Just like there are two kinds of people, there are two kinds of pens. I think that both kinds of people are worth keeping, but that’s not true for pens.
Insulin pens are either prefilled and disposable or they are reusable. You throw away your prefilled pens when the insulin in it is finished. If you use a reusable pen, you just through away the insulin cartridge, but you better keep the pen.
Most people, however, would do better not to buy a reusable pen at all. That’s because insurance companies consider reusable pens to be what they call "Durable Medical Equipment."
The problem is that insurance companies generally will not reimburse you for Durable Medical Equipment, according to Tim Cady, president of Advanced Diabetes Supply in San Diego.
"In this case, you would buy the cartridges separately through the pharmacy benefit," Tim says. "Because of the out-of-pocket expense of the reusable pen, many people did not adopt them as well as they do now with the disposables."
Most insulin companies are now making disposables pens. For instance, NovoLog, and Humalog come in disposable pens. These pens generally have 300 units of insulin in the pen cartridge. Pharmacies categorize disposable insulin pens simply as an insulin code, which they pay for routinely.
People who use Lantus, the most popular insulin, usually buy it by the vial and use syringes to inject it. The manufacturer, Sanofi-Aventis, does make a pen for Lantus, the OptiClik, but it is a reusable insulin delivery device.
Now, however, a serious challenger to Lantus has just become available in the United States. Levemir, another insulin that can work for up to 24 hours, is finally here. And in this case, the manufacturer, Novo Nordisk, provides it in a prefilled pen, the Levemir FlexPen.
Except for the new Levemir FlexPen, the magazine Diabetes Health has a complete list of insulin pens online. I can’t begin to understand the logic that calls reusable pens Durable Medical Equipment, while blood glucose meters aren’t. And I’m not going to ask.
It is simply not logical that insurance companies generally will pay for the pens that you just throw away after using, but refuse to pay for reusable pens. Until our landfills are full, we are truly living in a throw-away society.
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David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.