Own v. Rent INR Machine?

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cewilk

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Thanks for the great info everyone! I have pretty much been managing/self dosing this entire time so I think I am going to make the move to purchase my own monitor and supplies and cease the weekly INR call ins. My annual insurance deductible is $1400 so by the time I get close to meeting that it’s already almost the end of the year. I think it makes better financial sense to purchase my own stuff at this point since I’m already used to self dosing. I think I’ll start shopping around for my own Coaguchek XS meter since that’s what I’ve been using the entire time I’ve been home testing. Unfortunately the Lincare customer service rep informed me I do not own the machine and will have to send it back to them once I terminate their services, but I think getting by own equipment is the right move at this point.
 

Protimenow

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Amen to that. I really like my CoagSense PT2. I think it may be a bit more future proof than the CoaguChek XS. It has an Ethernet port and WiFi, and automatic firmware updates (when there ARE any) can be done by downloading the new firmware.

The color display is a nice addition to the original model (which you can buy on eBay for less than $200, and which I've been using for more than five years), and both use the same strips. I also like that the PT2 (and the original Coag-Sense meter) usually report INR just slightly below the labs. I'm much more comfortable with a rare 2.0 from this meter (meaning that the lab may give an INR of 2.2 or above) than I am with a 2.0 on a CoaguChek XS - which may mean that a lab might report an INR of 1.8 or above.

The CoaguChek XS and the PT2 are good meters. I've used both. I'm just more comfortable with the PT2 than I am with CoaguChek XS.

You can find the PT2 at a number of medical supply companies - one has a bundle, with four boxes of strips (more than you can use in two years, for about the price of the meter and one box of strips. You may be able to sell 2 or 3 boxes and bring the actual price way down).

Whichever you choose (and you know my preference), I'm glad that you'll be owning your own meter, and are no longer a slave to the 'services' that loan you a machine, provide strips, may call the INR to the doctor, and charge a lot of money for the 'service.'
 

pellicle

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Just an aside:
...Unfortunately the Lincare customer service rep informed me I do not own the machine and will have to send it back to them once I terminate their services,
which means that someone else will be getting that.

I mention this because of the "recoil in fear" reactions (I wouldn't trust a used one) I experience here to the suggestion that you (third person infinitive) buy a good used one (bought for granma who didn't like it) and save yourself a bundle.

Mine is 8 years old now and has done thousands of tests
 

Warrick

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I agree with PelI on the secondhand option, I have two meters .
The first which I use all the time was supplied free “as long as I want it” by the St Jude supplier in NZ.
The second I got for $100 with strips off an auction site by someone who tried it and didnt like sticking their finger... so its only ever done 2 tests.
 
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Protimenow

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I didn't get that Pellicle was saying to have two meters (although I, for some reason, have two Coag-Sense 'classics' (I got one for backup), and a new Coag-Sense PT2, and also have a CoaguChek XS).

I wouldn't worry about getting a 'used' meter (although Pellicle's comment about people recoiling 'in fear' at the thought of getting a used meter). These meters are designed for self-testing, but are also used in clinics and doctor's offices, where thousands of tests might be done in a few months. They're made to keep working, and to stay accurate.

Like Warrick, I've gotten INR test supplies from the 'estates' of users who died. My first meter - a Protime - was sent as a 'gift' from someone whose parent died. I sent some money so that I contributed a little to the price. I bought a CoaguChek S (I think) from a guy who did auctions and traded some hard drives (or something) to a hospital that stopped using them. I've gotten meters and supplies that got into the market through rather unusual means - and they all worked.

If I ever want another meter - or strips, I have little problem buying from an auction site - especially if the seller will take it back if it doesn't work.
 

Warrick

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I didnt mean you should have 2 meters...

I was getting at theres nothing wrong with secondhand and alot of secondhand meters have had minimal use.
I have edited that post to make it clearer...

Secondhand meters here are like hens teeth and then they are either cheap or theyv looked at the new price and want the earth for them.
 
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Protimenow

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I've seen a bit of inflation in secondhand meters here, too.

Of course, in the United States, some people don't look at current listings and just post the meters at a price that they want to get -- but if it isn't 'Buy It Now,' bidders can push the price up.

In some cases, they don't know how to list the meters and use search words that don't place it with other INR testers. In that case, if you can find a misnamed or misdescribed meter, you may be able to get it pretty reasonably.

In the case of the original Coag-Sense, there's a new meter available now. There's a vendor (maybe two) on eBay who is selling these meters for under $200. Unlike the CoaguChek S, which was replaced by the XS, used different strips, and became obsolete (and arguably worthless) when Roche stopped making strips for it, the Coag-Sense uses the same strips as the PT2, so there's little risk of obsolescence for this earlier generation of meters.

