So finally encountered the split boxes of pens myself. Not sure if this is a state by state thing or if everywhere is doing it now. This was the first time I’d picked up at a brick and mortar pharmacy recently and they handed me three pens in a sandwich baggy for a 30 day supply. No package insert, no detailed info like comes inside the box. Whole thing seems pretty lame to me.
My question is—- has anyone seen this happen through mail order also or is this strictly a retail pharmacy practice?
the solution is obvious enough… my daily dose is going to immediately become 50 units so that 30 days = one box… but still how silly
Yeah I just have to use mail order to get a 90 day supply. The bright side is my wife’s new rx coverage provides humalog, tresiba, levemir and Lantus With no copay… I’m willing to give humalog another try, worst case scenario I just have to order novolog through my plan and continue pay $75 copay for 90 day supply
I have gotten the pens in the ziplock bag too, but I got over it when I viewed it this way.
Suppose you have a prescription for a pill for something, like maybe a thyroid pill. You take one a day, so you get 30 pills per month.
The pharmaceutical company ships thousands of those pills to the local brick-and-mortar pharmacy. They might come in a giant case of 1,000 thyroid pills.
The pharmacist counts out 30 pills. They have those little counting trays. And he slides them from the counting tray into one of the little plastic child-proof pill bottles and gives you that little bottle with only 30 pills in it.
The ziplock bag is kind of the same thing. The ziplock bag is like the little pill bottle you get with your number of pills in it.
You would not expect to get the complete 1,000 pill shipment from the pharmaceutical company.
If you look at it that way, it becomes easier to accept.
In my mind, my prescription is not for the pen box. I am just interested in getting the insulin. So I don’t have a problem with them splitting it.
I wonder who gets the packaging and the package insert? @Sam said this was missing from his order. And, he got the majority of the box of pens in his baggie.
I know at our pharmacy they attach a detailed sheet about each rx with the order/cost sheet; I’m not sure if it is the same as the package insert or not. I doubt it as it does not have all of the detailed information the package insert has. (side bar: ever try to refold one of those! Argh!)
For an experienced person, these details might not be necessary, but for a newbie, these inserts could be most valuable - especially for someone without the internet or who isn’t internet savvy.
More packaging would only add to the cost of the medicine, which is something we’re trying our best to cut. Still, we each only need a certain amount of medicine and packaging five pens in one box seems like a lot for many people - perhaps packaging them two pens to a box, we’d have better odds at getting one box, with all the labeling and inserts and one odd pen in a baggie, without the labeling and inserts.
The last Tresiba prescription I got a three pen box. But it was marked that my next refill would be in 42 days. Previously I got a full box every month.
Can hardly wait to see what happens now that I live in the sticks.
I never got the thin tissue paper lengthy insert when my local pharmacy started doing the ziploc bag trick on me. And I get a box worth of pens and they were giving me five pens from different boxes with different expiration dates and no insert. And they were using their internal baggies that say “MIX” on them…so they’re clearly not meant for the public and could probably confuse a newbie. I was unimpressed.
Absolutely agree with this thinking, though here’s a situation I encountered recently…
I take a very low dose of basal. Last time I saw my doctor, it was 3u/day. She said, one pen would be enough for 90 days, right? I did the math and said yes, forgetting to factor in that I prime my needles every time I use them (so I’ve been living on faith the past 4 months ). In worrying about that afterwards, I completely missed something I just thought of last week - aren’t we technically supposed to toss these pens after 28 days? Why would a doctor prescribe you a single pen to last you 90 days? I was at my doctor’s office seeing the NP for a sinus infection this past week and brought it up, my main reason being I now take 4u/day, so one pen is no longer adequate. I mentioned the 28 day thing, and she said, “I’ll prescribe you two pens - that will be enough, right? If you’re tossing them about every 30 days?” I was sick, had two sick toddlers in tow, so I just said yes without pointing out the error in that math…
All that to say - if someone uses 450 units in 90 days (counting a primed unit each day), is it unreasonable to ask it be written for 3 pens, since that’s double what I actually need? I honestly would prefer the cushion of an extra pen in case something weird does happen and I need a new one right away.
Hell no it’s not unreasonable. I ask my doctor to prescribe me about 2x what I actually use just so that I have a cushion and I’m very upfront with them about that. They don’t care, they’re not the insulin police… they’re there to act in your best interest.
It’s weird, but these last two visits have made me feel like they kinda are becoming the insulin police. This doctor was very willing to over prescribe Novolog for me when I was first diagnosed - prescription for a box a month, and each box would last me 5-6 months (so I only had to refill 3x a year to have a nice cushion). Now this one pen/two pen nonsense (and I pick up a new script for Novolog tomorrow…can’t wait to see what they did there, especially since we haven’t talked about my current dosage in over a year).
