Need Help With U.S. Diabetes Supplies and Medications? UPDATED!

 

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This is a current list of currently available programs, co-pay cards, organizations and manufacturers that may help, and the requirements to participate in the programs.

Included in this update is a large expansion in the co-pay card program, which is helpful for individuals with insurance (but high co-pays!). You can now scroll quickly through this list, as medications are now bolded in RED.  It is also separated into insulin/injectable meds and oral meds to help make your medications easier to find. 

These links are up to date as of 23 August 2015. (If you have links or resources, please list them in the comment section and if they’re legitimate, I’ll add them.)

Why did I create this?

Every other “diabetes financial assistance/resource” page that I would visit would give you a link to supposed help – but you had to dig deep to find out if there were exclusions or restrictions. Some of the resource pages had links that no longer exist. Others had a single page that said: “We no longer offer a program.”

This page will give you the restrictions/exclusions I’ve found and the contact information and site to get yourself started if you qualify. (And in some cases, all of us will qualify!)

Hope this helps you.

Share this information – no one should be “sick” with diabetes from a lack of medication or supplies – let’s help each other by getting the word out. 


Got Twitter? Help spread the word easily by clicking here:

Tweet: Need help with U.S. #diabetes supplies and meds? Click here: http://ctt.ec/q2s85+ Includes co-pay help for insulin, oral meds.


 

Insulin, Injectable Diabetes Medication, & Needles

Astra-Zeneca Prescription Savings Program – NO insurance

If you take BYDUREON, BYETTA, or SYMLIN, you may be eligible for free medications mailed to your home or provider. Requirements include:

  • You must be resident of the US, or have a Work Visa or Green Card.
  • You aren’t currently receiving prescription drug coverage under a private insurance or government program, or receiving any other assistance to help pay for medicine.
  • Your annual income* should be at or below:
    • $35,000 for a single person
    • $48,000 for a family of two
    • $60,000 for a family of three
    • $70,000 for a family of four
    • $80,000 for a family of five
      • *Income limits may be higher in Alaska and Hawaii

If you are a Medicare Part D Beneficiary:

  • You aren’t eligible for or enrolled in Limited Income Subsidy (LIS) for Medicare Part D

If you have experienced a life changing event in the past year, and your financial documentation does not accurately reflect your current situation, we encourage you to apply for the AZ&Me Prescription Savings Program. You may still meet the criteria to enroll. Some examples of this type of event would be:

  • Loss of employment
  • Change in income
  • Loss of, or change in, prescription drug coverage
  • Marriage
  • Change in household number

For assistance and additional information, you can call  1-800-AZandMe (292-6363).

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

There is also a MySavingsRX Card for BYDUREON, BYETTA, or SYMLINThe cost would be reduced to $25 per month.

You may be eligible for the Savings Card if:

  • You are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions.
  • Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees.
  • You are enrolled in a state or federally funded prescription insurance program, you may not use this Savings Card even if you elect to be processed as an uninsured (cash-paying) patient.
  • You are 18 years of age or older.
  • This offer is not insurance and is restricted to residents of the United States and Puerto Rico.

Eli Lilly – Lilly Cares – NO insurance

Eli Lilly offers Glucagon, Trulicity, Humalog, Humalin, and Humalog Mix under the Lilly Cares program.

  • You must be a U.S. resident. (This program is not available in Puerto Rico or the US Virgin Islands.)
  • You must not have prescription coverage.
  • You must meet the household guidelines:

Household Income Guidelines:

  • The total number of people in the household includes yourself and each of your dependents.
  • Total yearly income includes incomes from all earners in your household before taxes and deductions.
  • To qualify, your total yearly income cannot exceed the values listed below.
Number of People in Your Home 1 2 3 4 5 6 7 8
Total Yearly Income
(48 Contiguous States and DC)
$35,310 $47,790 $60,270 $72,750 $85,230 $97,710 $110,190 $122,670
Alaska $44,160 $59,760 $75,360 $90,960 $106,560 $122,160 $137,760 $153,360
Hawaii $40,650 $54,990 $69,330 $83,670 $98,010 $112,350 $126,690 $141,030

For additional information about Lilly Cares, call at 1-800-545-6962.

*A 120-day supply of medicine will be shipped to your health care provider’s office. Prescription refills will be available during your 1-year enrollment period.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

There is a Prescription Copay Card for the Humalog U-200 Kwikpen, but you must ask your physician for it. You must have commercial insurance through your employer or independent insurance that is not a government-sponsored plan (for example, Medicaid or Medicare).  If eligible, you’ll pay as little as $25 for your prescription.

Trulicity has a savings card, giving you this medication for $25 per month for up to two years. You must meet the following criteria:

  • 18 or older and currently living in the United States or Puerto Rico.
  • Have commercial health insurance (insurance other than Medicare, Medicaid, etc)
  • Not have your prescription paid in part or full by any government funded program, including but not limited to, Medicare, Medicare Part D, Medicaid, Medigap, VA, CHAMPUS, DOD, TRICARE® or any State Patient or Pharmaceutical Assistance Program.
  • This offer is invalid for patients without commercial insurance coverage.

Eli Lilly Lilly MedicareAnswers

For those individuals on Medicare, you have an option!

Eli Lilly offers Glucagon, Trulicity,  Humalog, Humalin, and Humalog Mix under the Eli Lilly LillyMedicareAnswers program.

  • You must be enrolled in a Medicare Part D prescription plan.
  • You must be denied or ineligible for Low Income Subsidy.
  • You must be a United States resident.(This program includes Puerto Rico.)
  • You must meet the household guidelines:

Household Income Guidelines:

  • The total number of people in the household includes yourself and each of your dependents.
  • Total yearly income includes incomes from all earners in your household before taxes and deductions.
  • To qualify, your total yearly income cannot exceed the values listed below.
Number of People in Your Home 1 2 3 4 5 6 7 8
Total Yearly Income
(48 Contiguous States and DC)
$35,310 $47,790 $60,270 $72,750 $85,230 $97,710 $110,190 $122,670
Alaska $44,160 $59,760 $75,360 $90,960 $106,560 $122,160 $137,760 $153,360
Hawaii $40,650 $54,990 $69,330 $83,670 $98,010 $112,350 $126,690 $141,030

*A 90-day supply of medicine will be shipped to your home via mail order pharmacy. Prescription refills will be available during your 1-year enrollment period.

NovoNordisk – NO insurance

Novo Nordisk Patient Assistance Program (PAP) provides free medicine (to those who qualify), including: Levemir, Novolog, Novolog Mix 70/30, Novolin, GlucaGen Hypo Kit, Victoza, and disposable needles for FlexPens and Victoza. (Please be aware that all insulin is vial only; no FlexPens.)

The application for Novo Nordisk’s medication assistance program is downloadable here. 

  • There are several restrictions to the program. Please download the application and review.
  • You must be a U.S. citizen.
  • You must have a household income less than 200% of federal poverty level. 200% FPL* $47,700
  • You cannot have private prescription coverage,VA prescription benefits, any federal, state, or local program such as Medicare or Medicaid. Exceptions include patients who have entered the coverage gap (donut hole) in Medicare Part D and patients who have applied for and been denied Medicare Extra Help/Low Income Subsidy (LIS) and are Medicare eligible.

You can get more information by calling the Novo Nordisk Patient Assistance Program toll free at 866-310-7549.

If approved, a free 120-day supply of medicine will be sent to the prescribing health care providers’ office to be picked up at the patient’s convenience. Novo Nordisk will automatically contact the health care provider 90 days later to approve the medication reorder.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

There is an Instant Savings Card for Victoza, which brings the cost to $25 per monthly prescription for up to 2 years.

The Instant Savings Card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or government-funded benefit programs. This includes Medicare, Medicaid, Medigap, VA, DOD, and TRICARE, as well as any other state or federal employee benefit programs.