When I was in the market for meters and strips, I kept looking for listings. Sometimes one is listed at a low price -- in this case, I used to quickly buy a meter that I wanted. For anyone in the market for a meter - if you can wait - just keep looking on eBay -- grannie's meter may eventually become available, with a 'Buy it Now' price of $50. You just have to keep looking.
 

tom in MO

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I got a meter for free from a provider. I was forced to switch to a new provider by insurance, but it turns out it the new provider was a front for the old provider. So I place my order with the new and its shipped by the old. The new provider said since I was "new" I'd get a new meter. I asked what I was supposed to do with the old, they said send it back. What they sent me was a new meter same as the old. Since at the time I didn't know the meter was "free", I sent back my meter and got a new one. I could have had two :(

The professionals don't recycle meters. They send you a new one. There's a host of medical device regulations to protect patients that would make providing used equipment a bad business decision and put patients at risk. Essentially they would have to verify the old meter's performance before supplying it to a patient and that is more expensive than producing a new meter.

How many people have dropped their cell phones in the toilet? Not I, but I know plenty that have. Billy knocks Grandma's meter in the toilet, he doesn't tell anyone but thanks God it works after a wipe down and some time in a bag of rice...

If you buy a used meter you don't know where it's been. Kind of like having unprotected sex with strangers.

Sure bet your life on used equipment...not I.
 

Protimenow

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Meters are made for thousands of uses -- there are many quality controls built into the meters.

The CoaguChek XS has quality control built into each strip, and verifies that the code on a chip that comes with the strips matches the code on the strip. If you doubt that quality control is built into the XS, watch the screen carefully when you run a test.

Roche can't risk having a meter in the public - whether it runs its first tests for a self-tester, or its 10,000th test at a lab or clinic.

For Coag-Sense, it's no different. Rather than using a code chip, with the PT2, you have to scan wirelessly (NFC scan) the code on a new box of strips. When you start to do a test, it confirms the code on the box. Finally, there's a bar code printed on the strip, that gets read before the test is run.

Neither company can risk having a machine or strips that don't give accurate results. This applies to the first CoaguChek XS that they shipped many years ago, the original Coag-Sense meter that shipped more than a decade ago, and to the new meter that you've just removed from the box.

Roche lost some of its shine last year, when some strips were recalled.

Errors caused Alere to discontinue the HemoSense meter because of errors (including one that caused me to have a stroke, because I put faith into its results and shouldn't have).

If I was in the market for another meter, I would have no concerns about buying a used one.
 

pellicle

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The professionals don't recycle meters. They send you a new one.
so why then do they demand you return it? Just to ensure its destroyed? Do you have some evidence that the meters are NOT just cleaned up inspected and turned around?

How many people have dropped their cell phones in the toilet?
my dad a couple of times (stupid bastard, may whoever it is rest his soul), he pulled the battery out, dried it out and it worked fine it was on the third time that I found out about it ... Now a cell phone is a FAR FAR more sensitive and electronically complex bit of gear than a Coaguchek, which is barely more complex than a TV remote control. As you know the actual important stuff is in the chemistry and that's in the strips.

As to betting your life that feels like drama. I'm not sure if its available where you live, but you could get a blood draw done and compare the results ... a few times even .. heck, even every 6 months after it proved itself. That would take some of that uncertainty out of it.

I bought a used meter on eBay last week, and sent it back. It didn't power up and there was clear evidence on the battery terminals (and in the compartment of classic "long storage not used battery leak" (which if you ask me is the most likely cause of death of these instruments.

887186


Now I'm not sure if you've dealt with eBay but if you buy using paypal then you have buyer protection, which allows you to return the item, giving you time to inspect and test it.

I know that well off people who have plenty of money and good insurance wouldn't touch one (because why) but there are quite a number of people who do scratch for a coin and I would much much rather see them see this in a realistic manner and be able to self test than not.

I think its important.
 

tom in MO

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I work in the industry, believe me when I say that medical devices like your INR machine are not recycled. They want the meter back, for two reasons (1) so they can control the supply and (2) liability if someone gets a defective used meter. They have to do their legal "due diligence."

Your defective meter that you bought on ebay is proof that you shouln't buy a used one. You were lucky you could see the damage. What if a tinkerer took it apart and reassembled it, you'd never know.

Home testing has been the standard of care for about 15 years. You can get one through your medical provider whether it be insurance or your government if you want one.
 

Protimenow

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I work in the industry, believe me when I say that medical devices like your INR machine are not recycled. They want the meter back, for two reasons (1) so they can control the supply and (2) liability if someone gets a defective used meter. They have to do their legal "due diligence."

