Coumadin vs Lovenox??

[JeanneImp]

Matt had to have his INR's done at the hospital last week due to it being so low for a couple of months.

The PC's nurse told me to start talking to Matt (19 yrs old, valves and coumadin for 10 years) about switching to Lovenox as the insurance companies are not wanting to pay for Coumadin! Has anyone else heard of this??

What is the difference? Besides him not wanting to do the shots 2 x a day, is there a good reason to consider changing??

Thanks!

 

[geebee]

I just cannot imagine that an insurance company would rather pay for Lovenox than coumadin as it is many times the price. To say nothing of why someone would want to agree to shots vs taking a pill.

Something is very amiss here. I would talk to her again and make sure there was not a misunderstanding.

 

[Karlynn]

Not to mention that Lovenox is much harder to regulate. You are giving yourself shots every 12 hours, can't veer off the timing too much. You forget a shot and you are coagulating like a normal person. I have to believe that these people have no idea what they are talking about. Run like crazy the other way!!!!

Lovenox is much more expensive than Coumadin. If they don't want to pay for Coumadin (which I highly, highly doubt - it's got "mega lawsuit" written all over it.) they sure aren't going to want to pay for Lovenox.

How low has his INR been in the last few months? Does he do his own dosing, or does the clinic, doctor, hospital?

 

[JeanneImp]

Hi Gina,
Thanks for the quick reply. There was not a misunderstanding. We discussed this at length. The reason was the ins. company refusing to pay for the Coumadin. Yet Lovenox costs much more, hmmmmm????

Matt has always refused Lovenox, he just doesn't want to do the shots. (If there was no other alternative, he would.)



I guess I need to call back and find out what is going on.

 

[geebee]

I would talk to the insurance company as something is not right. If the doctor prescribes coumadin, I've not heard of an insurance company refusing to let a patient take it.

After all, it's not like it's an experimental drug or the like.

Have fun - we all know how cooperative insurance people can be.

 

[JeanneImp]

Hi Karlynn,

*Not to mention that Lovenox is much harder to regulate. You are giving yourself shots every 12 hours, can't veer off the timing too much. You forget a shot and you are coagulating like a normal person. I have to believe that these people have no idea what they are talking about. Run like crazy the other way!!!!


I think I will call his hemotologist to get involved in this.... I can't imagine Matt giving himself shots every 12 hours without forgetting a dose here and there. He is in his first year of college, first time away from home and it's tough...


*Lovenox is much more expensive than Coumadin. If they don't want to pay for Coumadin (which I highly, highly doubt - it's got "mega lawsuit" written all over it.) they sure aren't going to want to pay for Lovenox.


That is interesting. Especially since Matt has problems with Coumadin. He has the rash, poor kid. He can maintain his INR around 3. for a while and then for no reason it flucuates. he either goes way to high or much too low. This has been going on since he started it.



*How low has his INR been in the last few months? Does he do his own dosing, or does the clinic, doctor, hospital?



The PC does his dosing. Right now it is 4 1/2 mgs. We have a home monitor kit for bi monthly/monthly testing, plus he gets his blood work every 6 months at the hospital. The last 3 tests have been 1.7 - 2.1 We are increasing 1/2 mg at a time....

 

[Ross]

Lovenox - 100mg/ml Solution 1ml Syringe
Quantity Our Price
10 syringes $632.27 - save 18% ($141.70)
20 syringes $1,232.84 - save 20% ($315.10)
30 syringes $1,849.26 - save 20% ($472.64)
40 syringes $2,465.68 - save 20% ($630.19)
50 syringes $3,082.10 - save 20% ($787.74)
60 syringes $3,698.53 - save 20% ($945.28)


Coumadin - 5mg Tablets
Quantity Our Price
30 tablets $23.99
90 tablets $65.97
100 tablets $73.30
120 tablets $87.96
150 tablets $109.95
180 tablets $131.94

