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New Member
jam65613
Total Posts: 1
Registered on: ‎06-07-2012

Lowest cash cost insulin / over the counter?

I'm on a high deductible health insurance plan and don't have prescription coverage until I reach my deductible.  I am currently taking Lantus and Novolog but at about $125/vial they are putting a big strain on my budget.  I have heard/read that Walmart may have a lower cost insulin but the pharmacist at my local Walmart won't answer my questions about lower cost insulins.  He just tells me to talk to my doctor.  I'm sure I could adjust to using just one type of insulin if necessary but need to know what type of insulin to talk to my doctor about.  Can anyone give my any suggestions.  I live near Springfield Missouri.  I don't think that you can get insulin over the counter in Missouri but I'm not sure about that?

lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,988
Solutions: 142
Registered on: ‎10-31-2009

Re: Lowest cash cost insulin / over the counter?


jam65613 wrote:

I'm on a high deductible health insurance plan and don't have prescription coverage until I reach my deductible.  I am currently taking Lantus and Novolog but at about $125/vial they are putting a big strain on my budget.  I have heard/read that Walmart may have a lower cost insulin but the pharmacist at my local Walmart won't answer my questions about lower cost insulins.  He just tells me to talk to my doctor.  I'm sure I could adjust to using just one type of insulin if necessary but need to know what type of insulin to talk to my doctor about.  Can anyone give my any suggestions.  I live near Springfield Missouri.  I don't think that you can get insulin over the counter in Missouri but I'm not sure about that?


Hi Jam,

 

Walmart has lower cost insulin, but not the type you use.  They have regular and NPH insulin for about $25-$30 a vial.  The NPH is much different from the brands you use, and there are no discount rapid insulins available.

 

You can look at the link about discount medications and products for more information. 

 

Lizzy

Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


Responder
pill_lady
Total Posts: 40
Registered on: ‎07-31-2011

Re: Lowest cash cost insulin / over the counter?

There are some older insulins available over the counter and they may be some cheaper for you. BUT they are VERY different from what you are doing now and will require your MD's supervision to change. Also please consider that they are older and not used freuqently anymore for many reasons and you will find them much more difficult to "use" and live your life around their action . Read some posts here about "the way it used to be" in diabetes care. Please consider your health first, you will probably find it is best to stick with what you are doing. There is information on this site about financial assistance programs as well.

Diagnosed 1995 T2 Various oral meds,diet, carb restrict
Sept 2011 - Novolog- MDI, Actos, Amaryl
April 2013 - Pumping -Accuchek Spirit Combo, Actos
11/11 A1c 6.0
5/12 A1c 5.6
9/12 A1c 5.6
3/13 A1c 6.1
7/13 A1c 6.4
11/13 A1c 5.5
mollythed
Total Posts: 5,896
Topics: 75
High Fives: 1,035
Solutions: 114
Registered on: ‎10-31-2009

Re: Lowest cash cost insulin / over the counter?

Just very briefly, here is the difficulty in using Regular and NPH insulin.  Each kind of insulin is designed to have its own length of time until the onset of its activity, it's time of peak activity, and a duration of time until its activity is done.

 

This chart is a sort of simplified description of how different kinds of insuin work.

 

Comparing of Different Insulins

 

Novolog is a rapid acting insulin

Lantus is long acting

 

You can see that with Novolog, it begins to go to work almost as soon as the food it is supposed to cover, and then fades away within about four hours.  Meanwhile, the Lantus has a slow, steady effect over a whole day for most people, so it works well to take care of the blood glucose that comes from your liver in a slow steady stream over the entire day.

 

Regular is a short acting insulin

NPH has an intermediate action.

 

It's pretty complicated to get anything like the same effect with Regular and NPH.  For one thing, it takes a lot longer after injecting to get to the point where the Regular insulin begins to be effective, and even long until it reaches its peak. You can't just inject and eat.  You have to plan ahead, inject, and then wait a while for the Regular to be available before you can start to eat.  Once that time comes, you MUST eat or you will go low. You have to plan your schedule to fit the action of the insulin instead of taking the insulin whenever you happen to want to eat.  Then you have to figure when to fill in with the NPH, so that together, the NPH and Regular can do the background job that is now handled by your Lantus.  The overall effect will never be as smooth as Novolog and Lantus, but it will make do.  With time, you can figure out when to take snacks to help even out the effect of the those shorter acting insulins.

