Nobody said it was. Blatantly lying about how many supplies you have on hand to get even more is fraud. That is what is being said
I personally don’t find a 6-12 month stockpile to be egregious. I really don’t find any stockpile to be a bad thing. I can tell you that Dexcom sure as heck isn’t going to complain about customers refilling their orders on time every time. Their business depends on it. Edgepark isn’t going to complain about it. They call me five million times a day as soon as I’m eligible to refill my prescriptions. Walgreens does the same thing. Every time my cell phone rings, my husband jokes that it is Walgreens. And about 50% of the time, he’s right.
If we can get more life out of sensors than what the FDA approved, what can the insurance company crow about? Can they really claim that diabetics should not be allowed as many prescription refills as mathematically adds up to what the product is approved for on its lifespan? (i.e. 10 days per sensor)
Now if people are lying in order to get one huge prescription fill so that they limit how many fills they need and therefore pay fewer prescription copays…maybe the insurance company could crow about that. If people are selling their extras? That seems bad. But being upset that people have varying definitions of a rainy day supply? I don’t know. That seems unhelpful. But maybe I am misunderstanding something. I do believe a bit more discretion on forming a stockpile would be advisable for optics, but I haven’t personally seen anything on FUD that gives me concern.
I have a friend who is a minister on the side since he does not have his own congregation yet. Sometimes I donate to him to help him fund his preaching/mission trips. It’s funny how careful he has to be to not share photos of some of the beautiful landscapes he sees on these trips with other people who donated to his trip…bc unfortunately, lots of people assume that if he sees a beautiful beach on a mission trip and if he actually had an afternoon to go swimming, then he must not have been working that hard at preaching and maybe they shouldn’t have donated to him. That’s so crazy that he has to worry about those optics, but he does! Same for us diabetics, IMO. I have a stockpile. I don’t advertise it, but I have it. And I have done nothing wrong in being mindful enough to create it. It doesn’t mean that I wasn’t due all of that supplies. I was. And I got it honestly.
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See my most recent post just above.
Still not fraud by definition. No hard feelings. It’s just not.
ETA:
I think someone did cite restarts as fraud…
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The insurance companies will have a completely different view
My personal experience says I’m at bigger risk of hassle from my insurance company if I don’t refill my prescriptions frequently enough bc then they ask if I really need so much per fill bc I didn’t fill enough times per year, etc. That’s what has motivated me to stay on top of my fills as much as anything. YDMV.
I haven’t had anybody show up to inventory my underwear drawer yet, though. Pretty sure I would have remembered that but I did have one saucy year in there where things blend together.
Are you just upset that people talk about it online? Or are you upset about tax dollars?
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I’ve been on Medicare for over 1 year and have not had the misfortune of having to buy Novolog insulin in all that time. Instead, I had the foresight to stockpile over a years worth of Novolog before I retired.
And I say misfortune because that insulin with Medicare would have cost me about $5000. Medicare ain’t exactly free.
I don’t consider this to be egregious. But I find it pretty egregious of the insurance companies and PBM’s charging as much as they do for insulin.
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Due to my high deductible insurance and the high cost of dexcom, I don’t use CGM. (of course, the costs I was quoted aren’t the “real” costs, but who knows what those are?) As someone mentioned before, the root of this is the 3rd party payment system… with all its layers of overhead and graft between doctor and patent.
On the topic of stockpiling, last week I took delivery of 10 vials of Humalog from my Canadian friends, without need for my benevolent overlords at United Healthcare/Medica. (I wonder if they think I’m not using insulin as a T1D?? I imagine they’ll call me to inquire, someday)…
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I started changing my lancet weekly when I switched to the Fastclix. I’m now using a setting of 1 on my finger poker. It kind of confuses me why people don’t do something so simple and cheap. But to each their own…
I’m not in the US, but I paid out of pocket for Dexcom for years. The only way I could afford it was by stretching sensors and getting financial assistance from my parents. I definitely had no stockpile to speak of, but I stretched sensors as long as they would go. Even now, I have insurance coverage for Libre sensors, which can only be stretched for 12 hours. But still, no stockpile to speak of. I’d like a few extra sensors so that I’d have replacements if sensors failed early. I just had two in a row fail at five days. I’m hoping Abbott will replace them, but if not (I’ve heard they will only replace the first few then consider them falling off early your problem), I either go a month without sensors or pay $200 to buy my own replacements. My insurance covers a maximum of 26 sensors per year, so I won’t be getting any extra sensors from them.
I do keep some extra insulin and test strips, though it wouldn’t meet your definition of a stockpile of six to nine months. Since I’ll die without these things, I like to keep some available. I also keep expired EpiPens in my earthquake kit and to bring when travelling for the same reason. Keeping expired EpiPens was actually recommended by health organizations and the government due to a series of extended North American shortages over the past couple years.
I can see how having a warehouse full of extra supplies to last years would be problematic if not paid for by the individual. I don’t think that describes the vast, vast majority of people who reuse supplies, though.
