Lantus prescriptions and insurance

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  • 2 Post By mbuster
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Lantus prescriptions and insurance


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Old 05-12-2014, 16:38   #1
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Angry Lantus prescriptions and insurance

I recently started Lantus using the Solostar pen. These pens come in a box of 5 pens with 300 units in each pen or 1,500 units in a box.

My starting dosage was 12 units per day with 2 units for the safety test. That makes 14 units per day.

With my insurance I can get a 90 day supply of a medicine for two copays instead of three. At 14 units a day I would use 1,260 in 90 days. However, my dosage is now at 18 units a day. At 20 units a day (18 + 2) I now need 1,800 in 90 days but my insurance will still only give me one box of five pens. That means I will only get a 75 days supply for my 90 day copay. Since I am sill not at target, I expect my dosage to go up more. If I reach a point where I am using 22 units per day I will only get 63 days supply for my 90 day copay.

I found some instructions on the BD website for writing Lantus prescriptions that contradict this pattern.

How many people are paying for a 90 day supply but getting far less that that?

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Old 05-12-2014, 22:07   #2
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Although I'm not answering your question, it is relative to costs associated with insulin purchases. In this quest of bringing newly added glucose into the bloodstream to equilibrium (so to speak) with countermeasures of insulin, reducing the glucose going in would reduce the required insulin to keep things in balance. Second, and often overlooked, benefit of this is that the chance of error also becomes less.

Welcome to the forum. I am sure someone will be along with a more direct answer, probably as I am typing.

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Old 05-13-2014, 00:20   #3
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I think mbuster has hit on a strong point of your problem, and one you should carefully consider going on into managing your diabetes with insulin.

You haven't told us anything about yourself - how long have you been diabetic or what other management techniques you've tried. But the important part of diabetes management is preventing rising blood sugar to begin with. That is done by limiting the amount of carbohydrate we consume, and then if necessary, using the meds in our arsenal to take care of the rest.

If you are still eating loads of bread, pasta, potatoes, rice & fruit, you are going to have a devil-of-a-time managing your insulin, and will obviously require more and more insulin. If you eliminate high carb foods to prevent higher and higher blood sugar levels, you won't have to increase your insulin usage and will be staying ahead of this less-for-more issue with the pharmacy.




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Old 05-13-2014, 08:41   #4
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A 90-day supply should be however much insulin you actually need and use during a 90-day period. It doesn't have anything to do with how the drug is packaged.

You need to make certain that your doctor writes your prescription to specify how many units you take per day. For instance, if you were taking 20 units per day the prescription should be written to say "take 20 units by subcutaneous injection at bedtime" and then to dispense 1800 units (90 * 20) with three refills.

The SoloStar pens come in the boxes of 5 pens, but they also come in boxes with just a single pen. I can't see any reason why your insurance company would dispense only one box when that's an insufficient amount to cover your prescribed need just because of how the drug is packaged. They should either give you one box of 5 pens plus one box with 1 pen to equal 1,800 units (or six boxes of single pen packages). The bottom line is, the method of packaging isn't what dictates how much insulin you get for a 90 day supply, the way your doctor writes the prescription is what ultimately determines that.

If your doctor has told you to increase the amount of Lantus you are using, which is typical when first starting it to figure out how much you need for basal dosing, but you don't have a new prescription to match the higher amount, this could be the issue at hand. The best answer is to contact your insurance company's prescription benefits administrator and ask them how your doctor should write the prescription so that you get the full amount of insulin you need for a 90-day period and pay the 90-day period copay amount. The devil is usually in the details when it comes to how insurance companies want things written.


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Old 05-16-2014, 10:17   #5
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Best to really start watching carbs first.

After that, I doubt its really a problem. A call to your doc if you're running low on insulin will have their office revise the 'script to reflect increased usage.

Should you end up insulin dependent, neither doc nor insurance are apt to refuse you.

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Old 06-01-2014, 22:42   #6
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This is kind of off-base, but you need to manage your diabetes better and then this will be something you won't need to worry about often.
Exercise more or lower your carb intake and you will start needing less Lantus as you progress. I stopped taking Lantus for 2 days straight just to see how it effects me and my BS average for the day was just 10-15mg/dL higher than normal. I do exercise routinely though and there is obviously other variables, but just an example.

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