 

Nevertheless, it can be done.  People used to do it all the time back before the newer Novolog and Lantus became available, and some people still do it today because they have no alternative.  A few continue to use the older Regular and NPH because that is what they learned years ago, and they are more comfortable continuing with what they know than learning a whole new set of adjustments.

 

Keep in mind that if you can hang in there until you meet your deductible, you will have better coverage.  Your cost will be higher at first, but with the Lantus and Novolog combo, you will meet your deductible sooner.  You  pay the whole deductible, either way but you get to the better coverage sooner.  The challenge is to plan ahead so that you can make it through the deductible period each year.


"Molly" (aka mollythed)
Type 2 diabetes diagnosed in 1995, now managed with Lantus, Humalog and Metformin; diet and exercise.
My husband and three adult sons also have type 2 diabetes.





New Member
KevinHidden
Total Posts: 1
Registered on: ‎03-15-2013

Re: Lowest cash cost insulin / over the counter?

It is true that you should not change your insulin without the guidance of your Endo. However between the low cost 70/30,N, and R any type 1 should be able to survive and actually control their diabetes quite well. Testing is much more urgent on these types of insulin because of the danger of unexpected low blood sugar.  I have not had to go native on the test strips yet so I have no suggestions on those. I can not over stress the importance of FREQUENT testing when you are using a different Insulin.

lizzylou
Total Posts: 13,930
Topics: 565
High Fives: 1,988
Solutions: 142
Registered on: ‎10-31-2009

Re: Lowest cash cost insulin / over the counter?

Folks this is a very old post from June of last year.

 

Just so you know.

 

Lizzy

Knowledge is Power!





Here's some useful links, click on the titles


Testing 101
 
 All About Carbs

Resources For The Un-insured and Discount Medicine and Equipment

LizzyLou Videos



Lizzy's Blog
for lots more  


New Member
zinataylor
Total Posts: 1
Registered on: ‎03-20-2013

Re: Lowest cash cost insulin / over the counter?

Hello, I am responding to your message about the insulin.  I am also on Lantus and humalog and both prescriptions are so very high.  Walmart has the 70/30 insulin at 24.88 per bottle.  I use to be on that particular insulin a few years ago.  Just to answer your question, yes walmart has over the counter insulin and its 70/30 for 24.88 per bottle.  I hope that I have been some help to you!!

 

Frequent Visitor
lleffler
Total Posts: 3
Registered on: ‎06-30-2013

Re: Lowest cash cost insulin / over the counter?

The chart is very informative.  However, the main point of the thread is missing.  Many people, myself included, are on high deductible plans because it is the only kind of insurance we can afford.  Deductibles in many cases cannot even be met, and care is often avoided due to the cost.

 

If cash is unavailable to pay for the high cost of lantus or novolog (or the like), then it is simply unaffordable from the get-go.  So, the only alternative is the lower cost medicine. 

 

Now all of this may change with the Affordable Care Act in 2014, but until then, people with limited means are stuck with the choices available.  If I wanted to get "good" insurance with a prescription health plan, the lowest cost plan would be over $700 per month (as opposed to the $160/mo for catastrophic insurance).  Considering my income is just over $1500 per month, and will be dropping about $130 in the next month, I see some extreme limitations.  I doubt I am the only one with such financial concerns.  Is catastrophic insurance worthless insurance.  Basically, yes, in my humble opinion.  But what it does give people with limited income is access.  So in the event of an emergency, you will be admitted into the hospital and treated.  And, you can at least communicate with your doctor via email which costs you nothing but an internet connection (but not a doctor's visit which runs $50 for the copay and another $70 for coinsurance).  So, I have arranged with my physician to work with me electronically at no additional cost.

 

So when you are suggesting that the deductible level would be met sooner with the high-cost insulin, that is assuming (falsely and incorrectly) that people are going to be able to meet that deductible in any event, and that the insurance they have is a "choice" and not due to a financial limitation.

 

I apologize in advance if my response is curt or brusque, but I think too many people misconstrue financial choices from financial limitations, and I just wanted to be clear that my understanding of this thread was that it initially began due to someone seeking pricing assistance due to financial limitations.

