I just received notification that as of January 1, my Aetna drug plan will no longer cover my Novolog insulin. They want me to use Fiasp. I am on Medicare, have a great supplementary policy, and use an OmniPod 5 pump and a G6 Dexcom CGM. In researching Fiasp, I only see say-nothing advertisements or comments here online that Fiasp stops working after 2 days or leaves the user sore or bruised. The latest news I can see is from 2022. My questions are these:
Does anyone use Fiasp in an OmniPod 5 pump? If so, can you use the Pods for three days without occlusions?
I know that Fiasp works more quickly than my current Novolog. What kind of problems does that cause, if any?
How did your switch from your previous insulin to Fiasp affect your A1C and control? Did you have to make a lot of adjustments?
What kind of reactions do you get at the Pod or infusion site?
Is it worth trying to get an exception from my doctor to stay on Novolog (which I have used FOREVER)?
Is the cost of Fiasp nearly the same as Novolog? I know that Medicare will cover it, but will they do that without a fuss?
What else am I missing as I prepare for this change?
Thanks for all of your help. I am trying not to freak out about this, and I know I will feel better once I get current information on Fiasp and how it is working – or not working – for people.
Hi Sherry Ann. I used Lyumjev in the Om5 for most of 2023 and then used Fiasp for the past 2 months. My Cigna Part D plan does not cover Novolog. Plus I have always liked the faster insulins. For me, Fiasp has not caused any occlusions vs Lyumjev which did have that problem occasionally, maybe every 2 weeks or so. One thing I do to help absorption with both Fiasp and Lyumjev is limit bolus to 5 units or so and (if needed) use extended bolus for the remainder.
I have now almost used up my stockpiled Fiasp and have been planning to dive into Glooko and post a comparison of Fiasp vs Lyumjev in Om5. Hopefully I will get this done and hopefully it will be helpful. In general, I think my avg BG is probably lower with Fiasp but not by much…and with more lows. Stay tuned.
I use lumjev. No matter what pump anyone uses, it makes sense to use the fastest acting insulin available. The pumps I have used (7 to date) are programable in 4 minute intervals. Getting the basal right is important and it will change with diet and aging. Up to the last 4 years I have always had a doubled basal from 4 am to 8 am. That’s 33 years. The last 4 year, I have only one basal rate in 24 hours. Your body will tell you when it has to change.
I rarely go over 5 units for a bolus at any time since I am very sensitive to insulin, so I do not see this as a problem. Thanks for your response regarding the occlusion question. I maybe will have the OmniPod occlude once every five years or so, so that is not something I want to start to deal with just because of the insulin I use.
I guess I mostly am irritated that once again, the INSURANCE company is disrupting my life and my diabetic control just because they, I am guessing, want to save a few dollars. How sad that our medical treatments now are dictated by a group of greedy individuals that have had absolutely no medical training. Sigh.
I have been diabetic for 57 years, so I know all about adjusting basal rates for lifestyle, diet, and age. I generally stay on the Auto mode with my OmniPod 5, so it adjusts to my changing blood sugars as the day goes on. With an insulin which reacts even more quickly than my Novolog, I wonder how that will change what the OmniPod gives me as my blood sugar changes after a meal. The OmniPod 5 is set up to look an hour ahead at what might be coming, so I wonder if it will adjust to the speed of the insulin. Hm-m-m. Something to consider…
Thanks for your response. I may be better off just changing my drug plan so I can stay with the Novolog, which has served me well for many years.
UPDATE: I have decided that I will not allow an insurance company to dictate to me what insulin to take when my highly-trained endocrinologist and I have decided that Novolog works very well for me.
I looked into just paying for Novolog on my current drug plan and learned that if the insulin is NOT covered under the plan’s formulary, then they do not have to abide by Medicare’s $35/vial/month mandate. My drug plan calculated that if I wanted to stay with Novolog next year and pay for it out-of-pocket, they would charge me over $41,000! Yup, you read that correctly… over $41 thousand dollars! Nope. That’s not going to happen.
So… I dropped that plan as of December 31. My husband did a search online, found a drug plan that will cover both Novolog AND my OmniPod 5 Pods for less than I am paying now, and will cover my other drugs. As of January 2024, I will get to stay on Novolog, still have my other drugs covered, and even though I will pay higher in a monthly premium, overall, I will save more money in the end with lower drug and Pod costs. No way will I let an insurance company tell me what I can or cannot inject into my body.
The drug plan that I chose (after reviewing about 5 different plans) is the AARP Medicare Rx Preferred from UHC (PDP). I went with this plan because 1) it covers Novolog at the $35/vial price, 2) it covers all of my other medications at reasonable prices, 3) it has NO deductible, and 4) it covers my OmniPod 5 pods at a substantial discount from my old plan. The premiums for this plan ($103/ month) are about double what I used to pay with my old plan , but I will SAVE that much in a year on just the purchase of my OmniPod 5 pods alone, so financially, this plan works out for me. It also is available in all 50 states and although Walgreens is its Preferred pharmacy, I can use the plan at any pharmacy. Since I already get my Dexcom supplies through a Community Walgreens, getting my insulin and pump supplies from Walgreens is just fine with me. This plan gets better ratings than my old plan does, so it will suit both my husband and me just fine.
The best thing to do is to run your full list of medications through each plan that interests you, and then choose the plan that offers you good service, convenience of pharmacy locations, and the best return for your money.
When I first started reading this thread, I was about to reply that you should simply switch to a Part D Rx plan that covers Novolog. It appears that is just what you did! Congrats on making a good choice.
There is sufficient competition out there to provide decent economic choices. You do, however, have to learn how to use the software tool on Medicare.gov.
