Type 1 Insulin for a UK diabetic in the US

Hellikopta

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I will be travelling to the US for 6 months next year - I'm walking the Pacific Crest Trail. My UK insulin will only last for 1 month so I need to buy 5 months worth of Humalog and Levemir while I'm out there. Does anyone have any idea as to how the system works in the US. Will they allow me to buy insulin in a pharmacy with a UK Doctors note / prescription or do I need a US one. Can I just arrange an appointment with any doctor to get a 5 month prescription or will it need to be a different one for each state I visit (I'm travelling through 3 states) or each time I need a new month's supply. How much is it likely to cost?

Any insight you can give me will be really helpful.

Cheers

Helen
 

DCUKMod

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I will be travelling to the US for 6 months next year - I'm walking the Pacific Crest Trail. My UK insulin will only last for 1 month so I need to buy 5 months worth of Humalog and Levemir while I'm out there. Does anyone have any idea as to how the system works in the US. Will they allow me to buy insulin in a pharmacy with a UK Doctors note / prescription or do I need a US one. Can I just arrange an appointment with any doctor to get a 5 month prescription or will it need to be a different one for each state I visit (I'm travelling through 3 states) or each time I need a new month's supply. How much is it likely to cost?

Any insight you can give me will be really helpful.

Cheers

Helen

Hi Helen - I can't answer your question at all, but I'm wondering if you have discussed your plans with your GP?

The reason I ask is I was diagnosed 3 weeks before going off to the tropics for 9 months. Good timing, eh? Anyway, at the time, when I was flapping, in case I needed Meds, my Doc told me he'd be happy to prescribe 3 months supply at once, and if we had any guests coming to see us, I could order up a prescription for someone to collect, fill and bring to me.

As it transpired, I managed to do without meds, so didn't have to put it to the test. My GP was more jealous of our adventure than concerned about me being "off grid".

Could be worth a chat - even if it cuts down the amount of self sufficiency you'll maybe need to tackle. Meds in the US can be costly, unfortunately.
 
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Hellikopta

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Hi there. Yes I have discussed this with every medical professional who would listen including my diabetes specialist team. They told me to email / contact the drug companies which I have done but they can't help with the prescription and costs side of things. My insulin is not viable after it has been outside the fridge for more than 1 month and I can't get extra supplies send to the US from the UK as they would be sent out in the hold of the aircraft and therefore subject to freezing temperatures - which would make the insulin useless. Only option therefore is to buy in the US.
 

scotteric

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Hi there. Yes I have discussed this with every medical professional who would listen including my diabetes specialist team. They told me to email / contact the drug companies which I have done but they can't help with the prescription and costs side of things. My insulin is not viable after it has been outside the fridge for more than 1 month and I can't get extra supplies send to the US from the UK as they would be sent out in the hold of the aircraft and therefore subject to freezing temperatures - which would make the insulin useless. Only option therefore is to buy in the US.

The costs of insulin in the US are insane, as well as the cost to see a doctor and get a prescription which you will need. Will you be close to Canada at any time? All insulin is cheap and available over the counter without a prescription up here.
 

urbanracer

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The costs of insulin in the US are insane, as well as the cost to see a doctor and get a prescription which you will need. Will you be close to Canada at any time? All insulin is cheap and available over the counter without a prescription up here.

Anyone can walk into a pharmacy and buy insulin?
 

NaijaChick

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Get extra insulin here and buy a Foro bag to store your insulin in. Good luck. American prescriptions are very expensive.
 
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DCUKMod

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Anyone can walk into a pharmacy and buy insulin?

There are quite a few places like that, and some places, where you would usually need a prescription, they will dispense if you have your meds, with the packaging, showing it's yours (although it could be anyone's as they don't ask for ID0, they'll happily dispense.
 
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ringi

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Check costs in the USA, as it may be cheaper to fly back to the UK a few times to collect more inslin.
 

urbanracer

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There are quite a few places like that, and some places, where you would usually need a prescription, they will dispense if you have your meds, with the packaging, showing it's yours (although it could be anyone's as they don't ask for ID0, they'll happily dispense.

From personal experience I know the rules are pretty slack across asia, but assumed the rules in Canada would be similar to here.
 

Hellikopta

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Thank you for all your comments. I have managed to find out that some pharmacies in the US will dispense without a prescription, some will do it with a UK prescription but most are supposed to only dispense with a US prescription. I get this prescription from the doctor which is likely to cost about $180 for the pleasure of the consultation.

The cheapest price of the insulin (Levemir and Humalog in my case) can be found using a website called www.goodrx.com. 5 Flexpens of Levemir in a carton will cost $425 or £315 whereas a carton of 5 Humalog cartridges costs $535 or £396. Humalog is available in individual vials to buy but not Levemir.

I would love to be able to take the enire 5 months supply with me from the UK but insulin will only last for up to a month after you take it out of the fridge I'm told so that's no good. I can't send it to myself as it would freeze in the hold of the plane and then not be of any use. My only choice is to buy in the US - I won't be near enough to Canada until I finish the walk and I'll be off home then anyway.

Has anyone ever used insulin that has been out of the fridge for longer than a month?
 

Hellikopta

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I've just done a Google search for the costs of insulin in the US. I seem to recall there was something (maybe on here actually) the other day baout the costs, but Dr Google returned this, which could be thought provoking: https://www.t1international.com/blog/2017/02/15/america-1-diabetes-costs/
Sobering read that but they have a valid point. Only a few months ago there was an article in teh press about a lad who had died in the US as he couldn't afford insulin - shocking in this day and age.
 

