Backup insulin refused by GP.

[deanfeast]

Hi all,
Just thought I'd share this experience with you all.
As you know that when you are on an insulin pump, you should have a backup insulin delivery method if the pump fails. I use novorapid in my pump that I draw out of a vial to refill the reservoir. My backup method is using a novo-pen which takes the 3ml novorapid cartridges

I took my prescription to my GP the other day and she refused to supply me with the pen fill cartridges with the reason being, I have the 10ml vials, therefore in her opinion I don't need them.

I explained to the receptionist on the desk that I need them as a backup. She said that as the doctor had said no I would be unlikely to get them.

As a result, I staged a one man protest by holding up the que until a doctor come out and signed the form.

Has anyone else experienced problems like this?

It would be interesting to hear your thoughts and opinions regarding this!

 

[sugar2]

NOt really. I discussed this with the DSN at the surgery (who only sees me once a year for my "MOT". At this appointment she reviews my prescription, and said, ohh, we can take teh penfills off then. I said "no", and we agreed that instead of prescibing a box of 5, I would have 1x3ml penfill og both novorapis and levimir. So far, no problems. Th epen is still on my script as well, but I don't think I iwll need a new one for years..unless they change the cartridges etc.

I have been diabetic long enough to still have a very old stash of insulin syringes..still in the sterile wrapping. I don't plan on using them, unless I abolutely have to, but could, if it was an emergency use this syringe, with the vial of novo I have for my pump.

teh consultant at tthe hospital also made it clear that pump users need a back up, and teh GP has this in writing..should I face a situation like yourself.

Good for you, Glad it worked out in the end.

 

[SophiaW]

When my daughter first got her pump I made an appointment with our GP. During that appointment we discussed the new medication she would need for the pump (had letter from DSN explaining what was needed) and I also talked to her about keeping the Novopen refills on the repeat. I explained why they needed to stay on repeat and she was quite happy with this. I haven't needed to order any new penfills yet but I don't expect there to be a problem when I do. My thinking is that perhaps your GP didn't realise why the penfills are still needed and it was a simple mix up in communication and understanding. If your GP is anything like ours, she doesn't know a lot of detail about how pumps work so she wouldn't necessarily realise that penfills are still needed. My experience with GP receptionists is that they can be difficult at times like this and I always speak directly to my GP rather than taking their word that the GP won't change their mind about the prescription. In the past when there has been a problem with our repeat prescription, as it wasn't an emergency that I needed the medication straight away, I emailed the GP with another repeat request but explained on the email why it was needed. The prescription was issued without any problem after an explanation had be attached to the request.

 

[noblehead]

As a result, I staged a one man protest by holding up the que until a doctor come out and signed the form.

I like your style!

Not insulin related but recently my gp questioned the amount of test strips I was using, after explaining my reasons for testing and getting a letter of support from my diabetes consultant he's not said a word since.

Nigel

 

[iHs]

NOt really. I discussed this with the DSN at the surgery (who only sees me once a year for my "MOT". At this appointment she reviews my prescription, and said, ohh, we can take teh penfills off then. I said "no", and we agreed that instead of prescibing a box of 5, I would have 1x3ml penfill og both novorapis and levimir.

Hi sugar

Can you get a prescription now just for 1x3ml pen cartridges or do you mean 5x3ml (1 box)?

 

[phoenix]

As you know I'm not in the UK. When my pump nurse comes to visit me every 6 months and she makes sure she actually sees that I have insulin pens and that they are in date, reminding me to get a new prescription if they are approaching 'sell by date'
Three points that may help reduce waste.
My pharmacist asks me to give him some notice before he dispenses the back-up prescription. This allows him to get boxes with a long time before expiry.
I also try to use up my rapid back-up insulin. It is possible to fill up reservoirs from the pens so you don't need to waste any rapid insulin.
Even less wasteful (though I admit I don't do this) would be to ask for some syringes. You could then use the rapid insulin in the vials as a back-up, though of course you would still need some basal.

 

[sugar2]

NOt really. I discussed this with the DSN at the surgery (who only sees me once a year for my "MOT". At this appointment she reviews my prescription, and said, ohh, we can take teh penfills off then. I said "no", and we agreed that instead of prescibing a box of 5, I would have 1x3ml penfill og both novorapis and levimir.

Hi sugar

Can you get a prescription now just for 1x3ml pen cartridges or do you mean 5x3ml (1 box)?

Yes, I thoughtthatit was odd too. I just get one, 3ml cartridge, not a box of 5. My repeat presecription only had one box of five on it when I was not on the pump.

 

[iHs]

Cheers sugar

Thanks for that. Think I will have to pay my gp a visit. Since changing to the pump last year I haven't been issued with any Novorapid in cartridges just the Levemir. It's true to say that my gp doesn't understand much about pumps at all. At the moment I'm using my old Apidra cartridges in my Luxura pen and just refilling them with some Novorapid using a syringe. My gp moaned about prescribing me the Luxura pen as it was so expensive and asked if I really needed it. At the time it cost around the £50 mark and it's still as good as new so I will have it for a long time.

Must see if I can get gp to prescribe me 1 x3ml Novorapid cartridge and then I'll get a half unit Novopen thru eBay lol

 

[SophiaW]

That's interesting sugar, I must look into getting just the one cartridge. At the moment our repeat is for a box of five which would be very wasteful. I haven't needed to order more yet as we have left overs from pre-pump but going to need to order at some point as they reach their expiry date.

 

[cally]

I don't use lantus as a backup but have a vial of Insulatard and 1/2 ml syringes.

My pump did fail last week and I had to use my backup insulin for a day and a half. The only problem I found was that using the syringe was difficult beacause it was impossible to inject small enough amounts of novorapid for snacks. So Maybe I should think about getting a 1/2 unit novopen.

I do worry about waste. That is the first time I have used my backup Insulatard in 3 years pumping so have thrown several vials away when date expired.

 

[jopar]

You need to speak to your pump team and get your consultant to send your GP a letter...

As you also need a supply of background insulin, and at leasy syringes for drawing up quick if necessary,,

I've now asked my GP if I can have syringes instead of insulin cartridges, and a pack of 10 syringes rather than a box of 100, Cheaper throwing out 10 syringes if not needed..

I'm lucky as my husband is also a T1 diabetic and used the same background insulin as I did, Levimer so if needs be I can swip one of his cartridges until I get my own sorted, so not worth ording any up for myself..

 

[Unicornz]

As a result, I staged a one man protest by holding up the que until a doctor come out and signed the form.

Well done you! Glad you got it sorted. Haven't had problems with it myself as of yet (they have tried to reduce the amount of test strips I use but I got them to put that back up to 300!) but I wouldn't be surprised if this was their next step in their quest of saving money...

The annoying thing is that my practice never tell me if they change anything on my repeat prescription they just do it without my consent or knowledge. I then have to find out when I come back from the chemist with 3 packs of test strips instead of 6