Living with diabetes blog
Several insulin delivery devices are being discontinued by a major insulin manufacturer. On Jan. 1, 2010, the Novolin Innolet R, Innolet N, Innolet 70/30, and any of the Novolin Pen fills, except the Novolog Pen fill, will no longer be available.
This will be difficult for those of you who depend on these insulin devices to manage diabetes. The prefilled Flex pen is a great device and is easier to use than the Pen fill cartridge pens, but it doesn't come with NPH insulin. The Innolet is also a great pen device. In fact, when it first came out I often said it was the best thing since sliced bread to happen to diabetes education.
I have a patient with severe rheumatoid arthritis who's on twice- a-day NPH insulin program. The only way she can give her own injections is with the Innolet pen. She has tried the other NPH pen and is unable to manage it. She's at the point where she may need to hire a nursing service and have a nurse come into her home to give her injections twice a day. This is a major expense and she'd lose her independent living. A number of our patients have dexterity issues and the Innolet has been an extremely useful tool. I've also found it useful for illiterate clients and individuals with poor eyesight.
The same company will only have NPH insulin available in a vial. This means that a healthcare provider will have to order the NPH for their patients as vial/syringes, write a prescription for the other major insulin company's NPH pen, or switch to another insulin program. All these options do come with some obstacles.
- Many insurance providers contract with a specific pharmaceutical company and if the product isn't on their formulary, it isn't covered or is covered at higher co-pay.
- The insulin programs using basal/bolus insulin are more complex and can involve multiple daily injections and blood glucose monitoring.
- Analog insulin is more expensive then NPH.
- The insulin action of NPH insulin provides better coverage and is a simpler insulin program for specific health conditions; patients on chemotherapy or steroids, such as prednisone.
The bottom line — talk to your health care provider about your options.
Have a great week!
Dec. 04, 2009