DCUKMod

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Where we have our home from home, they operate a US style health care system. A few weeks ago, we heard of a young woman, known to us in a sort of "x, who works in y basis", who had had a nasty fall and broken her pelvis. Fortunately, she didn't appear to have a significant bleed, and didn't require surgery.

Whilst that seems all god, the reality was she was in hospital overnight (for observations, in case of a catastrophic bleed), but when she left next day her family weren't able to afford to buy her any pain relief. Can you imagin that? Going home, in someone's car, with a broken pelvis and no pain relief.

People were clearing out the medicine cabinets and hoping their contributions to her might help, and not do any harm. It's just unimaginable.

Our NHS may be very broken and limping along, but we have no idea how fortunate we are.

Enjoy your adventure. Some things just have to be done!
 

Hellikopta

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Where we have our home from home, they operate a US style health care system. A few weeks ago, we heard of a young woman, known to us in a sort of "x, who works in y basis", who had had a nasty fall and broken her pelvis. Fortunately, she didn't appear to have a significant bleed, and didn't require surgery.

Whilst that seems all god, the reality was she was in hospital overnight (for observations, in case of a catastrophic bleed), but when she left next day her family weren't able to afford to buy her any pain relief. Can you imagin that? Going home, in someone's car, with a broken pelvis and no pain relief.

People were clearing out the medicine cabinets and hoping their contributions to her might help, and not do any harm. It's just unimaginable.

Our NHS may be very broken and limping along, but we have no idea how fortunate we are.

Enjoy your adventure. Some things just have to be done!
Yes, it has taken this trek I am organising to realise how expensive the medication I am on actually is. We are very lucky with our health care system in the UK even if it is painfully slow. I hope this young lady was ok in the end and it is unimaginable the pain she must have been in.
 
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Dodo

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Thank you for all your comments. I have managed to find out that some pharmacies in the US will dispense without a prescription, some will do it with a UK prescription but most are supposed to only dispense with a US prescription. I get this prescription from the doctor which is likely to cost about $180 for the pleasure of the consultation.

The cheapest price of the insulin (Levemir and Humalog in my case) can be found using a website called www.goodrx.com. 5 Flexpens of Levemir in a carton will cost $425 or £315 whereas a carton of 5 Humalog cartridges costs $535 or £396. Humalog is available in individual vials to buy but not Levemir.

I would love to be able to take the enire 5 months supply with me from the UK but insulin will only last for up to a month after you take it out of the fridge I'm told so that's no good. I can't send it to myself as it would freeze in the hold of the plane and then not be of any use. My only choice is to buy in the US - I won't be near enough to Canada until I finish the walk and I'll be off home then anyway.

Has anyone ever used insulin that has been out of the fridge for longer than a month?
Maybe you could take a few Frio wallets with you. All you need is a supply of cold water every couple of days and they will keep for a few months.
 
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Hellikopta

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Maybe you could take a few Frio wallets with you. All you need is a supply of cold water every couple of days and they will keep for a few months.
Yes, I've got a supply of Frio wallets as they are sponsoring me on the trip. Will definitely need them to keep all the insulin cool through the desert. :D

Do you mean that the insulin will last for a few months? I've been told 1 month max but perhaps they were being cautious?
 

EllieM

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Do you mean that the insulin will last for a few months? I've been told 1 month max but perhaps they were being cautious?

When I moved from Australia to NZ last year I took all my insulin in my hand luggage. I went over 6 months before I got a prescription for more. I think they're just over cautious, personally. (It's a bit like you're told to keep eggs in a fridge with a relatively low use by date. When I was a child/young adult we used to keep them for months out of the fridge.)

When I get a prescription (3 * 1 month) for insulin, I get 3 months worth at once. There's no way I'm going back every month for insulin.... In Australia they were so generous with the quantities that I used to get a prescription more like twice a year. Never noticed an issue, though I did keep it in the fridge. I'm on lantus and humalog, by the way, though I've had the same attitude towards other insulins in the past.
 
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Dodo

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Yes, I've got a supply of Frio wallets as they are sponsoring me on the trip. Will definitely need them to keep all the insulin cool through the desert. :D

Do you mean that the insulin will last for a few months? I've been told 1 month max but perhaps they were being cautious?
I believe the Frio is supposed to act like a fridge. If you resoak them every couple of days in cold water the insulin cartridges stay cold.
 
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Scott-C

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Has anyone ever used insulin that has been out of the fridge for longer than a month?

About twenty years ago, I did a four month stint backpacking round Eastern Europe and then six months in Asia. Took a bit of persuading the gp to give me a script for 4 and then 6 months worth of insulin. It's so long ago that I can't even remember the names of the insulins.

Maybe modern insulins are more delicate now, but I was still using the same insulin supply at the end of the six month Asia trip as I was at the start.

None of it had been in a frio or in a fridge the whole time, just carefully packed in the backpack and stored in a dark space in hostels.

I think the 28 day thing is the manufacturer's lawyers being paranoid about their client being sued. I think they last well over 28 days.

But, like I say, maybe modern insulins aren't as tough as 20 years ago. I don't know.

Even if they do wimp out after 28 days, it's not like they just suddenly stop working. The efficiency slowly degrades in stages, so you might need to inject a little more for the same effect, so there will likely be plenty of safe room to decide, ok, this is tailing off now, better bail out to the nearest small town and see if I can buy some.

It's not going to be like one day it works and the next it doesn't. There will be plenty of time to find some more, even if it will cost you a buck.

Looks like a fantastic trip ahead of you!
 
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