Does everyone here go through A service?

[Bugsy]

It seems like every year it gets more difficult to get test strips. My doctor is fine with me home testing so I don't see the need to go through a service such as Philips Medical. It seems though that these companies are trying to put every roadblock in place that they can to force me to go through them. I would imagine this is quite profitable for them. Other than getting your supplies to you it appears all they do is forward your numbers to your doctors office. I'm capable of doing that myself. Are any of you getting your test strips from another source?

 

[tom in MO]

I get my test strips through EdgePark. They also supply the meter for free. They required a prescription with a weekly test, but don't care if I test every two, three etc. weeks. I call in my results to the cardio myself.

I used to get my strips and meter through Allere, which handled and called in my results. My insurance carrier dropped them, and picked up with EdgePark. I sent my meter back to Allere, but the meter I got from "Edgepark" also came from Allere. Allere also tried to get me to call in my results to them, even though I was now with EdgePark but I did not. They called me many times and sent two letters. On the phone, Allere told me I would not be able to get resupplies if I did not call my results into them. I told them that this is not a requirement of my Cardio or Edgepark. They said it was an EdgePark requirement. I called my insurance company, they were suprised. They no longer like Allere, that's why they were dropped. They talked to EdgePark and then called me back, saying that I can get supplies w/o using Allere to call in results.

I will find out soon, because I need new supplies.

 

[Bugsy]

Thanks for the reply. After reading your post I called Edgepark and it sounds like Allere has to be involved.

 

[pellicle]

Hi

As there are members here who are not from the USA I would say no. There are Europeans, Australians as well as many others.

I personallyfully self manage and buy my strips out of pocket. The strips cost about what a coffee shop charges for a coffee, so a strip a week is no biggie.

Also many of us here (even the USA citizens) use a coaguchek XS, which at the moment is not suffering from the issues that Allere is.

 

[Protimenow]

I don't know about 'everyone,' but I don't use a service. I know that **** reported that he had a service, but that it was hard to use and way too expensive, and as far as I know, he is self-testing and may also be self-managing.
It's been written that many (all?) of these services charge way more than is necessary, and that they're a rip-off of the insurer or government funds.

Personally, I've been self-managing for five+ years. I started managing once I was able to get a meter.

I personally do not trust my INR to the InRatio meters -- they report values that are significantly higher than the labs (or most of my other meters), and I had an 'event' two years ago that can be related to incorrect results. Plus, with the current supply problems and recall of InRatio strips, I don't know how affordable or available supplies for this meter will be for some time to come.

One of the more rational things about these services is that they seem to want weekly reports, which they call in to your doctor. Weekly reporting is good -- I often test weekly, and hardly ever go more than 10 days or so between tests. In spite of my being nearly always (with very rare exceptions) in range, I still want to test weekly (and usually never test every other week).

I have bought my meters on eBay. My supplies often come from eBay, although I've also used medical supply companies or other sources for the testing supplies.

You can often get a working meter relatively inexpensively on eBay -- just keep watching. Although the rules of this forum may require suggestions of only using professional sources of meters and supplies, I'm just stating what I've been able to do. In my experience, I've saved a lot of money buying meters on eBay, and have rarely run into problems. The InRatio 2 that Alere sent to me (after I reported a major problem resulting from probable errors produced by the InRatio 'classic') was one of the meters that significantly overstated my INR in many cases.

No -- you don't need a service.

I have a clinic that feels as if it is managing my INR, but with monthly tests, it really isn't doing me much of a service (other than prescribing my Warfarin and letting me get monthly blood draws that I compare to my Coag-Sense and CoaguChek XS (or XS Plus).

There are resources available (plus some of us on the forum) that may be able to help you do self-management. (I don't always trust the clinics or other 'professionals' to give good advice about dosing. I've ignored bad advice from one clinic, and am almost ALWAYS in range -- because I am able to self-manage). Self-management shouldn't be all that intimidating -- and, after all, it's YOUR life, and you have a much higher stake in keeping your INR in range than any clinic or service does.

 

[chaconne]

Allere stinks! The meter is good, and it was made by Hemosense before Alere bought them out, but I don't like their style. They seem to think they're the FBI or something, trying to bully people into using their service. I once called to ask about the test strips and told them I got them from Amazon. They told me that was illegal and tried to get my name. I won't be calling them again!

 

[dick0236]

...... I know that **** reported that he had a service, but that it was hard to use and way too expensive, and as far as I know, he is self-testing and may also be self-managing.
It's been written that many (all?) of these services charge way more than is necessary, and that they're a rip-off of the insurer or government funds.........

