Barbados Drug Service on the availability of Insulin and change in protocol on Insulin Pens.
There is no shortage of any therapeutic class of insulin on the Barbados National Drug Formulary (BNDF). However, due to supply challenges, there is currently a scarce supply of Humulin 70/30 on island.
The Ministry of Health and Wellness, through the Barbados Drug Service (BDS), endeavours to provide an uninterrupted supply of quality insulin products for all residents of Barbados at an affordable cost.
On the Barbados National Drug Formulary (BNDF), as shown in Tables 1. and 2., there are currently thirteen brands of insulin available to all beneficiaries. Patients are advised that in the event they are unable to source Humulin 70/30 they should consult with their physicians regarding the selection of a suitable comparable product.
To ensure the long-term continuous care of all insulin dependent diabetics and the financial viability of the national programme, there has been a policy decision to institute protocol changes in the maximum quantity of insulin pens for which the BDS will cover the cost.
The Barbados Drug Service will pay for a maximum of two (2) pens per client per month, for each allowed therapeutic class or classes. The protocols for all other insulins remain the same as outlined in Table 2.
The change in protocols will not prevent a client from receiving an adequate amount of insulin to treat their condition, as comparable options are available in every therapeutic class of insulin.
The exceptions to the new protocol are visually impaired persons and persons 18 years of age and under. The BDS will continue to provide a monthly maximum of four (4) Apidra Solostar pens and/or five (5) of the other pens, listed in Table 1., for these two categories of persons filling their prescriptions in the government pharmacies only.
Table 1. Insulin Pens and Cartridges available on the Barbados National Drug Formulary
Therapeutic Class | Brand Name | Active Ingredient | Package Size | New Protocol Maximum | ||
18 yrs and Under* | Visually Impaired* | All other Beneficiaries | ||||
Rapid-acting Insulin | Apidra Solostar 100U/ml Inj | Insulin Glulisine | 3ml pre-filled pen | 4* | 4* | 2 |
Novorapid Flexpens 100U/ml | Insulin Aspart | 3ml pre-filled pen | 5* | 5* | 2 | |
Premix- Intermediate-acting Insulin/Rapid-acting Insulin | Novomix 70/30 Flexpens | Insulin Aspart Protamine/Insulin Aspart | 3ml pre-filled pen | 5* | 5* | 2 |
Long-acting Insulin |
Lantus Solostar 100U/ml Inj | Insulin Glargine | 3ml pre-filled pen | 5* | 5* | 2 |
Levemir Pen 100U/ml Inj | Insulin Detemir | 3ml pre-filled pen | 5* | 5* | 2 |
* Facilitated in Government Pharmacies Only
Table 2. Insulin Vials available on the Barbados National Drug Formulary
Therapeutic Class | Brand Name | Active Ingredient | Package Size | Protocol Maximum for all Beneficiaries |
Rapid-acting Insulin | Humalog 100U/ml Inj | Insulin Lispro | 10ml vial | 5 |
Apidra 100U/ml Inj | Insulin Glulisine | 10ml vial | 5 | |
Fast-acting Insulin | Humulin-R 100U/ml | Insulin Rapid | 10ml vial | 5 |
Novolin-R 100U/ml | Insulin Rapid | 10ml vial | 5 | |
Intermediate-acting/Fast-acting Insulin | Humulin 70/30 Inj | Insulin Isphane/Insulin Regular | 10ml vial | 5 |
Novolin 70/30 Inj | Insulin Isphane/Insulin Regular | 10ml vial | 5 | |
Intermediate-acting Insulin | Humulin-N 100U/ml Inj | Insulin Isophane | 10ml vial | 5 |
Novolin-N 100U/ml Inj | Insulin Isophane | 10ml vial | 5 | |
Long-acting Insulin | Lantus 100U/ml Inj | Insulin Glargine | 10ml vial | 5 |