Yesterday, a reader emailed me and said that her Medicare Advantage Plan was no longer covering Apidra. When she went to the Medicare website, no plans were coming up that covered it.
I went to the Medicare site and typed in Apidra to see if any plans covered it. Apidra was no longer in their system. I saw this:
I Googled Avodart – that has something to do with the prostrate gland. Not quite the same drug category as Apidra!
Thinking maybe someone misspelled it (although unlikely because it was there last year, but you never know), I looked at the drugs in the A list and didn’t see any misspellings. I looked for insulin glulisine and it didn’t come up that way either. Lantus, Levemir, Humalog and Novolog were all there. Only Apidra was missing. Oh joy!
There was a help prompt, “why can’t I find my drug,” so I clicked that.
Last year when they put Apidra in a higher tier, I did call my plan. I was told that Medicare is the one that develops the formulary and sets the pricing tiers for the various drugs.
I checked my plan and they don’t have the 2013 formulary up yet. I am sure that will be coming in the mail soon – I guess I won’t have to have a heart attack the day that comes because I already had mine yesterday. Right now the only thing I can say to do is
I have used other insulins and they do not work the same as Apidra does for me. I have been able to manage my gastroparesis because it is out of my system in two hours. Humalog and Novolog are both hanging around four hours later. These stupid morons that set formularies and make these decisions are clueless how things work.
EDITED TO ADD: I found out from Sanofi-Aventis that Medicare made a mistake and did not put Apidra on the search tool. It is still covered by most Medicare plans. See that update here.