New Year’s Blog: Preparing for Cost of Diabetes Medications in the New Year

2019 year-end expenses hit CGee hard.  Between the car insurance, property taxes and household maintenance issues hitting all at once, all money in the budget has been spoken for with only a few dollars left in the checking account. CGee wonders now how he will afford the copay for his once daily basal insulin.  CGee decides to ration what insulin he has left and actually feels he has a plan.

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The ushering in of 2020 may create dreadful challenges in affording diabetes medications depending on your prescription drug coverage.  A few questions to consider prior to the start of the new year.

  • Is your drug formulary (list of medications covered by your insurance usually put into tiers) changing?
  • Are your medication copays changing?
  • Is the deductible for medications changing?   If uncertain, for employer-based health plans, contact your employee benefits department or human resource department for answers to these questions.  If you are participating in a government sponsored health plan, contact the phone number provided most likely on the back of your prescription drug card.  

For those who have an employer-based health plan, inquire if any employee wellness program or disease state-based program pairs you with a nurse or health coach for additional support in managing your diabetes.  The perk of these programs is often reduced or $0 medication copays.

Bottom line – Be proactive regarding drug formulary changes by doing your homework before going to the pharmacy to pick up your refill this month.  

Additionally, regarding generic medications, always ask whether the cash price is less than copay through insurance coverage.  A really helpful tool for generic medications is to find the lowest cash price using GoodRx.

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Additional helpful resources throughout the year:

  • If enrolled in commercial insurance plan (i.e. employer based), many pharmaceutical companies offer savings programs through co-pay cards. 
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  • Insulin specific savings programs for cash paying patients: may be less than insurance copay
    • Sanofi Insulins Valyou Savings Program (Lantus, Toujeo, Admelog, Apidra) – $99 monthly prescription program
      • May receive up to 10 vials or 10 boxes of pens (or any combination of the two). Fixed
    • Novo Nordisk Cash Card Program
      • $99 per month for 3 vials or 2 packs of FlexPen/FlexTouch pens with any combination of NovoNordisk analog insulin (Novolog, Tresiba, Fiasp)
  • New update from Novo Nordisk
    • Free, one-time supply of insulin to people in immediate need and at risk of rationing medication

The costs of all medications continue to be a challenge no matter your walk of life.  Rather than simply not taking medication or not filling a prescription, let your pharmacist, physician, nurse practitioner or physician assistant know that you cannot afford your medication and work with them collaboratively to find affordable medication options.  Your medical team is here to help, and they will be glad that you explained your personal situation to allow them to assist you with other available options. 

Back to CGee, he debates internally whether to cancel his appointment with his medical team.  CGee feels embarrassed there is no money to afford the medication and does not read the “non-adherent to your medications” label attached to the medication again.  The last time he did this it was painful enough.  CGee decides to bite the bullet and keep the medical appointment.  During the visit, CGee shares with his medical team that medication cost is a real challenge for him.  To his delight, they empathize with CGee and identify ways to help him afford the cost of medications.

Remember, your medical team wants to help you and not judge you. The medical team can’t help if you don’t share your challenges with cost of medications. Trust me, you will not be the only one asking!

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#medication #cost #savings #diabetes

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Wednesday’s Daily Piece: Happy New Year 2020!

Well, time for the fresh beginnings of a new year and decade. The last decade was exciting times for diabetes medication and technology advancements, and peer support for those living with diabetes. I can not begin to wrap my mind around the advancements in diabetes that we will see in this new decade. My wish for each of you is to break free from the stigma and guilt of diabetes, and to live rich full lives achieving your greatest dreams. One practical tip in closing is to join a peer support community in 2020. Since my prediabetes recently came back, I will be joining Diabetes Sisters – yes, it is for women with prediabetes, Type 1 and Type 2 diabetes. The struggle is real, and don’t do it alone.

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#Happy #New #Year #2020 #Peer #Support

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Thursday’s Daily Piece: Icosapent ethyl (Vascepa): Unique Medication in Heart Health Toolkit

When it comes to a healthy heart, our cholesterol (lipid) numbers matter in a major way. FDA’s recent approval of icosapent ethyl as adjunctive therapy to lower risk for heart (cardiovascular events like heart attacks and strokes) in adults with elevated triglyceride levels (150 mg/dL or higher) and established heart (cardiovascular) disease or diabetes with 2 or more risk factors for heart disease (i.e. body mass index of 25% or greater, high blood pressure, physical inactivity, family history).

So why is this a big deal? This is the first FDA approved drug to reduce cardiovascular risk among adults with elevated triglyceride level as add on to maximally tolerated statin medication. Now we have another medication in our tool kit for reducing risk for cardiovascular event.

https://www.fda.gov/news-events/press-announcements/fda-approves-use-drug-reduce-risk-cardiovascular-events-certain-adult-patient-groups

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#FDA #Vascepa #CV #Event #Risk #Reduction

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Tuesday’s Daily Piece: Game Changer -Tandem’s Control-IQ Technology FDA Approval

FDA’s approval of Tandem’s Control-IQ, automated insulin delivery (AID) system, is game changer. Why? It is the first insulin dosing software to win fast approval by FDA “interoperability” approval pathway. The interoperable automated glycemic controller device automatically adjusts insulin delivery by connecting to an alternate controlled enabled pump (ACE pump) and integrated continuous glucose monitor (iCGM). Automated insulin dosing (AID) system typically consists of pump, CGM and software to control system of compatible devices. With regards to Tandem, Control-IQ combines Tandem’s t:slim X2 insulin pump, Dexcom G6 CGM and algorithm built into the pump to give automatic bolus doses and adjust basal insulin delivery.