I recently (June 2014) went back to a service administered by a division of Rouche (Coaguchek Patient Services), Indianapolis IN. . While I feel the cost is too high (about $30/test) it is covered 80% by Medicare and I feel more comfortable than going thru ebay...especially after the strip problems with Alere. I kinda self manage but do not make significant changes without my docs knowledge. I also go in quarterly, or so, and check my CoaguchekXS against his CoaguchekXS for accuracy. The CoaguchekXS seems to read my INRs with less deviation, test to test, than the INRatio2....... and the people at Coag Patient Services are a LOT easier to deal with than the Alere folks( I used the Alere service a couple years ago....for a short while before going to ebay)

 

[Bugsy]

Thanks everyone for the replies. I guess I should have been a little more clear. I have been self testing and managing since 2006 and just calling my results in to my doctors office one a month. I also own my own machine and until now have purchased test strips out of pocket. The problem now is I can't buy test strips anywhere. Like many of you Alere tried to bully me as well. I called Roche and they told me the only way I could buy a Coaguchek and test strips is through them. Where are you folks buying your test strips? If you are in the U.S. and haven't experienced this problem its likely you will in the near future.

 

[pellicle]

Hi

...I called Roche and they told me the only way I could buy a Coaguchek and test strips is through them. Where are you folks buying your test strips?

sounds like **** and bull story (from them) to me. eBay is one such place you can buy them. I can't see how they'll manage to successfully isolate the USA from the global market even if they manage to stop all the companies in the USA from selling machines or strips. From what little I know of the USA the only way they can even come close to such is if they were to attempt to snooker you by your health care provider dropping you if you fail to comply with any specific request.

I also buy my strips on line (as I know some of the US folks do too) If at worst you can't get them there (doubtful) you can buy them from where I buy mine from in Australia and it will probably save you money (even with the postage) . There is also a place in Germany I buy from when I'm living in Finland (and the EU tarrifs are killers)

 

[Bugsy]

Thanks, Pellicle. I believe its a **** and bull story as well. I actually have some phone calls in to the FDA to try to find the truth. I don't understand all of the security around selling the test strips. I swear I could buy a controlled substance easier. Why can't I just purchase them at a pharmacy? Meanwhile, I was researching all of this and found this webpage. Makes it all sound very official and as though they're only concerned about us patients. Any surprise Alere is behind it?

http://www.ptinr.com/node/4472

Sorry, I don't know how to hyperlink on this website so you'll have to cut and paste.

 

[catwoman]

Thanks, Pellicle. I believe its a **** and bull story as well. I actually have some phone calls in to the FDA to try to find the truth. I don't understand all of the security around selling the test strips. I swear I could buy a controlled substance easier. Why can't I just purchase them at a pharmacy? Meanwhile, I was researching all of this and found this webpage. Makes it all sound very official and as though they're only concerned about us patients. Any surprise Alere is behind it?

http://www.ptinr.com/node/4472

Sorry, I don't know how to hyperlink on this website so you'll have to cut and paste.

Is this the same thing or perhaps related?
http://en.wikipedia.org/wiki/National_Quality_Forum

I never divulge exactly who I buy strips from. I abandoned using a service about 5 years ago, due to cost and my being able to manage my INR just as well as someone else who has to involve a series of phone calls.

I recently purchased a CoaguChek. Because I have some INRatio strips left, I am running concurrent tests. INR results arewither identical or 0.1 different. My doctor's offices uses CoaguChek monitors. Will probably take in my monitor to my family doctor's office for a cross test -- JUST FOR GRINS.

 

[big_L]

I bought my Coaguchek XS and strips on Ebay. I checked with Roche early on and once they got through explaining all they did to 'help', I said no thanks and just buy my own strips. If you go this route, you want to know the expiration date on the strips and of course, you want an unopened box.

http://www.ebay.com/itm/Brand-New-S...602?pt=LH_DefaultDomain_0&hash=item339704416a

 

[T in YVR]

I bought my Coaguchek XS from an authorized dealer - a pharmacy (I am in Canada) - paid $500 Cdn for it, so about $450 USD brand new. I buy the lancets from the same pharmacy as well since they are super cheap. For my test strips, I bought them on eBay and it went great - I found a very reputable dealer, with published expiry dates and a good price of about $5/strip, and I bought a box of 48 strips. Home testing has been a breeze - and I think that's probably BS about Roche forcing people to buy strips from them - In Canada I had to buy their unit from an authorized Roche/Coaguchek dealer/pharmacy, but not the supplies.

