Doctor Restricting Insulin Prescription

[Munchers]

Hi

My Doctors surgery is very good and one that I would be loathe to leave. Unfortunately the the Doctor who's 'expertise' is diabetes is a different story. I now refuse to see her as I get far better advise / help from the other GP's in the surgery. However this clearly isn't ideal and the diabetic doctor persistently reduces my repeat prescription (feels like retaliation). When I was first diagnosed some 6 years ago I was given 5 boxes of levemir and 5 boxes of novorapid (each box containing 5 pens). This allowed me to continue self medicating without having to go back every month. About 2-3 years ago I submitted a repeat prescription only to find on collection that it had been reduced to one box of each. I was told that if I wanted more then I had to jump through a lot of hoops i.e. blood test, appointment with practice nurse etc. I reluctantly jumped through each hoop until they agreed to increase prescriptions to 3 boxes of each. This didn't last long before they changed again - which they never discuss with me or tell me.

I am tired off their approach and feel that their approach is inappropriate and dangerous. I recently went too Africa for a month and beforehand put in a repeat prescription. Unfortunately I didn't check the prescription when I collected it from the surgery and my wife picked up the prescription the day before we flew out. I only realised that I had one box of each when packing a few hours before flying out. It was too late to do anything about it (surgery apologised and said come back for another prescription - but there wasn't time)! So I spent a month in Africa with 5 Levemir pens which was nowhere near enough as I use this a lot when in hot weather.

I would like to know where I stand on prescriptions and whether being given 5 pens at a time is the standard for other diabetics. I really am tired of this approach which is being forced on me by a selfish over zealous doctor (my opinion). By the way I have had no complications or diabetic related issues to date.

I'd welcome other people's views / comments.

 

[picklebean]

No doctor should be restricting your access to insulin. That is terrible!

Have you spoken about your concerns to the doctor responsible for this? That would be a first step. It may be as simple as explaining what your insulin requirements are and that having more than one box at a time makes your life a lot easier and should make no difference to them.

If that doesn't work, I would take it up with the practice manager or contact someone who is more senior and/or is responsible for overseeing your surgery - I'm not sure who this is. Maybe somone else on here will be able to tell you who you need to get in touch with.... maybe your local MP?!?


Basically, this shouldn't be happening and it needs to be sorted out ASAP.


EDIT: to say that every repeat prescription I get is 4 or 5 boxes (can't remember which) each of my basal and bolus insulins, each with 5 pens in them.

 

[Munchers]

I've raised with Doctor who refused to budge unless I jumped through a whole set of hoops. I then saw another doctor who increased my prescription but the this never lasts. After the last incident I was told (by receptionist who talked to doctor) that I couldn't have more than one box until I had seen the nurse at the surgery (because I hadn't seen her for over 12 months). I just can't take this continued withholding reasonable levels of insulin unless I do everything she says.

 

[iHs]

Sadly, this restriction on the amount of cartridges prescribed is all down to the expense that analogue insulins cost the NHS which I believe is over £50 per pack of 5 x 300u cartridges. Pre filled pens might cost an awful lot more.

I dont like to say it but Novorapid is available in 3ml vials and is considerably cheaper. Not sure, but Levemir might also be available in vials as well. There are also other types of insulin that are not analogue and they are much cheaper still and although they are not as fast in action, they still work all ok .

What some GPs and practice managers might fail to realise is that diabetics do need to adjust their insulin from time to time........ nothing stays the same forever.

:roll: :roll:

 

[picklebean]

Are you just under the care of the GP or do you go to a diabetes clinic / have a diabetes consultant or DSN? They would be able to back you up about needing a larger supply!


It does seem utterly ridiculous. How does limiting your supply help anyone? You still need the same amount of insulin whether you get it one box at a time or five boxes at a time... it makes no sense!! :roll:

 

[Daibell]

Hi. I submit my prescription renewal request thru the web each month, but I bring it forward by one or two days each time. That way I build-up a small stock that no one notices! For interest how many units do you inject of each insulin per day? I think you should raise your concerns with the practice nurse. Ideally you want the prescription stored on the computer to represent one months agreed need. This is not so easy with insulin. Currently my insulin represents 3 months need i.e. 5-pack of Levemir cartridges, whereas my tablets are exactly 1 month's need. I'm going to have to be careful not to trip over the same problem as you. I use a Novo pen with Levemir cartridges. I wonder whether changing from a disposable pen to disposable cartridges would be more acceptable to your surgery?

 

[donnellysdogs]

My gp pre pump actually asked how much insulin I used esch day and calculated how many cartridges I needed.
My cartidges then went down to 1 box a month.

Gp practices only have to prescribe a months doseage.

In some ways they are right, I know that I then went over to a pump and had lots of cartridges just wasted in my fridge.

Trouble is, some people will have one box on their prescriptions each month and not use a complete box.. Because the way our gp's prescribe in a way that 'one size fits all' those that need more seem to be penalised...

 

[donnellysdogs]

If 5 pens are lasting you one month, sadly, the gp does not have to supply more.

 

[noblehead]

Under the circumstances (your trip to Africa) the gp should have temporarily increased your insulin but they could only do this if they were aware of your holiday, did you tell them when requesting the prescription?

Like you I use to get 5 boxes of each insulin at a time then it went down to 3 and now I get 2 boxes of Novorapid and 1 box of Lantus, it would appear that most gp practises don't prescribe much more than 1-2 months ahead now and this may be due to cutting down on waste, I know with insulin it keeps for a long time in the fridge and we need it for life but other prescription drugs can be stopped and alternatives given at any time.

