Re: Diabetes: a financial/insurance question abou... - Page 3

CatLoverDogsToo · ‎03-10-2010

I am confused. Toujeo and is the same as Lantus. Both made by Sanofi. Toujeo is essentially twice the number of units of insulin per dose as Lantus would be. (confusing, not sure how to word that.) Why they would be buying both makes no sense to me. Both are basal insulins.

Pens come 5 per box. No more, no less. So I am not sure what they are doing at the pharmacy. 19 pens would mean 5 boxes, giving her one extra pen. Still, I cannot make any sense of this.

Vials while cheaper at the outset, give only 1000 units per vial. A box of pens gives 1500 units of insulin. (Toujeo is sligthly different as it is more concentrated.)

The endo should write the prescription reflecting number of units of insulin used per day, then if he is really nice, add some to the number of units so she actually gets more than she needs. (That is what my doctor ended up doing, because as he has said: "You may need to increase a dose, and we never know when." The doctor's office should give her a separate instruction sheet telling her exactly how much insulin to inject.

I still cannot figure out why someone would be taking Toujeo and Lantus.

“The price of light is less than the cost of darkness.”
– Arthur C. Nielsen

Sammycat1 · ‎03-09-2010

Thank you for your continued responses. I don't know any more particulars than what I've given you. This woman is very ill with next to no pancreatic function left. Two major surgeries within the last 3 months plus a serious bout of pneumonia requiring prednisone and a second battle with a hospital-acquired Cdiff infection has pushed her metabolic system to the limits. One pen is for long-acting insulin; the other, a fast-acting one to be given with food in the short term given these recent downturns in her health. Her condition is tenuous and he must call her numbers to the physician every week.

She also has Afib, incontinence and shrinking eyeball. It's a handful of a situation. And I learned long ago after working at two major academic medical centers not to compare one person's complex clinical situation to another's and render judgment -- there are no valid person-to-person comparisons without the full details and clinical expertise to make such a call.

Also, if there's a clinical issue it's her husband's responsibility to address it with her practitioners. Whether I or anyone here agrees or understands the approach is immaterial to the request at hand.

I did not bother to list all the clinical details because, frankly, they are irrelevant to the question I originally asked. I only requested suggestions related to the financial end of this one part of her health care because he asked me.

151949 · ‎03-09-2010

So instead of refilling their Rx every 30 dasys they have to refill it every 19 days, and have to pay the copay 2x each month. That is unfortunate but perhaps the solution to their issue is to do research into various supplements and drug plans to see if they can get a lower copay.Or perhaps the doctor would consider trying the patient on some older drugs that are less expensive. The drugs she is taking are very new and expensive. There are older drugs that may be effective.

OR - maybe if the doctor wrote the Rx for 38 doses (2boxes) it would only be one copay.

CatLoverDogsToo · ‎03-10-2010

@Sammycat1 Now it makes more sense, she is on a fast acting mealtime insulin and a basal insulin. She obviously is medically a very complicated case.

In any case, in order to decrease the number or amount of copays, her husband needs to ask the endo to write the prescriptions based on total number of units injected per day, and to be nice, add some extra to that. I know the endos where I live will do that, so will internal medicine docs. If she has more insulin at home, that is a plus, if she needs it, great, if not, it can sit in the refrigerator until she does.

Toujeo (Solostar) 3 pens per box.

Apidra (Solostar) 5 pens per box.

Both of these have online coupons that can be used with copays as well.

I

“The price of light is less than the cost of darkness.”
– Arthur C. Nielsen