There is an Instant Savings Card for Levemir. If eligible, you will pay no more than $25 for your Levemir® prescription and each refill for up to 2 yearsa with a Novo Nordisk Instant Savings Card. The savings card can be used like a coupon when you pick up your Levemir® prescription from the pharmacy.

In addition, pay no more than $20 (maximum savings up to $100 per fill) for the next prescribed product and each refill for up to 2 years. Offer available for a 30-day supply of Victoza® (liraglutide [rDNA origin] injection), Levemir® (insulin detemir [rDNA origin] injection), NovoLog® (insulin aspart [rDNA origin] injection), and NovoLog® Mix 70/30 (70% insulin aspart protamine suspension and 30% insulin aspart, [rDNA origin] injection). Offer is valid for a maximum of $100 off your co-pay for each 30-day supply of Victoza®, Levemir®, NovoLog®, and NovoLog® Mix 70/30. Offer is valid for a maximum of 24 refills per product over 2 years. Novo Nordisk reserves the right to modify or cancel this program at any time.

There is also a  Novo Nordisk prescription savings card for other products: Offer available for a 30-day supply of Levemir® FlexPen, NovoLog® Mix 70/30 FlexPen, and NovoLog. Like the other prescription savings cards, it has restrictions, but these also give $25 per month prescription savings.

Sanofi Patient Connection Program– NO insurance

Provides Apidra, Lantus, and Toujeo at no cost to patients who meet program eligibility requirements.

Eligibility requirements include:

  • Patient must be a U.S. citizen or resident and be under the care of a licensed healthcare provider authorized to prescribe, dispense and administer medicine in the U.S.
  • Patient must have no insurance coverage or no access to the prescribed product or treatment via their insurance
  • Patient must not be eligible for Medicare or Medicaid
    • See program application for Medicare Part D eligibility criteria
  • Patient must meet the following financial criteria:
    • Annual household income of ≤250% of the current Federal Poverty Level for all non-Oncology/non-Hematology Products
Persons in family / household Poverty Guideline 2015* Maximum Annual Household Income (for uninsured or functionally uninsured patients)
250%
1 $11,770 $29,425
2 $15,930 $39,825
3 $20,090 $50,225
4 $24,250 $60,625
5 $28,410 $71,025
6 $32,570 $81,425
7 $36,730 $91,825
8 $40,890 $102,225
For families / households with more than 8 persons, add $4,160 for each individual person All products except Oncology / Hematology

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Apidra

Those who take Apidra can use the Apidra® No Co-Pay Savings Program with their Apidra® prescription payments. Activate your card by checking this box and you can get No Co-Pay* on Apidra®. If you’re registering someone under the age of 18, please call 855-242-6938.

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible, even those with insurance that places Apidra® on the 3rd tier.
  • Cash-paying patients are also eligible for a benefit of up to $100 off per prescription.

Lantus

Sanofi offers a discount card for those who use Lantus SoloStar – pay no more than $25 for up to 3 prescriptions. (Maximum $100 benefit off of each prescription, for up to $300 for three prescriptions.)

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible.

Toujeo

Pay no more than $15 for the 12 months after activating the savings program. (Maximum benefit is $400 off per prescription depending on your out of pocket costs.)

  • The card is not valid for prescriptions purchased under Medicaid, Medicare, or similar federal, state, or other government funded benefit programs.
  • Only patients who reside in the United States or Puerto Rico can participate in this program.
  • All commercially insured patients are eligible.

Afrezza

With the Afrezza Patient Savings Card, you pay $0 for your first prescription. After that you pay no more than $30 for each prescription refill, depending on your insurance coverage. With each prescription, you get 2 inhalers and a month’s supply of Afrezza® cartridges.

  • Offer is not valid for patients if their prescriptions are paid in part or in full by any state or federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA, DOD or TriCare.
  • Only patients who reside in the United States, Puerto Rico, Guam or the US Virgin Islands can participate in this program.
  • If you have any questions about this program, please call 866-991-2840.

Diabetes Oral Medications

Astra-Zeneca Prescription Savings Program– NO insurance

If you take FARXIGA, KOMBIGLYZE XR, ONGLYZA, or XIGDUO XR, you may be eligible for free medications mailed to your home or provider. Requirements include:

  • You must be resident of the US, or have a Work Visa or Green Card.
  • You aren’t currently receiving prescription drug coverage under a private insurance or government program, or receiving any other assistance to help pay for medicine.
  • Your annual income* should be at or below:
    • $35,000 for a single person
    • $48,000 for a family of two
    • $60,000 for a family of three
    • $70,000 for a family of four
    • $80,000 for a family of five
      • *Income limits may be higher in Alaska and Hawaii

If you are a Medicare Part D Beneficiary:

  • You aren’t eligible for or enrolled in Limited Income Subsidy (LIS) for Medicare Part D

If you have experienced a life changing event in the past year, and your financial documentation does not accurately reflect your current situation, we encourage you to apply for the AZ&Me Prescription Savings Program. You may still meet the criteria to enroll. Some examples of this type of event would be:

  • Loss of employment
  • Change in income
  • Loss of, or change in, prescription drug coverage
  • Marriage
  • Change in household number

For assistance and additional information, you can call  1-800-AZandMe (292-6363).

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Farxiga and Xigduo XR have a prescription Savings Card that can be $0 per month as long as your physician prescribes a dose of either medication.

You may be eligible for the Savings Card if:

  • You are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions.
  • Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees.
  • You are enrolled in a state or federally funded prescription insurance program, you may not use this Savings Card even if you elect to be processed as an uninsured (cash-paying) patient.
  • You are 18 years of age or older.
  • This offer is not insurance and is restricted to residents of the United States and Puerto Rico.

Onglyza and Kombiglyze XR has a prescription savings card as well that can be $0 per month.

You may be eligible for the Savings Card if:

  • You are insured by commercial insurance and your insurance does not cover the full cost of your prescription, or you are not insured and are responsible for the cost of your prescriptions.
  • Patients who are enrolled in a state or federally funded prescription insurance program are not eligible for this offer. This includes patients enrolled in Medicare Part D, Medicaid, Medigap, Veterans Affairs (VA), Department of Defense (DOD) programs or TriCare, and patients who are Medicare eligible and enrolled in an employer-sponsored group waiver health plan or government-subsidized prescription drug benefit program for retirees.
  • You are enrolled in a state or federally funded prescription insurance program, you may not use this Savings Card even if you elect to be processed as an uninsured (cash-paying) patient.
  • You are 18 years of age or older.
  • This offer is not insurance and is restricted to residents of the United States and Puerto Rico.

Eli Lilly – Lilly Cares – NO insurance

Eli Lilly offers Cymbalta under the Lilly Cares program.

  • You must be a U.S. resident. (This program is not available in Puerto Rico or the US Virgin Islands.)
  • You must not have prescription coverage.
  • You must meet the household guidelines:

Household Income Guidelines:

  • The total number of people in the household includes yourself and each of your dependents.
  • Total yearly income includes incomes from all earners in your household before taxes and deductions.
  • To qualify, your total yearly income cannot exceed the values listed below.

 

Number of People in Your Home 1 2 3 4 5 6 7 8
Total Yearly Income
(48 Contiguous States and DC)
$35,310 $47,790 $60,270 $72,750 $85,230 $97,710 $110,190 $122,670
Alaska $44,160 $59,760 $75,360 $90,960 $106,560 $122,160 $137,760 $153,360
Hawaii $40,650 $54,990 $69,330 $83,670 $98,010 $112,350 $126,690 $141,030

For additional information about Lilly Cares, call at 1-800-545-6962.

*A 120-day supply of medicine will be shipped to your health care provider’s office. Prescription refills will be available during your 1-year enrollment period.

Boehringer Ingelheim Cares Patient Assistance Program – NO insurance

Tradjenta, Jentadueto, Jardiance, and Glyxambi are available under the BI Cares Patient Assistance Program.

