Prescription Assistance question

At the beginning of the year, I lost my insurance coverage (through the marketplace–I’m unemployed). I’m not in too dire straits, because I’ve gotten enough free samples to have about a six months supply of novolog and lantus, but I don’t like eating through it too quickly. Well, this week, I went in to get my prescriptions filled, and together they were over $500.

I went online to look up some prescription assistance services, but there’s so much information and I wanted to check if there was anything more reputable. Right now, I’m considering something called Simplefill (looks like it’s a paid service once they’ve determined eligibility) or going to Novolog and Lantus and signing up with their help services, but then I remembered that I could come here and ask people who might have a similar need. So, has anyone used Simplefill? Was it a good experience? Is there anything better that anyone can recommend? I live in the US.

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How much insulin do you use in a day?

I’m on 15 u Lantus/day (I take it in two doses) and 1:10 of Novolog, 1:60 correction–it ends up being between 18-24/day usually, unless I’m sick. Since I’m on MDI, that translates to 1 vial each/month.

I used to be on Sanofi’s patient assistance program before I switched to Tresiba and it is a very good program but you need a lot of help from your Dr. (paperwork) to get into the program initially and get your reorders.

Novolog is $47 per vial (plus shipping) from Mark’s in Canada. Pretty cheap.

Lantus is a bit more. $110 per vial, from the same place. But you are only using 1/2 a vial per month. (It will last for a long time, the “Use within x days of opening” type of warnings are ridiculous. I have used a singe vial of it for about 5 months with no problem.)

So depending on where you live, you can probably get a 2 month supply shipped to you for about $230 total (2 x novolog @ $47, plus 1 x lantus @ $110, plus $25 shipping).

You might be able to get it cheaper in the U.S. with discounts, but the prices from Canada are hard to beat.

I’ve used Mark’s. I highly recommend them. All you need is a prescription faxed to them and then you make one call to them to order it. If you order more vials it will save you some on shipping.

Here is the link to Mark’s in Canada.


Less preferable insulin can be purchased for $20/bottle at Walmart, over the counter (no prescription needed). This is my fallback solution when my pump fails because I often dont have a valid Rx for Lantus.

My HMO took Novolog off the preferred tier. I am severely allergic to Humalog. I went to the Novo Nordisk site and am using their RX card, which is getting me one vial a month for $25. I think two vials was about $97. I like getting two but I have a stash so I am going to be ok on one. Thanks to someone over on the pumpers list, I was able to go right for this card. I’m thankful for it, because my copay was going to be $300 a month!

Do you know what component in Humalog that you are allergic to?

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Basaglar is a biosimilar to Lantus and tends to be quite a bit cheaper. Might be worth trying out if you’re pinching pennies.

I have pretty good insurance so I’m not in this situation, but it’s painful to me to see that others are having to deal with this for life-maintaining medications.

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I don’t. I started pumping Humalog in October 2000, and it wasnt too long after that I started having terrible issues with giant red splotches. So we got into the trial Novolog program and then I ate a cookie and took a bolus so we could observe what happened next. lol…

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The grievance board sent a letter today defending their actions and stating they will not allow anything on the formulary except Humalog for us pumpers.

If you have an allergy, your doctor should be able to appeal on your behalf. What insurance company do you have? Also, do you have any non-formulary benefits?

It’s not acceptable for an insurance company to require you to use an insulin to which you’re allergic. When I say not acceptable, I don’t just mean unethical. I mean that if you appeal, you should be able to get an approval for use of another insulin. That might be Apridra or Novolog, but it should be an insulin to which you’re not allergic.


At 15u of Lantus a day, you may be running into the issue where a 1000-unit (10mL) vial is only fractionally used when its official 28 days is up. I push it out to 40-45 days all the time. But if you wanted to really economize and stay within the 28 day rule, going to the 3mL (300 unit) cartridges would make sense. You would go through a 3mL cartridge in 20 days which is just about right. Similar for Novolog. Most of the 3mL cartridges you can either use with the pen system or just use the cartridge with a syringe (not an expert on all the cartridges out there!)

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Good information here!

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The HMO pharmacy division, Optum RX states they sent a letter to all customers notifying them that Novolog was not going to be formulary anymore. Tresiba isn’t covered either. I didn’t get the letter and the HMO web site did not indicate this information until after the Health Exchange enrollment period was over. So at least for myself, I chose a plan that I did not realize had taken my insulin off. Apidra isn’t on there either. So if you are a pumper on our plan, you have to use Humalog. No other options except to pay high copay or go back to old fashioned insulin. You can bet I have plans to address this lovely grievance board in one more letter. I have this wonderful article saved up from Harvard medicine stating this is happening to so many people, and Optum RX s one of the companies listed. They are gaining financially for pushing only Humalog, The HMO which is a local co-op in my state, has a no tier lowering policy. Not even a prior auth will work. Pretty disgusting.

have your doctor provide a letter of medical exception necessity stating that the allergic reaction to humolog makes it an unacceptable insulin for your use. He could remind them that allergic reactions can become life-threatening, and requiring you to use a formulary to which you are allergic rather than a non-formulary to which you are not is medically irresponsible. He could also remind them that if you end up in hospital due to allergic reactions and complications it will end up costing them a lot more than it would to make a simple medical exception for a well documented circumstance. Have your doctor fight for you. I use non-formulary test strips because I am on am Animas Ping pump that is linked to a One Touch Ping glucometer. My doctor fought with my insurance company to get them covered and I got medical exemption. My co pays are the same as for the formulary. Don’t take no for an answer.


I definitely use a vial for more than 28 days. I’m not fond of pens–I don’t like the fact that they are so drippy-drippy so that I’m always thinking that I didn’t get enough especially since I use relatively small amounts of insulin–I think I might be more confident if it were 10 or more units at a time, but a 1 unit correction? I would be scared. I have used cartridges with syringes, but the pen cartridges tend to run higher than the vials (at least, that’s been my experience)

Well, I too prefer syringes over pens, and I would give the same dosing accuracy reasons you do. But maybe it’s just because I’m an old-timer who has been doing syringes for nearly 40 years now. (Well, at least it’s not those glass syringes they trained me on in the hospital! Trained but never used one in real life.)

My insurance company has dropped Lantus from its preferred formulary and now I have to switch to either Tresiba or Basaglar both of which seem to be available only in pens (3mL) and not in vials. So maybe I will actually learn how to use a pen!

Highly recommend Tresiba :slight_smile: