2's, even those on insulin..Cut back support of all diabetic supplies for any type( I am experiencing that with the plan my State retirement board bought to cover us). Water down all changes in any health-care inititatives so that the masses will never have anything close to health casre for all in this most "enlightened" and relatively wealthy
country .So I do not think it was just ONE bean counter; not by a LONG shot... I have, unfortunately, heard stories similar to yours on the diabetic sites and in person from people who talk to me about their care.Has any one else observed such a trend?
Jean, I wish I could offer other suggestions to you that may lead to a resolutin of your problem, but I cannot. The other posters have done a formidable job in trying to assist you, just by posting and caring. We ALL care about you. I am praying for your peace,providence, and protection in this time.. I know that something will come to resolve this situation to your benefit. Keep praying and try not to lose faith.
God Bless,
Brunetta
Hi Jean,
When I first went on Humalog, my endocrinologist gave me four vials, along with the pen, to start with. Can you get some free insulin this way from your doctor? Just to tide you over until you get things straightened out with the insurance company?
Don't be afraid to take your problem to your congressional representative and to your local media, either. It's often surprising the difference politicians and the media can make.
If I'm looking at the right web site, it says you can ask for an exception to formulary. I saw where you can click through.
You need to find a supervisor there, or better still make your doctor find one and say you must have your rapid acting, current insulin.
If your BG records are pretty good, even more reason they should be letting you have waht you need and your doctor should be beind it.
I've been through these things before, and always managed to get authorized via my doctor. Last resort, appeals committee but before that make some calls or have your physicians office investigate for you.
I just found my eyes filling up with tears and I don't know what to say to you! Sometimes all I can do is pray, and I will!
I know that you feel totally undermined by these events, but it is important that you develop some strong self-determination in this matter. Your health is yours and you need to convince yourself that you won't let some petty bureaucrat take away your health. If all you can get right now is NPH and R, then take this on and show them. Figure out how to get NPH and R to work. We will certainly help.
Don't give up on the fight. Continue escalating with the insurance company. Complain to your state insurance commissioner. Enlist the help of other doctors and a local diabetes center. But don't let this undermine your determination to take good care of yourself.
No, that's not exactly how it works. A lot of it comes down to cost. All of this stuff costs A LOT. The companies who manufacture these things (insulin, pumps, test strips, etc) know that they can get away with charging a lot because people need these things to survive. In addition, they roll in costs associated with the lengthy FDA clearance process, which costs companies millions.
Take, for example, an insulin pump. I use the Revel and it retails for about $8,500. Now, I cannot imagine that it actually costs Medtronic $8,500 to manufacture a gadget that is WAY less complicated than my iPhone. Some of the costs take into account what they had to go through to get FDA approval (no small task anymore). Some of the cost is just a mark-up to profit off my condition and keep the shareholders happy.
Big Pharma LOVES type 2 diabetics. Keep in mind that one of the biggest things taking place in Big Pharma right now is finding drugs and devices for TYPE 2 diabetics, because they represent a MUCH larger portion of the "diabetic" market (we type 1s are the least of their concern, because we don't translate into dollars the way type 2s do). Big Pharma loves the fact that we have a type 2 "epidemic" in the U.S. My pump trainer, who also happens to be a T1, told me recently that Medtronic is really pushing to complete studies that show the pump also provides significant benefits for T2s, because that market is so much larger. Same goes with companies like Eli Lilly and Novo Nordisk - they are constantly looking at new products specifically aimed at T2D, because of the size of that market.
Insurance companies want to keep costs down because that's how they make a profit. If there's something they can get away with cutting or denying, they will. It has nothing to do with Big Pharma or congress. They are just looking for ways to make a larger profit or keep costs down.
OK, but let's agree that NPH is not lantus/levemir and regular is not humalog/novorapid.
Choose whichever costs less, but don't sell me an orange if I need an apple.
And please FDA and others, free insulin patents next year, so "Insurance companies can keep costs down" and people can be cured well.
I think this is an intriguing idea, as a "national" practice might have experience/ resources to feud with a bullying insurance company?
I had just looked you up to see if you were posting over the weekend and am glad that you returned for a visit. Perhaps it's time to visit the insurance company?
Jean, you may know this already, but I have found this info from the GHC website:http://www.ghc.org/pjarmacy/about-formulary/jhtml
Many of our Group Health, Options, and Alliant health plans cover certain prescription drugs, but we do not cover all medications in the formulary.
Coverage for certain medications is subject to an individual member's medical coverage agreement. >
So it may be to your advantage as another poster noted, to contact your HR department and see if any changes can be made to the plan. I do not know it you have pursued this avenue.
Hope you are staying strong and confident as possible. This will work out in your favor.
God bless,
Brunetta
Lst night I looked at the formulary list, which you can see on the site, and Levemir and Lantus ARe listed.. I do not remember if Humalog is listed, but Novolog is.