  • You must be a U.S. resident ineligible for private prescription, Medicaid, or Low Income Subsidy coverage.
  • You must meet the established financial criteria, which was not posted online.
  • You must be 18 years of age or older. Please note, while people of all ages are eligible for the program, applications can be sent only to people at least 18 years of age.

Medication is shipped directly to the patient’s home.

Applications are evaluated on a case by case basis. Current application form, valid prescription, and patient’s income documentation are required.To learn more about the Boehringer Ingelheim Patient Assistance Program, please call 1-800-556-8317 or apply online at www.bipatientassistance.com.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Trajenta has a prescription savings card, which can drop the price for your prescription to as little as $10 per month. Eligible patients 18 years or older may pay as little as $10/month with a maximum savings up to $150/monthly prescription.  Only valid for commercially insured patients in the 50 United States, DC, and Puerto Rico. Not eligible if prescriptions are paid for in part/full by state or federally funded program(s), like Medicare Part D, Medicaid, Vet. Aff., Dept. of Def., or TRICARE and where prohibited by law. Offer may change at any time, without notice.

Jentadueto also has a prescription savings card, which can drop the price for your prescription to as little as $10 per month. Eligible patients 18 years or older may pay as little as $10/month with a maximum savings up to $150/monthly prescription.  Only valid for commercially insured patients in the 50 United States, DC, and Puerto Rico. Not eligible if prescriptions are paid for in part/full by state or federally funded program(s), like Medicare Part D, Medicaid, Vet. Aff., Dept. of Def., or TRICARE and where prohibited by law. Offer may change at any time, without notice.

Jardiance also has a prescription savings card – eligible patients get their first year’s prescription FREE. Eligible patients 18 years or older may pay as little as $0/month with a maximum savings up to $384/monthly prescription. Only valid for commercially insured patients in the 50 United States, DC, and Puerto Rico. Not eligible if prescriptions are paid for in part/whole by state or federally funded program(s), like Medicare Part D, Medicaid, Vet. Aff., Dept. of Def., or TRICARE.

Glyxambi also has a prescription savings card and eligible patients get their first year’s prescription FREE. Eligible patients 18 years or older may pay as little as $0/month with a maximum savings up to $538/monthly prescription. Only valid for commercially insured patients in the 50 United States, DC, and Puerto Rico. Not eligible if prescriptions are paid for in part/whole by state or federally funded program(s), like Medicare Part D, Medicaid, Vet. Aff., Dept. of Def., or TRICARE. Offer may change at any time, without notice.

GlaxoSmithKline – NO insurance

Avandia is available under the Bridges to Access Program for individuals not on Medicare.

To qualify for Bridges To Access, patients must:

  • Live in one of the 50 states, District of Columbia or Puerto Rico.
  • Have no prescription drug benefits through any insurer/payer/program.
  • Not be eligible for Medicaid or Puerto Rico’s Government Health Plan Mi Salud. Puerto Rico applicants who are financially eligible for Puerto Rico’s Government Health Plan must have documentation of denial of coverage through Mi Salud before applying to a GSK Patient Assistance Program.
  • Have gross monthly household income at or below the following:
Maximum Monthly Gross Income
Household Size 
48 states and D.C.
Alaska
Hawaii
Puerto Rico
1
$2,452.08
$3,066.67
$2,822.92
$2,000.00
2
$3,318.75
$4,150.00
$3,818.75
$2,500.00
3
$4,185.42
$5,233.33
$4,814.58
$3,000.00
4
$5,052.09
$6,316.66
$5,810.41
$3,500.00
For each additional person, add
$866.67
$1,083.33
$995.83
$500.00

You can apply by mail or fax (proof of income must be provided), or call Bridges to Access at 1-866-PATIENT (1-866-728-4368) after downloading the application.

If you are on Medicare and have a Part D prescription plan, you may be able to receive Avandia through GSK Access.

To qualify for GSK Access and enroll, you must:

  • Be enrolled in a Medicare Part D Prescription Drug Plan.
  • Have spent at least $600 on prescription medicines through their Medicare Part D Prescription Drug Plan during this calendar year.
  • Live in one of the 50 states, District of Columbia or Puerto Rico. Puerto Rico applicants who are financially eligible for Puerto Rico’s Government Health Plan must have documentation of denial of coverage through Mi Salud before applying to a GSK Patient Assistance Program.
  • Have total monthly household income at or below the following:
Maximum Monthly Gross Income
Household Size 
48 states and D.C.
Alaska
Hawaii
Puerto Rico
1
$2,452.08
$3,066.67
$2,822.92
$2,000.00
2
$3,318.75
$4,150.00
$3,818.75
$2,500.00
3
$4,185.42
$5,233.33
$4,814.58
$3,000.00
4
$5,052.09
$6,316.66
$5,810.41
$3,500.00
For each additional person, add
$866.67
$1,083.33
$995.83
$500.00

Upon initial enrollment in GSK Access and with a valid prescription on file, the first 90-day supply of GlaxoSmithKline medicine(s) will be shipped to the address provided on the application. (Some medicines are only available at a retail pharmacy. Patients will be notified if their prescription is for one of these medicines.) Medicines received from this program do not count toward True Out-of-Pocket Spending Costs (TrOOP).

Fill out this application online, download and add documentation to send or fax. If you have questions about this program, call 1-866-518-HELP.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Tanzeum Coupons, up to 12 months free.

Tanzeum, a GSK product, has a “dollars off” coupon program. Coupon program eligibility is extended to patients with or without insurance coverage with a valid signed prescription.

  • You are NOT eligible to use this coupon if you are a government beneficiary. You are a government beneficiary if you are enrolled in any federal healthcare program, including Medicaid, Medicare (Part D or otherwise), or any similar federal or state programs, including any state pharmaceutical assistance program. Further, you CANNOT use this coupon if you are Medicare eligible.

Eligible patients without insurance can receive the dollars off amount specified on the coupon. Patients with insurance can receive up to the amount for which they are responsible for the prescription, less any amounts specified on the coupon.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Invokana or Invokamet CarePath Savings Program

This program offers 12 months of prescription co-pay relief (According to Invoking CarePath’s marketing material “12 months NO COST to you” for those who have been prescribed Invokana or Invokamet.) You must have commercial insurance.

After registering, you receive a savings card that you use at your retail pharmacy. It is subject to a $4,600 annual program benefit, 12 months after activation or 12 uses, whichever comes first. It is not valid for those enrolled in Medicare Part D or Medicaid, or those enrolled in a federal or state subsidized healthcare program that covers prescription drugs such as TRICARE. The offer is only valid for new enrollment until December 31, 2016.

Johnson & Johnson Patient Assistance Program– NO insurance

If you do not have prescription coverage, you may be eligible to receive Invokana or Invokamet through the Johnson & Johnson Patient Assistance Program.

Requirements are:

  • You do not have public or private prescription coverage.
  • You reside in the U.S. or a U.S. territory.
  • You are being treated as an outpatient by a U.S. healthcare provider.
  • You meet annual financial eligibility criteria:
    • Single person: $23,540 annual income or less
    • Two person family: $31,860 or less
    • Larger families: income levels are adjusted “accordingly”

You can begin the application process online by clicking here or by calling 1-800-652-6227.

Merck Helps – NO insurance

Merck Patient Assistance Program

Merck offers a prescription assistance program for Januvia, Janumet, and Janumet XR.

  • You do not have to be a US citizen. Legal residents of the United States, including US Territories, are also eligible.
  • Your prescription for a Merck medicine from a health care provider licensed in the United States.*
  • You do not have insurance or other coverage for your prescription medicine. Some examples of other insurance coverage include private insurance, HMOs, Medicaid, Medicare, state pharmacy assistance programs, veterans assistance, or any other social service agency support.
  • You may qualify for the program if you have a household income of $47,080 or less for individuals, $63,720 or less for couples, or $97,000 or less for a family of 4.

The application for this program must be downloaded, filled out, and brought to your medical provider. Click here for the Merck Helps application.  (It is also available in Spanish.)

Individuals who don’t meet the insurance criteria may still qualify for the Merck Patient Assistance Program if they attest that they have special circumstances of financial and medical hardship, and their income meets the program criteria. A single application may provide for up to 1 year of medicine free of charge to eligible individuals and an individual may reapply as many times as needed.

If you have any questions about the Merck Patient Assistance Program including the status of an application, please call 1-800-727-5400, 8 AM to 8 PM EST, Monday through Friday.

There is also the ACT Program. The ACT Program provides free reimbursement support services to help answer questions related to insurance coverage and reimbursement. If you do not meet the prescription drug coverage criteria, your income meets the program criteria, and there are special circumstances of financial and medical hardship that apply to your situation, you can request that an exception be made for you. If you have any questions, the ACT Program Specialists are available 8 AM to 8 PM EST, Monday through Friday at 1-866-363-6379.

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

If you don’t meet the criteria, you can also try and use the “Januvia copay assistance coupon”. 

Januvia’s coupon is for “as little as $5 per prescription” for up to 12 months. Here’s the information on the restrictions and what you’d need to do. 

CO-PAY Savings Card –  Private/Commercial Insurance Coverage Help

Pfizer

If you use Glucotrol, Glynase Prestab, Glyset, and Lyrica, Pfizer offers a discount card for individuals who have NO prescription coverage. You’ll need to call 866-706-2400 to apply. 

  • You must be prescribed a Pfizer medicine available at a savings.
  • Have no prescription coverage.
  • Live in the United States, Puerto Rico, or the U.S. Virgin Islands

They also offer free medication for uninsured individuals through some clinics and hospitals. You can see if there is one located near you by entering your zip code at this website

Lyrica Co-Pay Savings Card

Lyrica Co-pay of $25 per month up to 12 months. There are restrictions, but worth checking out and downloading. 

Other Savings Programs

Patient Access Network Foundation

The Patient Access Network (PAN) Foundation, an independent, national 501 (c)(3) organization dedicated to providing underinsured patients with co-payment assistance through more than 60 disease-specific programs that give them access to the treatments they need.

Diabetic Foot Ulcers

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must treat the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 400% of the Federal Poverty Level. (Here’s the handy chart showing you what that is based on how many people are in your household.)

Diabetic Macular Edema

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

Kidney Transplant Immunosuppressants 

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

Solid Organ Transplant Immunosuppressant Therapy

This will cover pancreas transplants and kidney-pancreas transplants.

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must treat the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 400% of the Federal Poverty Level. (Here’s the handy chart showing you what that is based on how many people are in your household.)

Retinal Vein Occlusion (RVO)

From the Patient Access Network Foundation website:

Central and branch retinal vein occulusions (RVO) happen when the vein at the back of the eye is blocked. This blockage causes pressure build and some of the small blood vessels in the eye may burst and cause fluid to leak into the retina. If untreated the vessels may be able to repair themselves and bypass the blockage but there may be permanent damage to the retina resulting in vision loss. 

Eligibility Criteria

  •  Patient should be insured and insurance must cover the medication for which patient seeks assistance.
  •  The medication must fight the disease directly.
  •  Patient must reside and receive treatment in the United States.
  •  Patient’s income must fall below 500% of the Federal Poverty Level. (You can use the chart and do the calculations for 500%. For instance, if you are a household of one, you qualify if you earn less than $48,350 gross income annually. For a household of three, you qualify if the household earns less than $98,950.)

 

Healthwell Foundation

For children under eighteen years of age

HealthWell Pediatric Assistance Fund® assists children 18 years old or younger living with a chronic or life-altering condition that their families are struggling to treat due to cost. They provide financial assistance to families so their children can start or continue critical medical treatments, including diabetes.

Families must meet HealthWell’s standard income and insurance eligibility criteria to qualify for a grant. Grants are awarded on a case by case basis. To apply for a grant, call 1-800-675-8416 anytime Monday through Friday, 9:00 a.m. to 5:00 p.m. (ET).

  • You must have some form of health insurance (major medical or prescription drug) that covers part of the cost of your medication.
  • Families with incomes up to 400 percent of the Federal Poverty Level may qualify. HealthWell also considers the cost of living in a particular city or state.
  • If you appear to be eligible for assistance through the Pediatric Assistance Fund, additional information and documentation is required for review and consideration prior to grant approval. Once all information has been received and reviewed by the committee, grant determinations will be made.
  • You will be asked to provide the Foundation with the patient’s diagnosis, which must be verified by a physician, nurse practitioner, or physician assistant’s signature. The patient must receive treatment in the United States.

Immunosuppressive Treatment for Solid Organ Transplant Recipients

HealthWell will pay for the following medications for immunosuppressive therapy:

Astagraf XL, Cellcept, Gengraf, Hecoria, Imuran, Myfortic, Neoral, Nulojix, Prograf, Rapamune, Sandimmune, and Zortress.

  • You must have some form of health insurance (major medical or prescription drug) that covers part of the cost of your medication.
  • Families with incomes up to 400 percent of the Federal Poverty Level may qualify. HealthWell also considers the cost of living in a particular city or state.

You can apply online for this medication grant here.  or call 800-675-8416. Agents are available Monday–Friday 9am–5pm EST.

Insulin Pumps

Please be aware that many insulin pump companies do not offer charitable or financial assistance to obtain insulin pumps or supplies. If you find yourself without the financial means to continue on insulin pump therapy, contact your medical team right away for alternatives.

Medtronic MiniMed

The Medtronic Financial Assistance Program offers help to those who:

  • Use an insulin pump and/or continuous glucose monitoring
  • Meet specific income guidelines
  • Have an insurance company that allows for additional assistance

It also provides temporary coverage for specific situations:

  • Unemployment within the last 12 months
  • Gap in insurance coverage because of a pre-existing condition
  • Multiple pumpers in one household
  • Permanent disability

You’ll need to call Medtronic 1-800-646-4633 and select option 4 to get specific information.

Other pump companies offer self-funding payment programs. You should call them individually to find out the particulars. (The plans may change based on what you are looking for…)

*** If you have information regarding insulin pump programs, please contact me via email at theperfectd [at] gmail.com – you’ll be helping us all out!***

Equipment

Charles Ray III Diabetes Association

The CR3 Diabetes Association, Inc. is a 501(c)3 non-profit organization. 

According to the website, the organization is currently accepting applications for insulin pumps, blood glucose meters, and blood glucose test strips. You must review the following criteria:

  • You are uninsured
  • You are under insured (which means that your yearly deductible is unattainable)
  • Household income is less than $60,000
  • Your physician has recommended insulin pump therapy for you

They will only accept online applications on their website. The link to the online application is here.

Supplies for CWD Foundation (For children aged 18 years and younger)

Supplies for CWD Foundation (SCWDF) is a branch of the Children with Diabetes Foundation, a non-profit 501(c)(3) organization, providing short-term (up to three months) diabetes supplies for children with type 1 diabetes who are in emergency situations. (An emergency situation may be defined as: loss of health insurance, loss of a parent’s job, or a local disaster, combined with the family having no other resources with which to purchase diabetes supplies.)

Diabetes supplies is defined as any of the following: blood glucose meter, blood glucose test strips, insulin, insulin pump supplies, blood or urine ketone strips, lancets, syringes, and glucose tablets.

Download and fill out this application after reviewing all the requirements on the website.

Blood Glucose Meters/Test Strips

Freestyle Promise Program – $15 copays and a free Abbott Freestyle meter.

  • Co-pay assistance is not valid for prescriptions reimbursed under Medicare, Medicaid, or similar federal or state programs or in Massachusetts.
  • Eligible patients are responsible for the first $15 of co-pay under their insurance coverage, and can receive up to a maximum of $50 in co-pay savings. Uninsured patients are also eligible for savings in most situations.

