have a prescription for a inr monitor,,,now what?

[carverelli]

my nurse practioner gave me a script for an inr monitor, but my town doesnt seem to have any or even know what they are. Are there sites they sell to the public or does my dr need to purchase it then resell it to me?

 

[pellicle]

only heard of ones which sell to the public ... do you have to buy it out of your own money or out of some company funded system?

the Roche Coaguchek XS is what I use (others here use other devices). I got my device thrown in with my valve. If you are paying for it I recommend ebay and a used one from somone who didn't want theirs.

Some suggestions
http://www.amazon.com/Roche-Diagnos...472&sr=8-2&keywords=roche+coaguchek+xs+system

http://wilburnmedicalusa.com/-c-0/roche-coaguchek-xs-products-p-149228

I live in Australia (as my Location suggests) so I'm not sure about prices in the USA.

Other brands include the INRatio which I have no experience on.

It was just the other day when I was discussing with one user here that my Coaguchek seemed easier to use than his INRatio, but he (not having used mine either) thought it was OK once you got used to it.

I have noticed that few people on an INRatio machine get as close a results to lab tests as I (and other Coaguchek users seem to) get with the Coaguchek, but then saying that may simply get people upset.

dunno

I'd price strips and make a comparison on which is the cheapest to run too.

 

[pellicle]

also, some previous calculations on a previous topic

Online prices can be down to US$6 per strip if buying in 48 strips.

A used coaguchek can make it cheaper.

An alternate cost benefit analysis could be:
* Used coaguchek (sold by someone who didn't like home testing for instance) ~= $500
* 48 strips ~= $260
Yeilds $15.80 each for those 48 tests
However you get to keep the meter so subsequent tests are $5.41 each test.

Compared to lab tests you are ahead before you complete the first 48

 

[JimL]

I contacted Roche and let them handle all the doctor and insurance questions for me. Here's a link with a telephone number: https://www.poc.roche.com/coaguchek/rewrite/content/en_PT/10:10/article/POC_general_article_04.htm

 

[AgilityDog]

If you buy direct from Philips or Roche, make sure you tell them you want an outright purchase. And buy your own strips. Don't let them suck you into a lease/supervision plan. If you do, they'll charge your insurance, and you'll burn up your deductible every year before insurance pays a dime. And if you are under 65, Philips, for one, charges as much as $250 per MONTH for their "lease/supervision" plan, which goes against your deductible! For which they do nothing except fax your doctor with the INR you call in to them. Hey, my doctor has a phone! I can call my results in to him/her directly all by my lonesome! I don't need a stinking 3rd party to make sure I'm running my tests. I'm a grown up.

 

[pellicle]

! I can call my results in to him/her directly all by my lonesome! I don't need a stinking 3rd party to make sure I'm running my tests. I'm a grown up.

That's the spirit

 

[Protimenow]

I have gotten all my meters through eBay (with one exception). Aside from one that was As Is (but came with a power supply that I needed for the others) for $1, all my meters have been functional.

I concur with the advice -- don't get sucked into those lease plans. Personally, without insurance, owning the meter was the only way that I was able to go.

I'm waiting to get the results of my last blood draw from the lab, but will probably stay with the Coag-Sense that I recently bought. (In addition to that, I have an InRatio and InRatio 2, and a few Protime and Protime 3 meters -- and may be willing to part with one, if you're interested).

 

[dick0236]

I have used both the Alere and Phillips "lease" plans in the past few years with terrible customer service results for an extremely overpriced program. Personaly, I think it is an insurance rip off. Six months ago I went to e-bay and purchsed a brand new(in original box)INRatio2 for about $500 and strips for about $4 each....no insurance, Dr. Rx approval needed. I test at home weekly and go to my GP lab once per month. Kentucky docs apparently don't feel patients have sense enough to selftest.....46 years of INR experience doesn't seem to matter to them.

 

[pellicle]

Kentucky docs apparently don't feel patients have sense enough to selftest.....46 years of INR experience doesn't seem to matter to them.

