Remote INR taking over Coaguchek

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RAS

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only the Roche as far as I know because I've been told that the Coagsense is freely available

It's two different things...
1. Yes available for sale direct to patients but...
2. Still requires a prescription from a Dr. as specified by the FDA. Legit medical suppliers will specify that on their website.


CoagSense made a different business decision from Roche in allowing sale direct to patients for some reason. That has nothing to do with the FDA.
 

pellicle

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good morning
We covered that earlier in this thread: Post 170
Also another thread: Post 5

ok, reviewed those (thanks), so firstly and not without significance is "I don't care and I have nothing invested in what you choose to do"

here you say
This is the reason I switched to a service. The direct buy options are eBay or a revolving door of suppliers. A service does cost more (through my current ACA insurer), but I never have to worry about acquiring strips ...

as an argument is rather like saying "I'll only ever buy a car from an authorised dealer" when there is nothing inherently wrong with the used market. There is no apparent enforcement of the laws mentioned about what Roche requires and indeed you can buy new from eBay too ... as to "revolving door of suppliers" what if your personal choice of pharmacy closes? The product is the same no matter who the supplier (at least to my eye). That I
  1. save money
  2. don't have to have (the myriad of) arguments (over stupid decisions) with Clinics
  3. can actually improve my time in range to typically >95% (linked to positive health outcomes)
are things I count highly

Yeah that's correct. I'd be happy to buy via Rx from a pharmacy or medical distributor here in the US even if not covered by insurance as I did in the past

and so I'm not sure why you chose to be held down? Is it because you like to follow the rules strictly (I hope you never speed or run a red light, cos that's seriously policed)

but for some reason Roche is no longer allowing that.

key word ... Roche ... not Coagsense or other possible units.

One other fact to note is US Federal law restricts sale of medical devices like an INR meter
only the Roche and only because of (one really must wonder why) the wording of the specifics of the Coaguchek XS approval.

Best Wishes
 

pellicle

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It's two different things...
1. Yes available for sale direct to patients but...

some of the people I've had personal discussions with here have used it and bought it

2. Still requires a prescription from a Dr. as specified by the FDA. Legit medical suppliers will specify that on their website.

not based on what they have told me, but then I have no interest in using that device for all the problems that have been identified with it.

CoagSense made a different business decision from Roche in allowing sale direct to patients for some reason. That has nothing to do with the FDA.
well I seem to recall that the wording of the FDA approval was key to them turning the entire US market into their PoC gimp (and maybe nice incentives by companies like Allere who make money for nothing (and their Chicks for free) out of this.

I'm a bit of a wild colonial boy at heart, so I'd buck that system because it seems overly restrictive to me, but then I'm probably a libertarian.

Oh, and in Australia ATS is still giving Coaguchecks away if you ask for one with a mech valve. Apparently they have seen the benefits of "your valve vs my valve"


but thanks for answering, I believe I now understand your choice.
 

RAS

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only the Roche and only because of (one really must wonder why) the wording of the specifics of the Coaguchek XS approval.

not based on what they have told me, but then I have no interest in using that device for all the problems that have been identified with it.


Yeah I realize people manage to buy CoauguSense without a prescription but from an FDA standpoint prescription is required. The specific document for the current model is on FDA.gov. ("Prescription Use" as noted on Page 3). An example of a supplier specifying the prescription requirement here.
I also have no interest in using that device.

Anyway, to elaborate on the reasons I'll stick with the Monitoring Service...
  • They provide a CoaguChek device.
  • Logging the result in their website is simple, quick.
  • The additional cost of the service is not material to me and given the Biotel/Cardionet billing issues (all in my favor so far!) My cost has been less than expected.
  • Ordering/shipping supplies, transmitting results to my Dr. are handled well.
  • My Cardio continues to allow me to manage my dose. I do have to put up with the required call from my Cardio nurse after each reported INR but more often than not it's just a voice email.
  • I'm only 2 years away from Medicare which will cover 80%. I've assumed this cost will be much lower under Medicare, but hadn't found any specific credible base cost info to calculate what my 20% share would amount to. Kudos to mecretired for his post detailing Medicare costs of this service. Based on that info it's no more than $14.42 per 4 reported tests. My cost could be less or even zero if I get a Medicare Supplement plan. A couple more years at the current cost does not bother me.
 

Protimenow

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I don't know if this will change anyone's mind about self-testing.

