Insurance stopped covering my Victoza :( and I switched to Trulcity and UGH!


#1

So dumb BCBS stopped covering my Victoza beginning of this year. I am so bummed… that was a miracle drug for me. I could even EAT - it was the only thing that got my blood sugar down in the morning to normal ranges and I didn’t have to starve myself. I was so happy with it - I am so mad at BCBS.

I had one of those card which I used before when my insurance covered it and I was only paying $25 for three pens. I was on a low dosage so pens lasted. But the card now doesn’t not work unless the insurance covers it because with BCBS coverage it was at $90.

Anyhow, my endo switched me to Trulicity which is covered and I tried for the first time tonight and it was a total failure. I can’t even begin to express how design flawed this big clunky pen is. You basically have NO control over the injection and it is ONE shot and if it doesn’t pierce your skin first time- the stuff goes all over the place and you just wasted a whole pen (which is supposed to be a once a week dosage). And yeah, that is what happened to me.

Ugh, just ugh. I am pretty disappointed. I didn’t want to switch to this. I love my Victoza!

Anyhow my rant done. The pharmacist said that in order to get the Victoza my doctor would have to call the insurance company first and “authorize it” (I think that is the phrasing she used).

Does that actually work? If the dr calls your insurance company when a drug is not covered (or in my case they stopped covering it), the insurance will cover it? It is really that simple.

I go see my endo on Tuesday thank god. I did send her a message and asked her about calling. If not, I want to discuss other options. I don’t like this Trulicity. I want control over the injection. What is the point if it is not going to even get in my skin. (the needle is BIG too - I looked up in there - I used to those nano needles).

Anyone else try this drug? Any other alternatives to Victoza?


#2

@KimKat

Following is the website and “Prior Authorization” (PA) form for Independence Blue Cross (IBX) which uses Future Scripts as its Pharmacy Benefits Manager (PBM). Perhaps your insurance has something very similar? In any event, I thought these links might give you a good overview of how the process works at one particular insurance company so you could perhaps apply similar information to your own situation.

https://www.ibx.com/providers/pharmacy_information/prior_authorization/index.html

https://www.futurescripts.com/FutureScripts/pdfs/for_health_care_professionals/prior_authorization/prior_auth_commercial/drugs/IncretinMimetics_FSP.pdf


#3

I also had to switch from Victoza to Trulicity and was initially hesitant because the Victoza was working. But once I got use to the bigger pen and to the more painful injection, I liked the Trulicity a lot better. The side effects were way less severe than they were with Victoza (I was having a lot of nausea). Now my insurance has me switched back to Victoza and I’m annoyed.

Anyways, I’d encourage you to not give up so easily on Trulicity. Watch a video or two about how to give the injection. I’m a little confused about how the needle didn’t pierce your skin and the medicine leaked everywhere. You just have to press it up against your abdomen with some pressure, then just hold down the button without flinching until it’s over. Takes about 2 seconds.

The fight with your insurance won’t be resolved quickly, so in the meantime why not try and see if Trulicity can work for you too?


#4

Thanks David!

I will admit that the whole experience confused me. I did read somewhere else that another user had the same problem (where solution leaked on their skin after the injection went “off”) I would like to give it another try (it is only $25 for 4 pens) but I don’t want to do another pen for the same week.

I did hold it against my abdomen (I normally inject my Victoza and Lantus in belly fat) and I did follow the instructions and read them several times. I waited for the second “click” and it was well over 10 seconds and I thought I did something wrong and then all of a sudden it was like the pen wanted to rocket off my skin and I will admit it took me by surprise and I gasped and the force of it (probably because I wasn’t expecting it to be like a “stabbing” and “quick” injection like that - also because it took longer then the instructions said. I want to liken it to the game “Perfection” - you know it is coming but who knows when and how fast and loud lol - you still jump and scream though) made the pen move off my skin - and I was holding it down firmly.

The needle did hit my skin because I have a small red mark and I did feel it but I honestly can’t tell it completely went in and injected any solution since the pen moved off my skin a bit when the injection “push” happened. Although I couldn’t always feel my needle injections with Lantus and Victoza - I have the Nano needles - other days, certain spots were just so sensitive I could even put the needle in (could be the individual needle too). But you do need to push the needle all the way into your skin before you inject - not just on the surface.

Looking in the barrel after the whole ordeal was over - the need doesn’t look very thin to me. The whole idea of being stabbed with it - it not a thing to look forward to. haha! I guess I startle easy and would rather have control over the injection myself so I could do it slower and make sure it went it. With this device the needle is covered and I can’t see that is went in. I am used to getting the needle in and pushing on the plunger. Is this supposed to be that quick?

With Victoza, I did have nausea when I start with it years ago and it wasn’t that bad, just worrying and distressing. I get nausea for other issues too so I am thinking I would adjust well to the Trulicity and my endo seems confident that it would do the same thing for me.

My concern is whether or not it actually went in (honestly I don’t think it did). Even though I felt it hit my skin - it didn’t seem like it stayed in long enough (or went in deep enough) to deliver anything. The automation of it doesn’t seem very reliable. I wish it came in a different format where I could control it and push it.

All of this said, I still woke up with a 95 and I haven’t had any Victoza since Wednesday night (and I only had enough for a half a dose that night). I did take two extra units of Lantus so I guess I will just keep monitoring and see.

What insurance do you have?


#5

Thanks Tim!

Yes I believe my BCBS does have this Future Scripts thing…or something similarly named. I have the BCBS through my employer (PPO).

I noticed that it is very difficult to find out what meds are covered on BC’s website.
I had another insurance before (United Healthcare) where you could search for the meds name or their website and it would tell you whether it was coveredn under your plan and how much you might pay and compare prices to alternative meds. It was great.

Considering how long BCBS has been around, you would think they would be more automated technically but they are not. How inconvenient is it to call customer service and wait on the phone for eons for something so common and small question wise and honestly I feel like I get no where with the reps when you finally DO get them on the phone!


#6

I feel for you as I am having issues with getting Lantus on Medicare. They will need to fill out a form. Nancy


#7

I take Lantus too Nancy. I have a card where I pay $0!!!. The company who makes Lantus sent it to me in the mail. Not sure how it would work for you with Medicare though. I take very little of it though so I don’t go through it so fast.


#8

I am bummed as I woke up with a 153 like in my pre-Victoza days… I broke down crying. I had OK morning numbers until today - hardly ate anything last night. People are saying Trulicity is just like Victoza - sorry not believing in yet. That still doesn’t mean it is going to work on me.

I am so mad at BCBS. I talked to someone the other day who has BCBS in MInnesota and they are doing the opposite to her.
She is on Trulicity and wants to stay on it and they stopped covering it for her telling her she needed to try Victoza or Byetta first before they would cover it for it. Why? I really don’t get that it makes no sense - she was already taking it. Why do they do this? Why cover it in certain states and not others? It is like they flag us to see who has been continuously taking something (realize it must be working for us) and purposely stop covering it and tell us to try something else. I don’t get it.