 

That said, I would suggest to anyone with financial limitations to seek out financial assistance from the pharmaceutical company if possible.  Also, do not be afraid to let your doctor know of your financial constraints.  I have been on NPH and R since I was diagnosed with T1D 18 months ago.  My endocrinologist, a NP not an MD, moved me to Lantus and Novolog without asking if I could afford it.  When I went to the pharmacy, the cost for a one month supply jumped to over $435 per month.  After initially freaking out, I contacted my primary doctor and explained my distress.  He calmed me down, indicated that I was doing well on NPH and R, and re-adjusted my prescriptions accordingly. 

 

Larry

Responder
ksingleton101
Total Posts: 30
Registered on: ‎09-30-2010

Re: Lowest cash cost insulin / over the counter?

Hello,

 

How are you doing?  Did you find lower cost insulin?  I also am on Lantus but I no longer take the Novolog I've substituted it with Novolin R.  Novolin R is an over the counter insulin that works almost the same as Novolog only rather than a 3 hour window form start to finish Novolin R will last 5 hours.  That means after you eat you will need to keep an eye on your sugar for 5 hours.  I've been on Novolin R for a month now and see no difference in my sugar.  Wal-Mart has it for $24.88 a vial.  Here is some background of my situation.  I'm on Disability and have Medicare.  I pay for the Medicare Advantage Part D plan so my medication is covered by the insurance.  The problem I have is because insulin is so expensive, I pay or paid $174 for Novolog and $194 for Lantus (per/vial).  I have just entered the Catastrophic Medication Drug Coverage (Donut Hole) and am now required to pay 47.5% of the cost.  Before I fell into this thing called the Donut Hole I had a co-pay of $45 per prescription.  I was also only allowed to get a 30 day supply of insulin per prescription (not 31 or more)  That means if you use less than 67 units a day you will only be allowed 1 vial of insulin for your $45 per prescription.  I used to take 50 units of Lantus a day and every 20 days (1 vial) I had to refill my prescription ($45).  Now being on Medicare I have $2850 to spend before I reach the Donut Hole.  That $2850 includes what I spend (co-pay) and what the insurance spends on my medication.  My insulin by the way is a Tier 3 medication and he insurance company tells me all insulin is a tier 3 medication.  Now here is the problem I have with all insulin being considered a Tier 3 medication.  Novolin 4 cost $24.88 a vial and you don't need a prescription.  Because I'm in the Donut Hole and am required by law to pay 47.5% of the medication costs I only have to pay $11.82 per vial.  I also am getting 3 vials with one prescription rather than just the 2 that I use each month.  No one can figure out why I get 3 rather than 2 as the prescription is written for 67 units a day or 20+ 3x a day before meals (Novolin r).  My guess is when you’re in the Donut Hole and your paying for it the insurance companies could care less how many vials you get but that will change soon because after I spend 47.5% of $1700 things change.  I will then be required to pay 5% of the medication cost.  Now in the past month I have contacted via Email the Ohio Board of Pharmacies to find out how we all can pay the same price for our insulin’s.  Here is what happened for me to find out we all have different prices.  I was told to call around when I reached the Donut Hole by my insurance company to find the lowest costing Insulin.  When I called my pharmacy and asked what the cash price was I was quoted a different price than my insurance pays ($20 less per vial) When I called the insurance company and asked why they didn't believe me so I had them call the pharmacy and ask the price.  I told the insurance agent to tell the pharmacist that he didn't have insurance and was new to diabetes. I waited on the phone while he called them (Kroger's).  When he came back he was flabbergasted at the price they told him.  Not only was it more expensive than what I was quoted (cash) but it was more expensive than what the insurance was paying (by $100 more).  They quoted him $300 per vial of Novolog.  At that time he asked if I would file a grievance with the insurance company so they could investigate but I was busy and had already been on the phone for over an hour so didn't continue on with his request.  I continued getting my insulin from Kroger's until I reached the Donut Hole and the reason being was they would not let me pay the 47.5% as required by law.  The Pharmacist told me I was already getting a factory discount of $66 so I would have to pay the full balance of $174.  If you add the $66 factory discount and the $174 the total cost of the Novolog would be $240 per vial.  When I told Kroger's Pharmacy I would just take the full cost and pay the 47.5% as required by law they said no I would not get the vial at 47.5% that they had already received the factory discount and there was no way to returning it to the manufacture.  So being told to shop around to find the cheapest priced insulin led me to Wal-Mart where I was told over the phone by a pharmacy technician that Novolog was $18.36 a vial and Lantus will cost $22 a vial.  But after getting the phone call that my prescription was ready for pick up and to bring $1200.00 I found out that the $18.36 and $22 (according to bar code)  I was quoted over the phone was for the prices without a prescription and that the type of insulin Novolog and Lantus could not be sold without a prescription.  The price at Wal-Mart then changed to $194 for Novolog and $222 for Lantus.  That is over a 1000% mark up from cash to prescription cost.  As you can see there are no set prices for medication of any kind and if you call at different times of the day or even on different days you may get a different price.  I would hope and wish everyone would check the price even if they have insurance that covers your medication with a co-payment.  I have found as with Novilin R my co-pay is more than the actual cost of the medication.  I wonder if that is how these insurance companies are able to pay bonuses and if there is some kind of kickback to the pharmacies for over charging us.  Something else that has happened to my wife and I is Pharmacies telling us the medication is cheaper if we pay cash rather than pay a co-pay only to find out later that the pharmacies have also been billing the insurance company for our medication.  In my case because I'm on Medicare doing that is called Medicare Fraud and I'm happy to report Walgreens is being investigated for that very reason thanks to me.  I hope to spread the word on how we are being taken advantage of because of our disability.  Thank you for taking the time to read this.  Please tell your friends to ask the price of their medication before they tell them they have insurance.  They may find out they can save money by just paying for the cash value.

