Own v. Rent INR Machine?

[tom in MO]

I’ll throw my 2cents in—-i have been on warfarin for 9 yrs. I got so frustrated with doing monthly testing that my Coumadin clinic ordered. I purchased my own Coaguchek xs on eBay so I could test weekly. It was new in the box and about a third of the price that Roche wanted. I had no problems with it—worked great. I used it for 4-5 years. When I became eligible for Medicare I got a new Coaguchek and strips from Roche at no cost (my supplement pays what Medicare doesn’t).

Key thing for me is you bought new off Ebay, not used from Grandson Fred

You got your new one at 1/3 the cost, and Allere gives the meters away for the price of the strips, that gives you an idea of how cheap the meters really are.

 

[cewilk]

I have been bidding on eBay for a used Coaguchek XS but keep getting outbid there are many “buy it now” options that aren’t too much higher than the ending prices on the ones for bid. I think I’m just going to do that. It’s far cheaper for me to buy my own rather than the amount I still have to pay through insurance. Simply calling my INR in to my cardio costs $80 per month just to call it in! And the RN either makes no further recommendations or an adjustment that I already know how to make on my own. The “service” just isn’t worth it anymore to me. I’m happy to hear others have been going solo with their testing and warfarin management for quite awhile now. I am confident I can get a used Coaguchek for <$250. Seems to be about the average on eBay right now.

 

[pellicle]

I have been bidding on eBay for a used Coaguchek XS but keep getting outbid there are many “buy it now” options that aren’t too much higher than the ending prices on the ones for bid. ... I am confident I can get a used Coaguchek for <$250. Seems to be about the average on eBay right now.

That's a good price, and seems a lot cheaper than new. Sometimes it's not worth saving 20% of the price to get one which does not look perfectly presented and actually "as new" especially when you are going to then be using it over years and it just therefore keeps getting cheaper (amortized per rest)

 

[mecretired]

I paid $800 for a new one on eBay and it included 48 test strips. I was very pleased with it and used it for several years. When I needed more test strips i purchased them on eBay. Just be sure to check out the person you’re buying from.

 

[Protimenow]

Alere (one l, not two) will give you the strips -- but at what price? They probably also want you to use a service to call the results in. The 'free with strips' offer sounds dubious, but I haven't checked it out.

I've bought most of my meters on eBay.

I prefer Coag-Sense over CoaguChek XS -- I also have one for sale. I no longer need it. I have to check to see how many tests have been run on it, but I know that it's practlcally new.

ANd I'd feel comfortable buying Grandpa Fred's meter. It probably hasn't been used much, it was working properly when it was being used for testing. The grandkids have no idea what it is, and just want to get a few bucks out of it. As far as amount of use on Grandpa's meter - it sure is a hell of a lot less use than buying from a hospital, clinic, or doctor's office that ran thousands of error free tests on it.

These meters last a LONG time - they're designed to.

 

[ScribeWithALancet]

Yep, thats them. If you click on that image they have coaguchek xs meter and strips available to buy.

Anyways I already filed a dispute with my credit card.

If you do not mind my asking, are they still in business?
They are not answering their phone calls nor do the calls
transfer to an answering machine? Did you get your strips
from them?

I assume this is the company
https://shop.dakotamedicalsolutions...htm?productId=-8607720&catalogId=-19346&fpg=1Dakota Medical Solutions
6555 Cahill Ave., Suite 103
Inver Grove Heights, MN 55076
Phone: (651) 340-6745
I was thinking of buying a CoaguChek XS from them as backup when I get a "bad" reading from my Coag-Sense to determine if I should go in to the lab to get checked. However, if they are not in business or are behaving as though they are having issues then I might want to postpone the purchase. That is a lot of money to go into never never land.
Are you aware of any other medical vendors that sell direct to the customer. I prefer to avoid ebay and paypal. If you did not get your strips, I doubt that I would get a meter.
Thank you,
ScribeWithALancet

 

[tom in MO]

If you do not mind my asking, are they still in business?
They are not answering their phone calls nor do the calls
transfer to an answering machine? Did you get your strips
from them?

I assume this is the company
https://shop.dakotamedicalsolutions...htm?productId=-8607720&catalogId=-19346&fpg=1Dakota Medical Solutions
6555 Cahill Ave., Suite 103
Inver Grove Heights, MN 55076
Phone: (651) 340-6745
I was thinking of buying a CoaguChek XS from them as backup when I get a "bad" reading from my Coag-Sense to determine if I should go in to the lab to get checked. However, if they are not in business or are behaving as though they are having issues then I might want to postpone the purchase. That is a lot of money to go into never never land.
Are you aware of any other medical vendors that sell direct to the customer. I prefer to avoid ebay and paypal. If you did not get your strips, I doubt that I would get a meter.
Thank you,
ScribeWithALancet

Allere supplies meters. I got mine straight from them at first. Then my insurance told me to go to Edgepark. They have Allere send me the meter and strips although I call Edgepark and they bill me. In both cases, the meter is free, you pay for the strips. Since its through insurance, both firms required a prescription. However per FDA a prescription is not required for an INR test machine.