Don't feel alone there, similar story here in Queensland Australia. (Although I lack the depth and breadth of your experience, and am but a padawan learner)

 

[ski girl]

However, in Western Australia, you are completely left alone to test, monitor, and manage! And some say we're a nanny state?? ;-)

 

[Protimenow]

Some doctors - who apparently walk on clouds and seem to think that they're smarter than mere mortals - went crazy on me a few months ago when I mentioned that I was also taking an 81 mg Aspirin daily. They seemed to think that this imbecile was incapable of understanding how aspirin effects clotting and, of course, they would have freaked if I admitted to them that I do my own self-testing (and management). They would have preferred that I get a monthly blood draw and somehow trust that my INR didn't change during the month between tests. The reaction of these cardiology interns was insulting and entirely inappropriate.

So - what I'm saying is that some doctors really don't understand that some (probably not all) patients are perfectly capable of running their own tests and, in some cases, even managing their dosages.

As far as meters go -- I've had an issue with the InRatio reporting considerably higher than actual lab tests. In fact, I had a dangerous situation because I relied on the accuracy of my meter. Others have reported consistently higher than lab results. In fact, when I called Alere and asked about the difference between the InRatio numbers and the lab numbers, what they told me was simple: Trust the Lab. (Not all labs, unfortunately, are always so trustworthy).

The CoaguChek XS is supposedly more accurate than the InRatio, with results that are closer to the lab values than the InRatio. (This isn't a problem for InRatio users, if the InRatio results are ALWAYS high by the same amount). I'll probably know more on Friday -- I was able to get a CoaguChek XS on EBay at a very nice price, and should have the meter in my hands tomorrow - and six strips in my hands in three days. My normal testing day is Friday, so I'll probably test with the XS, and also do a test with my new Coag-Sense meter.

Owning your own meter can feel like a liberating thing -- you're not stuck going to a lab for a monthy (?) blood draw. You can determine your own INR at your own convenience.

As I noted in an earlier post, I have acquired all but one meter over eBay. I've acquired my strips from eBay or other medical suppliers.

One thing that I've been doing from the first test I did at home is to maintain a spreadsheet. It records the time of my test (and, with more than one different meter, which meter was used), my weekly dosage, my INR and any details that may have had (or possibly had) an impact on my INR. When I get a blood draw, I also keep track of that value. This is not only useful historical data, it also helps to convince doctors who might be skeptical about your ability to do your own testing that you are, indeed, on top of it.

 

[pellicle]

However, in Western Australia, you are completely left alone to test, monitor, and manage! And some say we're a nanny state?? ;-)

thats only over here in the Eastern States where population density has reached high levels. Up in the Pilbra I'd reckon you're on your own

 

[m11_9]

just got one a few months ago, coaguchek xs are @600 new on ebay. There is a billing code for home test interpretation that your provider can use, so you shouldn't get any grief from your doc. and you don't need that prescription.

I had check into the programs and they seemed scammy to me. wildly overpriced, all that is wrong with healthcare expenses these days.

I was uninsured for it because it was durable equipment and I am not home-bound, but they would have paid for the overpriced service plan. makes no sense, but that is the crazy US healthcare system for you.

 

[chaconne]

At Protimenow and other's suggestion, I recently got an InRatio2 off ebay. The going rate for new ones seems to be about $500, which is a good price. I opted for a cheaper $350 meter which said it had only been used twice (according to the memory history it was more like used 5-times). After using it more than a dozen times, it seems to function well and matches up within 0.2 of lab draws. There is a crack in it but that doesn't seem to affect its function. I am a definite believer in ebay purchased meters.

 

[Protimenow]

You might contact Alere about the crack in the meter. The worst that they can do is tell you that you'll just have to live with it.

(In my experience, the InRatio wasn't as close to the lab as you've experienced. You may want to test against a lab every few months, if only to verify that it's still within 0.2 of the labs. Of course, even lab results aren't always reliable, so knowing your ACTUAL INR is almost a matter of faith in the method used for testing. In my case - with a target INR of 2.5 - 3.5, or according to another doctor 2.0 - 3.0, if my InRatio tells me 2.5-4.0 or so, I'm okay with that. I'm still trying to figure out why some of my other meters don't agree more than they do).

It's good to hear that you've got your own meter.