 

[Protimenow]

I've been buying my meters on eBay. Strips come to me over eBay, from medical supply companies, or, occasionally, directly from the manufacturer.
I don't really see that a prescription should be needed in order to buy meter or strips. In theory, you can check all day, until you run out of fingertips to puncture and do no harm UNLESS you can get warfarin to make any changes to. It's the medical professionals who prescribe the warfarin. Without a prescription for warfarin, testing is more for entertainment(?) than it is for actual INR management.
The situation may be something like blood sugar monitoring. I think that there was a time when you couldn't buy a tester or test strips without a prescription. But here in the United States, anyone can buy a blood sugar monitor, and test strips, just from walking into any pharmacy. Without a prescription for Insulin, which is pretty tightly controlled, you can't really act on the results. Plus, it's faster (and probably easier) to hurt yourself with the wrong dose insulin than it is with the wrong dose of Warfarin. But there are no controls on buying THESE meters or their supplies.

--

It should be obvious that there are significantly higher sales volumes for the people with the blood glucose monitors and strips (with millions of tests being run each day) than there are for the INR meters. It's probably no wonder why these manufacturers want to capture as much revenue as they can -- by offering overpriced services that do little other than sell overpriced supplies and make phone calls to your doctor, to restricting your access to the strips and meters so that you overpay for these, too. In some ways, perhaps they ARE doing us a service -- by offering a viable alternative to lab testing (like in the 'old days') and giving us the freedom of self-testing or rapid results in a doctor's office or clinic, to making a weekly test not seem like a bad idea. They should be entitled to a fair profit (which I am certain that most of them get), but they shouldn't be lying to us or squeezing us just to get more profits.

 

[Bugsy]

I agree with everything you just said. As I have stated previously I contacted the FDA and have someone working on getting answers to some of my questions regarding the need for a prescription and going through a service. As soon as I get some answers I'll post what I find out.

 

[tom in MO]

I had to order supplies and was once again was incensed by the price $500 for 12 compared to $250 on-line for 48. I called BC/BS, they were no help. They don't care, and they are the ones getting shafted (I only pay 10% or $50.)

I then called Roche-US to see if I can order directly from them. I have a meter from my mil, but it has not been used for a few years, I use one supplied "free" by the strip supplier. He told me they cannot sell directly to me and will not service any meter not supplied by them (even though they made the meter.) I asked the Roche guy striaght up why they sell strips and monitors in Europe directly to the consumer but not in the US. He told me it was the US FDA requirements. Roche told me per US FDA they can not sell strips and monitor to me directly. They must sell a "service" which is why they give away the monitor but charge you a "service fee" for supplies. This is the set-up even if you call your own results in to the doctor.

Not sure who to believe, but it sure is a scam.

 

[Protimenow]

This sure sounds like B.S. to me. If your meter is a CoaguChek S, you won't be able to use it. Roche stopped supporting it (or manufacturing test strips) a year or so ago.

As far as purchasing supplies, you should have little trouble finding them on eBay or Amazon. Alternatively, if your M.D. wants you to self-test, perhaps he or she can order for you.

 

[Bugsy]

I wish it was that easy Protimenow. Tom has just described my recent experience. The employee with the FDA I have been in contact with told me there is no FDA requirement that you sign up with a service. They're still looking into it and I stay in contact with them so they don't just brush it under the rug.

 

[Bugsy]

For those of you that are interested I have received a response from the FDA. If a representative from Roche or Alere or anyone else tries to tell you the FDA requires you to go through their service they're not telling you the truth. This is the FDA response:


We have completed our investigation of your inquiry regarding PT/INR Meters and Test Strips. In short, there is no FDA requirement that PT/INR Meters and Test Strips can only be sold to consumers directly by the manufacturers of the meters and test strips.

A manufacturer may only sell their PT/INR Meter and Test Strip directly to a consumer who holds a prescription when the manufacturer has obtained an FDA clearance that includes such an intended use. To a small extent, FDA has cleared some PT/INR Meter and Test Strips only for prescription use and by trained health care professionals. However, the majority of PT/INR Meters and Test Strips, including the Alere INRatio®2 PT/INR Home Monitor and INRatio®2 PT/INR Test Strip and Roche CoaguChek XS Plus System, have been cleared by FDA for home use with a prescription or other order of a treating physician.

As previously expressed, it is not within FDA’s authority to review Medicaid fraud, insurance, or business practice matters. For additional assistance regarding questions about FDA’s role in this matter, please contact the Center for Devices and Radiological Health Ombudsman, Abiy Desta, at 301-796-5699 or [email protected]. We hope you find this information useful.

Kind Regards,
Kennita Riddick

 

[tom in MO]

Thanks a lot for doing the leg work. Next year I will see if I can buy it on my own again if BC/BS will allow it as a medical device and supplies purchase. If I get the OK, I may have to use the FDA to pry it out of Roche.