Contour Choice Program – For ContourNext test strips. Eligible patients pay the first $15 in co-pays each month. Insured patients can receive savings of up to $35 per month of co-pays using the Contour Choice Card.

Not valid for patients with prescription benefits covered by federal and/or state government programs (e.g. Medicare, Medicaid.)

Free Meter Offers

Accu-Chek Nano or Aviva

One Touch Verio or Verio IQ Meter

Low Cost Meter/Strips Offers

Abott Neo Coupon Offer – The Neo is a low-cost meter and strips option, often costing less than co-pay prescriptions.

Clinical Trials

Do not forget about participating in clinical trials, some of which provide monetary compensation in addition to supplies and medications at no cost. (Some also provide physician/medical visits!)

Please seriously consider participating in these trials – in some, you can get access to pumps or medications that would not be available to you due to cost – or FDA approval. And… you can help others (and yourself) through clinical trials.

Click here for a list of clinical trials for diabetes that are recruiting  (general, which include both Type 1, Type 2, LADA, MODY, and gestational).

Any other sites/supplies/organizations/medication programs that might be helpful to others? Help us!


Got Twitter? Help spread the word easily by clicking here:

Tweet: Need help with U.S. #diabetes supplies and meds? Click here: http://ctt.ec/q2s85+ Includes co-pay help for insulin, oral meds.


 

My Heart Is Snapped In Two

1414426_86457786There are worse things happening in the world. There are always worse things.

On Friday, as I was making dinner, a friend texted me:

“Did you hear the horrible news?”

My heart skipped a beat. The diabetes community is vast and wide and filled with people I love. Who was suffering? Or worse…who had died?

I didn’t respond by text. I rang her up and asked: “What happened?”

“Asante closed their doors today. They shut down.”

If you use an insulin pump, you’ll quickly understand how I felt. Your insulin pump is like a member of your family (it’s there at every meal, every occasion, and sometimes you fight with it…) and I have quickly grown to love my Asante Snap pump. I loved it so much that I became a consultant for them, writing about my experience with their pump and insulin pumping in general. It was no secret that I felt my control had improved that it was going to be the last insulin pump I used before the Bionic Pancreas became commercially available.

I am mourning the loss of an innovative company that attempted to give their customers what they wanted: choice. Some of the features the Asante Snap pump has is not available with any other pump on the market, and we’ll be hard pressed to find them integrated into any future insulin pumps (although they should – site change reminder? Missed bolus? Small things that made a difference in my time in range and overall control.).

Because I consulted with them, I also knew the employees that were just as passionate about the Asante Snap pump as I was. They were caught unaware, as all of the customers were. They found out Friday, right before the rumors started to fly and the public announcement was published on the website.

Customize-your-snap-insulin-pump-2Simply put, funding didn’t happen. The company attempted to go public, but pulled their IPO at the end of March when investors and the stock market didn’t bite. (Another pump company attempted an IPO at the same time, without success, and two other pump companies’ stocks were not doing well during the IPO offering.) From what I was told, the CEO was working with a company for a partnership and at the last minute, the deal fell apart.

 

I’ll choose another pump. (Both Animas and Insulet are offering Asante Snap users offers to switch.) The talented employees will find other jobs.

But my heart right now is snapped in two.

Goodbye, Snap.

Snap Decision

You grab a pack of gum at the checkout counter. It’s an impulse purchase and you don’t think about it. It’s a snap decision, made right then and there.

Choosing an insulin pump is anything but a snap decision. You research all of your options, talk with other people who wear pumps, weigh the pros and cons of each pump, and of course, find out if insurance will cover your pump and supplies.

In my case, my insulin pump choice was a snap decision. With a capital S.

unnamed-3The Asante Snap pump. 

After my warranty expired on my previous pump (Of course, it was pining for the fjords five weeks later.) and an opportunity to try the next generation of that company’s pump, I recognized that I needed to do further investigating. I’d only worn two brands of insulin pumps in the over 15 years of pumping. I am still happy with the choices I made back then, but back then, I didn’t have a lot of choices.

I cheer the fact that we have more choices now when it comes to insulin pumps and continuous glucose monitoring devices. Each pump and CGM has its strengths and weaknesses, which of course, means that some people will choose them based on their own needs, wants, and desires.

Here’s why I chose the Asante Snap Insulin Pump.

I Am Ricardo Montalbán

You can’t “test drive” a piece of gum. You buy it and if that new flavor isn’t what you wanted, you throw it away or foist it off onto someone else. It’s gum, right? Costs a buck? Pshh. Get outta here.

But it’s rare (or in some cases, impossible) to test out an insulin pump. This device is going to be a part of your life for a hopefully good, happy, healthy long time. And it’s not cheap. You choose a pump based on what you think it will do for you, go through the hoops (and oh, are there big, flaming hoops!) to get approval from everyone involved, only to find that… you hate it. I know some individuals who have returned their insulin pumps before the “trial” period is over, but it’s a big, ugly hassle and insulin pump companies don’t make it easy.

Asante gets that you should be able to take a pump for a test drive. Feel the rich Corinthian leather seats. Determine if what you want is what you actually get. They offer everyone who is interested in trying the Asante Snap pump a four-week free trial, including supplies, training, and support. I got to sit in the driver’s seat and go for a long drive. I wish all pump companies would do the same.

No More Rebel Yell Time In Range!

The four-week free trial is one thing. It’s another thing entirely when you discover that by not changing a single basal rate or bolus factor, that your time in range with your blood sugar skyrockets. (And when I say skyrockets, I mean supersonic space age shiny skyrockets.) Having the luxury of a Dexcom CGM allows me to see how my blood sugars play nicely (or not nicely) during the day. I was doing a lot of Billy Idol hair spikes. Without changing my eating habits or dosing timing, I saw spikes turn into smoother lines and when I downloaded my Dexcom (Finally able to do it on my Mac!), I was shocked. 80% time in range (for me, range is 70 – 180, but I’m already tightening the higher end).

Less lows. Less highs. All of a sudden, I wasn’t exhausted at the end of the day, chasing the blood sugar dragon. My head was clearer. I had energy. I thought it was a fluke, but after almost 8 weeks on this pump, I’ve come to realize it’s two things: the Asante Snap pump algorithm and the pre filled glass cartridges making this happen. I can’t take any credit for better blood glucose levels.

 Heart of Glass

The pre-filled glass cartridges not only help the insulin not degrade and lose potency as quickly as the plastic cartridges I once had to fill; it also cuts down on the time I used to fiddle around with pump  set-up. Doesn’t seem like a big deal, right? It’s a big deal. You get that I’m a two-minute sort of woman when it comes to diabetes.

Instead of the elaborate ritual of drawing up the insulin into a plastic cartridge, checking for bubbles, filling the tubing, checking for bubbles, priming the pump, checking for bubbles, I drop the cartridge into the pump body and it auto primes. In two minutes, I can complete an insulin pump set up, including a new insertion set. All that extra time I have now? I can rock out. 

(And I don’t have to hunt for a battery in the bottom of my purse. The battery for this pump is built into the pump body. You replace the pump body with the changing of the cartridge. Easy.)

I’m not the only one who thinks this is a good thing. I join Scott Johnson of Scott’s Diabetes, Melissa Lee of Sweetly Voiced and others who have switched from other pumps to Asante. Here’s what some people had to say about how easy it is…

The Little Things Add Up to Awesome

It’s the little things. A customizable color screen. A built in flashlight on the pump for those early morning BG checks. A missed bolus calculation if you stop your pump for a shower. (I never realized how much insulin I had missed even disconnecting for 20 minutes.) The ability to set alarms to NOT go off at 3am to wake you up to remind you to change your cartridge.

