Posted by on Sunday 31 October 2010

A little consistency would be nice

Here's a thing... And for once I'm not whining about trying to keep my blood glucose levels in range while attemping some semblance of a normal life.

There are quite a few insulin pens on the market, I think it's fair to say that some are nicer that others. Some offer half unit doses, others permit particularly large single doses. There are even those (actually just one in the UK right now until the NovoPen Echo is released) that automatically record recent timings and doses. There are prefilled disposable ones and more luxurious-feeling metal cased ones. Brightly coloured ones and grown up serious ones. You would think we diabetics would be happy.

However, aside from the fact that many of the pens are actually quite nasty (flimsy, plasticky affairs that feel rather less than reliable), there is something about their design that frustrates me intently. Because there is no consistency in the design of the pen cartridges, different insulins are only compatible with a tiny fraction of a pretty meagre range. There is, of course, no reason for this. Readers of a certain age will remember the development of Betamax and VHS video. After the early excitement of both formats, it became clear to the industry that all the electronics brands would need to produce players compatible with a single format. For many MDI users the paltry choice of available pens is little more than a minor irritation, but I read a forum thread recently where a doctor was looking for an pen device which was easy to use with one hand. Someone suggested a pen which had a spring-loaded delivery via a sliding switch (the Autopen 24), but because of the current limitations such a choice will limit the patient to particular insulins. On the other hand if you are on Lantus glargine and would benefit from half-unit doses there are simply no compatible pens on the market. There are half-unit pens available, but none that fit Lantus cartridges.

There is, as I say, no reason for this. Where formats are common (audio CD, DVD, USB) competition still exists, brands are still able to assert their own identities and strengths. It feels as though development of the pens is seen by the pharmaceutical giants as a bit of a bind. But these companies are investing (probably considerable) R&D budgets into the development of these devices. Wouldn't it make sense then to see the pens themselves as an opportunity in their own right. To make each pen compatible with all insulins on the market. To produce better/more solid/more stylish/more advanced/more [insert your own wish here] delivery devices to build relationships with insulin users. After all these are things we are using day in, day out.

So come on Big Pharma, how about a little consistency in insulin cartridge design. Then patients could match the best insulin for them with the injection pen that best suits their needs. Not too much to ask, surely?

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