Do you have the insert that says to discard after 28 days?
I am not sure if I have one, but I can look for one and send it to you if you need one.
At that point it is very simple, because they HAVE to follow that. They can’t tell you to use it for longer than 28 days, they would have to prescribe you one per month at the minimum.
Alternatively, you can just print this out. I don’t think they would argue with this. It’s from the FDA. Go to page 23, I think. Just bring it with you for your next appointment.
EDIT:
For the record, I don’t follow the 28 day rule myself. In fact, I don’t even follow a 5 year rule! But I sure as hell will use it for getting what I need if it is ever necessary.
EDIT 2:
By the way Em, it is great to see you back. Haven’t seen you here in a while. Don’t be a stranger!
Yeah I get the math and how pharmacies work. There’s just something psychologically different about something you are going to inject into your body than a pill you’re going to swallow… and the age old precedent that they didn’t start this crap until a year or so ago as far as I know…
Just seems dirty and lame…
Like getting omnipod or infusion sets in the mail that somebody had shoved into a ziplock bag instead of the sealed sterile container.
Would he a far better practice, imo to just adjust their refill date accordingly…
Yes, I can understand the idea of getting it in a ziplock bag seems somewhat “street-corner”.
But if you get just a small increase in your prescribed daily dosage, and you went to a 90 day prescription, your 3 pens each month would turn into 10 pens every 3 months. And then you would get 2 boxes of 5 (I think they all come in boxes of 5, but I’m not 100% sure).
All but stronger formulations come in boxes of five. I know tresiba u200 comes in boxes of three. Not sure about toujeo u300?
Does anyone know if they split open boxes with mail order? I wonder if there’s different regulations involved if you’re not actually face to face with a pharmacist… as I mentioned I’d been ordering mail order forever and if they were inclined and allowed to split boxes they could have… but never did
I hear ya about bumping the numbers and going to 90 day… the only way I can get 90 days is through mail order . Has anyone seen them split boxes with mail order?
Though at least with the pens, it’s still super clear what you’re getting, since the pen itself is labeled. With pills, it’s way more possible that they put the wrong thing in your bottle, if you don’t double check the code that’s printed on the tablet (and with generics, that can frequently change).
The only benefit to retail is that you can have your meds in hand within an hour or so vs within sometimes over a week after ordering… if you’re maintaining an adequate stockpile, which it’d be crazy not to if you have diabetes, there’s no good reason so go to retail unless it’s for a short term temporary condition that pops up, like you need antibiotics for an infection…
Also there’s frequently major financial incentives to mail order. Both my rx coverages actually require you to use mail order if you’ve filled the same med more than twice… although at least one of them offered a little flexibility when it came to insulin.
That’s not unusual because the pharmacy receives pens often times in master cartons. Have your doctor write the script for a 90 day supply. That way you’ll get all the paperwork that comes in the five pen per carton box. I use syringes and vials (10 ml each) and I get all that unnecessary paperwork that I try to recycle.
I don’t, but I will just show her something on my phone. The NP I saw was diabetic, too…I thought she’d understand.
Aw, thanks! I’ve been sick for months (chronic stuff with acute mixed in here and there), so I haven’t had the brainpower for anything. Hopefully my brain (and body) will return to normal soon.
I have CVS Caremark and pick up all of my 90 day supply prescriptions at the pharmacy. The only thing mailed is my Afrezza, which is a special deal…
I picked up my Novolog today (written for up to 20us/day - I average 10, so YES for being prescribed extra). The gal presented me with my options: $25 for a 30 day supply or (here she sounded bummed out) $75 for a 90 day supply. O_o Didn’t get what the big deal was, but I chose 90 day (of course). I received a big prescription bottle with 5 pen fill cartridges in it, not a box.
). In worrying about that afterwards, I completely missed something I just thought of last week - aren’t we technically supposed to toss these pens after 28 days? Why would a doctor prescribe you a single pen to last you 90 days? I was at my doctor’s office seeing the NP for a sinus infection this past week and brought it up, my main reason being I now take 4u/day, so one pen is no longer adequate. I mentioned the 28 day thing, and she said, “I’ll prescribe you two pens - that will be enough, right? If you’re tossing them about every 30 days?” I was sick, had two sick toddlers in tow, so I just said yes without pointing out the error in that math…
But I sure as hell will use it for getting what I need if it is ever necessary.
I’ve been sick for months (chronic stuff with acute mixed in here and there), so I haven’t had the brainpower for anything. Hopefully my brain (and body) will return to normal soon.