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What can we expect from G7?
Dexcom G7 takes all the good of G6 and takes it to another level. The whole system becomes disposable, the transmitter and sensor all become one piece. We’re shooting for an extended life within the batteries of the iCGM standards. Connected, easier insertion, you just go down the list — what do patients want? And that’s what we’ve tried to make.
It’s going to be a spectacular product offering. Before the G6, from 2006 to literally 2018, the physical thing you wore on your body never changed. G6 changed all that and we’ve just been through this very complicated changeover. The G7, we’re now going to take it on again. So we’re going to make sure we have this worked out before we go. We’ve learned with G6 that patients’ willingness to change is pretty big. We thought there’d be this gradual influx of change but no… People wanted to change very, very quickly. And G7 is going to create the exact same thing.
Dexcom CEO Kevin sayer interview. Dexcoms solution and goal is to become the libre
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Hum, like the lancets which you are supposed to replace after a single use. My reasons for restarting sensors and not even attempting to restart the transmitter are:
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Laziness; just like your lancets and just like I run my Omnipod to 80 hours. This is really not a good reason for any of the three. It’s just after 48 years having to shot up before every meal having to find a restroom PDQ because of high blood sugar, having to stop, sit down and beg for food because of low blood sugar, anything to do with diabetes that I can put off I do. A really bad reason.
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I get more working days by replacing the sensor at about 15 days, i.e. after one xDrip+ auto-restart at 9 days. I’ve explained this elsewhere but, in summary, my sensor is unstable for the first day and retains stability up to around 15 days. The initial instability is scary because I really can’t believe any of the readings in the first 24 hours whereas at the end of the period I get sensor failures which xDrip+ manages to sync out in about an hour; better than 24 hours of poor readings. Consequently I push the sensor even though it is reporting errors.
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I’m a Diabetic Squirrel. After 48 years of running at the limit on supplies I never pass up an opportunity to acquire a stock. With G6 sensors this interacts with (1); some of my sensors fail after under 10 days, this impacts the hoard. I could telephone Dexcom and ask for replacements but that fails reason (1); laziness. It also saves a lot of money for everyone if I don’t do that; given that I have a stock what is the point wasting everyone’s time and postage of rapid shipping if I don’t actually need the replacement?
- There’s also the accident issue. When I was young and not arrogant I used to go to the restroom to shoot up. This was using a syringe (disposable, reused until it wouldn’t go in) and a vial of pig insulin. I was always terrified that I would drop the vial down the bog and then have to retrieve it [Trainspotting] Having a hoard would have helped with this, somewhat, but I admit arrogance turns out to work better; I don’t shoot up in restrooms.
- Transmitters fail (1) and (2); if I’m replacing a sensor it is but a moment to replace the transmitter too, in fact it is easier because I don’t have to carefully clean the new one, so laziness gets a replaced transmitter. (2) because I start getting increased bluetooth dropouts at about 60 days with the 81x transmitters; by that time the battery voltage low has dropped to around 2.8V or 2.9V and I suspect that means that the bluetooth energy is failing. This is the biggest problem I have with the G6, so I want to replace the transmitter as soon as I can. This may change with the 8G and 8H.
Having a hoard raises a stock control problem. At some point with both insulin and sensors we hit the point where we’re always using stuff which is almost out of date and, then, we have to throw away the oldest stuff because it is out of date. This depends on the shelf life of the item vs the length of time it lasts in use:
Dexcom G6 transmitter (81x); lasts 90 days, shelf life 245 days
Dexcom G6 sensors; lasts 30 days, shelf life at least 322 days
Dexcom G6 transmitter (8Gx); lasts 90 days, shelf life 367 days
Dexcom G6 transmitter (8Hx); lasts 90 days, shelf life 367 days
Omnipod Dash (2 boxes); lasts 30 days, shelf life 550 days
Humalog Kwikpen; lasts 30 days, shelf life at least 820 days
So the squirrel limits on a safely usable hoard are:
81x transmitter: 3
G6 sensor: 11 boxes
8Gx, 8Hx transmitter: 4
Omnipod Dash: 38 boxes (5 pods/box)
Humalog Kwikpen (1 month supply): 28
Ok, so the solution is easy for us squirrels, right? We look at the nuts and if the pile is more than we can eat before they go off we stop squirreling and start eating (hum, probably not a good analogy for a bunch of diabetics).
Therein lies the problem, at least in the US; if I drop a repeat prescription on an item that requires pre-approval (Dexcom, Omnipod) then my insurance company, at least, assumes I’ve stopped using it and requires the dreaded re-authorization before I can get it again. I did this with the Omnipod - the hoard was maxing out so I dropped one, maybe two, 90-day refills. The result so scared my wife that I am no longer permitted to delay refills, indeed, she does it for me if I am tardy.
So what is the problem here, is it?