 

[Protimenow]

I don't think Dakota is still in business - or in the business of INR meter or supplies. I dealt with them a few years ago, and it seemed that they'd abandoned or left the business.

I've had an issue with the CoagSense machine - the results are fairly consistent -- and I'll be devoting three fingers to each of my three CoagSense meters (a PT2 and two PT1s), to see if they all agree - or if the results are close to each other. Last Friday, I had a blood draw from a lab that was wildly inaccurate last March, and I had an experience with the lab's results being much higher then the meter results.

At that time, I tested with blood draws from other labs - and their results were much closer to the meter than they were to that other lab.

I'm hoping to get some CoaguChek XS strips so I can also test on that meter. Right now, I can't afford any, and the expired strips that I received from someone on this forum aren't usable.

I am still inclined to trust my meter before trusting this lab.

If I were you, I'd wait before getting an XS -- just to be sure that it's not the lab that's messing up the results.

 

[trav]

If you do not mind my asking, are they still in business?
They are not answering their phone calls nor do the calls
transfer to an answering machine? Did you get your strips
from them?

I assume this is the company
https://shop.dakotamedicalsolutions...htm?productId=-8607720&catalogId=-19346&fpg=1Dakota Medical Solutions
6555 Cahill Ave., Suite 103
Inver Grove Heights, MN 55076
Phone: (651) 340-6745
I was thinking of buying a CoaguChek XS from them as backup when I get a "bad" reading from my Coag-Sense to determine if I should go in to the lab to get checked. However, if they are not in business or are behaving as though they are having issues then I might want to postpone the purchase. That is a lot of money to go into never never land.
Are you aware of any other medical vendors that sell direct to the customer. I prefer to avoid ebay and paypal. If you did not get your strips, I doubt that I would get a meter.
Thank you,
ScribeWithALancet

Honestly, I don't think Dakota Medical is in business, or like protime said at least for INR strips and meters.

Yes, that is their website and the same thing happened with my strips, they never responded to any messages I sent them.
Never got my strips, I filed a dispute with my credit card and got credited back the amount.

If you look them up on the Better Business Bureau you will see multiple complaints about not receiving the item ordered.
Also a civil lawsuit (dont know much as court records dont give much info online) was filed against Dakota Medical in the Dakota County Court, so I would not purchase anything from them.

 

[ScribeWithALancet]

I don't think Dakota is still in business - or in the business of INR meter or supplies. I dealt with them a few years ago, and it seemed that they'd abandoned or left the business.

I've had an issue with the CoagSense machine - the results are fairly consistent -- and I'll be devoting three fingers to each of my three CoagSense meters (a PT2 and two PT1s), to see if they all agree - or if the results are close to each other. Last Friday, I had a blood draw from a lab that was wildly inaccurate last March, and I had an experience with the lab's results being much higher then the meter results.

At that time, I tested with blood draws from other labs - and their results were much closer to the meter than they were to that other lab.

I'm hoping to get some CoaguChek XS strips so I can also test on that meter. Right now, I can't afford any, and the expired strips that I received from someone on this forum aren't usable.

I am still inclined to trust my meter before trusting this lab.

If I were you, I'd wait before getting an XS -- just to be sure that it's not the lab that's messing up the results.

Thanks for the tips. My current issue is that my meter (for the first 4 lab tests) can be correlated with the lab to about 96%. The regression equation puts the meter with + or minus 0.1 of the lab. The issue to me is that you had mentioned in another post that your meter tended to read about 0.2 below your lab readings. Mine tends to read 0.2 to 0.4 above - before the regression equation correction. I am wondering if there is a systematic error in either the Coag-Sense device or the Lab Device. The correlation is amazingly good when corrected and good even when not corrected. 0.4 twice and 0.2 twice. Unfortunately, this includes one value at the high end of my range, 2 in the middle and 1 at the low end. I will keep testing between lab draws always at lab draws. Gathering information is interesting but I am puzzled.

Also, I cannot get information on where the TEVA brand of generic coumadin is made. After listening to "Bottle of Lies", my mistrust of Indian and Chinese generics has gone up.

Because I was prediabetic, I track everything I eat on a scale. Spreadsheets have wonderful capabilities and I collect data on all the K1 I consume. (the K2 as well but with Agriculture's definition of organic being 100 or more days of grass fed - that data is capable of being way off).

By the way, the spreadsheet worked. I followed Dr. Atkins and Dr. Richard Bernstein's Diabetes book diets. My A1c is down to 5.1 which is well within the normal range. My endocronologist says whatever you are doing following their diets, keep doing it and you will probably stay not a prediebetic and never a diabetic. So I will keep tracking both carbohydrates, K1 and K2 with my spreadsheets. The INR spreadsheet is still developing as I have had to develop data to convince my doctors. Happily, Dr. Stacy Johnson and others have published research on correlating INR meters with Lab machines. I have modeled my regression math on theirs. As Dr. Johnson put it, it is really 1st semester statistics. It helps to walk in with research papers by M.D.s and PharmD's that look similar to your spreadsheets.