Some people prefer an integrated CGM and insulin pump. I tried it.  I’ve come to realize that I’m a Dexcom chick, tried and true. The other pump company with an integrated system has not yet updated its algorithm for increased accuracy. Plus… here’s the thing: The Dexcom G5 screen will be accessible to view on my iPhone I won’t even need to look at my pump to see my CGM graph.

When I was at AADE last summer and saw a glimpse of the future with Asante Snap (I sat next to Wil and we got to ooh and ahh at the demonstration, they announced not only would they be partnering with Dexcom for future upgrades, but they were the first company hooked up with Tidepool. (And you know how much I love them!). And then they blew everyone’s socks off my demonstrating bolusing the Asante Snap from an iPhone. I’ve never had a remote bolus device. I am totally ready for this. And when it does happen, it won’t cost me an arm and a leg (or a pancreas) to upgrade, because upgrades are $99. Straight. No chaser. 

I got to design my Snap. (Well, I got to have input. The Kid actually decided on the colors.)

No Pump is Perfect

No insulin pump is 100% perfect. (If it was, it would be called a pancreas and this blog wouldn’t exist.) I do miss the vibrating alarm option I had on my previous pump. I am a little jealous of other pumps that do have remote bolusing devices. I am a lot jealous of the current integrated pumps and CGM systems that work well. And I can’t upload my data at home; Asante currently uses the clinic version of Diasend.

I’ve talked with the management team at Asante. I’ve asked questions about their future models. They listen (and they even have a patient advisory board so they can get feedback). I see the Asante Snap becoming more perfect soon.

IMG_5863Time. In. Range.

Oh… that time in range. That blissful time in range that makes me feel more rested, less stressed, and looking forward to getting my A1C done. That makes it all worth while.

My new time in range makes my diabetes management easier and less about diabetes and more about me. 

Best Snap decision I’ve ever made.

I talked to Asante so much and gushed about how much this pump has improved my life that I’ve agreed to enter into a consulting agreement with Asante Solutions to write about my experiences pumping on their website. Please check the updated About page  for disclosures. Remember: My thoughts are my own. No one can make me write what I don’t feel or believe in on this blog. In fact, I get zero compensation for this – or any – blog posts on this blog. This is MY blog. MY words. MY thoughts. You get to read the uncensored version – always. 

How Much Do Diabetes Supplies/Medications Cost in The U.S.?

batch of dollarsWhile everyone’s diabetes treatment plan, medications, and technology may be different, there is one thing we can all agree on: diabetes is expensive. In two previous posts at The Perfect D, I gave some sense of what the bare minimum of care for a U.S. adult with Type 1 diabetes would be and also financial resources and programs to help with the financial burden of living with diabetes.

However, this post is about how much it could cost an adult with Type 1 diabetes if they used the technology and medications that are currently out on the market (and thought of as “the latest and greatest”) and paid out of pocket with no insurance. Research on this topic has shown me that: 1) prices can fluctuate wildly, so it pays to shop around and 2) there is a very big gap (financially, medically, and technologically) between the bare minimum and “surviving” and actually utilizing the tools and latest technology that is out there.

So, the hypothetical person for this exercise is a Type 1 adult in the United States who weighs 60kg, just like the other calculation post I did.

Ground Rules

  • These prices are accurate on the websites I have referenced for December 1, 2014. They may change, they may add shipping, they may not offer the services, technology, or drugs on their website after this is posted. These prices are not a guarantee. They are to be used as a reference.
  • The listing of prices/websites on this post does not mean that I endorse the company or product or service.
  • I have not listed all the products available on the market for people with Type 1 diabetes. I have listed major ones to give you an idea of major manufacturers’ costs for the products that are available for general public viewing.
  • I did not call any companies and ask for pricing. Why? Because I believe that we, the diabetes community, should be able to really know how much something costs without having to go through hoops and customer service/sales representatives. Device prices should be listed on a company’s website, knowing that insurance pricing will be different. (We should be able to know how much a drug would cost without insurance, too.)
  • Some of the items are only dispensed with a prescription.
  • Yes, I know that some people with Type 1 do not use an insulin pump. In fact, only 30% of Type 1s use a pump for insulin delivery. Some are happy and do well with MDIs/pen needles. The cost of pen needles are comparable to using a syringe, so you can refer to this post if you want to do your own calculations. As I say, my blog, my words…
  • I used averages. That means that some pump therapies may cost more or less than the average.

Insulin

mediumIf you take a total of 30 units per day (hey, adjust for more or less, this is a hypothetical Type 1 adult weighing 60kg), you will take about 900 units per month. You might be able to get by on one vial a month, but this doesn’t factor in correction boluses that might need to be raged to bring down a high blood sugar or a heavy carb meal. So…. two vials per month.  If you’re on a pump, it’s two vials of fast acting. (Don’t forget that you’ll need that back up prescription for long-acting insulin if your pump malfunctions…)

Fast-acting:

Apidra vial 10ml = $177.59

Humalog vial 10ml = $217.45

Novolog vial 10ml = $210.49

Average cost per month (insulin pump): $403.68

Average cost per year (insulin pump): $4,844.16

Average cost per month (MDI): $201.84

Average cost per year (MDI): $2,422.08

Basal/long-acting:

If you aren’t on an insulin pump, T1s must use a long-acting insulin in conjunction with their fast acting. This hypothetical (hopefully not hypoglycemic) T1 would use one vial of fast-acting and one vial of long-acting insulin per month.

Lantus vial 10ml = $284.39

Levemir vial 10ml = $216.69

Average cost per month (MDI): $250.54

Average cost per year (MDI): $3,006.48

(So, for those of you keeping a tally for comparison,  the total cost per year for insulin using a pump is $4,844.16 and for MDI, it’s $5,428.56.)

Insulin Pumps

800px-Early_insulin_pump
This is an early version of an insulin pump. You’d never get a button error with this. Dials!

You know that some of these prices may not be the price you actually pay if you have no insurance. You call the manufacturer and explain that you will be paying out of pocket and ask what the “cash pay price” would be and if they have a financing program. (Some companies offer this; others do not.) But these prices are what’s shown on websites where you can purchase them….so ta-da.)

Most pumps are under warranty for four years. Some have upgrade programs. Others have a “trade your old pump from another company and we’ll give you a discount…) Do your homework before committing to a pump. Please. Some will let you test drive. Others have a return in 30 days policy.

Minimed Paradigm Real-Time Revel 723 Pump = $5655.99

t:Slim Insulin Pump = $5720.00

Omnipod = $800 for the PDM, which is the brains of the pod. The pods are extra. ($337.00 per 10 pod box and 12 boxes needed annually) = $4844.00

Animas Ping = $4977.29

Accu-Chek Spirit Pump = $4,751.07

(I would have added the Asante Snap, but there are no places online to get an actual price. I got estimates from blogs and news outlets that say $700ish, but without a definitive click, I can’t in good faith include it.)

Cartridges

Got pumps? Then you need cartridges. Can’t have one without the other (except if you’re talking the Omnipod, because the pods act as the cartridge and the insertion set.). Cartridges (or reservoirs, if you are Medtronic) are needed to hold that expensive insulin you purchased.

Omnipod = $0.00 because the pod acts as cartridge and insertion set. See below.

T:Slim Insulin Pump Cartridge – 3ml – Box of 10– 10/bx = $46.19

Animas 2ml Cartridge 1200 Pump – 10 Bx = $45.79

Accu-Chek Disetronic Spirit 3.15mL Plastic Cartridge System – Box of 5 = $24.30

Medtronic

Some people change their cartridges once per week, while others change every three days. So, you could use 4 per month or 10 per month.

Average Total Cost per month: $41.39

Average Total cost per year (9 boxes): $372.51

Average Total cost per year (12 boxes): $496.68

Insertion Sets

800px-Infusion_set_3Those pumps and cartridges aren’t enough to get the insulin into your body. You need insertion sets (again, unless you use Omnipod, which are tubeless and incorporate the cannula directly into the pod).