Your defective meter that you bought on ebay is proof that you shouln't buy a used one. You were lucky you could see the damage. What if a tinkerer took it apart and reassembled it, you'd never know.

Home testing has been the standard of care for about 15 years. You can get one through your medical provider whether it be insurance or your government if you want one.
Tom - here in Southern California, when they say 'the industry' it means motion pictures and television. I'm assuming that you're referring to a medical device industry.

Having ONE defective meter doesn't seem like 'proof' that you shouldn't buy a used one. It is proof that you BOUGHT one with a defect. If I buy a used car, and the transmission is bad, this doesn't prove that anyone should NEVER buy a used car.

These meters are made to perform thousands of tests. Some facilities treat them as 'capital equipment' -- once they've fully amortized them, it's time for them to replace with new meters. Where do the old ones go? Wholesalers, vendors of used medical devices, some may be auctioned off. This doesn't necessarily mean that they're bad - just that they're used.

The person who sold this damaged meter probably didn't check for leakage in the battery compartment. This seller may not have known to check before selling it. This doesn't PROVE that you shouldn't buy a used meter - just that, if you do buy one, it's from a reputable seller (with a good feedback rating), and see if you can get a refund if the product isn't as described. If you buy with PayPal or a credit card, you should be able to get your money back.

The statement that you shouldn't buy a used meter sounds like it came from a person in 'the industry.' If you have concerns about your meter, confirm the results with another meter or a blood draw.

Not everyone can afford a new meter. Cutting off the possibility of getting a perfectly functional meter on an auction site isn't helping those people who can't afford new.
 

Keithl

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I work in the industry, believe me when I say that medical devices like your INR machine are not recycled. They want the meter back, for two reasons (1) so they can control the supply and (2) liability if someone gets a defective used meter. They have to do their legal "due diligence."

Your defective meter that you bought on ebay is proof that you shouln't buy a used one. You were lucky you could see the damage. What if a tinkerer took it apart and reassembled it, you'd never know.

Home testing has been the standard of care for about 15 years. You can get one through your medical provider whether it be insurance or your government if you want one.
I don't want to start a soap box speech, but the medical device industry and health care companies drive this. First with a valid prescription I can buy one. What ever is going on here in my area is a scam where doctors will not write a script and only support a service. Then the service is $120 a month and I am forced to only use a CoagaCheck XS. I am exploring other services to see what I can get and see how my cardiologist will handle it. This is always has been and always will be about the money. True there is always a risk buying anything off ebay, but the best advice would be buy one, take it to the clinic a few times and do A/B testing to check. Hell I did that with the new one I bought, compared to clinic's machine, the service machine and then blood draw as you can always get a new defective. And a leaky battery compartment does not mean the meter is bad, just clean the terminals. My guess in any other industrialized country this is not even a debate.
 

pellicle

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Your defective meter that you bought on ebay is proof that you shouln't buy a used one.
I suggest its evidence not proof but more evidence that when you buy a used one you should:
  1. make sure you have the sort of buyer protection ebay/paypal affords
  2. do due dilligence such as inspecting it closely for such defects as "it won't turn on with fresh batteries"
  3. assuming you get to here make a test on the same day as you get bloods done in your usual way and compare results
... rather than evidence one should avoid the used market. I know this is really a very complex set of steps, but being poor does not mean one is stupid, so perhaps the lower socio-economic group members reading this may choose to see it as a possibility and helpful guidance.

You have not clarified if the meters were destroyed or returned to Roche for inspection. Having been one of the technicians (for a different medical company) doing those inspections I can say that they probably just test on a standard test strip, if that passes give them a wipe down and return them to Allere who will send it to you. *(unless you have some evidence this conjecture is wrong)

Lastly (as you should know) the meters have a self test AND the strips too ... so I can't imagine how a tinkerer could defeat that ... but then there are probably Cunning Russian hackers out there doing this to subvert the population of america one INR patient at a time.
 

Protimenow

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Those cunning Russian hackers also put wi-fi into the modified meters, so they know your INR every time they test it. They tried to send continuous audio of everything that happens within range of the meter (hey, isn't what Amazon Alexa and Google Echo already do?) but their batteries couldn't support this type of monitoring.
 

mecretired

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I’ll throw my 2cents in—-i have been on warfarin for 9 yrs. I got so frustrated with doing monthly testing that my Coumadin clinic ordered. I purchased my own Coaguchek xs on eBay so I could test weekly. It was new in the box and about a third of the price that Roche wanted. I had no problems with it—worked great. I used it for 4-5 years. When I became eligible for Medicare I got a new Coaguchek and strips from Roche at no cost (my supplement pays what Medicare doesn’t).
 
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