Recommendations For Home INR Machine

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tom in MO

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If it is covered by your insurance, ask them and also ask your cardiologist or whomever is managing your warfarin therapy. In my case, my cardiologist handled it for me. My insurance company has only one provider for test meters and supplies, so if you want the insurance to pay all or some, you need to comply or pay more.

My meter is the Coaguchek XS made by Roche, distributed by Allere. I originally tested and called in my results to Allere. Then my insurance company changed things and I call my results in to my cardiologist. Then my cardiologist started charging to write down my INR value, which changed to a monthly charge. So I don't call it in anymore, but my cardio's office didn't like that. We had "discussions" and I'm now allowed to do it myself, but I've got to see my cardio a little more often. That's actually cheaper ($40 every so often vs. $30/month.)
 

Protimenow

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I use the CoagSense. In my testing of CoagSense versus Roche CoaguChek XS, I found that my results with the CoagSense was a bit lower than the labs, and the XS results were a bit higher than the labs. For myself, I'd prefer a meter that reports slightly below the labs.

Both meters are usually a few percent different from each other - and it's probably easier to get strips for the XS - a lot more vendors seem to carry them. It's also easier to waste strips (in my experience) with the XS than it is with the CoagSense.

Both are solid meters. Roche has two newer models that take XS strips. CoagSense came out with a sexy new meter (PT2) last March.

I don't work for either company, and I'm not compensated for my comments. For myself, I prefer the CoagSense, but I'd still like to get some XS strips so I can compare the results. (Labs aren't always reliable, either).
 

Protimenow

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Now I know why you have so many meters.
It took me a while to accumulate the meters. After I had a TIA because my Hemosense gave me a 2.6 and the hospital said my INR was 1.7, I decided to gind the meter that I trusted most.

With a lot of testing of many meters - comparing them to lab results and to each other - I somehow acquired and tested numerous meters: Hemosense, Protime (classic), Protime 3 (I think that's what they called it), Coaguchek S and Coaguchek XS, CoagSense (the original, now called PT1). I did a lot of tests, poked a lot of fingers, and had many blood draws. One hospital used a meter that's also used in operating rooms. THAT's a primary reason why I have so many meters.

Many of the meters were bought on eBay - I got extra CoagSense meters (two meters) because they were available on eBay for very little money -- I thought of them as spares or as meters that can be sold later.

I don't have any CoaguChek aside from the XS, a non-functioning XS Pro, and a now obsolete S.

Of the new meters, one is supposedly unavailable in the United States, and the other is only available as part of a monitoring contract with Roche.

(FWIW - I can be persuade to sell a spare CoagSense PT1, if anyone is interested. My personal choice of meters is the CoagSense because, in my testing, I found that its results either match most labs, or is slightly lower than the lab. Of course, this isn't a good choice for anyone outside of the United States because I don't know if it's available internationally)

Agian - I didn't miss the humor in your comment.
 

Protimenow

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Pat: I wish I had some XS strips, so I can again compare results to the CoagSense, and to the lab (which I suspect was incorrect).

I'm contacting Coag-Sense (the manufacture or the Coag-Sense) meter about the 'possible' discrepancies and will report the answer. If my HMO allowed me to get tested at another lab, I would, just to see if its results match my meter's results.

However, in the past, as I reported on a few forums, this particular lab reported results that were much higher than other labs or my meter. I'm still inclined not to trust this particular lab.

For any of you out there thinking about changing from a Coag-Sense to an XS, I suggest that you wait. I don't think there's anything wrong with the Coag-Sense meters. (I'm going to see if there are any local cardiologists who will sell me a few strips,or test me there, so I can compare results to my Coag-Sense).
 

Bina

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COAGUCHEK XS------here in Canada, we can get a doctor prescription and buy it outright. Also, my personal insurance covers the cost of the test strips at 80 %.
I have been using it since 2007.
 

Protimenow

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Bina - I'm glad to see that you've been testing even longer than I have. When you say 'buy it outright,' are you saying that Canada buys it, or you have to buy it, and then they pay 80% for the strips?

Some countries are just much more enlightened about healthcare than we are in the United States. (Supposedly, Medicare will pay the cost of the meter - none of my doctors have suggested this, none have responded to my question about prescribing one (it wouldn't hurt to be able to get strips that are paid for), and, in my experience, this seems more like an urban legend than it does actual fact).
 

ForeverThankful

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I use the CoaguChek XS. I have one meter that was provided by the company through insurance. I test once a week on this meter, report my INR to the company via the internet and the company reports it to the cardiologist's office. A bit of a redundant system but that's how they set it up here in the US.