New Tandem pumps with advanced hybrid closed loop algorithm Control-IQ will ship by end of January 2020.

https://www.tandemdiabetes.com/products/t-slim-x2-insulin-pump/control-iq

https://www.fda.gov/news-events/press-announcements/fda-authorizes-first-interoperable-automated-insulin-dosing-controller-designed-allow-more-choices

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#FDA #Control-IQ #Interoperability #Tandem

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Thursday’s Daily Piece: Medicare Eligible – Prescription Medication Coverage

The time arrives that you are eligible for Medicare. You have your Medicare Part A and B so you are good to go. Right? Not so fast. Medicare Part A covers hospitalization. Medication Part B your outpatient office visits, certain vaccines (i.e. flu and pneumococcal), durable medical supplies (i.e. blood glucose testing supplies, insulin pumps and supplies (must meet certain criteria to qualify), continuous glucose monitors (must meet certain criteria to qualify).

What about your prescription medications? Well, Medicare Part D covers prescription medications and certain vaccines (i.e. shingles). Another option for prescription drug coverage is a Medicare Advantage Plan (combines Medicare Part A, B and prescription drug coverage). Well if this is not confusing enough, there are specific annual enrollment periods for Medicare Part D and Medicare Advantage Plans. Below is a link that provides more details on the open enrollment period. Bottom line Medicare Part A and B will not cover your prescription medications.

https://www.medicareresources.org/faqs/when-is-the-next-medicare-open-enrollment-period/

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#Medicare #prescription #drug #coverage

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Tuesday’s Daily Piece: Navigating Holiday Parties

When it comes to our health, nutrition is medicine so it is imperative that we consider the food and beverages that we consume. The holiday season is so challenging in navigating our food and beverage choices as much temptation exist to over indulge and make lots of unhealthy food choices. Below are some wonderful tips to help you navigate your way through holiday parties.

  1. Make physical activity a top priority the day of the party. Be intentional! Schedule an “appointment” for this vital physical activity.
  2. Avoid arriving at the party hungry.  We all know what happens if we are hungry at a party, we overindulge.  Eat a small meal or snack of protein and non-starchy vegetables before going to party.
  3. Check out all your food options before putting any food on your plate. Consider which foods are worth eating and which foods can be skipped – stick with your decision.
  4. If after the first bite, you realize that you do not enjoy the food item, leave it on your plate.  Remember, you do not have to be a member of the clean plate club.
  5. Select your non starchy veggies first (they will fill you up) (i.e., broccoli, baby carrots, tomatoes, celery, cucumbers, cauliflower). Keep the dip to very small spoonful.  Think of “touching” the food in the sauce vs “dipping”!
  6. Eat sweet treats, chips, crackers and cheese in moderation.  Avoid eating while fixing your plate rather take time to sit down and enjoy your food. 
  7. Keeping some distance between yourself and the food will prevent you from grazing. 
  8. Moderating alcohol is key (one drink for a woman and possibly two for men).  Sipping on a glass of water or mineral water is a great alternative. Often, simply having the glass of water in your hand will ward off the desire for additional alcohol or food.
  9. Focus your time at the party on catching up with friends and making new connections.
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#holiday #party #tips #navigating

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Saturday’s Daily Piece: Expanded Age Indication for Toujeo

Insulin glargine (Toujeo) is now FDA approved for children ages 6 and older with type 1 and 2 diabetes. Previously, Toujeo was indicated for people ages 18 and older with type 1 and 2 diabetes. To learn more about the results EDITION JUNIOR trial, please click below.

https://www.biospace.com/article/fda-approves-sanofi-s-toujeo-for-pediatric-diabetes/

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#pediatrics #diabetes #Toujeo

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Thursday’s Daily Piece: Campaign for Sustainable Rx Pricing

Have you heard of the Campaign for Sustainable Rx Pricing? If not, it is important to learn about this vital campaign. The price of prescription medications has risen at exponential rates over the last several years. This campaign addresses the unsustainable price for medications. To learn more, please click below.

https://www.csrxp.org/news-updates/

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#DrugPrices #diabetes #advocacy

Wednesday Daily Piece: Vaccination Update for Adults Aged 65 and Older

Advisory Committee on Immunization Practices (ACIP) no longer recommends routine administration of pneumococcal 13-valent conjugate vaccine (PCV-13) in adults aged 65 and older. Rather, adults aged 65 and older are advised to engage with their healthcare provider in shared clinical decision making regarding PCV-13.

https://www.cdc.gov/vaccines/vpd/pneumo/hcp/PCV13-adults.html

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#PCV13 #ACIP #Immunizations

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Thursday’s Daily Piece: Insulin Storage Misconception

Did you know that it is a misconception that insulin must always be in the refrigerator or on ice? The truth is prior to first use an insulin vial or pen should be kept in the refrigerator. However, once it is opened and used, it can be kept a room temperature. So if you are going out to eat with friends or family, simply slide your insulin pen into your pocket or purse. Don’t miss out on fun outings simply because of insulin.

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#insulin #storage #misconception

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