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No more Alere InRatio2?????

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slipkid

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Am wondering if anyone knows what this is all about.

Supposedly my monitoring service (RCS) is going to send me some type of device by "Roche" instead of the Alere InRatio2 that I have been using the past 2 years since Alere is withdrawing the InRatio2 and getting out of the INR device testing business altogether, according to RCS (??).

Once I get the new device I will post again to see if people have any experiences with that one....

Thanks.
 

dick0236

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Doesn't surprise me that Alere is discontinuing their monitoring business using the InRatio2 after the problems of the last few years. You will probably get a CoaguchekXS meter manufactured by Roche Diagnostics. I switched from the INRatio2 to CoaguchekXS a few years ago......and I like the CoaguchekXS better.
 

LondonAndy

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There's an FDA announcement about the voluntary withdrawal here

I've only ever used a CoaguChek XS so can't comment on difference, but I am also diabetic and so used to blood glucose meters and the CoaguChek is just like most of those - just everything (machine, test strips and the drop of blood) is bigger! Easy to use.
 

Protimenow

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Personally, I'm glad to see that Alere is discontinuing that meter. I attribute a stroke to the erroneous values that the original InRatio was giving me -- the meter said 2.6 - the hospital said 1.7. When I reported this to Alere, after getting home from the hospital, all they did was send me a newer meter. No apologies. No filings with the FDA. Nothing except a new meter.

I began a quest to find a meter that I could trust, comparing the INRs taken within minutes of each other, from different fingers, and using different meters. I compared the results between meters, and frequently compared the results to blood draws.

The InRatio was often much higher than the other meters. Although I had a years' supply of strips that I bought, I determined that I couldn't/wouldn't trust my life to this faulty metering method. The debacle over defective InRatio 2 strips; recall; temporary unavailability; extremely high prices when they became available; and eventual price stabilization didn't do much to help the meter's prospects. I didn't trust it. I wouldn't trust it. I don't trust it.

I'm glad to see it gone.

When doing my comparison testing, I tested other meters in addition to the CoaguChek XS. I also tested against the Coag-Sense, the Protime 'classic' and the Protime 3. My personal choice, in terms of test accuracy and testing method, was the Coag-Sense. Although slightly more difficult to use, I believe that it's more accurate than the CoaguChek XS. In my testing, I found that the Coag-Sense reported INR resluts that were slightly lower than a blood draw. I'm a lot more comfortable with a 2.2 result from the Coag-Sense (often meaning that my INR in a blood draw may be around 2.4 or 2.5) than I am with a CoaguChek giving me a 2.6 (which, in my testing may mean someting as low as 2.3 or 2.4). I prefer a meter that reports a result that may be slightly lower than the blood draw over one that is slightly higher.

Roche is a marketing juggernaut. They've got the market share for INR test meters pretty well nailed down. Coag-Sense is probably not a large enough player to cause Roche a lot of grief (although I certainly hope that Coag-Sense is around for a long, long time - they make the meter that I trust). I hope that Roche doesn't use Alere's exit of the INR testing market as an opportunity to spike the prices of the meters and strips.
 

bradvo

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I did not know there was a voluntary recall until I bought a dozen test strips . I received a letter with my order and told me to go online for more info and also I requested someone contact me. ​Nobody contacted me after waiting for 2 weeks. So today I called Alere and was grateful for the person who assisted me. She did not tell me they were getting out of the testing but I also did not ask.
She said they would do a swap of meters for me at no cost to me. I would receive a cuag(sp) and 12 test strips. They would also send me a bag to return my Alere meter.

I guess I felt the benefit to me would be to start with a new meter, mine is about 4.5 yrs old. Many of my reading on the Alere seemed to be progressively lower then past readings, not high as some have said .
At any rate, I should see some new equipment and strips in the near future. I don't check as often as I used to, I had in the past did it weekly, then every 2 weeks now about once a month.
I'm thinking I should get back to every 2 weeks .
Thanks
Brad
 

Protimenow

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Were you using Alere's testing service?
I'm wondering if Alere will replace ALL InRatio meters. I have two -- and I haven't trusted EITHER for a number of years.
 

Protimenow

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I did a little digging.
If you have an InRatio meter and are using their service (which I'm guessing costs you, your insurance company, or Medicare around $60-80 a month), they'll take back their error prone meter and replace it with, what an Alere person told me 'a different brand InRatio meter.' I'm assuming that this well trained person meant 'a different brand INR meter.' If they're soaking the government or insurance $60-80 or so, each month, just so that you can test weekly, call in your results, and have them call the results to your doctor, they can AFFORD to send out a different meter. Why mess with the golden goose that's paying for the testing.

If not, they'll let you return the recalled meter (how nice of them), and may or may not make any accommodation for it.

I'll know more when I get my 'return' package.

I'm more curious about how they are doing the recall than about getting another CoaguChek XS (which I assume is what they'll replace the InRatio with). I'm sticking with my Coag-Sense.
 

slipkid

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I received a Roche CoaguChek XS meter & just used it for the first time today.

For the heck of it I did two tests, one with the Roche CC and the other with the Alere INR2. The CC gave a result of 1.7. The INR2 gave 1.8. So they are pretty close but the INR2 gave a higher number.

Last time I had a blood draw (about 2 months ago) I also did a companion home test right b4 I left for the lab and the blood draw gave me a lower result as well (blood draw was 1.7, INR2 was 2.1). So yeah, I believe the Alere INR2 does give higher results than it should.