I just bought a CoaguChek XS on eBay for a tremendous fee of $29.95. It isn't exactly new. It's missing the battery door (not a big deal if you're careful), and the blue strip guide. I've been able to put a used strip in the area where the guide used to go, and have been able to insert a strip into the meter and run a test.

I've read here that some people were able to get a new back and guide by calling Roche. I haven't tried this.

I have an older meter that I've been using for years. I bought it used on eBay and have had no issues with it.

I thought that this new, $29.95 meter would be a good backup.

It's not - it's a replacement for the one I had been using since, I think, 2014.

I put batteries in, checked memory (the meter stores 100 tests (I think),) and the oldest test was in October last year. Only three tests were done on the meter - and these may have been quality control tests that the manufacturer ran.

The display is brighter than the one on my old meter. The new meter even had the plastic sheet that they put on the display before shipping it out.

With the exception of a missing battery door and slide guide, this was a new meter. I transferred the guide from my old meter and the battery door onto the new meter, and for $29.95 I have what I consider to be a NEW CoaguChek XS. The test I ran was just fine. I expect to get a lot of use from this meter.

If you're still on the fence about an XS, this may be an inexpensive way of putting your toe into the water. Although you can buy a tube of six strips on eBay - just for testing to see if you like the XS, it's more economical to buy them in larger units.

Not all of these meters will be new, I guess, but it's reasonable to assume that Roche (or a service, or something) pulled the strip guide and battery cover off to 'disable' them, so they can't be sold as test meters - but vendors bought these units and are now selling them. I'm not sure of the reason for this -- maybe Roche is getting ready to discontinue the classic XS and replace it with the newer model that they sell in Europe. Maybe not. I'm just guessing here.

-----

RAS - you're of course free to make your choices of using a service or self-testing with your own meter. You say that you're already managing your dose. I'm at a partial loss to understand your reason for not owning your own meter. (Maybe the $29.95 meter that I wrote above will convince you to give it a try). Remember, too, that when you use a service, the service is charging your insurance, or Medicare, a LOT of money for the privilege of sending you strips and lancets, loaning you the meter, and informing the doctor of your INR. Taken individually, the few hundred dollars these companies make fior practically no effort adds up - and increases our insurance premiums and the financial load on Medicare.

I've been buying my strips on eBay. The only bad batch I got was for the Coag-Sense. I buy my XS strips form sellers with good ratings, with guaranteed expiration dates. A return policy doesn't hurt.

----

If you're able to self test, and maybe even self manage, I see little reason to avoid eBay. Also - if you buy one of these $29.95 meters, your experience may not be as good as mine was - but I bought another of these meters a few months ago and, although it wasn't as new as the one I just bought, it was also somewhat newer than the one that was my primary meter. All three meters work the same way. The results are almost identical.
 

pellicle

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Yeah I realize people manage to buy CoauguSense without a prescription but from an FDA standpoint prescription is required.
ok ... perhaps they just haven't mentioned it. However they can buy them, and I'd have thought you should be able to buy a Coaguchek in the same manner.

Thanks for clarifying your reasons.
 

Timmay

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I bought both of my XS meters off eBay for around $150 each. They’re definitely both used meters. For one of the meters you can tell that the seller 3D prints their own strip guides and battery covers. That’s cool with me … and they did a great job with the printing. The other meter looks 100% original.

FWIW, I’ve done back to back tests between the meters and in both cases that I did this the result was only 0.1 different. Totally acceptable in my book.

I, personally, think it’s nice to have a backup in case you get an INR reading that makes you say “hmmmm”. Do you need a backup meter? Definitely not. I just think it’s nice.
 

Protimenow

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Actually, now I have two backups - one that I got a year or so ago ($29.99), and the one that I have been using since 2014. I tested the last two against each other, and they were within 0.1. I haven't checked my new meter against the one that I'd been using.

I just got nine fresh Coag-Sense strips for $15. I may give these a try - and compare the results to the XS. If I can get a prescription, I'll also compare to a lab's values.
 

Chuck C

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I bought both of my XS meters off eBay for around $150 each. They’re definitely both used meters. For one of the meters you can tell that the seller 3D prints their own strip guides and battery covers. That’s cool with me … and they did a great job with the printing. The other meter looks 100% original.

FWIW, I’ve done back to back tests between the meters and in both cases that I did this the result was only 0.1 different. Totally acceptable in my book.

