Buying insulin without going through insurance

Sometime maybe two years ago the pharmacy/insurance company treatment of insulin prescriptions for pens changed. Now the doctor has to prescribe an amount in IU and the pharmacist has to calculate the amount per month in terms of number of pens; “1 box per month” is no longer accepted. The pharmacist will split a box of pens as required to supply that number of pens. Prior to the change the pharmacist would not split a box, so had to round up to a whole box.

The new treatment exposes the inaccuracies of ignoring things like the air-shot and the variability and extras caused by snacking, anyway, your daughter probably wasn’t snacking much at 15 months.

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Wow. That’s interesting. Thanks for letting me know about the change with the pharmacy.

Very similar to us but we bumped it up. We have the script for 150 units per day for a 30 day supply. That is (150 * 30) 4500 units which gets rounded up by the pharmacist to 5000 units which is five vials.

I do not refill at 30 days so the script is not on auto fill. When I crack open the last vial is when I refill the script. The five vials last longer than 30 days so it is never a problem having it filled.

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I just (the last couple of days) went through the same amusing exercise in Kafkaesk bureaucracy. Kafka, of course, was an Austrian insurance adjuster, so he knew his stuff.

I was on 1 box of Humalog a month, I’m going to try using Fiasp because of insurance changes. After discussing this with my doctor we came up with a prescription for 20ml of Fiasp a month in vials; Omnipods take 2ml/pod and last 3 days, so a 30 day supply is 20ml. That part was easy. But I also need the Fiasp pens because sometimes I need to swap back to Lantus+fast-acting, and, anyway, they are a much better safety measure than vial+pod. So we came up with “5-10 units before meals, 5 pens per month” (there was some doctors office bad math there; I think I gave the number from this thread :frowning: ).

Anyway, proceed to Walmart, do not pass go, do not collect $100, vote as I tell you.

Now, some more bad math at Walmart, but I do get out my calculator, come up with 3 pens (10IU/meal, three meals a day) and realize that I forgot the air shot. Oops.

Two hours later, a telephone call from Melissa, who runs my doctor’s office, I remember the air-shot, we get to 40IU per day; four pens.

Today, I get to Walmart, two vials of Fiasp, three pens, in a zip-lock baggy of course (don’t all drugs come that way?) Fair enough, in the real world, not the world we live in at present, I need the pens for emergencies and vacations, where I don’t carry vials because 18 hours on an aeroplane followed by several hours in a taxi will probably kill these modern GE insulins. Three is actually what I wanted, the only reason I got it is because I am good at numbers and my wife is good at people.

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If all else fails, don’t let the nurse throw it away after 28 days. I understand the nurse may be unwilling to use it, but that doesn’t mean it can’t be sent home to you if you are comfortable using it. And although it would be an extra hassle, you could even change out the nurses pen every 14 days.

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Awesome suggestion. That is some out of the box thinking that would not have even occurred to me.

Nice !!!

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Thanks. I was feeling a little “dim” that I hadn’t thought of it days ago when I first replied.

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Thank you!! Very good advice and I did not think of that myself.

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