Sticker Shock!

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Sonya

Sonya

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I wasn't sure where to post this question, as a newbie I hope this is the right place. My cat Thomas had his first shot this morning, it was unevenful. Yay! Other than the fact that he later got mad because we wouldn't let him go outside. Obviously we are keeping an eye on him for any reactions. Since we wouldn't let him outside, and since there was a litter box 20 feet away, he chose to pee in the newspaper box instead! Brat!

Anyway, we are using Lantus and picked the vial up from the pharmacy yesterday. $165! So now I have two questions:

1. How long does a vial usually last? (He is starting out with 1 unit 2x a day, I know this could change as we get him regulated)

And

2. Any suggestions on where to purchase for a better price?

Thanks!

Sonya and Thomas
 
Yes Sonya - I'd say sticker shock! I know the cheapest way to buy Lantus is order from one of the Canadian pharmacies - can't remember the name right offhand. Get a prescription for 5 PENS rather than the vial - lasts longer - I THINK the price there is like $110 and will last much longer.

HUGS!!!
 
I got the vial, too, but it was $110 at Target pharmacy. I'm going to get a new rx for the pens when I need to fill it and try to find a pharmacy who will split the box as Mikey's dose is so tiny. You may also find someone in your area from the board who will split a box of pens with you.

If you keep it in the fridge, it can last up to six months if handled very gently. (That doesn't mean it will last that long. The manufacturer recommends changing the vial after 28 days.) If it gets cloudy or floaties, you need a new vial. Also, if his numbers suddenly stop going down after his shots, it's likely gone bad. If you don't keep it in the fridge, you'll need to replace it after 28 days.

Are you testing Thomas' blood glucose at home? We all recommend strongly that you do for a couple of reasons. One, every cat is different, and a safe dose for one cat may not be safe for another. (For example, my Mikey was started on 1U, which is pretty standard. He had a couple of scary episodes with dangerously low BG numbers. Even .25U was too much for him-he's doing very well on just .1U. I'm VERY glad I was testing so I could adjust his dose before he had a serious hypo episode!) You may need to adajust the dose up or down, but won't know that if you aren't testing often. Curves done at the vet can be very inaccurate due to stress, so aren't great for determining dose.. Second, testing often can really help you understand your cat's personal cycles and how the insulin affects him. I have found that knowing Mikey's cycles, when his nadir is and when it too early for a low number, has reduced my stress level exponentially! I feel SO much better leaving him for the day because i can look at his BG 2 hours after a shot and have a pretty solid idea where his numbers are headed.
 
Definitely get a prescription for the pens. The vial will last at least 28 days, and at most (with proper handling) 3-6 months. My first vial only lasted about a month because I didn't know you shouldn't inject insulin back into the vial. Here's some info on handling: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151.

The pens however, are like mini-vials (5 X 3ml vs. 10ml). So a pack of 5 pens will last you at least 5 months, but more likely a year or more with proper handling. If you order from Canada, it's about half the price of getting them at a pharmacy in the US. ($110 vs. $245). If you do end up opting for a US pharmacy, here's a coupon for $25 off the pens: http://www.lantus.com/solostar-insulin-pen/solostar-coupon.aspx

Also, as mentioned home testing will save you a TON of money. And it's safer and allows better glycemic control, increasing the chances of remission.
 
Wow!!! Yeah that's pricey. I'm newish to this and haven't looked into the pens but I have been calling around to different pharmacies locally to find out costs. So far the cheapest have been Costco (you don't need a membership but it's cheaper if you are) and Walgreens (IF you have the Rx savings club). But of course it might change depending on where you live. I also haven't called all the pharmacies in the area yet. :)
 
For home testing, I found the walmart brand relion micro meter is about the cheapest on strips...9.00 for the meter and 20.00 for 50 strips if I remember right.
Have you started the home testing process yet?
 
The price of the Lantus really does depend on area. That price isn't out of line with pharmacy costs here, I think I paid slightly less at around $130. The 5 pack of pens costs me $220 (the price that comes up with that pet Rx card at my pharmacy is actually higher than what I pay). I am uncomfortable ordering something that I am supposed to handle carefully through the mail so I am hostage to our rigid pharmacy state laws that limits the cheaper retailer competition.

Our vial lasted about 3 months and we didn't handle it well at all (told to roll, shot extra and air bubbles back in, forgot on the counter a few times). With the pens I am not seeing a box lasting much longer, they seem to be pettering out on me quicker than a month, but I found husband has been shooting extra and air bubbles back in and I think the pens are less forgiving on that stuff. I'd probably switch back to the vial because of the cost if it wasn't for the fact that I only handle 1/5 of the insulin at any time, so I can only damage/lose 1/5 of it and the rest is safely tucked in the fridge.
 
Yikes! That was an expensive Lantus vial! Definitely check out that link posted by Julia and Bandit about handling instructions.
When my cat was first diagnosed in 2006 I had been told that the Lantus only lasted 28 days, and that I should be rolling the vial and injecting air before drawing out insulin, and that it did not need to be refrigerated --- basically said it made no difference whether or not you refrigerated it, it would still last only 28 days. And treating it that way, it DID only last 28 days!

Then I came here ( at first just lurking) and saw that people were finding out it lasted quite a bit longer. (and one of the leading feline diabetes researchers, Dr. Rand at U of Queensland, wrote that it lasted 6 months in their refrigerator at their lab.
By careful handling I was able to have the 10 ml vials last about 5 months. ( but YMMV )
And re the the smaller cartridges / pens, my own experience was like Melanie said, that they do not tend to last as long (more like 2 months ) but it can still work out to be a better deal .

Congrats on your uneventful first injection! You're off to a great start, with an excellent insulin for cats.

Cheri and Louis
 
Our Costco has a free program you can sign up if you don't have insurance. That put our vial at... $113-116 back in November/early December.
 
I get the pens at Target for $220. You can go to the Lantus web site. They have a coupon for $25 off. The pens are more money, upfront, but at $125 for a vial that lasts, supposedly 1 month, the pens are cheaper by far. My cat is on a larger dose and a pen lasts about one month, so that works out to $40 a month for the pens (with the coupon). I also was skeptical about buying mail order, esp. because one of the web sites I looked at the insulin was made in Turkey!! (see below) I am sure the quality is fine, but I had serious doubts about the handling. How can you be sure it was refrigerated the entire way from Turkey to Canada? But there are sites where it is manufactured in Canada, so be sure to check, if you go that route.


Lantus Solostar(5 x 3ml) 100IU/mL

15 ml Insulin Glargine, Human Recombinant Analog
Sold from Pharmex. Product from Turkey.
The insulin is shipped in special packaging to keep the insulin cool during shipping. Storage requirements for insulin do allow them to be outside of refrigerated temperatures for up to 4 weeks
 
There is also a link in the Supply Closet for $25 for your first prescription of the Lantus pens. There is also a link for similar savings for Levemir pens. Make sure that you look for the one I posted this year. The other link from last year may have expired.
 
Thanks for all the good advice, especially the $25 off coupon.

I wish I had known more about Lantus before, we have been loading the pen with over the dosage amount and then pushing the overage back in. I guess that was a no - no.

Sonya
 
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