I, personally, think it’s nice to have a backup in case you get an INR reading that makes you say “hmmmm”. Do you need a backup meter? Definitely not. I just think it’s nice.

I've got two back ups as well. Got my first Coaguchek for $220 used on eBay. It has always tested accurate against the lab. The last check it was exactly the same as the lab. About a year ago I picked up another used meter on eBay for $50 and a few weeks later I could not resist picking up a third for $30. They have all tested accurately.
 

tom in MO

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... One other fact to note is US Federal law restricts sale of medical devices like an INR meter and test strips to physician ordered sales only. In other words an Rx is required...

That's incorrect. I contacted the FDA who told me the INR monitors and supplies do not require a prescription. The requirement for a prescription does not come from the FDA but comes from either the supplier or the insurance company. It's warfarin that FDA requires a prescription since it can kill you :)
 
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Timmay

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I've got two back ups as well. Got my first Coaguchek for $220 used on eBay. It has always tested accurate against the lab. The last check it was exactly the same as the lab. About a year ago I picked up another used meter on eBay for $50 and a few weeks later I could not resist picking up a third for $30. They have all tested accurately.

I see your 2 backups and I raise you another … for a total of 4.

Like you, I couldn’t resist the temptation to order a couple of the $29.99 ones (with free shipping). And since Roche is moving to the new model that uses the same strips, these XS units will eventually be gone. Getting mine now!
 

pellicle

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for a total of 4.
you and @Chuck C are becoming collectors...

1657679822544.png


its turning me green ...
1657680116519.png
 

slipkid

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I will never ever waste my time calling them again. I already called them something like 3-4 times last year to ask when they would be billing me and how much it would be (this was b4 they even started billing my insurance company BC/BS). No one there could/would tell me a goddam thing other than something like I was not yet in their billing system so they had no information they could give me. Eventually (like a year later) they did submit bills to BC/BS most of which were denied because they took so long to submit the bills that they were no longer even legal (or something). In the meantime I owe them something like $20-25 leftover from what BC/BS did allow towards the end of last year or beginning of this year (I 4get) yet still, they have yet to bill me for even that balance. Think I talked about this stuff earlier in this thread and others had similar experience with them.

Replying to myself (never a good thing - as one me likes to say JANE YOU IGNORANT SLUT! to the other me - sorry vintage Saturday night reference)....

Anyway, here is an update on biotel/philips/cardionet/whoever they are.

I said I would not call them again to point out their billing mistakes/lack of billing/the billing issue I mentioned just prior to that post but I had to call them about my Dr retiring and needing to update my physician that oversees my INR results.

So after getting into that, the lady I spoke to was very helpful and when she asked if there was anything else I needed or wanted to ask about I felt that I should let them know again that they still have yet to actually bill ME (have only ever billed my insurance company but never me for my part) and that their latest bill was rejected by my insurance because they/philips used the wrong billing code or whatever it was for that submission.

She thanked me for telling her about that and said she would pass that on to the billing dept.

So today, about 3 weeks later, I got a new BC/BS EOB and one of the things in there is a submission from cardionet which was rejected, this time because "service was submitted for payment after the claim filing limit". This is like the 3rd/4th/5th/100th time this happened btw. I'm not even sure if this one was them redoing the last one which they submitted wrong though, would need to find that other EOB and look at the "service date".

How do they stay in business??? I know there were some explanations of all this merger/service sell-off stuff already in this thread where many of us went over a year without a single bill but still, how can a company survive like this?? (just wondering)
 

Protimenow

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I now have two backup meters. One of my backup meters is the one that I've used since 2014. The other is a NEW XS that I got for $29.95 (missing strip guide and battery cover. The strip guide issue can be remedied by inserting a used strip into the top of the area where the strip slides in - it triggers the switch that keeps it from working. You can probably get away with slicing a strip-wide piece of plastic from a plastic cutting board cover.

As far as getting a unit that a grandson opened - it's pretty safe to get one of the $29.95 meters from a dealer who has '10 left' - this probably means that they bought a truckload of these things, disabled by Roche, at a steep discount. (After all, how much can disabled meters be worth, anyway?). I have two backup meters - both are accurate. I don't know why I would want or need another for backup, but for $29.95, it's still pretty tempting.
I'm waiting for the new meters to hit the legitimate U.S. market - maybe I can have Medicare get me one of THOSE.
 
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