Most people change their insertion set every 3 days. (You should. I don’t judge. Some people change it more frequently, due to inflammatory reactions or the dreaded occlusion.) So, you’ll go through one box per month… if not more.

Most people have a preference of the type of insertion type/tubing length they use. 90º or 30/45º angles, short tubing or long tubing, 9 or 6 mm cannula, metal or plastic… so I’m giving you a few choices. And again, it pays to shop around. Sometimes the manufacturer of the pump is not the cheapest place to get supplies (which confuses me to no end…).

Reference: Omnipod pods (10/box)= $337.00

Inset Infusion Set 23″ 9mm (10/box) = $95.77

Cleo 90 Infusion Set 24″ (60cm)/6mm 10/bx = $112.99

Comfort Infusion Set – Can be used with t:slim, Animas (Box of 10) = $105.99

Accu-Chek Disetronic Rapid D Infusion Sets – 6mm Cannula and 24″ (60cm) Tubing – 15/bx = $94.39

Medtronic

Quick-set 9mm Cannula / 43″ Tubing (10/box)  = $136.70

mio 9mm Cannula / 32″ Tubing CLEAR (10/box) = $151.00

Silhouette 17mm Cannula / 43″ Tubing (10/box) /cannula only = $121.19/$117.30

Sure-T 29g 10mm Needle / 32″ Tubing (10/box) = $94.60

Average Total Cost per month: $101.60

Average Total cost per year : $1219.20

Continuous Glucose Monitor (CGM) & Supplies

Dexcom

Dexcom Platinum G4 Sensors (4/pk) = $349.00

Dexcom Platinum G4 Transmitter = $599.00

Dexcom Platinum G4 Receiver = $599.00

(Remember that you need all three of these items to get your Dexcom to work properly. Start up can be expensive. In addition, the new Dexcom transmitter warranty is only good for 6 months and you will most likely need to purchase two each year.)

Initial/Replacement Cost of Transmitter & Receiver:$1797.00

Cost per month for sensors: $349.00

Total cost per year for sensors: $4188.00

Total Annual Dexcom cost: $5985.00 

Dexcom Share Cradle w/ Free Service = $299.00

(This is an add-on device that caregivers/loved ones can use to view the graph/numbers on the receiver in another room.)

Medtronic

The Medtronic insulin pumps use integrated technology on their Revel and 530G to show the continuous glucose monitor graphs/numbers, so you don’t need a “receiver” if you are using these pumps. You can purchase a receiver to use the Sof-Sensor sensors, but… why? (And I couldn’t find a place to purchase with a price on a stand-alone Medtronic receiver.) The sensors cost are per month, as the Enlites last longer than the Sof-sensors.

Enlite® Sensor (5 pack) – used with the Medtronic 530G pump only = $473.00

Total cost per month: $473.00

Total cost per year: $5676.00

Sof-sensor® Glucose Sensors (10 pack) = $439.00

Total cost per month: $439.00

Total cost per year: $5268.00

mySentry Outpost (this allows you to see data from the Medtronic pump/sensor in another room) = $500.00

Blood Glucose Monitors/Test Strips

1154350_32525829According to the ADA, for Type 1s, self-monitoring of blood glucose (SMBG) is key to diabetes management. They recommend 6 – 8 times per day as a minimum of blood glucose testing. When you read the Standard of Care document, they state:

“…prior to meals and snacks, occasionally postprandially, at bedtime, prior to exercise, when they suspect low blood glucose, after treating low blood glucose until they are normal glycemic, and prior to critical tasks such as driving.”

8x/day minimum = 240 strips per month minimum, so 250 (because that’s easy to purchase in boxes of 50). So, that’s what we are going with, although I know that some people with diabetes use more – and less – than that. We are not going with the bare minimum.

Here’s where it pays to shop around…

Wal-Mart is NOT always the least expensive when it comes to purchasing blood glucose monitors and blood glucose test strips – not by a long shot. Of course, prices always vary given the day, the website, the weather…. you get the drift. SHOP AROUND. (Click the link to be forwarded directly to the website that had the price listed.)

And don’t forget that there are certain meter companies that have “special savings programs“, even for those who have insurance!

Accu-Chek

Accu-Chek Aviva Plus Glucose Meter Kit = $9.97 or FREE.

(Remember, if you use the subscription based Accu-Chek To Program, you get a Aviva Plus Meter for free with your first shipment.)

Accu-Chek Aviva PLUS Test Strips – 50ct = $30.29

Cost per month without Accu-Chek To program: $151.45

Cot per year without Accu-Chek To program: $1817.40

Cost per month with Accu-Chek To Program + regular purchase: $131.77

Cost per year with Accu-Chek To Program + regular purchase: $1581.24

(Remember, if you use the subscription based Accu-Chek To Program, you can purchase 50ct Accu-Check Aviva Plus Test strips for $20.00 and 100ct. for $40.00 per month.)

Accu-Chek Nano Glucose Meter = $5.07 of FREE

(Remember, if you use the subscription based Accu-Chek To Program, you get a Aviva Nano for free with your first shipment.)

Accu-Chek Smartview Test Strips – 50ct = $27.77

(Remember, if you use the subscription based Accu-Chek To Program, you can purchase 50ct Accu-Check Aviva Smartview Test strips for $20.00 and 100ct. for $40.00 per month.)

Cost per month without Accu-Chek To program: $138.85

Cot per year without Accu-Chek To program: $1666.20

Cost per month with Accu-Chek To Program + regular purchase: $123.31

Cost per year with Accu-Chek To Program + regular purchase: $1479.72

Abbott FreeStyle

FreeStyle Lite Glucose MeterFreeStyle Freedom Lite Glucose Meter = $10.09

Abbott FreeStyle Lite Test Strips – 50 ct. = $46.99

Total cost per month: $234.95

Total cost per year: $2819.40

Bayer

Free Bayer Contour Next Meter  – shipped by Bayer to you. $0.00

Free bayer Contour Next USB Meter – shipped by Bayer to you. $0.00

Contour Next Link Blood Glucose Meter = $89.00

Wireless communication to Medtronic devices enables fast and easy bolus dosing and continuous glucose monitoring calibration
• Built-in USB cable has pass-through feature to allows for easy downloading to Medtronic’s convenient online CareLink® Personal software

(Bayer Contour Next Test Strips (box of 50 strips on Medtronic’s website) = $52.00 BUT THIS IS WHY YOU SHOP AROUND…)

Bayer Contour Next Test Strips – 50ct = $19.09

Total cost per month: $99.95

Total cost per year: $1199.40

LifeScan OneTouch

OneTouch Ultra 2 Glucose Meter Kit = $19.88

OneTouch Ultra Mini Glucose Meter Kit = $17.63

One Touch Ultra Blue Glucose Test Strips – 50 ct. = $74.99

Total cost per month: $374.95

Total cost per year: $4499.40

OneTouch Verio IQ Glucose Meter Kit = $29.99

OneTouch Verio Sync System Kit =  $29.99

OneTouch Verio IQ Gold Test Strips – 50ct = $90.89

Total cost per month: $454.45

Total cost per year: $5453.40

But We Aren’t Done Yet

If you’re on an intensive management plan, then you’re strongly encouraged to have a glucagon kit available in case you have a severe hypoglycemic reaction. This item isn’t cheap.

Glucagon Kit = $213.69

220623_1002Some people with diabetes on intensive management plans (those who are on pumps, microbolusing with flex pens, and/or CGMs are considered intensive management therapies) often see an endocrinologist and other specialists. You might need to include these in your team:

  • Endocrinologist/CDE
  • Cardiologist
  • Podiatrist
  • Nephrologist
  • Neurologist
  • Ophthalmologist/Retinal Specialist
  • Orthopedic specialist/surgeons

These specialist costs are higher than just seeing a regular general practitioner. Some by hundreds of dollars. The tests that may be prescribed can cost thousands of dollars out of pocket (say the word “nuclear stress test” and shudder when they tell you what it costs).

