newbie intro and a question about getting a prescription for Byetta

I’m skimming through older posts, and ordinarily I’d lurk a bit (and
definitely read more thoroughly through the old posts) before asking a
question like this, but I have an appointment at a diabetes clinic on Monday
and would like some ammunition before then. And gosh you guys are prolific
posters.

I was diagnosed about 7 years ago and have pretty much spent the time in
denial. I’ve taken the medications prescribed (all oral so far) but that’s
about all I did except for spurts of diet and exercise. So far I’ve avoided
complications (that we know of), but the writing’s on the wall unless I do
something about it now, so I’m pretty committed right now. I’m very
overweight (BMI above 40). My last A1C was 9% and I’m sure the specialists
will want to put me on insulin. I don’t want it, but will do it if
necessary. I would rather talk to them about Byetta first, though. The
thing is, I am a medical transcriptionist at the same hospital and I have

never once seen a reference to a patient using Byetta, though I’ve seen
thousands of documents on diabetic patients, which makes me wonder if
there’s some resistance to prescribing it. This is a major teaching
hospital, not a small community hospital, and ordinarily they’re cutting
edge. (Just because I haven’t seen it doesn’t mean they don’t prescribe it,
of course.)

Is it difficult to get a prescription for it? I’ve checked with my
insurance carrier and they classify it as a tier 2 drug (which determines my
co pay) but the rep claims they have no problem with it as long as it’s for
diabetes and not just weight loss. Am I just imagining that there might be
trouble with this? If it is difficult, what strategies can I use to
convince them to do it?

Thanks for your input.

Debbie

4 Responses to “newbie intro and a question about getting a prescription for Byetta”

  1. Abram Alston Says:

    Dedbbie, You may not have seen it because Byetta is a pretty new med. It was
    just approved last June. It has been marketed primarily to endocrinologists so
    far. For me, one of its biggest advantages over insulin is that insulin
    contributes to weight gain and byetta does not. In fact, clinical trials showed
    a small weight loss for most patients. It is approved for use in combination
    with metformin or metformin and a sulfanurea like Amaryl. Many insurance
    companies won’t pay for it unless patients have been unsuccessful with
    controlling their glulcose levels with other oral meds and are using the meds I
    mentioned. I have used it in combination with insulin which is off-label, so my
    insurance company won’t pay. You might go to www.byetta.com and print off the
    prescribing information that is available there. It’s got a lot of detail for
    docs to look at. I doubt there is any resistance to prescribing it–it’s just
    new. Pat in Idaho

    I’m skimming through older posts, and ordinarily I’d lurk a bit (and

    definitely read more thoroughly through the old posts) before asking a
    question like this, but I have an appointment at a diabetes clinic on Monday
    and would like some ammunition before then. And gosh you guys are prolific
    posters.

    I was diagnosed about 7 years ago and have pretty much spent the time in
    denial. I’ve taken the medications prescribed (all oral so far) but that’s
    about all I did except for spurts of diet and exercise. So far I’ve avoided
    complications (that we know of), but the writing’s on the wall unless I do
    something about it now, so I’m pretty committed right now. I’m very
    overweight (BMI above 40). My last A1C was 9% and I’m sure the specialists
    will want to put me on insulin. I don’t want it, but will do it if
    necessary. I would rather talk to them about Byetta first, though. The
    thing is, I am a medical transcriptionist at the same hospital and I have
    never once seen a reference to a patient using Byetta, though I’ve seen
    thousands of documents on diabetic patients, which makes me wonder if
    there’s some resistance to prescribing it. This is a major teaching
    hospital, not a small community hospital, and ordinarily they’re cutting
    edge. (Just because I haven’t seen it doesn’t mean they don’t prescribe it,
    of course.)

    Is it difficult to get a prescription for it? I’ve checked with my
    insurance carrier and they classify it as a tier 2 drug (which determines my
    co pay) but the rep claims they have no problem with it as long as it’s for
    diabetes and not just weight loss. Am I just imagining that there might be
    trouble with this? If it is difficult, what strategies can I use to
    convince them to do it?

    Thanks for your input.

  2. Darrin Kelley Says:

    Thanks, Pat

    Actually I had heard of it some time ago, but only recently became
    interested in it for myself. We’ve got a ton of endocrinologists (well,
    several anyway) but still I don’t recall any of them referencing Byetta in
    their documents. Kind of strange now that I think of it, really, these docs
    really like new things. My insurance carrier indicates they will cover it
    if it is prescribed; I know about the problems getting it covered if used
    off label–that’s not the case here. Apparently I’m also going to be
    meeting with a pharmacist, surely she will be reasonably knowledgeable about
    it. If not, I guess I’ll insruct them.

    I was just wondering what kind of reaction I was going to get when I brought
    the subject up in the diabetes clinic on Monday. Thanks for your response.


    Debbie

    _____

    Dedbbie, You may not have seen it because Byetta is a pretty new med. It
    was just approved last June. It has been marketed primarily to
    endocrinologists so far. For me, one of its biggest advantages over insulin
    is that insulin contributes to weight gain and byetta does not. In fact,
    clinical trials showed a small weight loss for most patients. It is
    approved for use in combination with metformin or metformin and a sulfanurea
    like Amaryl. Many insurance companies won’t pay for it unless patients have
    been unsuccessful with controlling their glulcose levels with other oral
    meds and are using the meds I mentioned. I have used it in combination with
    insulin which is off-label, so my insurance company won’t pay. You might go
    to www.byetta.com and print off the prescribing information that is
    available there. It’s got a lot of detail for docs to look at. I doubt
    there is any resistance to prescribing it–it’s just new. Pat in Idaho

  3. Madelyn Teresita Says:

    Hi Debbie,

    My doctor’s office was reluctant to prescribe byetta because they thought it
    would not be covered by any insurance yet. I said, "get real" and called my
    insurance company - which said, "sure we cover it, but it is no generic" - so I
    have an $8 co-pay. The doctor cheerfully called in the prescription and the
    rest, as they say, is history.

    Marsha
    Day two - third shot
    Finally lost the remaining 2 pounds of Avandia water weight - back to 260 lb
    Morning BG 177 - a heck of a lot better than the high 200’s or 300.
    No nausea this morning post shot
    Low carb smoothie - no fruit - seems to be an easy way to eat in the am.

  4. Irwin Mayme Says:

    Hi, Debbie, and welcome to our little corner of the ‘net. <s>

    Byetta is still relatively new and some docs are just getting on board
    with prescribing it. For three months, I took info about the spit to my
    doc, who finally decided to let me give it a try. I’m happy I hung in
    there and educated him, because it’s the best thing that’s ever happened
    to me.

    I’ve since changed doctors, and my current one wasn’t familiar with
    Byetta, but because of my last two A1C’s, will probably prescribe it to
    other patients. We are pioneers!

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