Patient Self Testing

Marie B. Walker
May 2004

In the Understanding the PT-INR Test section of ClotCare, I mention that the traditional way to run a PT-INR test is to have your blood drawn and sent to a lab, where the test is conducted. Another option for obtaining an INR is to use a point-of-care device, also known as a fingerstick testing device.

To use this device, you prick your finger and provide a drop of blood on a test strip. The test strip is fed into the device, and the device reports the INR. These devices typically are easy to use and report accurate results. Additionally, if an INR result is surprising, another test can be run immediately to either confirm or refute the result.

These devices are often used in clinic settings to obtain INR results. However, more and more, these devices are being used for home-testing by the patient. If you are interested in self-testing, then a good starting point is to discuss the issue with your anticoagulation clinician. Not everyone on warfarin is a good candidate for self-testing, but if you are, and your clinician likes the idea, then there are a few things you should know.

First, you need a prescription from your physician to do home testing.

Second, the devices are not cheap. Depending on where you purchase the device, you will pay anywhere from $1,500 to $2,500. Plus, you will need to purchase test strips to use in the device. The test strips will probably cost you about $48 for a 4-strip pack ($12 per test strip).

Although the cost of home testing may seem high, you should know that your insurance may be willing to cover some of the cost. If you are on Medicare, have a mechanical heart valve, and have been on warfarin (brand name Coumadin) for at least 3 months, then Medicare will cover the cost of your testing supplies once you have taken their required educational program on self-testing and anticoagulation therapy. If you do not fit this description, then your insurance still may cover some of the cost if you can get a letter of medical necessity from your physician. Also, some of the companies that provide self-testing materials are willing to work out a payment plan or leasing option with you.

If after discussing the issue with your physician, you decide that you would like to become a home-tester, then a good next step is to contact an IDTF (Independent Diagnostic Testing Facility). An IDTF can provide you with testing materials and will help you to complete all the necessary paperwork. Most IDTFs also will work with your insurance to get your supplies covered for you. As mentioned above, when your insurance will not cover your supplies, many IDTFs are willing to work out a payment plan or leasing option.

Below we have provided some links to websites that you may find useful if you wish to become a self-tester. Please note that ClotCare is in no way affiliated with any of the sites to which we provide links, nor do we endorse these companies. Further, we recognize that this list is not a complete list of all useful websites on this issue. We provide these links because they are the sites of which we are aware and because we feel that they may be useful to you.

Useful Links

The following links are to the websites of several IDTFs. These companies can help you to obtain a point of care device and testing materials.

The following links are to the websites of several companies that manufacture point of care devices for the PT-INR test. These sites provide more information on the various types of monitors and may provide information on how to obtain a particular type of monitor.