Home Instils

[ckam]

Would anyone know why my dr would say that I can't do home instills. He said that I can't get the meds needed. Is it only in certain areas that you can get those meds? Heprin, sodium bicarb, and lidocane or marcane (not sure which of those pretty sure its lido tho).

It doesn't make much sence to me, since i read alot about people doing them.
:confused::confused::confused:

karisa

[kadi]

Hi Karisa,
It has been a bit of a hassle to get it all set up, but for me, the treatments have been worth it.

Many local pharmacies do not carry these medicines. Target pharmacy is the only one in my area that will special order the marcaine, sodium bicarbonate, and sterile water for me. All the other local pharmacies refused. The heparin I have to get by mail from my prescription formulary. I had a bit of a battle to get the meds covered under my prescription benefit, but after an appeal, they were approved to be covered for 1 year. I guess we'll do the appeal again then. I have to mail order the durable medical supplies (catheters & syringes) through a company my health insurance company is contracted with.

It is easier to get the instillation covered by insurance & it is less of a hassle to have it done at the doctor's office if they'll order the meds & durable medical supplies. BUT, it is much less expensive to do them at home. And since I need them 1-2x a day, the doctor's office is not an option anymore.

I hope that information is useful to you.

[ckam]

Thanks kadi that makes sense. He's probably gone through that before, and decided that it's too much of a hassle, just do them in office. Besides, as quirky as my ins is you never know what they'll cover, and I really don't want to go through that hassle. Last year was bad enough when I flipped my motorcycle and had both to deal with both car and health ins. :rolleyes: :lmao:

Karisa

[navemj]

You have to go to a compounded pharmacy. Just call around. I just heard that Walgreens will be going compounded. I would call every pharmacy in your area and ask if they have sodium bicarb, heparin, and lidocaine (liquid form) available. It took me awhile to find one, but I did.

[JennyBird]

I'm being taught right now how to do these at home. In the past, they woudln't let me, but my doctor is leaving the practice, and I think she doesn't want me to be left without a treatment option.

Anyways...I called my insurance company, and they had a mailorder pharmacy that deals only with injectables (like diabetic shots). I actually spoke with one of the pharmacists there, and he knew actually what I was talking about and was even giving advice on how to mix, etc... I'm with united healthcare, and the pharmacy is CVS Caremark. Your doctor can fax the perscriptions in, or you can mail them, and they ship to you. I also have to get the supplies through durable medical supply. I haven't dealt with that yet.

It is alot of supplies and things you have to remember to do so everything stays sterile. My doctor also puts an antibiotic in the instill, which is an extra insurance to prevent infection. It's going to be a hassle until I get the hang of it...and is easier in the doctors office...you're in and out qickly. but...this is a huge life-saver for me. I have a 2 hour commute, and my doc is near home. I had to take a half day (unpaid through FMLA) from work every time I needed an instill. Plus, on my honeymoon last year I was in a horrible flare, and I couldn't do much about it. So...it's a big relief to me that i can give myself an instill when needed in the evenings or even weekend, and on vacation if necessary! it's worth the hassle to me....but it's a personal decision you have to make...b/c it's not easy to do these yourself.

Call your insurance company and ask for their mailorder pharmacy that deals with injectables. They should have one. If not...then maybe contact CVS caremark and see if they can ship it to you. HOpe this helps!

[L. Thomas]

There was a recall on heparin by one manufacturer was hard to get but there is no shortage now. You can get heparine from AAP. Heparin, lidocaine and sodium bicarbonate are all generic meds.

It depend on individual insurance policies and the location as to how easily you can get the ingredients and if insurance will cover the cost of the meds.

Other than the 6-8 months while heparin was recalled I have never had problems getting the meds or supplies locally. I live a a somewhat rual area and can get the meds at most of the local pharmacies.

The supplies are covered under the durable goods portion of my major medical coverage, not the drug coverage although the local pharmacies can supply the syringe, catheter and needles. The supplies are not covered by insurance if I get them from the pharmacy.

[kadi]

Just a note that not all pharmacies will sell the durable medical supplies. None near me will sell me the syringes or catheters and none of the local medical supply stores will take my insurance.

So, I buy syringes, catheters & needles by mail from a company approved by my insurance company & it keeps the costs way down. The last time I ordered a ninety day supply of caths & syringes (I do the instills 1x a day or 2x if flaring), I paid $68.00 copay. It would have been $750 without insurance.