I literally got tears in my eyes at the pharmacy today

I’m just now working through something called “step therapy”, which is a kind way of saying that our insurance can force me to have my son switch from Apidra to Humalog-even though he has been on Apidra since diagnosis. I’m not finding anywhere to go with my story, and this just keeps getting more frustrating every day. It is so unethical for them to dictate the medication, not understanding his schedule makes Humalog a bad option for him. Has anyone else gone through this? Where have you turned for advocacy. Even the ADA won’t work with this issue-which seems ridiculous.

What do you mean that his schedule makes humalog a poor choice? It’s not like he is being forced onto Regular

What about a pump? Will insurance pay for an insulin pump? There are countless people on insulin pumps using humalog and they don’t have complaints about what you are alluding to

He is 19, and very averse to a pump. Because of the long tail on Humalog, it’s difficult to work with a college schedule and irregular eating times and amounts. I’m also Type I, and immediately switched off of Humalog as soon as Apidra became available. My issue is not to debate with anyone about the appropriate meds for my son, but rather where to turn for help and support. The fact that an insurance company can dictate to me what’s best for my son is unconscionable.

Unfortunately, insurance companies have what is called a formulary which says which drugs they will cover under their plan and how much (in dollars and cents) they will pay for it. I’m not sure if there are other options, but what I do, because my Novolog is not on my insurance companies formulary, is to pay for it, in full [edited to add: - until now.] I just learned about a savings card and the application process was very simple and worked very well, once I realized the particulars (the max they pay is $100 [edited to add: $100 per month]).:

This savings card is for Novlog, not Apdira, but Apdira may have a similar savings card you and your son can use? I hope they do. It’s frustrating when the medicine you want to use isn’t available to you at a discounted (insurance) rate.

I just did a quick google and found this:


The best of luck to you!

There is a term for this, it’s called non-medical switching. If you use this in Google, you can find more information about this and what some advocate organizations are doing to combat it. If find this practice reprehensible.

That’s very helpful and exactly what I’m looking for. I have now spent 14 days working on trying to get his Apidra approved, only to be denied each time. It’s just a frustrating to try to find some organization that is combating this practice. My other option is the Canadian pharmacies, which offer Apidra at less than the insurance price!

I appreciate the information very much.


I have found that the copay cards are only valid when used with insurance. If your drug is not covered by insurance, they won’t even take this card. I have card for Apidra, and if you read the fine print, they basically tell you that it can only be used in conjunction with your copay for insurance approved medications. Very deceptive advertising.

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You made me sorry I asked you a couple of questions. I won’t make that mistake again

This has been a very frustrating process for us over the last 2 weeks. I apologize if my tone came off as unkind. I certainly didn’t intend that.

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I’m sure it is! I’ve run into issues with medications either being too expensive or only certain ones are covered. I was trying to help earlier but you seemed almost as angry at me, as you are at the insurance co. We should all be on the same team here!