Right to choose

[SidVicious]

Hi all,

Life member for 45 years, first time poster!

I've been on Novorapid for probably 20 years - never had a problem with it. My surgery moved me (without being given a choice) over to Trurapi 3 months ago.

I've had 2 mechanical failures of the pens in that time. They feel really cheaply made, and the most recent issue was a stripped thread meaning I've no idea what was actually injected.

Goodbye control for the next 3 days

Question is - what are my rights to ask to go back to Novorapid? Or at least something reliable?

 

[JITR]

I'm confident our surgery would accomodate your request as well as they could. It would be a matter for discussion rather than rights.

 

[Robin]

Hi all,

Life member for 45 years, first time poster!

I've been on Novorapid for probably 20 years - never had a problem with it. My surgery moved me (without being given a choice) over to Trurapi 3 months ago.

I've had 2 mechanical failures of the pens in that time. They feel really cheaply made, and the most recent issue was a stripped thread meaning I've no idea what was actually injected.

Goodbye control for the next 3 days

Question is - what are my rights to ask to go back to Novorapid? Or at least something reliable?

I’m sure our local formulary states that people starting on insulin should be given one of the biosimilar ones,(like Trurapi) on cost grounds, but that people already on insulin should not be swapped to them, unless they have had a discussion of the implications , and agreed.
I definitely wouldn’t agree, because I rely on my Novopen echo to record doses, so I can check if I’ve done my insulin, and how much I injected. I also need the precision of a pen that does half unit increments.

Sorry, the screenshot isn’t very readable, the relevant bit states ' First line choice… for NEW adult patients….Existing Novorapid patients should not be switched unless in line with an agreed protocol.'

 

[Lucyr]

I've had 2 mechanical failures of the pens in that time. They feel really cheaply made, and the most recent issue was a stripped thread meaning I've no idea what was actually injected.

Why not move to reusable pens for the trurapi if your complaint is about the quality of disposable pen

 

[Inka]

Welcome @SidVicious 🙂 It was a few years ago now that I had to insist on using the insulin of my choice, but I’m pretty sure that there were guidelines I referred to, saying that it was the patient’s choice. It’s disgraceful you were swapped without any consultation. Put a request in writing to move back to Novorapid and list the reasons why.

 

[Inka]

Had a quick Google and found this:

1.7.12​

If an adult with type 1 diabetes has a strong preference for an alternative mealtime insulin, respect their wishes and offer the preferred insulin. [2015]

 

[Flower]

Welcome @SidVicious

This was a thread from last year which includes a link to DiabetesUK position on the use of biosimilar insulins.

Post in thread 'Trurapi vs Novorapid ??'

Sep 3, 2024

Hi @Hawk22

This is Diabetes UK position on the use of biosimilar insulins from a few years ago. There's a link to their full position and advice on changing to a biosimilar on the page.

Biosimilar insulins (our position)

Biosimilar insulin is a biological copy of an original insulin and there is increasing interest in developing and using them. Biosimilar insulins are cheaper than original products so they present the NHS with opportunities around availability and cost of care. However, there is lack of...

www.diabetes.org.uk

I'd contact your daughters team and request she stays on the named brand that she started on, I did this a few years ago when I was changed without any discussion to Admelog a biosimilar of Humalog insulin.
Biosimilar insulins are as per the name very similar in...

• Flower

• 

If you are established & stable on Novorapid you shouldn’t be changed without discussion or if you don’t want to be changed over.

Could it be a case that your prescription no longer specifies the brand name Novorapid and instead has the generic Aspart insulin in which case the pharmacy will issue Trurapi?

I would ask for Novorapid back on your prescription. I did this when my insulin was swapped to a biosimilar after many years without any prior discussion or agreement. My surgery was fine about changing it back.

 

[Bruce Stephens]

I would ask for Novorapid back on your prescription.

Yes. I'm guessing it may have been the surgery's prescribing pharmacist doing this generally as a cost cutting measure? In theory it ought to be fine (they're biosimilar), but it's obviously not working for you so making that clear ought to fix things. And yes, they shouldn't do it without consultation: insulin is rather critical to us! And report the problems you had on the yellow card system: https://yellowcard.mhra.gov.uk/

(And if you aren't already, switch over to the reusable pens for Norovorapid (generally, for insulins produced by Novo Nordisk) because they're really nice. The insulin comes in cartridges, 3ml, so the same volume as the disposable pens but in a much smaller package. Same needles.)

 

[rebrascora]

Another vote for NovoPen Echo reusable pens and NovoRapid penfill cartridges and then you have another reason for them not to change you to Trurapi in the future once you get this sorted out this time.
The NovoPens are really, really good and other insulins like Trurapi don't fit them.

Hope you get it sorted out to your satisfaction and if the Trurapi pens have been faulty then definitely report them via the yellow card system.