Warfarin Sodium - 5mg Tablets
Quantity Our Price
30 tablets $13.99 - save 30% ($6.00)
90 tablets $34.99 - save 42% ($24.97)
100 tablets $38.88 - save 42% ($27.74)
120 tablets $46.66 - save 42% ($33.29)
150 tablets $58.32 - save 42% ($41.61)
180 tablets $67.63 - save 44% ($52.29)



Someone is full of bull on this one! Lawsuit is right on. The more I think about this, the more I think she means that the insurance will not pay for brand name Coumadin, but will for Warfarin and she's confusing Warfarin with Lovenox. Many insurance companies will not pay for the brand name, but will the generic.

 

[INRtest]

Jeanne,
Ross gave the specifics (pricing), but I think that you should pay for the meds yourself until your insurance co. gets smart or they understand that a lawsuit is pending.

I pay for my own meds (due to a very high deductible) and frankly this is a small price to pay for piece of mind.

Good luck.

 

[Ross]

I think I will call his hemotologist to get involved in this.... I can't imagine Matt giving himself shots every 12 hours without forgetting a dose here and there. He is in his first year of college, first time away from home and it's tough...

*No need too. This person is as cracked as a crack addict*


That is interesting. Especially since Matt has problems with Coumadin. He has the rash, poor kid. He can maintain his INR around 3. for a while and then for no reason it flucuates. he either goes way to high or much too low. This has been going on since he started it.

*What are you or they calling too high or too low? This could be mismanagement on their part*

The PC does his dosing. Right now it is 4 1/2 mgs. We have a home monitor kit for bi monthly/monthly testing, plus he gets his blood work every 6 months at the hospital. The last 3 tests have been 1.7 - 2.1 We are increasing 1/2 mg at a time....

*Are they dosing him? They are not doing it right. You need to get to another clinic or find someone that knows what they are doing. You may be better off dosing self dosing*

 

[JeanneImp]

Hi Ross,
I am almost speechless........... The cost difference just shocked me.


*Someone is full of bull on this one! Lawsuit is right on. The more I think about this, the more I think she means that the insurance will not pay for brand name Coumadin, but will for Warfarin and she's confusing Warfarin with Lovenox. Many insurance companies will not pay for the brand name, but will the generic.


No, she clearly stated Lovenox. I said to her no way will Matt give himself shots and she then replied that the ins companies have changed and they will pay for LOVENOX not Coumadin! Matt cannot take Warafin.

*What are you or they calling too high or too low? This could be mismanagement on their part*

No, it's not mismanagement. Matt will consistently take his dosage and maintain his INR around 3.0. Then for no reason, it can drop to 1.7 and lower or go as high as 10 and higher. I know this because I have managed his meds throughout his life.

*Are they dosing him? They are not doing it right. You need to get to another clinic or find someone that knows what they are doing. You may be better off dosing self dosing*

He has just had problems since he began taking this med. I am going to make calls tomorrow. Hemotolgy and PC.

Thanks so much.

 

[JeanneImp]

Hi Jess,

*Ross gave the specifics (pricing), but I think that you should pay for the meds yourself until your insurance co. gets smart or they understand that a lawsuit is pending.

I pay for my own meds (due to a very high deductible) and frankly this is a small price to pay for piece of mind.


I do not have a problem paying IF the insurance co. denies it. They haven't as of yet. They did fight paying for Coumadin a few years ago, but with the PC's letter as to why he needed it, they pay it.

We have fought to keep Matt alive since he was 9 days old, many, many surgeries and caths, hospitalizations and everything in between. Do you know, we never ever had a problem with the insurance co??? Even when we had to take him to Ann Arbor, MI......

This whole Lovenox thing has really upset me!

 

[geebee]

I think I am kind of confused when you say Matt cannot take warfarin and then talk about the insurance refusing to pay for Coumadin. Coumadin and warfarin are the same drug. Or am I misunderstanding something?