The KEY to your quote above is “simply.” I will not say that maneuvering anything in the Medicare world is simple, but you are correct that if people go to Medicare.gov, they can follow the links to the drug plan (Part D) choices.
I talked to a diabetic educator at my endo’s office this morning, and I am SO glad that I switched plans because she informed me that Fiasp is approved for the OmniPod DASH system, but Fiasp has NOT been approved yet for the OmniPod 5 or any other pump that uses an algorithm for auto delivery of insulin. Interesting…
She, too, congratulated me on being proactive in my healthcare management to choose what is best for me. We all have to be our own healthcare advocates to make educated choices rather than just letting Big Pharma or anyone else tell us what we “must” do. Most of us on this Forum do just that.
Contact Insulet Corporation. They will help you find online their list of insurance companies that support OmniPod use, and they also can connect you with their Medicare team. They have been very helpful to me in the past.
As my husband and I were looking for Part D drug plans that covered Novolog, we also looked to see if the ones that we were interested in covered the OmniPod. That is how we found the plan that will work for us.
Just a minor side comment. I couldn’t understand why Medicare Part B wouldn’t cover your Novolog completely, as it does for me. Then I reread your post, and remembered that Medicare Part B doesn’t cover OmniPod pumps That’s unfair! I wonder if that will ever change. And is there a medically justifiable reason the O-Pod is not included in covered pumps and supplies? Just wondering.
I too use Aetna Medicare advantage, and somehow missed that bit about Novolog, even after looking through the formulary! Thank you!
As with so much in life, things change, bringing new aggravations. Just what diabetics need. Or as one of my favourite SNL characters would say, “Well, it just goes to show you, it’s always something - if it ain’t one thing, it’s another.” – Gilda Radner as SNL’s Roseanne Roseannadanna
Before the $35 plan was available via Medicare, i purchased NovoRapid from Canada (same as Novolog in US) at $35/vial. Over the last 53 years i’ve probably used all the insulins, even the over-the-counter version for pets from Walmart! (Too long a story, but it worked.) Fiasp (insulin aspart) is new-ish form of NovoLog with niacinamide (vitamin B3), which seems to be what gives it faster absorption, and L-Arginine to make it stable. I suppose i will be trying that soon enough. I just wish patients did not have to be guinea pigs for big Pharma or insurance companies, higher profits, regardless of a newer drug’s impact for some patients.
I don’t use the Omnipod, still on Medtronic, though that might change next month to T-Slim. I guess now i need to research what issues Fiasp could raise with any pump.
Sherry,
I had the opposite experience, fighting with Optum Rx to get Fiasp. Have use both in a pen and an Omnipod 5 without problems traceable to the fast action. I thought it performed better in the pen and am brand new to the pump. Blood glucose all over the place with the pump - not what I had hoped for, but again I doubt that it is due to the Fiasp.
I struggled to use both Fiasp and Lyumjev with my Omnipod. I had maybe one good day before the site became irritated, itchy and painful. Apparently this is a common side effect.
Now I live in New Zealand and the downside is that Omnipod is not available here, nor are the ultrarapids. Just Hujalog and Novolog. However the Tandem X2 and Medtronic pumps are both available, and if you’re eligible there is no out of pocket cost for anything (pump, supplies and meds) under the public healthcare. I still find this miraculous.
Without a prescription, insulin costs about $55 nzd/bottle which is about $33 USD. That’s the everyday price that anyone can get even without access to the public healthcare. So if you’re traveling in NZ and you lose your insulin, you don’t have to worry. An unsubsidized visit to the doctor costs about $100 nzd ($61 USD). I pay $60 nzd ($36 USD) to visit my GP (primary care doctor) and anything she refers me to is $0 out of pocket (labs, specialists, etc.). That means my diabetic eye exams, etc. are completely free.
You can go to the eye doctor privately and pay out of pocket. But if you have time to wait and jump through the hoops the pubic system requires, it’s no cost.
Or, you can buy private health insurance which will cover costs of medical visits without having to jump through the public system hoops. The only downside is cost, and they tend to exclude pre-existing conditions. (That’s what the public system is for). Some policies will cover pre-existing conditions after paying 3 years of premiums.
We’ve only been here just over a year and I’m still amazed by all of this.
You are correct that since the Pods for the OmniPod system, which are filled with insulin like a pump and deliver that insulin to me like a pump, are still disposable after three days, Medicare will not cover them under Part B. We have had OmniPod users who are lawyers take this issue to court … to no avail. So NO, I don’t expect that Medicare’s inaccurate rules concerning the OmniPod system will change any time soon. It IS unfair and it IS unreasonable, but that is what happens when someone makes rules regarding a medical device about which they know little to nothing. Sad, but true.
I don’t think that the OmniPod system has any problems with the fast action of the insulin; however, I know that I personally would because I digest food very slowly (due to another medical condition I have). Because of that, I would have to change my whole routine with insulin and eating, remembering to take insulin about an hour after I eat, and constantly watching my blood glucose between the time I eat and the time I would take the insulin. I also would risk severe lows if I took the insulin just before I ate since the carbs from the food would not be digested in time to hit my bloodstream along with the fast-acting insulin. My Endocrinologist and I agreed that Fiasp would not be the best choice for me.
I see that you use Optum Rx. I learned many years ago that mail-order drug services were a pain to deal with and the company I used could not be trusted not to leave the insulin unrefrigerated in a truck for hours before it was delivered. I could not risk that, so I stopped using mail-order services many, many years ago. I hope they have improved since that time, but I will stick with going directly to the pharmacy to pick up my drugs.
That’s unfair! I wonder if that will ever change. And is there a medically justifiable reason the O-Pod is not included in covered pumps and supplies? Just wondering.