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Saw my doctor yesterday. She definitely agreed I need to stay at the current dose level and not move up, and has authorized refills for me. She also told me to discontinue the iron supplement I recently started last month, since that can cause or contribute to GI issues. She added tests to my bloodwork to check iron and vit b-12 levels.
Interestingly, my A1c only decreased by .1 since my last test (now 6.1) and my FBG was up a bit to 93, which is fine and within a normal range. Doc is quite happy with my A1c level. Personally, I'd like to see my A1c reduce to 5.7 or below. Maybe it will get there eventually, it's still considered early days at week 11, and the trial data studied 72 weeks. No change made to metformin dose, remaining at 2G/day, not that I was expecting any change.
I need to increase my hydration (she didn't say it, but I know it and struggle with it). I have Liquid IV electrolyte packets, but don't like them, even just using only 1/2 a packet.
Saw the updated formulary for my health insurance plan, as of Jan 2023. Mounjaro is not approved by my health insurance plan for T2D. No idea if it will get approved in 2023 or not. My doctor had requested a pre-authorization, and the insurance company firmly denied the request, as expected.
Assuming Mounjaro is not approved by my insurance plan in 2023, when my existing savings card expires mid-year, I'll transition to an older GLP drug, one on the formulary, unless Eli Lilly extends the dates of their coupon.
Saw the updated formulary for my health insurance plan, as of Jan 2023. Mounjaro is not approved by my health insurance plan for T2D. No idea if it will get approved in 2023 or not. My doctor had requested a pre-authorization, and the insurance company firmly denied the request, as expected.
Assuming Mounjaro is not approved by my insurance plan in 2023, when my existing savings card expires mid-year, I'll transition to an older GLP drug, one on the formulary, unless Eli Lilly extends the dates of their coupon.
I’m not surprised since most insurance companies (mine included) expect you to try the cheaper/older versions first. I started on Victoza, which worked well with only minor side effects but who wouldn’t rather take a weekly injection instead of a daily one. I tried Bydureon and Trulicity but had some nasty side effects with both. I’ve been on Ozempic for three years now but at first it took my doctor a three month battle with the insurance company to get it covered. It works great and whatever side effects I had in the beginning are now nonexistent. I highly recommend if you can no longer afford the Mounjaro, and have gotten true health gains from using it, to indeed try out whatever older ones your insurance will cover. The side effects are not as universal or awful as some claim, for instance my brothers do just fine with Trulicity, despite my issues with it.
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I’m not surprised since most insurance companies (mine included) expect you to try the cheaper/older versions first. I’ve been on Ozempic for three years now but at first it took my doctor a three month battle with the insurance company to get it covered. It works great and whatever side effects I had in the beginning are now nonexistent. I highly recommend if you can no longer afford the Mounjaro, and have gotten true health gains from using it, to indeed try out whatever older ones your insurance will cover.
The good news is I have 8 more fills left on the $25/month coupon and don't have to make any decisions until next May. The retail price for Mounjaro right now is around $1,100 per fill. That's an automatic no for me. Mounjaro will be a Tier 3 drug, with a copay of $20 a month, if/when it gets approved by my insurer. If not in 2023, then likely in 2024. The older approved drugs in the same class are all Tier 3.
As of Oct 3, Eli Lilly made some nuanced changes to their savings card program, since many practitioners are prescribing the med off-label. It's only approved for T2D right now, and they don't want any legal issues with the FDA.
Whether it's that change specifically or something else altogether, my local Walgreens is having problems with the savings card not being processed in their system. They need to talk with Eli Lilly support. Glad I start my refill 10 days in advance, just in case. I'll be talking to Lilly's consumer support to see if there's something I need to do, or have my doctor add to the Rx.
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Other than that, I'm feeling better than I was last month, with a return of energy and a much calmer GI system.
I called the manufacturer customer help center, and there's nothing about the coupon that has changed, and they said they're not rejecting older coupons from before Oct 1, as I was erroneously told.
My pharmacy has to call Eli Lilly and get assistance. I know that hasn't happened yet because the Rx status is showing payment due for the full retail price: $1,168. When the coupon is applied in their system correctly, the payment due will be: $25.00.
At nearly 4 months completed, I've had an escalation of side effects, now including nausea. I'm in my third month of the same dose, and wasn't expecting increased issues. However, I've been reading others reporting similar effects who have been on the drug about the same length of time. 7.5 mg is kicking some butts, including mine. Some on 10 mg are really having a rough go of it--I can't even imagine trying to titrate up.
I've got 3 more injection pens at the current dose, so my plan is to increase the time between injections to 10 days, then titrate down to the previous 5 mg dose when it's time to refill, and see how it goes.
Good luck with that. I hope it works out well for you.
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