My insurance company says NO to Tresiba!

Today I have another NP appointment to be switched to a different long-acting insulin because my insurance company has denied authorization for Tresiba twice. My pharmacist informed me that even with the savings card, my cost would be $500 out of pocket as the savings would amount to only $100. I meet with my NP today to be switched to a different medication. This really makes me feel down as the Tresiba was working well.

Have others members here had their insurance company deny Tresiba? What do you take for long-acting insulin? I was on Levemir prior to Tresiba.

I’m on pump, so it currently doesn’t apply to me, but I wonder - which insurance company was this?

My doctor had to write a letter of necessity for my insurance company to cover it, and I had been on Lantus and am allergic to Levemir. I am guessing it might have been difficult if I’d had tighter control already with Lantus and/or hadn’t yet tried Levemir.

If you sign up for the Tresiba discount card Tresiba® Savings Card | Tresiba® (insulin degludec) injection 100 Units/mL, 200 Units/mL
It cost $15 for the U100 box of pens regardless of what your insurance says. You can use the card for 24 refills. I use it for the U200 pens and it cost me $25 and my insurance wont approve the u200, only the u100.

My doctor did the same for me a couple months ago. He wanted me to switch from Lantus to Tresiba because Tresiba is less prone to producing lows. I can vouch for that. I think if there is a valid medical reason for the specific actions of Tresiba there really should be no reason to deny it.

Just an update to announce that I was finally able to get my Tresiba prescription filled last week using the savings card that came in the package. If anyone else has a problem using the savings card to get it at the $15.00 price, it might just be that your pharmacist doesn’t know how to enter the correct information or is entering it wrong. That was the case at the pharmacy I was using prior to switching last week. Also, the Tresiba rep in your area can also talk with the pharmacists and train them on how to enter the information.