Changes To Insulin Brands Covered By Formulary
Back to News/Alerts Directory Thank you for being part of the HMSA network and caring for our members. We’ve been working with providers and the business community to curb the rising cost of prescription drugs while making sure that our members have access to the medications they need. The cost of insulin has increased dramatically over the past several years. To keep insulin accessible and affordable, we’re making changes to the list of insulin brands that we pay for on behalf of our members. Starting December 1, 2016, Novolin® (with the exception of ReliOn® Novolin products), Novolog®, and Lantus® will be the preferred insulin brands on our commercial plan formularies. Below is a list that includes insulin brands that will be non-formulary or non-preferred on December 1, 2016. Your patients who continue on these products will pay more out-of-pocket and may even have to pay for the full cost of the drug. We’re providing a three-month transition period from December 1, 2016, to February 28, 2017, to give you time to switch your patients to preferred products. Insulin Name Essential Select / Choice / Metallic Afrezza Apidra Basaglar Humalog Humalog Mix Humulin N&R Humulin Mix Levemir ReliOn Novolin ReliOn Novolin Mix Ryzodeg Tresiba NF MN-PA Humulin R U-500 Lantus Novolin N&R Novolin Mix Novolog Novolog Mix 1 1 Toujeo NF 3 NF = non-formulary MN-PA = Medical necessity prior authorization required. If your patient isn’t insulin-dependent, consider other antidiabetic drugs, some of which are generic, have favorable dosing regimens, and preferable side effect profiles. If your patient is on an insulin that will become non-formulary or non-preferred and you believe they need to stay with their current medication, please request a non-formulary exception for them. Continue reading >>
Clinical Effectiveness Of Novolin 30r Versus Lantus Combined With Glucobay Treatment In Elderly Patients With Type 2 Diabetes Mellitus Controlled By Oral Hypoglycaemic Agents: A Randomized Study.
Department of Geriatric Medicine, East Hospital, Tongji University School of Medicine, Shanghai, China [email protected] To compare the treatment effects of Novolin 30R(a), versus Lantus(a) combined with acarbose (Glucobay), in elderly patients with type 2 diabetes mellitus. Patients (aged > 60 years) with type 2 diabetes mellitus were randomized to receive either Novolin 30R(a) (initial dose 0.5 IU/kg) or Lantus(a) (initial dose 0.2 IU/kg) combined with 50 mg acarbose. After a 32-week treatment period, the following parameters were measured: blood glucose control; blood lipid levels; body mass index; proportion of patients achieving a glycosylated haemoglobin (HbA1c) level <7.5%; rate of hypoglycaemic events; change in fasting blood glucose levels from baseline in patients stratified according to their baseline HbA1c level. A total of 188 patients were enrolled in the study. After 32 weeks' treatment, compared with baseline levels, there were significant reductions in FBG, 2 h-postprandial blood glucose during an oral glucose tolerance test, HbA1c, total cholesterol, triglycerides and low-density lipoprotein cholesterol values in both groups. Although there were fewer hypoglycaemic events in the Lantus combined with Glucobay group compared with the Novolin 30R group, the difference was not significant. Novolin 30R and Lantus combined with acarbose both had beneficial effects on blood glucose control and blood lipid levels in elderly patients with type 2 diabetes mellitus. The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav. Glucobay; Lantus; Novolin 30R; Type 2 diabetes mellitus; elderly patients Continue reading >>
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How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
Why I Switched From Novolin 70/30 To Novorapid And Lantus
In the 20 plus years of managing my type 1 diabetes, I have used several types of insulin. When I was first diagnosed I was prescribed Humulin N and Humulin R insulin. I used it for a couple of years until my doctor switched me to Novolin 70/30. At that age I did not understand the rationale behind the switch. Quite frankly it didn’t matter once I could stay healthy and keep my diabetes in check. I used Novolin 70/30 for many years, throughout my teenage years and most of my twenties. One insulin shot in the morning before breakfast and one before dinner. I dabbled in sports as a pre teen and teenager, doing taekwondo, playing hockey and badminton. It wasn’t until my early twenties that I became very cautious of my physique or lack there of. I was inspired to start working out with friends and eventually started following the gym lifestyle. With my busy work schedule and new fitness journey I discovered a couple of issues with 70/30 insulin. 