The FDA approval of nasal glucagon has been a very exciting development for our CWD family, and folks in our community are starting to integrate this new option into their care plan. We were interested in hearing about insurance coverage, access, and usability, so we asked our Facebook friends about roadblocks and success stories.
Most of the feedback was centered around insurance coverage, and while there were several initial denials, it seemed like the majority of respondents were approved (some after appealing the denial):
“We got a two pack, no problem. Our insurance is Tricare, and we have a supplement. Since we have met our cap, there was no copay.
“We were denied BCBS and the coupon only works if insurance covers it so we had our endo call BCBS and appeal and it was approved. We got only 1 though but it was only $25 and has refills. It was $600 without insurance.”
“We got two with no issues- and where a glucagon cost up around $100- two of these were a $25 co pay!!! Took an extra couple days for our local Walgreens to order but other than that it was easy- we have UHC Plus through my employer.”
“Aetna. Endo wrote the prescription (for the two pack). I went on the Lily website to join the “coupon” program. The first fill is free before 12/31/19 and after that it is supposed to be no more than $25. Haven’t used it yet so I don’t know how successful the refill will be.”
“If insurance denies it or if no insurance call Lilly Diabetes Center 1-833-808-1235 and ask for the card for cash pay patients!! I got two free and refills of two are only $95!!”
“We got denied with Anthem CA PPO but then requested prior auth from the M.D. and hit a two pack for $25.”
“I haven’t filled my prescription yet, but I’m looking forward to having an option in my house that doesn’t intimidate my daughter; the nasal glucagon makes her feel like she could actually help me if I had a severe low blood sugar.”
But it hasn’t all be in the win column. The never-ending, never-knowing state of “denied” drug coverage by Riva Greenberg outlines the hurdles that she has been presented in pursuit of Baqsimi coverage. We’re still waiting on stories from PWD and caregivers who have actually used nasal glucagon, but it’s weirdly okay with us that people haven’t had to tap that safety net yet. It’s more about know that safety net is there, and is making families feel more prepared in case of an emergency.
For more information on coverage for and access to Baqsimi, visit the official Baqsimi website.