Today I ran into a problem, wonder what I should do if I hit a bigger problem...

[tychrisbrown]

Hi guys,

Today I ran into the issue of a pharmacy I transferred my prescriptions to being out of the insulin pens I use and not getting them till 1030-1100am tomorrow, the reason they did not have them was because they screwed up transferring the prescription and gave me the bottled insulin which I have never used. It was also a lot more expensive. I do 18 units of Humalog 75/25 before breakfast, and 12 units of the same before dinner. Obviously I can hold off eating breakfast till then, but I will most likely be late for work and will have to eat lunch later, etc. What happens if I am out totally of insulin and the pharmacy cannot get the prescription to me till the next day? What are my options?:confused:

[plattb1]

If they're a national chain with other stores in the area, you can usually check with a different location & pick them up there. With everyone computerized, records are available pretty much nationally.

You don't say if you're in the US or not & I don't know about pharmacies elsewhere ...so this may not be pertinent to your situation.

Possibly, you could go back to your original pharmacy & ask for help?

[fgummett]

Unless your insurance is a real stickler for only filling scripts on the exact dates, I'd plan to visit the pharmacy a week or two before you run out... this way you are covered over any delay.

[tychrisbrown]

I am in the US. I transferred my prescription from Wal-mart to the local pharmacy because I do not drive at the moment and having to remember to call the bus a day in advance can be hectic. I can walk to the local pharmacy. They called the other local pharmacy and they did not have any as well. I called the hospital thinking they could give some to the local pharmacy, but no good. It is kind of scary.

[tychrisbrown]

Im not sure, it gets confusing. I ran into another issue recently where I used to get two boxes of the pens, but then my pharmacies started to get worried about being audited by the insurance company and restricted me to one box so it does not go over the one month supply limit for retail. I can get a 3 month supply if I do mail order, but that is a huge change and I do not feel comfortable attempting that unless I get frustrated into doing it. Having to worry about the politics between a pharmacy and an insurer is nerve racking.

[Bountyman]

Can't offer any advice on your immediate situation, but let me say this: I also use insulin pens. When I went from the (Lantus) vial to the (SoloSTAR) pens I went to the Bayer/diabetes site and read as much as I could. I get the pens in a box of 5 and keep them in the refrigerator at 40 degrees. As you know insulin, once the pen or vial is opened, has a shelf life of 28 days. The vial came in 1000 units and at the time I was using 20 units a day at bedtime. Well, doing the math that means I used 560 units of the insulin every 28 days before I'd have to order a new bottle. At $91.44 a bottle it seems crazy to toss the other 440 units in the sharps box. If the insulin had a longer shelf life I could have made the bottle last 50 days, instead of 28. That would have almost cut the cost of my insulin in half. Enter the pen...

My pens come in 300 units per pen. Nowadays I'm using 25 units of Lantus each night at bedtime. The pen requires I use 2 units to clear the needle of air first, but I still get 11 days from each pen. When there's just one last injection left in the pen I get a new pen from the refrigerator and give it a day to normalize to room temperature. That's 297 units from a 300 unit pen. I'm a happy camper about those figures. Anyway, to my point...

On the Bayer site, and other sites like the ADA, it's recommended that you always have a spare pen in case the one you're starting to use or have been using goes belly up. That way you still have insulin while you order a new box. I don't see any reason that you shouldn't order, or switch suppliers of your pens without having a spare to take care of situations like these. If you're taking a total of 30 units per day, plus a 2 units to clear your needle, I suggest that a few days after you've opened your 4th pen that you reorder another box. If your insurance, your pharmacy or your care provider thinks that's too soon, refer them to the manufactures that suggest you always have a spare pen in case you run into a situation like you're now in.

FWIW

[tychrisbrown]

Awesome advice, thank you.

[fairyblood]

In these kind of situations if the pharmacy is a good one they will provide you with some insulin (often one bottle or box) until they deal with the insurance issues. Insulin clearly isn't something that is ever optional.

I am a little confused about the vial vs. pen issues from your original post. Did they offer you a vial and you turned it down because you aren't use to them and now you might not have enough insulin until tomorrow? If so I don't understand why you would do that. As a type one you need your insulin breakfast or not and because you are taking such a regimented insulin it is going to be really hard if take your NPH later then you normally do because of the peak.

NPH is sold over the counter so you could go to Walmart or something like it and buy it. I think it is only sold in a bottle but that would be preferable to not having it on hand at all.

Good luck with everything and let us know how it all works out.

[lorilei]

agreed with fb above...and if you have to buy in an emergency without insurance..you can often recoup the losses by submitting a receipt..a pita, but worth a try...you might also call your doc and see about any vendor samples they might have (i've never done this personally, but it's been presented as an option?)

[tychrisbrown]

I have never used NPH and so have no clue how much to inject myself with it. My pen is Humalog Mix 75/25 Pen. Which translates to 75% Insulin Lispro protomine suspension and 25% Insulin lispro injection (rDNA origin). Normally I am ok if I wait later to inject/eat as long as I time my meals throughout the day the way I have always. I normally eat lunch two hours after I eat breakfast, and am a bit more flexible when dinner is. I rejected the bottle because I did not have any syringes or alcohol swabs and it would have been very expensive. Already the bottle was 30 dollars more than the pens. I realize that I would have had to take it if the timing was different, but I think I can live.

[Lizzy]

Can't your doctor write the script for using more insulin since your current script doesn't seem to be enough to carry you through?

[sarahspins]

Can't your doctor write the script for using more insulin since your current script doesn't seem to be enough to carry you through?