70/30 Premix Insulin is Very Restrictive I am quite a busy person and having a fixed schedule to eat each day isn’t exactly feasible. With numerous meetings, presentations and training sessions, having flexibility with my meals is very important. I would often feel like a slave to 70/30 insulin. It is rather annoying and inconvenient having to excuse yourself from conducting a presentation or training session because you feel a hypoglycemia episode coming on. I’ve been in meetings that were supposed to last 20 minutes but ended up lasting 2 hours. With the unpredictability of 70/30, it could peak at the most inappropriate times. Carb Counting and Flexible Dieting on 70/30 Insulin Premixes is Difficult At the beginning of my fitness journey I tried to follow a meal plan to achieve my goals. I discovered that it is almost impo Continue reading >>
Need Advise On Insulins-have To Get Off Lantus
Need Advise on Insulins-Have to get off Lantus Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Need Advise on Insulins-Have to get off Lantus I am no longer able to buy Lantus & have to switch to cheaper insulin. I am on my last bottle of Lantus & have no idea what I am going to do. I heard Walmart has Humulin R & Humulin N for $25 a bottle. I really need advise on how to wean off Lantus & which other insulin to use. Is Humulin really bad? Any help is greatly appreciated, everyone here has always been so helpful! Thanks! We buy our expensive meds in Canada. I know they have insulins much cheaper than the US. You might want to check their prices out. I think they have Lantus My doctor switched me to Novolin N when Lantus was too expensive for me. They seem to be the same, at least for me. The more carbs I cut from my diet, the less I need. Not getting into the reason why you want to switch, do a Google or Yahoo search on "Novolin N response curve" and then do one for Lantus and you can better gauge how to use Novolin N better. In short, it does not last as long and as flat as Lantus. yes you can buy lantus in pen form here in canada.... try calling a Shoppers Drugmart in a province close to your state... most will ship it to you no prob. We buy our expensive meds in Canada. I know they have insulins much cheaper than the US. You might want to check their prices out. I think they have Lantus Humalog/Novolog/Apidra are all rapid acting insulins and I can get them for about $13 a vial through my insurance. Not sure what the uninsured cost is or if you'd even need or want the fast acting stuff since you're on long acting now. You might talk to Continue reading >>
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Lantus Not Working | Diabetic Connect
It has been a while since I have replied on here, I guess close to a year by looking at the date, but I wanted to update since I last replied on here. As in reguards to the Lantus, my Dr. has switched me from Lantus to Novolin 70/30. I take 90 units in the morning, and 90 units in the evening. A half hour before meals. Also am taking Vitamin B Complex, plus a seperate tablet of B6, Fish oil capsul, Metformin, eating better and exercising and they have come down. Theese levels were so up and down last time I posted, that now they are at least averaging lower. HA1C is at 7.2 now. Down from 9.1. So that is much better. Thanks. Carl L. I met to say I take 180 units a day. Split in 2 of course. Well I went to the Dr. today and he agreed that Lantus does not work for me. Zilch notta nothing. So I am starting off on Levemir never used it but here goes. Also hes said Lantus was one of the ones that a lot of people had said it has caused weight gain. He also said Lyrica caused weight gain big time. So I switched off that to Topamax. We will see how it goes. I have to go back in 2 weeks to make sure I am ok. Thanks everybody for your input. my 10 year old daughter is on Lantus she takes 14units at night before bed at 9pm and then we count carbohydrates when she eats and she takes Novolog insulin with her meal 1unit for every 15-20 carbs(it varies)Lantus doesn't have a peak period it just goes along at the same rate through your body to keep it at a smooth level throughout the day,probaly if you stopped taking it you would notice the difference in your B.S. but don't do that unless your doctor advises it just know that it is working as it should to keep you healthy.nice to talk to you. I have been taking lantus for about 2 years now and I take 43 units in the morning and 40 units Continue reading >>
Can Lantus And Regular Insulin Be Taken Together?
