Why Is Express Scripts Making Me Buy A New Blood Glucose Meter?

imgresAs diabetics, people with diabetic loved ones, and anyone who has seen a TV commercial starring Wilford Brimley all know, keeping track of one’s blood glucose levels is an important part of staying healthy with diabetes. But what happens when you suddenly can’t get the supplies that you need for the brand of meter that you’ve chosen because your health insurer will only cover one brand of meter?

Some people who get their prescription coverage through ExpressScripts are upset because as of the first of the year, the company will only cover supplies for OneTouch meters. The customers have to buy new meters: that’s the only option. Reader Mike alerted us to this issue, noting the struggle from his point of view in the pharmacy line behind fellow customers taken by surprise.

“I’ve been in line at the pharmacy with many, many angry people, unaware that the change had even been made at the beginning of this year,” Mike writes. “Especially for those on a fixed income, this is an expense they did not need to incur.”

New glucose monitor systems usually have substantial rebates available, since buying a monitor locks the customer into buying that brand’s supplies. Not all consumers know this, though, and not all pharmacies will take the time to walk their customers through choosing a new meter.

We contacted Express Scripts to ask about the change, and they told us that the meter swap was sue to changes to preferred formulary that about 30% of their customers use. “Formulary” is health insurance-speak for “the drugs that we will cover.”

“[I]n the many instances when multiple products are clinically equivalent to one another, we – the nation, its employers, and its patients – are all better off when we choose the more affordable options,” an Express Scripts representative helpfully told Consumerist.

Here’s another helpful piece of information that they gave us: Express Scripts claims that they sent letters out to affected customers telling them about the upcoming mandatory switch, and telling them how and where they could get a new meter for free. Nothing to worry about for people on a fixed income…provided that they paid attention to the mail from their insurance company and their prescription coverage company.

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  1. theoriginalcatastrophegirl says:

    ooh! ooh! this is happening to me. sort of. i hoard supplies so i have about a year’s worth of freestyle strips on hand
    but unless you want the super duper fancy ass meter, you never have to buy a new one. and with a prescription your insurance will probably cover the new fancy ass meter under durable medical equipment anyway.
    but if you want a meter, you call the manufacturer and say “man, my insurance company says i have to use your test strips but i don’t have one of your meters. how do i get one of your meters?”
    i have never met a glucose meter manufacturer who wouldn’t send out a free meter with the promise of sales of test strips.

    also, express scripts is no longer covering my insulin and has asked me to go back on an insulin that failed to work for me. good thing i also hoarded some insulin so i have a few months to deal with the appeal process.

    • theoriginalcatastrophegirl says:

      additionally, the insulin they are no longer covering is NOT clinically equivalent to the one they want me to take, which has a slower mechanism of action

  2. shadowzen says:

    This happened to me and I’m pretty unhappy about it. I received a mailing with instructions on how to get a free reader but it irks me because I was diagnosed last year and had done the research and decided on going with Accu-Check and opted for their Compact Plus system that has test strips loaded into drums. It was one of the highest-rated and cited as one of the most accurate, has reasonably priced test strips and the convenience of not having to manually load a test strip every time appealed to me. OneTouch does not have an equivalent for this type of system.

    Furthermore, I’ve only done cursory research in this but it seems the OneTouch Ultra2 is less accurate than the Compact Plus that I already have and the test strips cost more on average; between $5 and $15 a box, depending on quantity. Of course, that’s without insurance factored in but over time, that cost adds up.

    • theoriginalcatastrophegirl says:

      i haven’t found an accuracy problem with the one touch ultra strips, but i’ve only compared them to freestyle and walgreens Tru Track.
      i have heard good things about the accu-check, and the pre loaded drum makes so much sense, as opposed to strips getting accidentally ruined by humidity or damp hands.
      it’s possible i am the last person in the US using a freestyle navigator CGMS and it takes freestyle strips. but it’s about dead and i am about out of (expired) sensors.
      this year i’ll be moving to a dexcom g4, and i am using the animas one touch ping, so the switch to the one touch meter doesn’t bug me much. i just haven’t actually ever used the ping WITH the connected meter, so it’s more junk to carry around.