Home test questions.

[greg]

These have probably been asked and answered several times but I'm new here so I missed them. Here goes again........
Q: How much do the home test units cost?
Q: How much do the supplies cost?
Q: How often do you normally check INR with home unit?
Q How often do you have to have them calibrated?
Q: Do you compare them to hospital/Dr. office readings for the calibration or are they sent somewhere?
I was told that they need regular calibration. Since I have been quite stable with my INR and only test every 4 to 5 weeks I am wondering if it's a good or bad investment.
Thanks,
greg

 

[Ross]

1.http://www.shopqas.com/ProductCart/pc/viewPrd.asp?idproduct=143&idaffiliate=6

2. http://www.shopqas.com/ProductCart/pc/viewPrd.asp?idcategory=67&idproduct=146. You may test as often as once a week or once a month.

4. Never unless there is a real big problem or difference from your testing sites readings and yours.

5. Someone is blowing smoke up you tail. These are state of the art electronic devices that measure the bloods clotting abilities in different ways, depending on which machine you choose. The high and low controls are built into the testing strips, so there is no calibration other then putting in the correct strip code before testing.

 

[Dennis S]

Machines

Machines

I performed the following test (InRatio) on my adult son, and found the results reassuring: Test on a Monday, reading 1.00. Test next Monday after he had taken a high dose of aspirin for ankle pain, reading 1.2. Maybe someone will come along and explain why that is just a coincidence, but so far it sounds good to me.

 

[greg]

Ross,
Please explain your #4.
Do I still have to have another testing site, like hospital or clinic, draw blood?
If so, how often is that comparison done?
greg

 

[Ross]

Ross,
Please explain your #4.
Do I still have to have another testing site, like hospital or clinic, draw blood?
If so, how often is that comparison done?
greg

Lets say you have your blood drawn at the clinic and your told your INR is 2.5. You also test with your machine at the same time they draw the blood and your machine says your 3.8. This might be a pretty good indication that something is wrong and to test it, find someone who is not anticoagulated and test their blood. It should be 1.0 to 1.2 if your meter and strips are accurate.

You don't have to check with a lab, but most of us like to every 6 months or so just to be sure.

 

[Ross]

I performed the following test (InRatio) on my adult son, and found the results reassuring: Test on a Monday, reading 1.00. Test next Monday after he had taken a high dose of aspirin for ankle pain, reading 1.2. Maybe someone will come along and explain why that is just a coincidence, but so far it sounds good to me.

That is perfectly normal. You will seldom ever get the same reading twice. That's just the nature of INR. Not even from the lab will it be the same.

 

[geebee]

I performed the following test (InRatio) on my adult son, and found the results reassuring: Test on a Monday, reading 1.00. Test next Monday after he had taken a high dose of aspirin for ankle pain, reading 1.2. Maybe someone will come along and explain why that is just a coincidence, but so far it sounds good to me.

Great way to double-check the accuracy of the INRatio. I test my SO every few months and he is usually at 1.0.
BTW - aspirin does not affect the INR so the higher INR was merely coincidence. Normal readings would be from 1.0-1.4 or so.

Greg - I test at a lab every 6 months because my cardio requested it for HIS peace of mind. I am very confident in the INRatio monitor. I test every 10 days to 2 weeks at home unless my INR is off. Then I make a dose change and retest in one week. I do not make dose changes very often.

 

[Deuce]

In regards to questions 1 and 2.
I just received my bill from QAS .The machine is $2495 and a box of strips is $156 for a total of $2651....Interestingly enough my insurance for Durable Medical Equipment with UH is limited to $2500. Hmmmm...fascinating...
I wonder if most insurance companies limit their DME to $2500.( It kind of reminds me of a roofer I know who finds out that insurance will cover $10,000 worth of damage to a customers roof so he charges $9995 to fix iteven though it is only a $5000 job.)
Does anyone know if the strips will fall under a different category than DME ?? Do you think I am going to have to pay for the strips this time or will insurance cover them under a different benefit category ?? What about next time i need strips?? I tend to be kinda tight with a buck(I prefer to be referred to as "frugal" not "cheap") . Especially at this time when there aren't many "bucks" coming in .

Thanks,
Tim

 

[Christine]

It depends on your insurance.. I have Cigna EPO which covers my strips at no cost to me.. when I bought the InRatio a year or so ago, I had Cigna HMO and they covered it 100%.. I have no limitations.. i'm lucky in that respect.. QAS is usually pretty good at working with you and your insurance.. with Cigna, they have to go thru a third party (Gentiva) but I've never had to pay a dime yet.. but even if I did, paying for the strips, while not cheap, gives me control in my life by being able to test at home.. if your limit is yearly (I don't remember if you stated) then you s/b ok next year and years afterwhich.. you just have the first year hit so to speak (both machine and strips)

Chris

 

[Blanche]

Greg:
My husband has been testing on a ProTime Microcoagulation System for more than 5 years. He tests weekly because he had a stroke which happened when his INR was very low. He had tested monthly for 10 years when this happened. If he had been testing weekly, the doctors say that it is likely that the strokes could have been avoided. This does not happen to everyone who has a low INR. In fact, I am told that it almost never happens. Well, it happened 3 times for my guy, so he tests weekly. Also, you might want to know that Medicare covers in-home-testing for those with Mechanical valves and REQUIRES weekly testing.

Al paid for the machine and continues to pay 100% for supplies. It gives him and me great peace of mind, especially when he has extensive dental procedures, antibiotics, pneumonia, or other illnesses.

You can do a net search to find costs. I have seen the ProTime at $1,800. on up to over $2,000. Supplies also vary. We pay $7.50 per test. THe machines do not need to be calibrated. Al's doctor has asked that he do a comparison test with the lab "several" times a year, so we do it once or twice.