Not ideal but not much we can do about it, if you are running seriously short of insuilin each month then a word with the practise manager might resolve matters.

 

[AMBrennan]

The GP is not restricting OP's insulin, and thus the title and many above posts are misleading and completely missing the point; the real question is whether doctors should have to prescribe a couple of on the worth of drugs at a time.

And to be honest, 5 packs at a time is rather a lot so I can see why they would want to see you to make sure it's the best treatment.

 

[scoyyt57]

I wouldn't trust my diabetes care to my GP. One of the GP's in the practice told me "if I lost weight I would cure MY diabetes". I am Type 1 and have been for 49 years! If losing weight would cure me I would weigh 6 stone wringing wet :lol:

 

[hanadr]

Doctors are tending to restrict all repeat prescriptions to a month's supply at a time.The idea is to limit waste.
I don't use insulin, but T1 husband does. He gets one month at a time. He's cut his insulin doses so much with reduced carbs, that he can go 2 months on what was a one month supply a couple of years ago.
I get my prescriptions, which include Metformin in 6 month batches. the surgery sends 6 prescriptions to my pharmacy and I collect as needed.
T1 uses vials to refill his pens, not pre filled pens.
Your doctor may not be trying to restrict your use, just to conttrol waste.
Hana

 

[picklebean]

The GP is not restricting OP's insulin, and thus the title and many above posts are misleading and completely missing the point; the real question is whether doctors should have to prescribe a couple of on the worth of drugs at a time.

And to be honest, 5 packs at a time is rather a lot so I can see why they would want to see you to make sure it's the best treatment.

The GP is restricting the OP's access to their insulin. I personally find it very difficult to get a repeat prescription in so frequently due to other health problems and access to my surgery, so having to get one box at a time would seriously affect me / cause a serious problem. So I don't think it's missing the point at all. Luckily my GP is flexible and understanding and allows me to have 4 or 5 boxes at a time.

 

[Lucyturner]

My gp is the same, I only get 1 box at a time but it's the same with my testing strips for my monitor and my needles the receptionists and I are on a first name basis and I don't even have to tell them what I need any more as they see me so often to pick up or call to order my prescription but there has are tied only the doctors can up my prescription which they refuse to do, it's insane.

Lucy

 

[malky]

I get 3 boxes of insulin at a time both my humalin I and Novo rapid so 15 vials of each what would last between 2-3 months. I have never had problems with re ordering or changing any of my prescription. I also get test strips no problem. I suppose it just depends on the GP i agree its easier to get a couple of months at a time but. Seems strange that your gp specialises in diabetes and puts these restrictions your would expect that from someone with less knowledge maybe. I am lucky my surgery are not like yours as I only go there for my flu jab once a year and cant remember the last time i saw my GP i tend to leave my care to the diabetes nurses at the hospital. I was once told by a GP to stop drinking diet drinks because of the sugar in them

 

[mark5745]

Doctors only supply one month at a time if you don't pay for your scrips so that could be 28 tablets one a day 56 two a day and so on same with insulin depends on how much you use


Sent from the [url=http://www.diabetes.co.u

 

[sip]

At one time I used to get three months' worth of Metformin on one script, then GP moved to once a month with all my meds -- pharmacy collects script(s) and delivers my meds end of each 28-day period.

I was advised that this was a directive from NHS HQ. When I went away for three weeks, my GP gave me an extra one-month's worth of script(s) and recently did the same to bring all my meds to the same issue date. All GP surgeries have to follow the directive.

The big problems are yet to come, now that GPs have to also be accountants -- they'll be too busy watching the bottom line on the balance sheet, and the first thing that will take a hit is prescriptions. No more branded stuff, only generic meds where available (the recent court ruling in India will give GPs a big boost if they are allowed to import meds from there). Previously, there had to be a clinical reason for denial of service, eg. changing from branded to generic, refusal to refer for specialist treatment, etc) -- that's all going out the window and there will be very little oversight of GP services.

Goodbye NHS -- welcome US-style health care.

 

[leking]

Hi. I submit my prescription renewal request thru the web each month, but I bring it forward by one or two days each time. That way I build-up a small stock that no one notices!

Thanks for the tip

As a T1, I stuggle more with getting test strips than insulin. i get about a month supply of each, which seems to be the norm. I'd of course rather have a longer supply, but those days are gone it seems..

 

[Munchers]

Thanks for all the comments.

I think the thing that's really gets to me is they change the repeat prescription without telling you.

 

[petertremelling]

Why is it that people on here are intent on bashing GPs? Why do people with diabetes always want to keep massive stocks of insulin, strips, etc? Clearly here the doctor is prescribing an adequate supply of insulin, if more were prescribed it would either mean you need closer attention/modification of insulin type or dosing, This is in your interest. As to the 'mix-up' before you travelled, that, friend, is down to you and your poor planning! It really is time that people with diabetes began appreciating what the NHS does for them and in their interests. When my treatment changed over to insulin, my practice diabetes nurse asked whether I would prefer disposable syringes or re-usable ones, also if I needed strips, which I now get 1 tub/month as I have got the blood glucose levels down. I cannot speak too highly of the NHS as between my wife and I we have need to use it quite a bit. Diabetes is a serious condition, no doubt about it, but taken seriously it is not a terminal illness. Keeping a positive attitude helps a lot.