My Dr. was denied lantus Rx for me, so he said to ask my endocrinologist to try getting it. Will my endo be able to get it? Why was it denied, is there special reason for it to be unavailable to me? Could it be that I really don’t have a diagnosis of type 1 or 2 but I am definitely diabetic. I will meet with the Dr. in afew weeks and we will either get another plan in place and scrap the lantus altogether or he will send me to the endo. He thought it would be easy to get for me. I guess not
I am not really familiar with how things work in Canada. In the US, insurance companies have preferred drug list (they are called formularies). They might cover Levemir instead of Lantus. Some drugs they say you have to try certain other ones before you can get. I know you said you dropped it off at the pharmacy. I would call the pharmacy and ask what reason was given - if you know why, then you will know the workaround to be able to get it.
From the Canadian Diabetes Association’s website :
The formulary for BC( my province ) regarding Lantus states : Special Authority required unless prescribed by an Endocrinologist
http://www.diabetes.ca/documents/get-involved/MB11.pdf I could not locate same statement for you in Manitoba …your Endo , I am sure can assist .
I did read this ; it seems to relate to Levemir …NOTE: Physicians can request benefit coverage for “not listed” drugs by writing to the
Appeals Committee of the Manitoba Drug Standards and Therapeutics Committee. This
committee meets monthly
PS I use CDA’s website as my bible , so to speak …$ 10,00 yearly membership fee helps all PWD ; they also advocate with our Canadian Provincial /Federal Governments …and they realize lots more work to do .
Hey, When I first was put on insulin NPH my Endo said to me there are better insulins to use but I have to put you on this one.
When I said I have extended health plus I would pay what ever it cost to be on the good stuff. He informed me it didn’t work that way.
I’m in BC so I assume that many of the provincial health guidelines set out are similiar.
My endo informed me that although starting out on NPH I would be able to switch to Levemir or Lantus as soon as I had an over night low ! He pretty much told me that it would happen, then I was to call the office and just like that the switch to in my case Levemir.
Its just a matter of jumping through the hoops and the Endo knows the system, I guess the only other reason is financial if some one is unable to pay the cost because of low income status.
Hope this helps
This is what happened to me last year. I had to show that Levemir was not an acceptable alternative and then my insurance would cover the lantus.
This all helps! Thank you. I did see a article saying it was covered by the Manitoba pharmacare program in 2008.
September 12, 2008
EIGHT NEW DRUGS, 32 GENERICS NOW COVERED BY PHARMACARE
– – –
Cost Savings from Province’s New Generic Drug Policy, Drug Use Management Agreements Allow for Expanded Drug Coverage: Oswald
Forty drugs that provide treatment for patients living with serious medical conditions including HIV/AIDS, cancer, diabetes and asthma have been added to Manitoba’s Pharmacare Program, Health Minister Theresa Oswald announced today.
“Making these drugs available under pharmacare will make a meaningful difference in the lives of many Manitobans,” Oswald said. “We’ve recognized significant savings by developing drug use management agreements and implementing a new generic drug policy. These sound practices deliver better value to Manitoba taxpayers and allow the province to expand the drugs available under pharmacare.”
New drugs added to the Manitoba Pharmacare Program include:
· Rilutek, the only treatment option available in Canada for the management of amyotrophic lateral sclerosis (ALS);
· Lantus, a long-acting insulin, usually given once or twice a day to help control the blood sugar level of those with diabetes;
· Enbrel, used for the treatment of patients with moderate to severe plaque psoriasis;
· Seroquel XR, an antipsychotic medication for patients with schizophrenia;
· Prezista, used as part of a HIV treatment for adult patients who have demonstrated treatment failure with other drugs;
· Emend, used for the treatment of nausea and vomiting for patients receiving certain kinds of chemotherapy;
· Alvesco, a treatment for bronchial asthma; and
· Humira, used for the treatment of patients with moderate to severely active Crohn’s disease who are not responding well to other therapies.
In addition, 32 generic drugs will also be added to the list of drugs approved for coverage in Manitoba.
The minister noted that Manitoba is one of the first provinces to make Lantus eligible for coverage under a provincial drug program.
More than 2,000 drugs have been added to the drug list for pharmacare coverage since 1999. The Manitoba Pharmacare Program covers 100 per cent of drug costs once the income-based deductible is reached, regardless of age or medical condition.
My friend who was offered it by her Dr. said it would cost $280.00/pen without coverage or some form of help. That freaked me out, and this is what we came up with.
One of my other options was to bolus…not sure what type of drug is used for that, but it sounded kinda scary especially the way my DR. described it! He was blunt in the explanations of going to low what would happen if no one was around and no sugar ect…been low before but had help with it.
would it be worth it to get it?? Or should I just scrap the whole thing and go with bolus or NPH was 3rd option.