At the end of last year I found out my insurance company would no longer pay anything toward the brand of insulin I use. There would be no co-pay on Apidra. If I continued to use it, I would pay 100% of the cost. Later I received the same letter about my Bayer test strips. I spoke to my endo and he agreed we would appeal.
The test strip fight went well. My insurance company called me to verify what pump and what meter I use. I confirmed that I use the Medtronic 530G and the Bayer Contour Next Link. They talk to each other so my blood sugar number automatically transfers to my pump, reducing the risk of user error when dosing my insulin. (Meaning I wouldn’t accidentally manually type in the wrong blood sugar number.) My test strips were approved and my co-pay is the same as it was in 2015.
The insulin fight was another story. In the end, my endo wrote a new prescription for NovoLog and I said good-bye to my beloved Apidra. The insulin that has helped me keep my A1C at target levels for eight years. The insulin I had no interest in ever switching away from. The insulin I was sure was the best fit for my body.
Or maybe not. I filled that first reservoir with NovoLog and waited to watch my blood sugars turn to crap. But they didn’t. The NovoLog is working just fine. Sometimes I think it’s working better. I feel like my overnights are flatter. Last night I stayed between 116 and 82 for eight hours and woke up with a fasting blood sugar of 99. I can’t complain about that.
I also feel that I’m having a lot less low blood sugars than I had when using Apidra. And it isn’t coming at the cost of more highs either. I do need to admit that Pete and I are working on shedding our many extra pounds, so I’m eating better and moving more. And I know that is helping to smooth things out. But I also honestly feel the new insulin is working better for me. I have to admit I was wrong when I said Apidra was the best fit.
BUT!!!! And here is the important part . . . . I am still 100% opposed to insurance companies dictating what brand of medications and devices we are able to use. I believe that decision should rest wholly in the hand of patients and their medical teams. Which is why I thought long and hard about putting this post out there. In the end, I feel I was lucky. I’m lucky that my new insulin works great for me. I do believe trying new brands might not be a bad idea once and a while, because maybe something out there will work better. But overall, people with chronic illnesses need to use what ever keeps them the most healthy and fits the best in their lives. We should not be at the mercy of what our insurance companies dictate.
A lucky outcome of a crud policy! I am happy for you.
ReplyDeleteI have never used Apidra but I might give it a try since I know it worked for you. Of course I would complain if I had to switch off of humalog, but someday I am certain I will have to do it. I hope I have the same good results.
ReplyDeleteI referred your blog to the TUDiabetes blog page for the week of May 30, 2016.
I felt the same way when my insurance company told me I had to switch from Humalog to Novalog. Unfortunately for me I did not feel better taking the Novalog and had to wait 5 years before my insurance company allowed me to switch back to Humalog. Insurance companies should not be allowed to dictate which medicines we take. It should be up to the patient and doctor to make those decisions.
ReplyDeleteAgreed (and glad to hear it's working for you).
ReplyDeleteI totally agree that decisions about which meds you can take should NEVER be in the hands of disconnected (& usually not-medically-trained!) people!! Gah! I have been switched between Himalog & Novolog randomly like that & thankfully they are both very similar so I don't have problems. Glad it also worked out for you! Now if I could just get the stupid insurance company to cover a CGM, yknow, since I have severe hypo-unawareness, I would be thrilled. 🙄😠
ReplyDeleteLiving in the UK, we do not have to deal with health insurance companies as our diabetes drugs are funded by our National Health Service. However, cost still comes into it: someone has to decide how much the tax payer will spend. For this reason some people find their test strip supply limited, we have much lower take up of pumps and CGM are almost unheard of.
ReplyDeleteAs frustrating as this is, I still feel cost has to be considered. Drug companies, like most companies, exist to make money for their shareholders. Therefore, they will charge as much as they can get away with for insulin, etc. The choice our NHS and your insurance companies have is: spend their time (which equates to money) negotiating with the drug companies; or deciding to walk away, work with a drugs company who is more reasonable and force us to take a different type of insulin.
I'm not saying this is right. I am suggesting your frustration should be aimed at the manufacturer of Apidra instead (or as well as) your insurance company.
I agree! Not only that, the same with the diabetic test strips. My mother's insurance stopped paying for her testing strips! Sure thing, give a free monitor but charge an arm and a leg for testing strips. That's why I decided to start my page. I think a lot of individuals are struggling with the loss of benefits.
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