Luckily the therapeutic range for my heart valve is only 1.5 to 2.0 so I've been OK with results like 1.7. Like someone said above I would rather have a meter under-reporting than over-reporting. I would prefer to be up around 2.0 or above though to give room for fluctuations though.

I like the CC but it has a major difference with the INR2 that I have to retrain my brain for. With the INR2 you put the blood drop on the strip and you're done. But with the CC the directions say to KEEP your finger on the strip UNTIL the unit beeps. I am so used to removing my finger right away after putting the blood on that I do that automatically.

Something I am impressed with the CC by is how fast the thing returns a result. Could not have even been 30 seconds. The INR2 however sits there thinking for at least 1-2 minutes and I have to hold my breath and hope it is working (sometimes in the past it took forever & either gave an error or just shut itself off - usually because the blood drop was not enough).
 

slipkid

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Protimenow;n868259 said:
Were you using Alere's testing service?
No, originally my Dr. tried to get me enrolled with Alere but there was a hugely confusing & complicated issue with Bluecross/BS as to the fact that they DID support/cover Alere as an in network provider but that the BC/BS in my home state had to process the billing and that this BC/BS entity did not have a "contract" with Alere despite BS/BS telling me I could use them - it was called some crazy thing like a "Bluegap"but I 4get the details now - it took me something like 6 weeks of phone calls and research to get to the bottom of it and thanks only to a very thorough lady at BC/BS who spent at least 2 weeks herself we were able to find a company called RemoteCardiacServices (RCS) to do the monitoring that was both covered by BC/BS AND had a contract with the billing arm of BC/BS in this state AND used the Alere device - like I said it was a totally complicated confusing mess of health care insurance gotchas & now 2 years after the fact I do not recall all the crazy details.
 

almost_hectic

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I have the Coaguchek and I dont hold my finger there. I just put a nice big drop on and then wait for the beep. They sent a nurse to my home to teach me how to use it and thats how she instructed me.
 

slipkid

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almost_hectic;n868493 said:
I have the Coaguchek and I dont hold my finger there. I just put a nice big drop on and then wait for the beep. They sent a nurse to my home to teach me how to use it and thats how she instructed me.
Weird. The instructional DVD, and the user manual, say to keep the finger there until it beeps. I'd prefer not to have to do that, am used to doing it on the INR2.
 

Protimenow

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The CoaguChek S used to require a big drop of blood, placed right on the strip. The XS apparently takes the blood as a big drop, or by touching the drop onto the side of the strip. The 'big drop' probably makes more sense, because it's easy to get too small a drop, touch it to the side of the strip, and wind up NOT getting enough blood for a complete test.

If you look at the strip, or see how the blood is drawn into it, you'll see that it has to go towards the middle of the strip (where you'd drop that drop or touch it to the center of the strip), then pulls it into the strip.

This is slightly easier than my preferred meter - the Coag-Sense, which uses a capillary tube to suck the blood into the tube, and then you have to deposit the blood onto the strip. With a bit of practice, either method works fine.
 

aussiemember

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Just found about this recall when I rang to order new strips. I talked to the Australian branch of Alere - they are emailing me a letter to get signed by my doctor and then sending me a CoaguChek Meter free of charge. I then have to return my old INR meter in the reply paid bag. I have been testing with the Inratio for 7 years so will be interesting to see the difference.
 

Protimenow

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Here in the United States, Alere didn't give me the replacement option. They said to discuss it with my doctor or anticoagulation provider. I've got the CoaguChek XS and the Coag-Sense (and also Protime and Protime 3 and some other meters intended for use inside hospitals). My personal preference is the Coag-Sense.

I'm glad to see that Alere will be replacing the InRatio with another meter (at least they will in Australia).

Unlike the reason for the recall, in my case, the InRatio gave results that were WAY too high. I had relied on the 2.6 that the InRatio was giving me, only to find out after I had a TIA that my INR was 1.7. My point - test weekly. But also get a blood draw (I do it monthly) to verify that the lab and meter are within 20% (or so) of each other.

And, as I've said earlier, I'm glad to see the InRatio exiting the market.
 

aussiemember

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Protimenow;n869053 said:
Here in the United States, Alere didn't give me the replacement option. They said to discuss it with my doctor or anticoagulation provider. I've got the CoaguChek XS and the Coag-Sense (and also Protime and Protime 3 and some other meters intended for use inside hospitals). My personal preference is the Coag-Sense.

I'm glad to see that Alere will be replacing the InRatio with another meter (at least they will in Australia).

Unlike the reason for the recall, in my case, the InRatio gave results that were WAY too high. I had relied on the 2.6 that the InRatio was giving me, only to find out after I had a TIA that my INR was 1.7. My point - test weekly. But also get a blood draw (I do it monthly) to verify that the lab and meter are within 20% (or so) of each other.

And, as I've said earlier, I'm glad to see the InRatio exiting the market.
Alere have sent me a letter to get signed by my doctor and then I have to forward it to them. It will be interesting to see if the replacement machine does arrive - I"ll update here when it does in case there are other Aussies out there with InRatio machines. I test weekly and do a lab draw every six weeks as a comparison - My InRatio was always slightly higher than the lab but nowhere near a variance as your readings. Sorry to hear about your TIA - I can understand totally why you are glad to see it exiting the market!!
 
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