After having a long talk with my PCP about my ever increasing blood sugar levels, and the fact that the progression from Metformin/diet, Metformin/Januvia®/diet, Metformin/Januvia®/Lantus®/diet, and even Metformin/Januvia®/Lantus® 2X daily/diet over the years still delivering HbA1C levels in the 9-10 ranges, we needed to take a good hard look at making substantial changes in my diabetes therapy. Added to these poor results, my insurance company had decided to "push back" against escalating insulin costs by dropping coverage for the Lantus®. At first, it was only for the Solostar® pens, and it appears that in 2018, they won't even cover Lantus® in the vial any more. And to further complicate things, they were also dropping Januvia® from the 2018 Formulary
So the decision was made to go off the oral meds entirely, and go to an all insulin therapy approach. In my mind, this, in effect moves me into that "insulin dependent" Type 2 diabetic category.
So my PCP gave me some sample pens of Novolog® and Basaglar®, a dosing chart, and some new prescriptions, and it was decided that the best approach would be to just jump in headfirst, and paddle like mad. And so I did.
Right off the bat, there was a problem with the Kwikpen® script for the Novolog®. Apparently in conjunction with the push back on rising insulin costs, any sort of disposable insulin pen is only covered if you are a juvenile. This meant an immediate change in my prescription to Novolog® vials and insulin needle/syringes was required. So about a week into the change, when my sample Novolog® pen is all used up, it's time to do my fast acting insulin dosing the old fashioned way, with vial and needle.
Not nearly as convenient as it was to use one of the Lantus® Solostar® pens or the Novolog® Kwikpen®, and don't get me started on the debacle of trying to choose between 1ml, .5ml, or, .3ml syringes!
As luck would have it, I ran across a couple of articles about using refill cartridges and reusable insulin pens, which are a big deal in countries like Canada and all over Europe. And as it turns out, it does appear that the Novolog® refill cartridges are on the Formulary list on my insurance. It's not really clear if the pen itself is covered, so the the current plan is to send in a script for Novolog® refill cartridges and a reusable dispensing pen next month when it's time to refill my insulin prescription.
And it may be that the script may have to be changed to a different brand, Humalog® vs Novolog® as well. Both refills are listed on the Formulary, and the Humalog® Luxura HD® reusable pen can be purchased for less than $11 from www.canadadrugs.com. So even if the insurance company won't cover the cost of the dispensing pen, purchasing one or two at this price would definitely be an option. Not so much buying a Novopen® over the counter with no insurance here in the US, which can easily run over $100 or more. Adding in the cost of a pen to a backup pen, and that's some serious money around my household!
More on how it all works out next month when the new scripts go into the pharmacy!
And, in the meantime, I'm working up a new blog entry on how to refill your own insulin cartridges, and some disposable pens, thanks to the excellent DIY efforts from some awesome folks at FUDiabetes.
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