Community Answers Lantus is a sterile solution of insulin glargine that is used in injection form. The main thing that makes Lantus stand out from other insulins is that is long-acting with a duration of up to 24 hours. Regular insulin tends to be more short lived and is better used for controlling spikes in your blood sugar levels. While you are taking Lantus it is perfectly safe to use regular insulin to control spikes in your blood sugar. However as with any other medication be sure to consult your doctor before mixing drugs. Too much insulin can cause an unsafe drop in BG levels. It is important to follow your prescribed dosing schedule to ensure you maintain the proper insulin levels. I want to add to that last part , although insulin may be taken " together," as in you may take the long lasting Lantus Insulin and then LATER, when your blood sugar spikes, (usually after meals) you may take Regular insulin and Inject the insulin in a different area. Ex: If giving a subcutaneous injection in the stomach works for you, give the second injection in another part of the stomach. The reason for this is because different parts of your body will absorb the insulin differently.For instance the absorption rate injected in to your arm would be different the the absorption rate in your thigh. So, you may take Insulin Lantus and Regular Insulin "together," However, you can not put Insulin regular and insulin Lantus in the same syringe and give it in one dose. Simplified: You will have 2 insulin's and 2 injections. Continue reading >>
How To Get Insulin At A Cheaper Price
Insulin can be expensive. If you’re one of the 6 million Americans with diabetes relying on this main-stay treatment, you could be paying out-of-pocket costs anywhere from $120 to $400 per month, according to a 2015 New England Journal of Medicine commentary. Drugs such as Lantus (insulin glargine) and Levemir (insulin detemir) have seen significant cost increases, according to a recent trend report by pharmacy benefit manager Express Scripts. One reason for the high prices is the lack of generic options for insulin. So for now, you’re stuck having to search around to find affordable options. Where do you shop for more affordable insulin? For some people though, high drug costs can mean making difficult financial choices. Our national polls show people might cut back on groceries and paying bills to pay for their medications. To minimize your costs, consider these options: Prescription Assistance Programs If you don’t have health insurance or are without drug coverage, look into applying for a patient assistance program (PAP). Through the nonprofit NeedyMeds, you can find some programs that offer free or low-cost insulin as long as you meet the eligibility requirements. Those are usually based on your insurance status, income, and diagnosis. You might also qualify for a diagnosis-specific program that can help you save on syringes, pumps, and other diabetes supplies. Pharmacists are also a great resource and can help you find a PAP that meets your financial needs. Switch Drugs Another way to save is by asking your doctor whether there’s a lower-priced insulin that’s right for you. While “long-acting” is a more popular type of insulin, it's also more expensive, but that doesn’t necessarily mean it works better. “It’s mostly a marketing ploy,” says M Continue reading >>
Onset of action - time period after injection that insulin will begin to work Duration of action - length of time after injection that insulin will have a measurable effect Peak effect - time after injection when insulin will have its greatest activity (effect) NOTE: Pharmacokinetic parameters are affected by age, kidney function, liver function, concomitant medications, medical conditions, and other variables. Because of this, parameters may vary widely among patients. In the U.S., most insulins cost > $150 a vial/pens with one exception; Walmart sells Novolin R, Novolin N, and Novolin 70/30 for $25 a vial * For use in HumaPen Luxura HD and HumaPen Memoir See Inhaled insulin for a complete review of Afrezza Afrezza comes in a sealed foil package with 2 blister cards inside Each blister card has 5 rows of 3 cartridges Before use, cartridge and inhaler should be at room temperature for 10 minutes Inhaler should be thrown away after 15 days Sealed foil package is good until expiration date Sealed blister cards + strips - use within 10 days SoloStar is compatible with all BD pen needles Apidra is a premeal (also called prandial) insulin Inject Apidra within 15 minutes before a meal or within 20 minutes after starting a meal Apidra is compatible with some insulin pumps UNPUNCTURED, REFRIGERATED (Vials and Pens) Inject Fiasp at the start of a meal or within 20 minutes after starting a meal KwikPen is compatible with all BD pen needles Inject Humalog within 15 minutes before a meal or immediately after a meal Humalog is compatible with some insulin pumps HumaPen Luxura HD is a reusable pen that allows dosing in 0.5 unit increments HumaPen Memoir records the time, date, and dose of the last 16 injections UNPUNCTURED, REFRIGERATED (Vials, Pens, Cartridges) UNPUNCTURED, ROOM TE Continue reading >>
Can Insulin Go Back In The Fridge?
