In 2025, I will be traveling to East Asia (separately, I'm also going to Europe for a shorter visit at a different time in 2025) for a few weeks. Because it is going to be an extended visit so far from home, that will necessitate me packing a lot of diabetes supplies to take with me. To ensure that I have the diabetes supplies for the duration of my trip, that requires some advance planning. But I don't expect my insurance company's Pharmacy Benefit Manager (PBM) to be helpful at all.
The good news is that insulin will be the easy part, and the reason is because all of the big insulin makers have effectively abandoned the rebate-contracting sales model for insulin, meaning U.S. list prices for insulins are falling (after rising inexplicably for more than a decade) quite unlike most other prescription drug classes. While purchase quantity limits represents a potential problem, I plan to ask my endocrinologist to write me another script (or two), and I can then fill those scripts at different pharmacies and use manufacturer coupons, hence the quantity limit ordinarily imposed by my insurance company's PBM might not represent a problem I might have encountered in the recent past.
Dexcom began selling its products through U.S. retail pharmacies back in 2020, and along with that, the company began paying the big PBMs legally-exempt rebate kickbacks which were contingent upon "formulary-exclusion" of any and all competing CGMs sold via retail pharmacies (which essentially means that Dexcom is the "preferred" CGM brand, while Abbott's Freestyle Libre CGM systems are explicitly excluded from Aetna and United Healthcare preferred drug formularies, which are managed by the PBMs known as Caremark and OptumRx respectively). But I think I have found an effective work-around for that.
Aside from insulin, here's my plan to stock-up on Dexcom G6 CGMs.
Dexcom has a manufacturer coupon (for the G6 model, it can be accessed at https://www.dexcom.com/savings-center-cgm-without-insurance where a coupon to save up to $200/month on both G6 sensors and G6 transmitters. The coupon can be downloaded at https://dexcompdf.s3.us-west-2.amazonaws.com/g7-g6-cash-pay-tearpad.pdf. Of course, finding the lowest price on Dexcom G6 sensors (and transmitters) also matters, because the lower the retail price for sensor, the lower the patients' out-of-pocket costs will be. And I have found Costco Pharmacy appears to have some of the most competitive prices on Dexcom G6 sensors (and transmitters). Costco Pharmacy has an online tool to check prescription prices which can be found at https://www.costco.com/cmpp and that tool is helpful to understand the cash prices for many prescriptions.
Costco's Member Prescription Program ("CMPP") price for Dexcom G6 Sensor (1 box containing 3 sensors in each box) is (as I write this) currently priced at $195.19 which works out to a price of $65.06 for each Dexcom G6 sensor. Once a prescription has been filled at Costco's in-store pharmacy, patients do have the option to refill their prescriptions by using Costco's Rx Home Delivery service which saves the time-consuming hassle of driving to Costco and finding a parking space for routine prescription refills. Costco's Rx Home Delivery service charges an addition $2 for shipping/handling over the in-store price for filling a script at the in-store pharmacy, hence the cost for a box of three G6 sensors by Costco Rx Home Delivery would be $197.19 which works out to a price $65.73 for each G6 sensor.
By comparison, rival CGM manufacturer Abbott also has a cash-pay manufacturer coupon as well. I blogged about that at https://blog.sstrumello.com/2023/12/abbott-gets-real-about-formulary.html. The Freestyle Libre 3 sensors are sold individually at a price of $68.32/sensor, or marginally more costly than Dexcom's price of around $65.73/sensor, but the real differential is how long can each CGM sensor be worn? That is where Abbott's Freestyle Libre 3 is vastly cheaper because those sensors can be worn for 14 days compared to just 10 days for each Dexcom G6 sensor. That means the cost per day of usage is $6.73 with Dexcom G6, while it is just $4.88 per day of usage on Libre 3 due to Libre's longer wear-time. And, don't overlook the not-so-little fact that the newer Libre 3 Plus can be worn for 15 days, which effectively cut prices on CGM sensors even further. So far, I do not see the Libre 3 Plus prices at Costco listed right now.
But remember how I mentioned that Dexcom offers a manufacturer coupon for up to $200/month for sensors and transmitters on the G6 model? That means I can get the CGM sensors covered for next to nothing, in addition to the sensors which my own insurance company's PBM is covering (at least partially; my plan covers about 37% of the cost prior to me having satisfied my annual deductible). In other words, I can keep using my Dexcom G6 sensors using my insurance, while concurrently buying G6 sensors to pack with me on my upcoming trip to Asia.
For me, the only wildcard will be fingerstick blood glucose test strips. I have bought Accu-Chek Guide test strips from Mark Cuban Cost Plus Drugs for $18.79 per box of 50 test strips which is not too bad. I filled one script at Cost Plus Drugs last year, but did not fill it again because I had already satisfied my deductible and insurance picked up the tab after that. However, that is not necessarily the lowest price I've ever seen for test strips. My old OneTouch Ultra meter is still working, and I have bought generic UniStrip1 test strips for that meter can be purchased for an even lower price, so we'll see what I decide to do on those.