For reference, I see a retinal specialist for a dilated eye exam follow up every six months: $335.00 without insurance. My annual cardiologist visit is $430.00 without insurance for the (literally) five minutes I talk with him, including the pleasantries. One orthopedic surgeon office visit was $295 while the second opinion office visit with another surgeon was $180. As with everything else, shopping around if you have no insurance, especially when it’s diabetes related, is necessary. 

Then there are the additional medications that might be needed: statins, blood pressure medications, medications for neuropathy, kidney disease, etc. These are too numerous to mention (and quantify), but you know that these are additional costs. Most people with diabetes wouldn’t be taking these medications if they didn’t have diabetes.

In a previous post, I mentioned the costs for treating mild hypoglycemia, for lancets and alcohol swabs, for the little things that all add up. The purchase of a juice/glucose-heavy item at a convenience store because you are low is a cost, but rarely factored in. Parking at hospitals for appointments. Tolls. Wear and tear on a vehicle as you travel to see various physicians to stay healthy. Batteries for the gear that isn’t rechargeable.

So, if you are truly calculating the costs of the latest supplies, technology, and treatments, there are items that you don’t even think about… the small ticket items that leech money from your pockets. They can add hundreds of dollars to the existing cost.

Let’s do some math.

If I am a T1 adult with no insurance who uses Humalog in a new Animas pump and a new CGM Dexcom, checking my blood glucose with a One Touch Verio IQ meter, it could be:

$23,348.47

If you have already purchased a pump and a Dexcom, the out of pocket costs would be:

$16,574.18

If I am a T1 adult with no insurance who uses Apidra in a new Omnipod and a new CGM Dexcom, checking my blood glucose with an Accu-Check Nano meter, it could be:

$14,439.80

If you have already purchased a pump and a Dexcom, the out of pocket costs would be:

$11,842.80

If I am a T1 adult with no insurance who uses Novolog in a new Medtronic (not 530G) pump and Sof-Sensor CGM, checking my blood glucose with a Bayer Next meter, it could be:

$16,917.27

(The price would be greater with the 530G pump and the Enlite CGM sensors.)

If you have already purchased a Medtronic pump with CGM integration, the out of pocket costs would be:

$11,261.28

That’s not counting the physicians (multiple visits), the labs, the other tests that you might need, the glucagon, the back up long-acting insulin, the small items, etc.

That’s just for the technology, supplies, and insulin analog.

Are You Getting What I’m Saying Here?

994448_53508805Without insurance, it is unlikely that you have thousands of dollars under a mattress for this type of intensive management. Even with insurance, many of these items can be cost-prohibitive, with deductibles to be met each year and percentages paid out each month to durable medical equipment companies and pharmacies.

This is not meant to shame medical device manufacturers and pharmaceutical companies. I’ve said before that they are not charities; they’re businesses and they can choose to set their prices and work with insurance companies for discounting.

Who loses in this scenario are those who want the technology but do not have an insurance company adept at bargaining or adept at meeting customer (that’s the subscriber) needs. Or those who don’t have insurance at all and fall into the gap of making too much to qualify for assistance programs but not enough to pay out of pocket for these items.

When someone asks a person with diabetes if it’s a hard disease to live with, they’re often asking about the physical aspects of the disease. Very few people outside of the community understand the financial burden many families face if they want what is the BEST technology and treatment for the person with diabetes.

Until there is a cure (be it biological or otherwise), this is the financial cost of living well with diabetes. Insurance companies can blunt some of the cost through their collective bargaining agreements, but we are still paying through premiums and deductibles and, in some scenarios, an inability to choose the medications or technology that they want, because of contracts.

There is no grand “THE END” to this post. For many people with diabetes, this is the reckoning that we do in our heads, wondering if we spend less now, will we pay more later? The answer is almost always… yes, but if we cannot even afford what the best treatments for diabetes on the market, how can we live long enough to get to that “later“?

I have no solutions. This is more of an academic exercise to see if what the statistics touted by the government on how much a person with diabetes pays for care was correct. It’s not.

People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes. – NIH

 

We pay much more if we want excellent care. What can be done? Beyond a cure? I don’t know. Do you?

 

Where I'm At With This…

img-530pumpIt’s been almost two months since I began the trial with the Medtronic MiniMed 530G System with Enlite. I’d like to tell you where I’m at with this…

Truth?

I don’t know where I’m at with this.

The Medtronic customer service is phenomenal. Mostly phenomenal.* The Medtronic trainer has followed up with me and checked out my Carelink updates, giving me suggestions to improve my experience. The StartRight representative has been helpful.

My graphs and reports are, frankly, abysmal. My weight is up three pounds (and as an individual with food/weight issues, you know that doesn’t make me happy) and my A1C rose 0.2%, which may not be much, but I wanted it to go in the other direction. My CDE’s comment to me when she walked into my appointment was: “What is going on? These can’t be your numbers!”

Threshold Suspend

Here’s the thing I like about the Medtronic MiniMed 530G system with Enlite: Threshold Suspend. It does work.

Except when it doesn’t for me.

There have been nights that the Threshold Suspend feature is activated. My blood sugar is 104 mg/dl when I check. I shut off the suspension and restart my basal. It alarms again. By this time, I’m up, out of bed, trying not to wake John, and angry that the pump is waking me up for no reason.

Twice in the past month, it has legitimately suspended and I’ve treated, thankful that it woke me. I’ve yet to sleep through an alarm. (Man, that alarm is loud.)

But I’m finding, for me, that the noise from the alarms compete with the noise in my head over my blood sugars. I’m questioning constantly whether the numbers I see on my MiniMed 530G insulin pump are accurate. When they are, I breathe a sigh of relief. When they’re not, I breathe a sigh of frustration.

That’s a lot of sighs.

I love my Medtronic MiniMed Revel. I’ve said that before. Medtronic has been very responsive with every issue I’ve had with the Medtronic 530G with Enlite system. (The CareLink issue? That’s another story. Quick side note: I’m hearing from others that I’m not alone in my frustration with CareLink.)

My goal with diabetes management is to keep blood glucose levels within my prescribed range while minimizing the intrusion of diabetes into my daily life. (It’s a Hurculean task some days, but others…) The technology I choose to use is meant to help minimize the intrusion.

The Medtronic 530G with Enlite is designed to help minimize the severe hypoglycemic episodes with Threshold Suspend – and it does when the accuracy of the Enlite sensor is working correctly. I’ve had meter readings of 45 and my Enlite sensor is telling my 530G pump that I’m 82 (and the arrow is not trending down). I’ve had meter readings of 64 and my Enlite sensor is telling my 530G that I’m 64.

It’s Me. But is it?

The rise in my A1C is because I’m over treating when I go low. I know this now. I didn’t over treat quite as frequently before I began the trial, because I could see the fall easily on the CGM transmitter of my Dexcom. It’s not as easy to see that on the screen of the 530G pump.

I’ve had to turn off the predictor high and low alarms and the high and low range limit alarms for my sanity. That, for me, lessens the ability of this technology to minimize the intrusion of diabetes into my daily life.

Others are not having these issues and perhaps it’s because their diabetes management is better controlled or their own diabetes is not marred by delayed gastric emptying or quirky days. I’m still not giving up on getting this MiniMed 530G with Enlite system to work for me.

Anyone have suggestions?

*The customer service issue I had? I called in on a weekend to get a few sensors replaced due to sensor errors. I spoke with technical support, who made some less than supportive remarks regarding how I was trained by my trainer. Not cool.

I was also told that when the pump tells me to “BG NOW” to calibrate, I should wait 10 minutes if I’m not stable… which to me says that the pump shouldn’t say “BG NOW”… and if you’re not trained properly or don’t know better, your readings are going to be inaccurate. But when you get a BG NOW for the first time during the wetting period, after two hours, if your blood sugars are fluctuating slightly up or down, how are you to know? These questions have me up at night…