After removing insulin glargine (Lantus) from the refrigerator for use, can it be refrigerated over and over again after having warmed to room temperature, or does this degrade it? Continue reading >>
Types Of Novolin Insulin
Insulin is a vital hormone produced by the pancreas. Insulin is responsible for carrying the glucose received from food to the cells to be stored and used later as energy. When the pancreas is not able to produce insulin, such as in the disease Diabetes, insulin must be injected to control the level of sugar in the blood. Novolin insulin, a specific brand of insulin manufactured by the company Novo Nordisk, is available in several types. Novolin R Novolin R is referred to as "regular" insulin, meaning it is short-acting. This type of insulin is injected 30 minutes prior to mealtime as it begins to act lowering blood sugar between 30 and 60 minutes after injection. This insulin reaches its peak performance between two and three hours and is completely used up within five to seven hours. Novolin N Novolin N is an intermediate-acting insulin. This means that it begins to work between two and four hours after injection. Novolin N reaches its peak performance between 4 and 12 hours after injection. The effects of Novolin N will last between 14 and 20 hours after injection. Novolin L Novolin L is a lente insulin, meaning that it is human insulin in a zinc suspension. This insulin begins working two and a half hours after injection and reaches its peak between 7 and 15 hours after injection. Novolin L keeps working for up to 22 hours. Novolin 70/30 Novolin 70/30 is a combination consisting of 70 percent NPH (Normal Pressure Hydrocephalus) human insulin in suspension and 30 percent regular human insulin. This combination insulin is an intermediate-acting insulin however unlike other intermediate-acting insulin it begins to work 30 minutes after injection. Novolin 70/30 reaches its peak performance between 2 and 12 hours and will remain active in the body for up to 24 hours. Nov Continue reading >>
Lantus Insulin Vs. Novolin N
Diabetes is a condition in which a person's blood sugar level is higher than normal. Novolin N and Lantus are types of insulin used to keep blood sugar within normal limits. Classification Lantus and Novolin N are classified therapeutically as antidiabetics or hormones. Their pharmacologic classification is pancreatics. Action Both medications lower blood sugar levels by stimulating absorption of glucose in skeletal muscle and fat. They also inhibit the production of glucose in the liver. Onset Novolin N is an intermediate-acting insulin that starts acting in from one to four hours after being taken. Lantus is a long-acting insulin that starts acting in from one to 10 hours after being injected. Peak The peak time of an insulin is the time during which the blood sugar is most affected. The peak time for Novolin N is four to 12 hours after administration. Lantus does not have a peak time because it is released at a constant rate. Duration Novolin N lasts for from 12 to 18 hours, while Lantus has a duration of up to 24 hours. Continue reading >>
Medicare And Insulin
Why does a drug cost $25 without insurance and $110 with Medicare Part D? Novolin N and R can be bought at Walmart for $24.88 without insurance. With a Part D plan, the cost is $110. Why? I have a client who has diabetes. She uses Novolin N and Novolin R. If she uses her Medicare Part D plan to purchase this insulin, she would go into the donut hole/coverage gap because the negotiated price is $110 per vial and she uses four vials per month. So she goes to Walmart and buys Novolin N and Novolin R without using her Part D card. Her cost is $24.88 per vial. How is it possible that the insurance company that runs her Part D plan hasnegotiated a price of $110 for Novolin when it sells at Walmart for $25? Although the insurance companies that provide Part D plans negotiate drug prices, it is Medicare that actually pays the bill. So why is Medicare paying $110 instead of $25 for Novolin? Medicare will spend70 billion dollars on Part D in 2015. How much lower would that incredible figure be if Medicare was not overpaying for drugs like Novolin? I looked upup Novolin N or Novolin R on the Medicare.gov Plan Finder. Here is just one of 30 stand-alone Part D plans available in Arizona. Some Medicare Advantage plans offer better co-pays for Novolin ($9 or $0), but the retail price is always over $100. I have written previously about my clients with high drug costs, and insulin has been part of the story: The retail price of insulin using a Part D plan ranges from $70 for a vial of Humalog to $395 for the Novolog Flexpen. Novolin is not the best insulin for managing diabetes, but it is the lowest-cost method if purchased at Walmart for $25. When I googled the cost of novolin I found an article from P hoenix Diabetes and Endocrinology : Preferred basal insulins are Lantus and Levemi Continue reading >>
Interactive Dosing Calculator
Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>
Basal Insulins (intermediate And Long-acting)
Who? Intermediate- and long-acting (basal) insulins are recommended for patients with type 1, type 2, or gestational diabetes. They may also be used in other types of diabetes (i.e. steroid-induced). Persons with type 1 diabetes generally use intermediate-acting insulin or long-acting insulin in conjunction with regular or rapid acting insulin. Persons with type 2 diabetes may use intermediate or long-acting insulins in conjunction with regular or rapid acting insulins or with oral medications. What? Injections given under the skin. Not suitable for insulin pumps. These medications can be injected with a traditional syringe and needle, or with a disposable pen that has been prefilled with insulin. Most patients tend to prefer pens though while convenient, they can be more expensive. The most common type of intermediate-acting insulin is: NPH (marketed as Humulin N and the Humulin N Pen) NPH (marketed as Novolin N and the Novolin N FlexPen) Long-acting insulins are marketed as different brands. The common ones are: Glargine (marketed as Lantus and the Solo Star Pen) Detemir (marketed as Levemir and the FlexPen) Degludec (marketed as Tresiba and the FlexTouch Pen) Where? These medicines are injected into the tissue under the skin and are slowly released into the body. These insulins allow glucose from the bloodstream to enter the cells in the body so that glucose can be used as energy. They also reduce glucose release into the bloodstream. When? NPH is usually injected twice a day. It begins working 1-3 hours after injection, and is most effective between 4-10 hours of injection. It generally keeps working for 10-16 hours. Detemir can be used once or twice a day. It begins working a few hours after injection and generally keeps working for anywhere from 20-24 hours. Glarg Continue reading >>