Recently I decided to change my pharmacy from Rite-Aid to mail order through Express Scripts.
My only reason for doing this was because it’s supposed to save me several hundred dollars a year on copay.
Unfortunately the experience has turned into a bit of a nightmare, the doctor, pharmacy and insurance company can’t seem to get their act together to authorize everything, even though the insulin I’m using will not change and the insurance company (Blue Cross Blue Shield) owns the pharmacy (Express Scripts).
Mean while I have 1/2 a vial of Humalog on hand and 5 full pens that have never been used. The pens are old but I’ve kept them refridgerated continuously and the seals have not been broken so I believe they’re good.
I have a pump so I want to transfer the insulin from one of the pens into the vial which will then be used to fill a reservoir.
I consider this a solution of last resort but if the yahoos at the doctor’s office, insurance company and pharmacy can’t get it figured out I’m not sure what choice I have.
I suppose I could walk into the doctor’s office, look someone in the eye and inform them of how screwed up the situation is and get a vial of Humalog, but I don’t want to do that. There’s a high likelihood I’d lose my temper and do something stupid.
So, the bottom line question, is it OK to transfer the insulin from a pen into the vial to facilitate filling a pump reservoir?
Doing that would increase the risk of denaturing it, which could cause it to lose potency. But otherwise I think it should be fine assuming you use it rather quickly
When I was switching from pens to pump I used up my remaining Novolog pens by injecting them directly into my pump reservoir. I would dial up the max dose, 60 units, put on a needle and inject it into the rubber fill port stopper on my pump reservoir. My pump at the time held three hundred units so I would do it 5 times to fill the reservoir.
I was using Humalog pens before I got my pump and just decided I would keep using the pens. So I use the syringe that comes with the pod to draw out the insulin and inject it into the pod. I’ve never had any issues because of it.
My pump is a Medtronic 670G so it’s a bit of a reverse process for me.
I replace a reservoir which is sort of like a syringe that has a plunger and a needle that’s used to pull the insulin from the vial, then the plunger and needle are removed from the reservoir and it’s inserted into the pump.
I’ll have to try injecting the insulin directly into the reservoir from the pen, if that works I’ll skip putting it in the vial first.
Hopefully this will become a completely academic question and the yahoos will get things straightened out in regards to my prescription.
I should’ve known better than to switch pharmacies, I made the same mistake years ago, I tried to switch to Walgreens, what a nightmare!!! Ended up canceling the whole thing after weeks of trying to get it all figured out. This may end up with the same result!!
Oh yes go to the doctors office and get that insulin. I have done this many times and I have a good 35 minute drive there. I will not use Express Scripts ever. Tried them once and they kept sending the scripts too soon and I had too much on hand. Good Luck with whatever you do.
I don’t want to blame Express Scripts alone for this mess, it’s the combination of all three entities that’s the root of the issue.
I think it mostly stems form the dr. sending the prescription in as Lispro instead of Humalog which has thrown everything for a loop. Even though those are 2 names for the exact same thing it triggered a requirement for an authorization from Blue Cross.
So, about 1 1/2 weeks ago I called Express Scripts to see why the script was held up, they said it was waiting on an authorization, so I called the dr, they said it had already been sent in, Ok I waited until this last monday, started the phone tag game again getting the same answers with a promise that a form would be sent to the dr who would fill it out and fax it back. Waited until today, started with Blue Cross this time, same answers, need the authorization from the dr, but this time the rep said they’d define this request as urgent which should prompt a phone call from the dr. But, the real kicker here that makes me mad is the staff at the clinic (my endo’s office) was too busy to speak to the insurance company rep so she left a message. So far Express Scripts and Blue Cross seem to be trying to help, it’s the stinking dr’s office that is dropping the ball.
Why don’t you just draw up the insulin directly from the pen? We use penfill cartridges to fill my son’t pump reservoirs all the time because a box of 5x3mL penfills costs the same as a single 10mL vial.
I’ve run into that same issue with auto refill through Medtronics.
I finally turned it off and now order far enough ahead so I’m not left hanging, at least that’s the goal.
I may have shot myself in the foot by waiting a bit too long to reorder glucose sensors but we’ll see.
I’m really beginning to learn you can’t use Just-In-Time scheduling with the medical world, nothing works as described.
At least I have a very large supply of reservoirs and MIO’s so I’m good on that front for now.
Thanks for listening to my rants and for the feedback, it’s nice to know I’m not completely alone in this!!
@Dylan_Sutton,
That’s what I intend to do now that I’ve got some feed back and have thought about it a little bit more. I was just thinking it might work better to put it in the vial first, but now that idea doesn’t seem as workable as going directly from a pen to a reservoir.
I called the dr office a few minutes ago and it sounds like I finally got ahold of someone who’ll get this straightened out. The office assistant I talked to said he’d call Express Scripts and/or Blue Cross to give them whatever info they need.
As another Express Script user, I have to agree with Gary…usually no problems with them.
It definitely sounds like it was your doctor’s office problem. If you’re getting coverage through BCBS, they prefer you use the generic (Humalog) instead of the brand name (Lispro). Your doc needs to send in a new prescription, and that should take care of the problem.