Is it a good investment??? Only you can decide that for yourself. Look at it this way, if you pay $1,800. for the machine and use it for 10 years, your cost for the machine will be $15.00 per month. Also, how much is your time worth? My guy spends 10 minutes a week at the dining room table testing his blood. That's 10 minutes from the time the machine is taken from the drawer to the time it is replaced in the drawer. He doesn't have to get dressed, spend money on gas, spend time waiting at the lab......etc.....He thinks that's just great. Hope this helps.

Kind regards,
Blanche
Also an Arizona resident

 

[Cris N]

My United Healthcare Policy would cover the monitor as DME at 80% and the supplies at 80% too. They cover the Raytel service at 100%. Go figure

 

[BDMc]

Machine Cost

Machine Cost

Greg, I have Tufts HMO, and they cover full lab costs. I was expecting a co-pay for the machine, but they cover the machine, lancets, and test strips in full! Good luck, Brian

 

[Amelia_mom]

Lets say you have your blood drawn at the clinic and your told your INR is 2.5. You also test with your machine at the same time they draw the blood and your machine says your 3.8. This might be a pretty good indication that something is wrong and to test it, find someone who is not anticoagulated and test their blood. It should be 1.0 to 1.2 if your meter and strips are accurate.

You don't have to check with a lab, but most of us like to every 6 months or so just to be sure.

hi Ross

I am in the process of getting the coaguchek XS for my daughter and the rep from Roche is kind enough to come down to counter check with the hospital's INR lab test on my daughter. So far we did 2 tests and the result are not so close.
wk 1 hospital lab test = 2.7 , Coagucheck = 2.0,
wk 2 hospital lab test = 1.9, coaguchek = 1.5

Both times, blood was drawn at the same time and wk 1 it was even from the same tiny hand!!!

The rep says that the diagnostic machine the hospital uses may have different ISI (may be higher than 1.0) and hence the difference.

However, the same machine has been tested and approved in other hospitals in Singapore. Is this difference acceptable?

I am so tempted to test another friend on warfarin on the coaguchek when she goes to another hospital to test her INR.

 

[jeffp]

The whole purpose of the ISI was to level the field of the different testing reagents so ideally the INR would be the same no matter on the unit used. There have been some reports of lab reagents testing lower than they should due to manufacturers calibration methods, the most recent I know of was last summer (I felll into that one, got a lab reading of 1.8, my INRatio gave 2.8 and my physician's CoaguChek gave 2.5 - ignored the lab and stuck with my same dose). Testing on a "normal" patient blood may give a false sense of confort as with an INR of 1.0 the ISI computation (which is an exponent factor) does not enter into the calculation; as the clotting time gets longer than 1:1, then the ISI begins to have more weight. It may be off only 0.1 at INR 1.0, but could be off by 2.0 or more as the INR increases to the 3-4 range. The portable test results don't seem to be any more or less reliable than lab tests in practice, but physicians rely on lab tests as being absolute as a matter of training and culture. Doesn't make it right, just feels better to say it is.
It sure beats the old way of controlling anticoagulation - increase until blood in urine and then back off a bit.

 

[johnM]

Amelia_mom
Have you tested yourself with the Roche (assuming you have a "Normal" INR)
It's unfortunate that INR testing is anything but an exact science - there is enormous ignorance in the med trade in this respect. Recently a Registrar was unbelieving when I told him that 2 hospitals in the UK belonging to the same hospital group both produced differing INR's - he was obviously totally ignorant of the whole "Science".

 

[Amelia_mom]

hi jeffp

yes. I tested after my daughter tested. We did twice on her on the first week INR = 2.0 and mine came spot on 1.0

I beleive that our cardio knows something about the testing as he says as long as it is always "reporting 0.4 below the hospital lab" it's acceptable. That;s why the cardiologist is also looking into getting a ProTime machine - in fact they got but it's stuck somewhere in the hospital's department.

The guy from Roche is knows his stuff and since the Coaguchek has been approved at the other hospitals (including the Heart Center), we'll get it. I am just very shock that the lab test result can be that much off.

So imagine if my little Amelia's INR is at 2.5 or just 2.4 and the doc is assuming it's safe when actually it's at merely 2.0. Long term wise it's NOT a good thing. Her INR needs to be 2.5 to 3.5

Hence we are definately getting a home test kit as my baby will be in warfarin for the rest of her life.

Is there anywhere I can read and learn about INR testing ie how the whole science of it? Thank you all for educating me ... it's really good to know how the whole thing works.

 

[Ross]

I know with INRatio, I'm off by .6 from the lab everytime, so I like to keep my INR at the higher end of the scale at 3.5. That way I know I'm going to be at least 2.9 on the labs draw. Yes ISI and all is supposed to level the playing field, but I'm not seeing that happen.

 

[jeffp]

Is there anywhere I can read and learn about INR testing ie how the whole science of it?

Actually the Hemosense web site has alot of interesting files on testing (with their unit of course, you have to go down a few menus though) and how the whole thing works. Also some comparision data on home testing vs. lab testing accuracy wise.
I agree with Ross on the 0.6 or so higher reading. I really try hard not to let my INR get too low and I only have the 2.5-4.0 range as a guide and I also find about 0.5-0.6 difference. Once I was up at 6.2 and agreed at 6.2 with a CoaguChek unit, so they're fairly close within tolerance. I figure if 1.0 is correct for both they probably have a proportional divergence from there on up.

 

[Lotti]

INR Testing

INR Testing

Hi Don't know about the strips but in UK you can buy the Roche Coagucheck XS for £400 direct from the Roche web site.

Lotti