Category Archives: diabetes coverage

Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the blockIt has been a long  time since the diabetes world has seen a new rapid acting insulin brought to market.  The last one that I can remember was  Apidra released back in 2004.  It is  not surprising  then that the release of Fiasp by NovoNordisk is creating a lot of buzz.  Not to be let out, my son recently began using this insulin. Since Fiasp insulin is the new kid on the block, I thought I would give everyone a brief rundown on the highs and lows associated with it.

What is it?

Fiasp insulin was released by NovoNordisk onto the Canadian market in March of 2017.  Many of us scrambled to get a prescription because it promised better blood glucose levels without pre-bolusing for meals! According to the press release, you can dose up to two minutes before a meal and up to 20 minutes after starting a meal without compromising overall glycemic control or safety!*

How is it different?

A Medscape article states that  Fiasp is  absorbed twice as fast as its counterparts.

It does this with the help of  two excipients–Vitamin B3 is responsible for the increase in the speed of absorption and Amino Acid (L-Arginine)  has been added for extra stability.**

What do users think?

All of this science is great but most people are wondering how well it works in real life settings.  From what I have seen, the bulk of users really like it.  I could only find one person out of about a dozen users who had returned to their old insulin aspart.

When I asked my son for his review I was told “I still have highs. I still have lows BUT if I have a heavy carb  loaded meal, Fiasp kicks butt and I don’t have the same crazy swings that I always did before.” For a 19 year old who can definitely binge on carbs, this is huge.

Other users seem to have  had similar results.

Some people with diabetes found that the insulin peaks were no longer as pronounced.  They had some difficulty battling highs with Fiasp however while others found it perfect for corrections. In fact some people are purchasing Fiasp just for corrections.

Other users explained that the faster insulin action allowed them to more quickly respond to rising blood glucose levels.  This in turn meant resulted in much  tighter control.  The quick action has  also left one user to caution about the timing of any  prebolus.

Most seemed to agree that Fiasp insulin resulted in fewer food spikes and more stable blood glucose levels but as I said not everyone loves it.  For some users, their traditional rapid acting insulin seemed to work better.

Final thoughts…

All in all, most people with diabetes who are  trying the new kid on the block seem to be happy with it.  It offers another insulin choice  for those who struggled with post-meal spikes or don’t pre-bolus meals.

It must also be noted however that while Fiasp is not currently approved for use in insulin pumps in Canada, both those on insulin pumps and MDI are using this insulin aspart.

Finally, I was also happy to see that the price of Fiasp insulin was par with NovoRapid.  This meant that there was no need to worry about an increased cost for out of pocket insulin expenses.  My understanding is that Fiasp insulin is not yet on many (or any) provincial formularies.  This most likely will mean that if you decide to use the insulin and are currently using a publicly funded program, you may have to either pay for this insulin out of pocket or speak to your doctor about having special authorization added to your benefits to ensure full coverage.

Please remember to check with your diabetes team before starting any new insulin regimen. 

*http://www.novonordisk.ca/content/dam/Canada/AFFILIATE/www-novonordisk-ca/News/Fiasp_Launch_PR_English.pdf

**http://www.medscape.com/viewarticle/877892

 

Costly Disease

Recently someone I know was diagnosed with diabetes. Because this person is an adult, they have yet to decide if they are Type 1 or Type 2.  The process of finding an exact diagnosis exceedingly slow and painful for me to watch.  I want to see this person feeling better and back on their feet. I want them to be able to learn how to take care of themselves and reclaim their lives.
 
In my desire to help, I have offered tips and information on treatment options. I am fully aware that some doctors prefer a  tried and true older method of care in part because of the costs associated with the best care  options.  I know that this person would want to have the best life possible.  I never thought a lot about the cost factor. I always tend to look at quality of life.
 
I am lucky.  My son has insurance that covers test strips and insulin.  We live in a province that covers his pump and supplies until he is 25. The only thing that we have to worry about paying for is a continuous glucose monitor and at the moment I am still working to convince him that he wants one.
 
I also have great credit and have been able to purchase his supplies out of pocket on my Visa card and then pay my Visa off when the reimbursement cheque came in.  Not everyone is so lucky.  In the case of this person who has diabetes (type unknown), there is some insurance but no direct billing.  All strips and medications must be paid up front.  This family does not have a credit card to use to help delay payment.  They have to look at paying everything in cash.
 
The cost of diabetes supplies was a huge shock to them.  The idea of paying $1 every time this person had to check their blood seemed ridiculous. Their answer was that testing would be cut down or non-existent once the doctors knew what was going on.
 
My heart broke.  Its not that simple especially if the diagnosis is Type 1(which is a strong possibility).  To stop testing puts this person at risk for so many things.  They do not yet understand how vital the information from that test strip will be for their daily lives.  They do not yet know that testing must occur before eating, during the night, before exercise, and even before driving.
 
This family now has to learn how to deal with a very serious disease that will bring stresses into their lives that were previously unknown.  There is relief for them in knowing what is going on health-wise but the financial burden is something that they have not anticipated.
 
We live in a country that is proud of its public health care system.  This family can recieve a diagnosis without worrying about spending a small fortune or having the proper insurance.  They cannot however anticipate any help to pay for the medications and supplies that will be needed to stay healthy after a diagnosis is finally made and that is the biggest tragedy of all.
health and money