V-Go® All-In-One Insulin Delivery Patch

The V-Go® all-in-one insulin delivery patch is a disposable device approved for use in patients with Type 2 diabetes. Because it is “disposable” and not “durable”, it is covered under Medicare Part D (rather than Part B). The device comes in three different strengths that deliver a basal dose of 20 units, 30 units, or 40 units of rapid acting U-100 insulin (such as Humalog® or Novolog®) per 24 hours. Additionally, each device can deliver up to 36 units of on-demand bolus insulin for mealtimes (in 2-unit increments). Prescribers will need to issue two separate prescriptions for patients – the prescription for #30 V-Go® devices to last one month and a prescription for the rapid acting U-100 insulin to put into the devices (typically 20-30 mL).

According to the instructions for patient use, patients must fill each device completely each day and each device holds slightly more than it can actually deliver. The amount of insulin each device can hold is referred to by the manufacturer as the Minimum System Daily Insulin Requirement and the amount of insulin each device can deliver is referred to as the Minimum Reservoir Dosing Capacity.

The table below summarizes each device and provides an estimated day supply to bill based on the number of vials of insulin and the amount of insulin used to fill each device.

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V-Go® Device Billing Quantity Minimum Reservoir Dosing Capacity Minimum System Daily Insulin Requirement Estimated Days’ Supply of Insulin
10 mL 20 mL 30 mL
V-Go® 20 30 EA 0.56 mL (56 units) 0.65 mL (65 units) 15 days 30 days 46 days
V-Go® 30 30 EA 0.66 mL (66 units) 0.75 mL (75 units) 13 days 26 days 40 days
V-Go® 40 30 EA 0.76 mL (76 units) 0.85 mL (85 units) 11 days 23 days 35 days

PAAS Tips:

  • Be careful to submit the correct days’ supply based on the amount of insulin each device can hold and not the amount it can deliver
  • There may be situations where billing greater than a 30 days’ supply will result in a higher copay or different pharmacy reimbursement – remember to always submit the correct days’ supply unless the PBM helpdesk advises differently (and be sure to document a clinical note)
  • See our Considerations for Billing Insulin Vials: Medicare Part B vs Part D resource for more information about disposable, and durable, pump billing

Eric Hartkopf, PharmD