With all that spreadsheet work and consuming 300 units of K1 per day, my INR still cycles nicely. (I take K1 pills to round the food K1 that I consume to 300 +-12.5 a day. If I go over (not often) I just say "oops" and take no K1 pills.

Unhappily, my INR is usually NOT always above 2 but has usually been below 3.5. I recently hit 2 again and had to increase my dose by 0.5. Since the highs in my cycles usually are around 3.3 I don't want to swap hitting the bottom for hitting the top. I keep reminding myself not to overthink it, but it is difficult.

Is there a generic manufacturer who has their coumadin tested for bioavailability, bioequivalence, etc? And publishes the results to show that their generic is truly equivalent to Warfarin? I wonder sometimes whether variations in manufacturing at a sloppy generics factory could be causing the variations. My last two months data when charted look more like an irregular roller coaster then like a regular sine wave. I am looking for a quality generic made in USA, Canada or Australia where the FDA or its local equivalent actually drives quality. Its one more potential reducer of variability. I know that variability will never go to zero.

Walk in His Peace,
Scribe With a Lancet

 

[Protimenow]

Scribe -- I'm not sure, but I believe that Teva is made in Israel (others - please correct me if I'm wrong).
I'm also pretty certain that ANY generic goes through FDA testing or bioequivalence testing - or some form of close scrutiny before it's approved for sale in the United States.

Having an INR within .1 or .2 of a lab is excellent. You can't expect to do any better than that.

In my recent experience, I've had some labs - even a hospital lab - that were WAY higher than my meter. Other labs were also slightly higher - but nowhere near as far off as one lab in particular. I've written how you can't always trust the labs in different threads.

Part of the problem with labs is the way they handle blood after it's been collected. Mishandling can cause results to be inaccurate. Some labs require that the blood be spun in a centrifuge, and they do their tests using the plasma that's left at the top of the tube. I know that there are ways to mishandle the specimens - and this could account for lab errors (and, unless taken by the lab, this can introduce error).

Friday, with concern about possible unreliability of my Coag-Sense meters (I have the old model, and the new PT2) I tested within minutes of each blood draw, using both meters and strips from the same lot.

The INRs were the same. The prothrombin times were one second apart. This shows that, at least, the meters can get the same results, and use the same calculations. It doesn't, unfortunately, have a lab to which the results can be compared.

If I had test strips for the CoaguChek XS, I would have made a third test with that meter.

For now, though, my statement stands -- you can't always trust the labs.

(It's interesting that you're taking K1. Recent research shows that it may be easier to regulate your INR if you take K1. I may eventually try this and adjust my dose to accommodate the added procoagulation effects of K1).

 

[DachsieMom]

I go through insurance. I pay 101 every four tests (I test weekly). I call in to coaguchek, they call my cardiology practice (kind of crazy). My Coumadin clinic does not charge. The6 just call me back and tell me what to do.

 

[pellicle]

Hi

(others - please correct me if I'm wrong).

you don't need to call out for that, someone will if its seen ;-)

 

[Protimenow]

I go through insurance. I pay 101 every four tests (I test weekly). I call in to coaguchek, they call my cardiology practice (kind of crazy). My Coumadin clinic does not charge. The6 just call me back and tell me what to do.

There must be a typo. HOW MUCH do you pay for four tests? How much does your insurance pay?

The strips should cost around $5 each- an I know that there are some services that charge insurance or the government a great deal just so they can provide the strips and call your doctor/coumadin clinic.

So - are your numbers wrong?

 

[Protimenow]

Hi


you don't need to call out for that, someone will if its seen ;-)

I have a pretty good idea who that will probably be...

 

[pellicle]

I have a pretty good idea who that will probably be...

well I was thinking it would be me ...

 

[DachsieMom]

Numbers are not wrong. I pay 101 per month. Without insurance it would be 250, but I get the benefit of the insurance negotiated rate. My deductible is about $4k so I pay the entire 101 per month myself. Insurance doesn’t pay anything, unless I have met my deductible for another reason.
Funny story - my daughter fractured her elbow and needed some rehab. It was $100 per session if I walked in off the street. $107 per session with insurance. Because I had insurance, I was required to use it!

 

[Protimenow]

well I was thinking it would be me ...

So was I

 

[Protimenow]

DachsieMom: $101 each month? You can do it yourself for 1/4 as much. What are you getting? A meter, some strips, a phone number to call so that they can call your doctor or clinic?

Are you paying this much just to meet your annual deductible?

Are you comfortable enriching the companies that supply your meter and strips for practically nothing?

(I can almost see it if you're looking to satisfy the deductible, but more office visits, more real medical services, etc. can also be used to meet your deductible.)

Personally, I avoid enriching greedy providers, if I can.

 

[berry678]

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