I also have a second meter that I bought on ebay because I didn't want to wait for insurance to take months to get a meter to me. I like having two meters so I can double check results anytime I want. To be honest I test more often than once a week on my own meter. I've done a lot of testing to look for patterns in foods, medications and so on. I also have strips both from the company and from ebay to be able to change things up.

I've been thinking of getting a Coag-Sense also. I like the idea of being able to cross check.
 

Protimenow

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I stopped cross checking a few years ago - because I had so much trust in my meter. However, I'd like to somehow get some XS strips so that I can occasionally check to see that both are in the same ballpark (or football field, or checkerboard, or whatever cliche you prefer).

And, of course, it's good if you can find a lab that you trust to get it 'right.' I have trust issues with my current lab - but my HMO would probably frown a great deal if I wanted to get my PT tested somewhere else.
 

gerrychuck

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COAGUCHEK XS------here in Canada, we can get a doctor prescription and buy it outright. Also, my personal insurance covers the cost of the test strips at 80 %.
I have been using it since 2007.
Your strips are covered? No kidding! I am in Canada as well, and using a coaguchek XS after having to retire my INRatio after their debacle. I have supplemental insurance but have always understood that INR testing supplies, unlike those for diabetes, weren't covered. I buy my strips off eBay and foot the bill myself. I'd be interested in who you have your insurance with.

As for the OP's question, as noted I use the Coaguchek XS. I recently did a lab crosscheck (did the blood draw at the lab and my finger stick at home within 15 minutes of each other), and the results were identical. When crosschecking like that I have never had a variance of more than 0.1 between my machine and the lab with either my Coaguchek or my old INRatio.
 

Protimenow

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Last Wednesday, I said that I would check with Coagusense about the large difference between some lab results and the results from my Coag-Sense meters.

I tested using strips from the same lot, using my original and new Coag-Sense meters - results matched (and this was required in order to get FDA approval). I was testing to see if there was any issue with one meter or the other.

I heard from Coagusense today.They insist that their reagents are very carefully tested and that their results ARE accurate. I believe them.

I haven't yet gotten a response from the lab.

Coagusense said that there's no reason that my 'unofficial experiments with multiple strips, multiple labs and multiple meters can be stopped.'

When I get blood tests, I always ask my doctor to add a PT/INR test to the menu.

If I had some XS strips, I would check against the lab and the Coag-Sense.

One more thing to consider -- if the lab results ARE far too high, and physicians or clinics receiving the erroneous results tell their patients to drop their dosage so that the INRs aren't so high -- are these patients being unnecessarily put into danger because of INRs that are TOO LOW?
 

pellicle

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If I had some XS strips, I would check against the lab and the Coag-Sense.
which I thought you'd already done extensively and which will not really be a worthwhile experiment from the perspective of generalisabilty (to others situations) because I'm quite sure various labs vary more than strips from Roche do.
 

Protimenow

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Yes, I did that extensively many years ago. The question was not what variance I would get from the Roche strips -- it was to give me another validation that the labs were wrong.

When I had my blood draws at UCLA's San Fernando Valley hospital, both meters (CoaguChek XS and Coag-Sense almost matched - and the average of the two meters (Coag-Sense was often slightly lower than the lab, and the XS was slightly higher) usually matched the lab results. My interest is not just to confirm that the labs were way off, but also to be able to satisfy my curiosity about any variance between the XS and the Coag-Sense.

I can certainly do without testing on an XS. I can rely on the accuracy of the Coag-Sense -- but it's hard to tell a lab that their results are so much higher than the meter. If I had similar results from two meters (Roche and Coag-Sense) it may be harder for the labs to just blame the meter.

I've written that I don't trust the labs. In many cases I don't. In this case, my INR was a somewhat high 3.6 (I've since slightly reduced my dose to bring it to the high 2s), and the lab got 5.1 - and they claim that they repeated the test to confirm the result. This could be mishandling of the sample - and they've done this twice. The difference from 3.6 to 5.1 is a bit distressing - and testing at another lab, or on two different meters would be helpful in demonstrating to the lab (or to the doctor prescribing the test) that their results were wrong.
 

Pat Heaney

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Nov 19, 2019
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I am having issues finding a distributor that will ship to my house rather than a medical facility. Anyone know of a distributor that will ship directly to the patient?
 

Protimenow

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Medical distributors might not do this - if they get a prescription from your doctor, perhaps they will.

As Pellicle suggested - you will probably do better on eBay. I can't see a good reason why you have to go through a distributor to get a meter (except, perhaps, some tax advantages, if you plan to itemize your 2020 return).

Distributors are often much more expensive than eBay -- even the distributors who use eBay for sales.
 
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