Tips for Prescribing Insulin to Prevent Problems at the Pharmacy

Every January, many health plans change their preferred insulin products on their formularies, creating confusion and frustration for patients, prescribers and pharmacies. A few simple strategies can help make this annual tradition a little less stressful. Below you’ll find helpful tips from Vanderbilt Health’s Population Health Pharmacy Team for prescribing insulin and more efficiently and effectively:

• Add a “note to pharmacy” allowing substitution. Pharmacies usually default to filling generics unless the brand is specified. Including a note for substitution may prevent delays from additional communication. For example: “Okay to substitute Lantus, Semglee, or biosimilar Insulin Glargine product based on patient’s insurance coverage.”
• Prescribe specific products by name. Coverage is usually product-specific. For instance, Novolog may be preferred over Humalog or even the generic insulin aspart product. If you know the preferred product, be specific.
• Ask a patient what is preferred. Payors usually notify patients when formulary changes require switching products. However, if starting a new plan (e.g. switching Medicare coverage), a patient may be unaware.
• Refer to the patient’s historic preference. When in doubt, refilling what the patient has been using is a good start.

Patients who are new to insulin or need a refresher could benefit from VHAN’s insulin education handouts. Find insulin pen and vial guides in English, Spanish and Arabic on the VHAN Hub Diabetes page in the “Additional Patient Resources” section. Diabetes resources related to nutrition, lifestyle and more medication content can be found here.