Type 1 - Connect

Given Novo Nordisk have taken it upon themselves to discontinue Fiasp Insulin, it would be an opportune time to also obtain information from them on why Novo Fine Plus 32G 4mm needles are no longer available. Sadly they appear to be holding the Type 1 diabetes  community to ransom,  which , at best , is entirely despicable.

I was also a regular user of BD UltraFine Pro 32g 4mm needles , which have also disappeared from Australian supply. BD website does not even have an Australian contact. Pharmaceutical companies need to be held to account by NDSS and Diabetes Australia.

Hello Rob

I sent an email to Novo Nordisk a few weeks ago asking about the availability of NovoFine Plus 32G x 4mm Pen Needles and also asked why Fiasp was not available in 5x3ml glass Penfill cartridges, their reply is posted below (note they made no mention of Fiasp being removed from the PBS)

Cheers

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Dear David,

Thank you for contacting Novo Nordisk Pharmaceuticals Pty Ltd.

Novo Nordisk has decided to temporarily stop production of 100pcs NovoFine^® Plus 32G (gauge) 4mm needle packs, due to a quality defect, which we expect will last until Q4 2023.

Other needle lengths are not affected as they are manufactured at different sites.

We expect supplies of 100pcs NovoFine^® Plus 4mm to be normalised during Q4 2023.

In Australia, possible options for replacement are either NovoFine^® 32G Tip 6mm (100 pcs) or NovoFine^® 30G 8mm (100 pcs). Switching between different types of needles are approved as interchangeable, but we recommend speaking to a healthcare professional for medical advice.

Unfortunately, Fiasp^® is not available in Penfill^® in Australia on the PBS and we do not have any further information regarding timing or availability of this product.

Novo Nordisk was required to select one pen presentation for Fiasp^® - FlexTouch^® was chosen due to number of patients that would likely use FlexTouch^® vs Penfill^® and the convenience this pen offers patients.

If you have any further enquiries please contact Novo Nordisk Customer Care on our toll free number 1800 668 626, or via email aunrccc@novonordisk.com.

EDIT: Novo Nordisk is not 'discontinuing' Fiasp insulin, it will still be available but only if you are prepared to pay the full price of >$200 - they are withdrawing it from the PBS because they want more money from the government for it.   

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David B.
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The NovoNordisk 4mm pen needle has been withdrawn from NDSS supply. This was done in response to NovoNordisk confirming in August 2022 that supply was not available and supply chain had essentially been exhausted, meaning orders would be unfulfilled.

It is anticipated to be returned to the Australian market, however there is currently no date for this to occur. 

The removal of NovoNordisk 4mm has created a ripple effect, which vendors supplying listed NDSS Products have adjusted to.

The BD 4mm pen needle has not been discontinued and is available, albeit with previous constraints to supply. Supply is however "normalising" and an individual ordering from their preferred pharmacy should be able to access the BD 4mm pen needle. 

As well as being informative, could discussions here  be adding more excitement than necessary. After 51 years of T1 diabetes, I am discovering when I stay calm about blood glucose not being where I expect it to be, I make better decisions to bring my glucose down over the next one or two days. 

Living in the southern Blue Mountains near Sydney, my pharmacist has enough BD 0.23 mm diameter, 4 mm long needles to supply her customers, sometimes after waiting a week. Because there was a supply shortage months ago, she investigated "Insupen" (made in Italy) needles which are also available in an even smaller 0.20 mm diameter 4 mm long size. I find them easier to use with their slippery feel. They do seem to be further along the path towards painless injections (although it was years ago scientists and pharmaceutical companies solved the problem with sharp, small disposable needles).

I like Fiasp insulin because of its initial rapid response. I also think the really helpful graph showing insulin absorption over time published by one of the users on this discussion showing a 300 minute duration put the 90 second initial faster absorption into better perspective. With my continuous glucose monitoring CGM I using a five hour duration now results in fewer hypos caused by underestimating "insulin on board". My nurse educator and my endocrinologist are happy for me to stock up on Fiasp until the PBS subsidy runs out in 2023 March, then I'll change over to the next fastest fast acting insulin.

Thinking about more important issues, I reckon it was environmentally wasteful that we could only use disposable pens rather than 3 mL vials of Fiasp. If we had been discussing damage to the environment with the super convenient (but bulky to store) disposable Fiasp pens, their cost might have been lower (for either Novo Nordisk or the Australian government PBS) and supply may have happily continued.

David.