 

[JeanneImp]

I think I am kind of confused when you say Matt cannot take warfarin and then talk about the insurance refusing to pay for Coumadin. Coumadin and warfarin are the same drug. Or am I misunderstanding something?

They are but are not. Warfarin has a different compound maybe?? I am not too sure, but when they tried Matt on it, his INR's were all over the place.

This is one of the articles sent to me regarding the 2.
http://www.uwnews.org/article.asp?articleID=7647

 

[geebee]

It has been proven that there is no difference between Coumadin and warfarin but the rumors still persist. In fact, Bristol/Meyers lost a lawsuit over claiming there was a difference. Many of us have switched from Coumadin to warfarin without any change in INR stability. Since Matt's INR seems to be all over the place right now, while on Coumadin, I can't help but think there is something else going on.

 

[Ross]

Coumadin and Warfarin are exactly the same drug. One is brand name and one generic. the generic is held to Federal Standards for potency of the original.

http://www.warfarinfo.com/generic.htm

 

[Guest]

I agree that you got misinformation. It was more likely a slip of the tongue about warfarin and Lovenox. They are not interchangeable. I can imagine myself making this slip up. I would not get the cardiologist or hematologist involved - it must have been a slip-up. Ther person who said it will probably wake up at 2 AM thinking WHAT?!

 

[Karlynn]

Lots of posting going on here because I think we are suspecting that his Coumadin managers don't know too much about what they are managing and we suspect that they may be the reason he's not very stable with his INR, and not that he just doesn't react well to Coumadin/warfarin. To even suggest that he use Lovenox instead of Coumadin for long-term anticoagulation is nuts.

Warfarin is the generic name for Coumadin, so they are the same drug. We just had a new member join who had an allergic reaction to the #5 warfarin. The doctor suspects it's the dye or filler.

What is Matt's target INR - I'm assuming with 2 valves, it's 3 - 4?

Some people do have a hard time staying stable with their INR - but it seems that quite often it's incorrect management by doctor or "clinic".

 

[Guest]

The way to get around the dye problem is to use the 10 mg tablet. It is dye-free. But it has the same filler. The generics probably have the same fillers too but maybe not in the exact same quantity.

 

[ALCapshaw2]

Ross was right on with this statement:

"The more I think about this, the more I think she means that the insurance will not pay for brand name Coumadin, but will for Warfarin and she's confusing Warfarin with Lovenox. Many insurance companies will not pay for the brand name, but will the generic."

My insurance company (BCBS) will no longer pay for Brand Name Drugs when generic drugs are available. IF you or your doctor insist on the brand name drug, they WILL pay up to the amount for the generic and the patient makes up the difference.

This sounds like a BIG MISUNDERSTANDING, probably on several peoples part, especially when it comes to recommending Lovenox ($32/day) vs. Coumadin ($0.70 or 70 CENTS/day) vs Warfarin ($0.30 or 30 CENTS/day).

FWIW, I switched from Brand Name Coumadin to Generic Warfarin made by TARO in Israel with absolutely NO discernable difference. BARR (made in USA) is another reputable manufacturer of Generic Warfarin.

I have to question the statement about not being able to take generic Warfarin but taking Brand Name Coumadin. Something is amiss here...

'AL Capshaw'

 

[JeanneImp]

The reaon why Matt does take Warfarin is because he had a reaction to it. They now deem him allergic. Also, his INR's could not be stablized while on it. One day his INR's would be 1 and within 3 days so high, he had bruising and constant bloody noses.

I am still waiting for a reply from the drs....



I know I am not crazy.. other parents are hearing the same! here is a reply from one,

Most hematologist recommend Lovenox, because it is a much easier drug to stabilize your levels. It does not interact with food and does not require frequent blood levels. Actually once you have been on it for awhile you are able to reduce your dose and keep the same level. It just seems to be a safer drug for patients all around. Most hematologist are quickly getting rid of coumadin, most insurance are not so happy since it is quite expensive.