4 Ways to Save on Test Strips
How to cut the cost of blood glucose test strips
As you scan your diabetes supply checklist and prepare for another trip to the pharmacy, you may wonder whether you could save some cash. And for good reason.
According to Tim Dall, a health economist and author of a 2012 study on the economic costs of diabetes in the United States, the average person with diabetes spends $13,700 per year on medical expenses. About $7,900 of that is directly attributed to diabetes.
Here's the breakdown: Of the $7,900 that people with diabetes spend on average, only $103 of that goes toward diabetes supplies such as test strips. The biggest expenses are hospital stays, which take up $3,404, and prescription diabetes medications, which eat up $1,967. Yet even though strips are just a fraction of the total diabetes cost for the entire population, their cost when purchased out of pocket can make a dent in a person's budget.
"Over the last five to seven years, we've seen a shift in the cost of diabetes management to the patient," says David Kliff, founder of DiabeticInvestor.com and an expert in the business side of diabetes. That's happening in two ways: higher co-pays and higher deductibles, which consumers pay. "That adds up," he says.
The burden of cost becomes a bigger problem when you don't have insurance coverage or are underinsured. "If you pay out of pocket, it's a huge difference," Kliff says. Some insurance companies are even eliminating reimbursements entirely for certain people with type 2 who are not on insulin, he says. "They don't believe there are correlations between regular monitoring of glucose and better outcomes."
The reason insurance companies are doing this is that, unlike for type 1, there is not good evidence to support how many times a day or week someone with type 2 diabetes on oral meds, other injectables, and/or a single daily dose of insulin should test, says Evan Sisson, PharmD, MHA, CDE, assistant professor at the Virginia Commonwealth University School of Pharmacy and practitioner in an outpatient clinic and a free clinic.
As for those who may need to test often, insurance companies know that people are staying on a particular plan for an average of only three years, which doesn't give insurers enough time to see the health care savings—savings that they might notice further down the road when better glycemic control prevents hospitalization or the need to treat long-term complications. "So it's in their best interest to cut costs as much as possible," he says, "and they will dial [strip reimbursement] back as much as their insured patients will tolerate."
This isn't good for people with diabetes. "Without that information [from blood glucose readings], it's nearly impossible to know when or how to intensify therapy in order to move patients to their A1C goal," Sisson says.
Sisson says one alternative for people with type 2 diabetes who aren't on insulin is to work with their diabetes educator or physician to determine the bare minimum of tests they need in order to maintain blood glucose control. You can do something called paired testing, which allows you to "spot check" and still gather enough information—say, by testing before and after different mealtimes throughout the month or by testing before and after certain activities. Over time, he says, "I can look at several different readings and see a general trend of where things are."
The alternative is buying more strips out of pocket or finding savings elsewhere. Though roughly only 1 in 10 people with diabetes has to pay out of pocket for strips, cost can add up even for the insured. Thankfully, there are money-saving options.
Here are four ways to save money on strips:
1. Assistance Programs
Patient assistance programs, either through strip manufacturers or other organizations, are traditionally for people who have limited or no insurance coverage and a proven financial need based on annual income. Over the past three years, pharmaceutical companies and manufacturers have phased out this type of program for their meters and strips in favor of savings programs for the commercially insured, says Sisson. The reasons for this shift are unclear, but it may be due in part to the Affordable Care Act. With greater access to insurance and fewer people paying out of pocket, pharmaceutical companies and manufacturers have shifted their focus to the insured.
Kliff refers to these programs as "co-pay equalization programs." If you opt to use a meter and strips system that is not on your insurance company's preferred list, these programs can pay the difference in co-pay cost. For instance, monthly strips not on your insurer's preferred list may cost $50 out of pocket, but with the help of a co-pay equalization program you might only have to shell out the $15 co-pay that preferred strips cost. The program would pay the difference: $35.
(See a breakdown of how the Roche and Abbott programs work here.)
Keep in mind: Some programs restrict membership to those with commercial insurance. You'll need a prescription for test strips if you're using insurance, says Sisson, but a prescription isn't necessary for people paying out of pocket for strips.
2. Outreach Organizations
Low-income or uninsured people who aren't eligible for a patient assistance program can look to other sources of financial help. Certain organizations can help you save money on prescription drugs or find programs that assist with general medical costs.