Responder
ksingleton101
Total Posts: 30
Registered on: ‎09-30-2010

Re: Lowest cash cost insulin / over the counter?

You have no idea how pissed I am at this whole problem with insulin cost.  I like you live on a limited income ($1425 a month).  I am disabled and on medicare with Mediare Advantage Part D, which is a secondary insurance that helps with Medication cost only.  In May I hit what is called the Catastrophic Drug Coverage or for short the Donut Hole.  I was told by my insurance company to shop around for the cheapest priced Novolog and Lantus because I would now be required to pay 47.5% of the medication cost.  The pharmacy I had been getting my insulin at (Kroger's) told me the price the insurance was paying $174 for Novolog and $194 for Lantus would be the price I would need to pay.  Kroger's told me I could not pay the 47.5% that I was required by law to pay because they had gotten a manufacture rebate of $66 for each vial and had passed that on to me.  Krogers told me I would need to pay $174 for novolog and $194 for lanuts or I would need to go somewhere else.  When I called Wal-Mart I was quoted Novolog at $18.36 a vial and Lantus $22 a vial, I was shocked and ask the clerk to double check the price which she said again I just scanned them and that is the price I am being told by the cash register.  I emediately placed my order.  One hour later I was contacted by Wal-Mart that my prescription was ready for pick up and to bring $1200.00 with me.  When I asked why so much I was told "we have made a terrible mistake the prices you were quoted over the phone an hour before was for the cash prices and that because I had a Prescription the price was different."  When I told the technician I wanted to pay the cash price I was told I couldn't because I would need a prescription for those insulins.  How are you feeling?  I am mad as hell!  I contacted the Ohio Board of Pharmacies to see what could be done but was told the pharmacies don't set the prices the insurance companies do and they can charge what ever they want, even 1000% more.  The price for Novolog jumped to $194 a vial and Lantus to $221 per vial.  When I contacted Miejer's Pharmacy I was told there is a slow acting insulin that I could get and I could get it over the counter.  I then contacted Wal-Mart which is closer to my home and they told me yes Novolin R is only $24.88 a vial.  I had forgotten to ask Meijer's the price but thought for sure it would be close to the same price but I was wrong, very wrong.  Meijer's Novolin R is $106 a vial.  Yes Novolin R may be an older insulin and need more vigulance but I can not afford to pay thousands of dollars a year on medication and insurance.  I now take 3 medications, 2 of them are cheaper if I pay cash (less than my co-pay)  If I can get or find a replacement for Lantus that is also cheaper than my co-pay I will not need Medicare Advantage Part D (drug coverage) and I will not be in the so called Donut Hole!  Although when I'm in the Donut Hole Novolin R only cost me (47.5%) $11.82 a vial.  My sugestion to you is what I tell everyone I know, tell the pharmacies you don't have insurance when you call and ask for the cheapest price they can give you. You may find as I have that again my medication is cheaper than my co-payment.

 

Good luck and above all stay healthy.