The recent announcement by Novo Nordisk of the withdrawal of Mixtard 30 has raised grave concerns for diabetes patients and the wider health service. The UKCPA Diabetes Group, a special interest group for pharmacists working with diabetes patients, believes that this decision by the pharmaceutical company will have ramifications which will be both unsettling and potentially unsafe for patients with diabetes, as well as incurring more expense for the NHS.
Natasha Jacques, Chair of the UKCPA Diabetes Groups says, “There are thousands of patients in the UK currently on Mixtard 30 insulin and to switch them to an alternative insulin is disruptive, costly, time consuming and may destabilise gylcaemic control.”
Pharmacists specialising in diabetes have found that the alternatives are not dose equivalent, which is likely to lead to patients having repeated appointments for dose titration.
NovoMix 30 (one of the likely alternative insulin choices) is more expensive than Mixtard 30, so it will impact heavily on drug budgets throughout the health care community. This may lead to a switch occurring on a cost basis rather than the insulin choice being tailored to each patients needs. It also has an impact on the use of ‘non-formulary’ insulins within secondary care and the difficulties that this creates in timely provision of medication.
The other very important factor is that Mixtard 30 is available as an Innolet injecting device, which is an extremely useful device for patients with visual impairment or manual dexterity problems. The Innolet device has allowed some of these patients to be independent and not reliant on a district nurse to administer their insulin. NovoMix 30 or Humulin M3 are not available in such a device which means that there is not an alternative device for many of these patients. Natasha Jacques says, “If a district nurse is required to administer insulin to large numbers of currently independent patients it will impact heavily on community resources, not to mention the inconvenience for the patients concerned.”
UKCPA have registered their concerns with the pharmaceutical company Novo Nordisk and have asked them to consider these serious ramifications of the withdrawal of Mixtard 30 insulin.