When, in fact, my pain in my very own posterior was actually caused by failing to place an order? Or is it simply that insurance companies are not very good at dealing with things that don’t fall into the “one pill three times a day for five days” category? I can’t find it in my heart to blame any insurance company either; they are doing a job that really isn’t necessary and are expected to make money out of it. However I do think that every insurance company in the US would take exception to this apparently supportive statement:
The implication is that insurance companies are deliberately trying to force patients to use items beyond their FDA approved limit; G6 sensors used more than 10 days, Omnipods used more than 3 days, G6 transmitters used more than 99 days (90 day expiry plus 10 day sensor), lancets used more than once.
I don’t believe they are, I can’t prove that, I just don’t believe it. I do believe they were right to ask pharmacies to split boxes of insulin pens, but I don’t believe they (the insurance companies) should exist either. For things like insulin and G6 sensors, neither of which have the attractions of codeine, there should be some flexibility to allow the patient to control the refills. That can only be achieved if insulin and G6 sensors have no resale value because they are freely available to those who need them; unlike codeine where want can supplant need.
Hey, anyone want to buy a used G6 sensor?
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Had to pick something to quote.
This was a really good post.
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I agree with you, I think you nailed it for me. I never implied keeping more insulin on hand than what you need is a bad thing. I in fact I encourage all insulin dependant people to do this. My only gripe from reading different forums and through Google searches is people having vast majorities of Dexcom supplies and still filling the maximum order each month. To your very thoughtful insight, these things have experiation dates. If one is sitting on a vast supply, they are not going to use the product before it expires. Whether or not they use said expired product can’t be verified. Most of us would would end up throwing them away. Here lies the problem I’ve been speaking of. I’m talking primarily about Medicare patients because this issue seems to be most relevant to them. Having Medicare pay for unused expired supplies that are going into the trash is a waste of money. I understand not everyone is doing this, but enough of them are to get me to perk up and say, hey something is wrong here. I’m not a government fanboy, but even the most anti government person would see that thousands of dollars going into the trash is not a good thing, especially for a program that is projected to be insolvent in 10 years.
With Dexcom supplies, there isn’t really a maximum order. There is only the set amount that “should” be used in 90 days.
If the standard order isn’t placed, then you run into the issues @jbowler so eloquently stated. I’d suspect- though I don’t really know- that this particular issue is an even bigger problem for patients on Medicare.
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I do think, from first hand knowledge, that you are way off base. Dexcom has to justify to CMS each recipient’s order. They do this with a form you fill out monthly in which they ask how many sensors you have left and how often you wear them. You sign under penalty of perjury.
In any event, they will make sure you will have five unused sensors when you place your order, enough to last a month. They track transmitters themselves and send you one a month before your current one expires.
There is no way to stockpile sensors, unless you’re willing to lie under penalty of perjury. Restarting a sensor has no bearing on how many unused ones you have left.
Apology accepted.
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Why I’m am I reading that these individuals run each senor for three weeks and then tell Dexcom they have zero supplies? You are obviously not willing to listen to what you don’t want to hear.
Apology Accepted? I have nothing to apologise for
That’s awful, @docslotnick. Absolutely awful. Could they have a more degrading process? Maybe include a strip down where they check the number of puncture scabs against what’s left in your supply?
To hear all of this makes me cringe. If I were speaking in a hushed voice before, I’m done. And if I’m allowed to keep a few sensors aside for you which remain in my name, let me know. I’ll tell my insurance company I got confused and ate them.
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@Nickyghaleb Thank you Nicky, but I am not in the least bit offended in the process. I just tell them the truth and they gladly fill my order. I have no cause to worry.
I guess @Jason99 just hangs around dishonest seniors.
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I guess it’s not that horrendous… just for a second there felt like it really is an enormous amount of accountability for something that can never cross into an area of misuse like so many prescription items can. My doctors, pharmacy, insurance company cannot give me enough Gabapentin. Nobody is asking me how many I take, if I’m taking them correctly, if I’m sharing with the neighbors, cat, or peddling them the corner, or if I’m using them as a spice. They don’t care. People sell their Gabapentin, people get hooked on Gabapentin, and people have serious long term side effects on Gabapentin… yet no comparable concern. So why the need to make me feel like a fiend when I need extra sensors? What could I possibly be doing with then other than watching my blood sugar? Set aside the small amount of people who really are engaging in true fraud, because of course there are those, what are most of us doing?
I once had an endo who gave out samples of insulin and MDI supplies as reward for patient compliance. My diabetes was very young, and, as I wasn’t doing much of my insulin or using many supplies, I wasn’t spending anything on them. I rolled my eyes at the whole handout system and swore I would never take part.
Now I’m hoping for these little gifts—be it an extra sensor, a transmitter they mailed by accident, a “sample” via of novolog at the doc’s office. I’m part of the machine, and it definitely feels a little demeaning to me at times. But I’m glad you don’t feel about your process the way I heard it. It can be upsetting to think of another diabetic struggling over the basics.
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Just be thankful most people are willing to believe seniors in Medicare are senile. Diminished capacities, like senility, are allowable defenses in federal court 
!
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