Benefits CheckUp: This service from the National Council on Aging provides information on savings programs for older adults with limited income and resources. Single people who make less than $17,655 a year and married couples making less than $23,895 are eligible. benefitscheckup.org, 1-800-677-1116.
RX Outreach: This organization has partnered with Prodigy, a meter and strip manufacturer, to provide supplies for low-income people with diabetes (making less than $35,310 a year for one person). rxoutreach.org, 1-888-796-1234.
CR3 Diabetes Association: This organization takes donations of diabetes supplies, including insulin pumps and unexpired test strips. If you are uninsured, underinsured, or have a household income of less than $60,000 a year, you may be eligible to receive a refurbished pump and/or discounted test strips. cr3diabetes.org, 919-303-6949.
Local organizations may provide similar services. Check with your health care provider or pharmacist about programs in your area.
3. Value Strips
If you currently use a brand-name meter with brand-name strips, you may be able to save some money by switching to a store-brand meter that uses store-brand strips. Retailers such as CVS, Walgreens, Rite Aid, Target, and Walmart all offer their own brand meters and strips, sold at a fraction of the cost of brand-name products. "You can buy two boxes of 50 [store-brand strips] at the same price [you'd] pay for one box of 25 of the brand name," Kliff says.
Some store-brand strips are simply brand-name versions dressed in a store's label. Abbott manufactures Walmart's ReliOn Ultima test strips, which are the same quality as its Precision Xtra strips but branded by the retail chain for use with its meters. "I think the store-brand meters certainly should be considered as a cost-saving measure," says Sisson. "And the technology is very good and comparable to the name-brand devices."
Another option—one that may be useful for people who have very high co-pays—is Abbott's FreeStyle Precision Neo, which uses FreeStyle Precision Neo strips. These low-cost strips can be purchased over the counter in major retail pharmacies, such as CVS, Rite Aid, and Walmart. The company is aiming the product at consumers who'd rather skip the co-pay and pay a smaller amount out of pocket. A box of 50 strips goes for $22.
Or look for pharmacy-specific programs. Walgreens, for instance, allows customers to purchase store-brand test strips through commercial insurance. Similar to the way a co-pay equalization program works, these pharmacy benefits let you buy store-brand strips at the lowest co-pay tier price, even if your insurance plan doesn't list the store brand in the formulary. Paying out of pocket for Walgreens' True Metrix strips will set you back $42.99 for 50 strips, but you may be able to get them for $15 (the typical cost of an insurance co-pay) with a rebate through the store.
But McKee says buying strips with a prescription and using a savings program may save you more money in the long run. "Prescriptions for diabetes test strips are often filled for more than one box of strips at a time," he says. For instance, your co-pay may be $30, but you are getting several boxes of strips for that price so the cost per strip is less than paying retail.
4. Loyalty Cards
Purchase all of your medications from a specific pharmacy, and you could rack up savings through the store's customer care program for necessities such as deodorant and toothpaste.
Pharmacy retailers such as CVS, Walgreens, Walmart, and Target offer loyalty cards that earn you savings and coupons as you buy things in the store throughout the year. Keep in mind: These programs typically don';t allow you to use savings on your medications. Instead, spending money on meds can help you accrue savings you can use on goods throughout the store.
Some programs, however, offer additional benefits for people with diabetes. For instance, CVS's ExtraCare Advantage for Diabetes program allows you to earn 4 percent back on diabetes products, including test strips. The store credit for these items is issued four times a year and can be redeemed online or at the coupon center in the store.
You already know the importance of checking your blood glucose. "The monitoring itself does not change glycemic control, but it gives the necessary information in order to make the adjustments we need," says Sisson. Have a conversation about the affordability of test strips with your health care provider and determine together the number of tests (and strips) per day you'll need in order to keep your blood glucose steady.
As for the issue of test strips for the entire diabetes population, Dall looks on the bright side: The overall cost is low compared with the cost of diabetes-related complications. "It's a relatively small portion of the overall burden of diabetes," he says. "You can buy a lot of test strips for [the cost of] one emergency room visit."
What is Durable Medical Equipment?
Many insurers cover test strips under their durable medical equipment policy. This is part of your insurance coverage and applies to medical equipment that your doctor prescribes for use in your home. Your co-pay for test strips under the durable medical equipment policy will often be much less if you use a mail-order service rather than go to a retail pharmacy. Check with your insurer to see what is covered for you.
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