[MrFoof]

Can confirm. Type 1 who switched away from Eli Lilly insulins (Humalog and Humulin N) to the Novo Nordisk (Novolin R and Novolin N) equivalents sold at Wal-Mart.

Much more planning involved, and a big adjustment compared to Humalog and Humulin. My A1Cs are also a bit higher (6.1 instead of 5.9) to give myself more safety margin.

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Why'd I switch? First I pay less out of pocket than I did compared to insurance co-pays for the name brand stuff. That is, $90/mo for short-acting, long-acting, lancets, test strips and syringes... compared to $170/mo in insurance co-pays for the Eli Lilly and Abbott equivalents, and probably around $800 MSRP.

The second is I no longer need to wait for refill authorizations which too many doctor offices drag their feet on, in addition to insurance companies enforcing only a tiny number of refills per auth (as in, requiring a physician's authorization for the insulin you'll use until you die EVERY SINGLE MONTH) which creates yet more delays and sometimes numerous phone calls to get a prescription refilled since you constantly need an authorization from the prescribing doctor. "If they keep messing up, why not switch doct--" I have. Four times, across three different HCOs, and three different insurance companies. They all screw up and fail to respond to the pharmacy on occasion, sometimes for several months (and a dozen plus phone calls) in a row.

It wasn't even about the cost anymore. The ridiculous bureaucracy with the ultimate position of, "it's the patient's fault" held by every other party forced my hand.

[grep_name]

IME people tend to underestimate most aspects of type 1 diabetes, especially how big an ask it is to suggest someone switch insulins on short notice and out of desperation.

And the bureaucracy is ridiculous. I'm the most financially responsible person I know in my age group, yet I annually get letters threatening to send me to collections for charges I was not warned about by a weird middleman company that I get automatically charged through for medical supplies for my pump. Haven't heard from them this year, and I've called them 4 times so far trying to figure out where the charges went. It turns out they have 3 accounts registered under my name for these things and none of them are the account that my orders have been going to. At this point I'm just going to wait for the annual letter I guess.

Good job on the A1C though. I want to get there someday, but I get sudden massive drops in blood sugar out of nowhere about once every two weeks and it scares the crap out of me. I'm optimistic I'll figure it out eventually though

[lolc]

Wow a monthly refill authorization sounds really onerous! I can't believe they make you do that. It sounds like they try to make the process as cumbersome as possible so you go away. Which you did. I think I would do the same.

A story like that really puts into context what expensive insulin means. When it's expensive, they want to make sure you don't sell it. So even people who can get it through insurance are affected.

For contrast an experience from a rich European country: My doc writes me a yearly prescription. I forgot to renew it once, and had to pay out of my pocket to get my insulin. He sent me a backdated prescription I could use to get the cost reimbursed.

[ihumanable]

Monthly refill authorization is simultaneously the craziest thing I’ve heard and also so characteristically on theme for US health insurance I didn’t doubt it for a second.

Hey this is Blue Cross, does Bill still need insulin this month?

Yea, he has type 1 diabetes, it’s a chronic and lifelong condition he will need insulin every month.

Cool, cool, we will check back in next month to see if he needs more.

Do you expect me to come up with a cure for type 1 diabetes by next month?

No, that would be ridiculous.

Well why check every month?

In case he doesn’t need it anymore.

How would that happen?

Hmm.... good point, we can talk about it more next month when we check in to see if Bill needs more insulin.

head slamming into desk sound