Agreed, but you may also want to read this page: children with DIABETES - Care Suggestions (http://www.childrenwithdiabetes.com/clinic/care.htm) (these recommendations apply to all type 1's, not just children)

[DanG]

Already the bottle was 30 dollars more than the pens. I realize that I would have had to take it if the timing was different, but I think I can live.

If expense is the issue - learn to do the vial of insulin - as Bountyman said - it has twice as much insulin as your pens. Bountyman did not need to worry about using the vial up within 28 days - I use a vial for 50 days - until it is gone. No problems. The 28 days thing is for the manufacturer to maintain quality control, but if expense is an issue - you can use the stuff - it is perfectly good stuff. Every once in a while you might find that at day 45 the insulin may not work - just toss it. Syringes are dirt cheap, alcohol is cheap, sterile cotton is cheap - talk to me, I'm master of cheap. Why, I even use my syringe 3 times - never ever do I stick a used syringe in the vial, but I load the syringe with enough juice to do 3 meals. If ya wanna talk cheap - plenty of us know cheap - I learned half my cheap through others here at the forum.

[cwathne]

I can't believe people don't keep at least 30 days supply of everything.

Just think, what if there was some kind of catastrophe? A huge earthquake, a tsunami, a blizzard that made it impossible to get out of the house, you accidently break your bottle/pen of insulin, or even a war; seriously, this stuff happens.

Either cut back and save supplies little by little, or just buy some extra. When you only have a 30-45 day supply left is when its time to order a new 30 day supply. When you pick up your new prescription use your old stuff and save the new, this way you always have extra and you area always using/re-stocking your reserves so it stays fresh.

[dbaratta]

Hi guys,

What happens if I am out totally of insulin and the pharmacy cannot get the prescription to me till the next day? What are my options?:confused:

The pharmacy screwed up my script almost every time I went to get it. Well let's say every time it had to be renewed. One pharmacy gave me the wrong insulin, instead of novolog they gave me the one that you shoot twice a day, a long acting. Can you imagine if I used my lantus and then shot that stuff three times in a day!? I was pretty new to D then and that could have cost me my life.

For me I try to have extra in the fridge. I can do that because I don't use all they give me. Good thing cause last month I dropped a whole bottle of novolog and broke it, bran new. Good thing I had a back up.

Pharmacies can usually get drugs in one day or less. My bet is that they will have it for you.

[Lizzy]

I can't believe people don't keep at least 30 days supply of everything.

Just think, what if there was some kind of catastrophe? A huge earthquake, a tsunami, a blizzard that made it impossible to get out of the house, you accidently break your bottle/pen of insulin, or even a war; seriously, this stuff happens.



I so totally agree. I have always had the doctor write my script for more then what I use. I also try to pick up an extra vial of insulin when I visit my Endo. I plan on never running low on insulin, pump supplies, or test strips, (unless something very major happens) they are my life-line.

[fairyblood]

I can't believe people don't keep at least 30 days supply of everything.

Some of us can't actually afford to have extra supplies. I can't afford my co-pays as they are and if I added more insulin then I wouldn't be able to to pay my rent or eat.

It is also near imposable to have extra test strips around unless you don't test much which isn't an option for me. I have a hard time as it is getting my perceptions written for the right amount of test strips without asking for more then I use which would never fly.

[sarahspins]

I can't believe people don't keep at least 30 days supply of everything.

I agree with this... on most RX plans you actually CAN refill your RX every 20 or 21 days.. or you can ask your Doctor to write your script for insulin to be a little generous (I do this, on the pump I use just about 2 vials a month.. but I get 3 just in case I need extra so I am not constantly refilling the RX early at $55 each time). You can ask even for samples from your doctor's office - most of them have insulin in the office to give away (mine gave me 2 vials of Apidra to try, then swapped out the Novolog vials I had for more). I don't feel bad getting "extra" with my RX because sometimes 2 vials is sometimes not a 30 day supply for me. If I only got 2 and dropped one or had a vial get hot, I'd be SOL.

I know that money is tight for almost everyone.. but I can't think of a time in the past 8 years when I hadn't had a small stockpile of supplies. It may not always be a full 30 days for everything, but it's never been less than a week's worth of whatever I need. I refill my cheaper RX's as often as I am allowed to... which is strips and lancets (I use the Renew system) so it's become fairly easy to have a small stockpile of those - as a result, I don't stress when I end up testing more than normal, because I have enough to absorb the difference.

I have definitely been in a place though where I used a vial of insulin until every last drop was gone before going to buy another, and I'd sometimes buy strips in boxes of 25 because I didn't have insurance and I was only able to buy what I could afford.. but with insurance, I really can't see how someone gets into a situation where they have to resort to that. If your "30 days" of supplies doesn't last 30 days, request more.

[CarrieJett]

Some of us can't actually afford to have extra supplies. I can't afford my co-pays as they are and if I added more insulin then I wouldn't be able to to pay my rent or eat.

It is also near imposable to have extra test strips around unless you don't test much which isn't an option for me. I have a hard time as it is getting my perceptions written for the right amount of test strips without asking for more then I use which would never fly.

I feel ya, fairyblood. At one point when I had no insurance I broke a vial of lantus and had to bum an almost-used vial off of a diabetic accquaintance to get me through the days until my paycheck rolled around. ( I know it's kind of back-alley...) I also used to be in the drugstore at midnight when I realized I had no teststrips, ccalling my brother or someone to lend me money so I wouldn't die. It's a terribly expensive lifestyle. I am absolutely enslaved to having insurance now, and don't know what i would ever do if I didn't have it. I am stockpiling for that event.

Keep pushing your doctor for more test strips, though. My endo got mine up to 200 per month, even though the insurance only says it wil do 100. Good luck!