38 Comments
In the past year, have you been required to change medications because of your health insurance?
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Novolog to Humalog
Yes my drug insurance company would only pay for Novalog brand insulin. I had been using insulin aspart previously.
My insurance want’s me to switch to Humalog (which I’m allergic to) from Novolog (which I’m not allergic to).
My insulin brand is no longer covered. I have gone back and forth between Humalog and Novalog over the years due to insurance changes. Now my current insurance company wants me to change to Lispro.
A while ago I had to switch from Humalog to Novalog but this year when my husband’s insurance changed, I had to switch to Lispro. Not a big deal, but I had to have my pharmacy call around to find a location that had enough vials for my Rx right before a trip out of town!
No, but I have had to fiercely fight to keep them more than once.
Not in 2023, but in 2024, I need to switch from Humalog to generic lispro. I have Toujeo for back up insulin and they will no longer cover that so I need to change Basaglar instead and they are not equivalent! Thankfully, I don’t need to use long acting often.
Insurance changed preferred brand of basal insulin from Tresiba to Toujeo.
Yes, I HATE FORMULARIES and how they control what medications I take, as opposed to what my doctors prescribed.
I had to go from a brand name to a generic drug when I moved out of state. Goi g on Medicare did not help. Its not as effective that’s for sure but cost for the name brand is prohibitive!
Yes but not my insulin. A medication for Rosacea. The previous medication worked really well but the one I have to change to, I know from past experience, does not work as well.
Beginning January 2024, Medicare is not covering Novolog or Humalog. Which are the only drugs FDA approved for insulin pumps.
Lispro, aspart, and glulisine are also FDA-approved for pump use (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695255/). These are the generic versions of Humalog, Novolog and Apidra, respectively.
My health insurance has not affected my diabetes medications. However, my insurance no longer will cover my Symbicort inhaler (for asthma). I will have to go to the doctor to get a different inhaler.
Not this year but starting in 2024 I will have to change from Humalog to lispro
@Sarah Austin. Humalog IS one of the brands sold as Lispro, ma’am. There are, of course, other brands. I also use Insulin Lispro, but that’s Apidra brand (Insulin glulisine).
Insulin lispro is a fast-acting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours.
Admelog, HumaLOG and Lyumjev are other types of insulin lispro. It’s a manufactured form of human insulin where the amino acids lysine and proline have been switched at the end of the B chain of the insulin molecule.
Long-acting insulin changed from basaglar to lantus for the upcoming year. Not a big deal since she moved to a pump this past year.
I was with Caremark now with Optimum and not a fan but was not a fan of Caremark in the beginning. Not a fan of mail order insulin! Opimum (still not sure it is spelled right) made me change from Novalog to Humalog. Both are the same, sure, but why should a RX company say what insulin I should be taking. Is that not my endocrinologist job? Would they not know what is best for me? Kind of burns me up how healthcare has gone in the past 5 to 10 years, miss the old days of knowing your pharmacist by first name and talking to them about the latest advancements in diabetic care at the conner pharmacy. Patient is no longer a factor in the equation. sorry for the rant.
@Jen Farley. Some MIGHT consider it a rant, ma’am, but being from the ‘other side of the pond’ I’ve ‘lost’ internet friends due to the American Health System when they’ve been in a position where they can’t afford insulin at all.
I quickly contacted my provider and requested an exception and did received one. It has happened 2 times to me. They wanted me to change to a less expensive medication.
I answered NO for 2023 but in 2024 I will have to switch from Humalog to Novolog.
I didn’t have to change but I couldn’t get a new one from Caremark because it wasn’t on the formulary. I used an AARP pharmacy card and got a $44 Rx for $18. Like Bob, I hate formulary!
I have to change my insurance company now for 2024 so that i can continue to afford humalog. (or I have to switch to Lyumjev if I keep my current plan)
I was startled to see that on my current plan, humalog would cost 16,000 next year (for the full year). Everyone, check your plans!
@lis be. Wise words for my American cousins, ma’am.
For 2024 I have to change insurance as my old plan won’t cover Novolog.
I have to use Novolog with my Tandem pump, so I changed insurance plans.
I selected “Other” as the response “N/A” appears to be for those that do not have a personal T1D connection.
I AM Type 1, but I live in the UK (United Kingdom of Great Britain and Northern Ireland) where my medications are all paid for by our NHS (National Health Service), which is funded via taxation of all working people that earn more than a given amount.
This year, I was not allowed to start a new med (Afrezza) because it was not on the formulary.
I lose words when coming up on something like this and can only roll my eyes and shake my head.
In July, I went on the only Medicare plan in my area that covered Afrezza. For 2024, no one is covering it. Like others, hate these formulary decisions by the Insurance providers.
With Medicare’s change to the cost of insulin, my Part D plan dropped Novolog. $35 “limit” only works if insurers have your medication on their formulary.
correct, if it’s not on the formulary, expect to pay almost full price.
Yes, several times. Antibiotics umeds changed.
Yes, I used to take lantus as my basal isulin. My health insurance would not cover it and my endocrinologist changed me to basaglar.
Medicare doesn’t want me to take Plavix daily, so they spoke with my cardiologist to change it to every other day.
Yes
Was forced to change one early this year and already have a notice that I will be forced to change another after Jan 1st
Literally every year when I used to be covered by employer-sponsored health insurance, the plan’s PHARMACY BENEFITS MANAGER (NOT the health insurer) would stop covering at least one of my needed prescriptions-either for one of the two types of insulin I use, or my CGM. That’s because the PBMs make a fortune in rebates for limiting patient choices. The PBMs business model should be disallowed.
Had to change from Humalog to the generic version due to insurance requirement.
Even though my insurance quit covering one of my medications, my doctor would have switched me anyway as she said there are some potential side effects to the medication I was previously taking.