Good Samaritan Pharmacy Employees Helped Encourage Development of U-500 Insulin Pen

Eli Lilly and Company recently developed the Humulin R U-500 KwikPen to improve glycemic control in people with severely insulin-resistant diabetes; something Good Samaritan’s Pharmacy staff knew was needed a few years ago.

Traditionally, most diabetic patients use U-100 insulin where there are 100 units of insulin per milliliter. U-100 insulin products are available in both vials and pens. In recent years, there has been an increasing number of patients with adult onset diabetes and increasing number of patients needing higher doses of insulin to control their blood sugar. Many of these patients require the use of U-500 insulin, a concentrated product with 500 units of insulin per milliliter. The U-500 insulin product is manufactured by Eli Lilly and Company and the product was only provided in vials that required each dose to be measured in syringe prior to its administration. A patient safety issue resulted since insulin syringes are only manufactured to measure and administer U-100 insulin. Using U-100 syringe with insulin U-500 results in a dose that is five times greater than is indicated on the syringe. This patient safety issue has resulted in a number of medication errors nationally.

Good Samaritan employees, Jim Eskew, R.Ph.,MBA, Director of Pharmacy, and Shane Wilson, R.Ph., Pharmacy Operations Coordinator, noticed the increase of confusion with dose conversion within the hospital when prescribing insulin to patients. “A physician may prescribe a patient to take 50 units of insulin, which, if using U-100, would be exactly 50 units,” said Eskew. “But if a patient was taking U-500, 50 units would be equal to 250 units of insulin when measured in a U-100 syringe because it is five times stronger.” In the hospital, the dose could be clarified following a discussion between the physician, pharmacist and patient. But the confusion over the use of U-100 syringes with U-500 insulin remained for patients at home.

Eskew, Wilson and other Good Samaritan Pharmacy employees began to brainstorm and decided that the development of a U-500 prefilled pen was needed. With an insulin U-500 pen the patient could dial up their actual dose of insulin, which would eliminate the confusion of giving U-500 insulin with a U-100 insulin syringe. Eskew shared this information with his brother, Mike Eskew, who is a member of the Eli Lilly Board of Directors. “I explained what was needed to my brother and asked him to pass the message along to John Leichliter, the CEO of Eli Lilly to see if the prefilled pen was a product they would consider,” said Eskew.

Eli Lilly was in the development stages of such a product and Good Samaritan’s interest accelerated the process. “Advancing innovation is at the heart of Lilly’s business,” said Enrique Conterno, president, Lilly Diabetes. “Unfortunately, diabetes continues to be a major public health problem in the U.S., and the needs of people with diabetes continue to evolve. When our customers provide insight into how we can make life better for people with diabetes, we listen intently and work to provide solutions.”

The U.S. Food and Drug Administration recently approved the use of the Humulin® R U-500 KwikPen® in January of 2016. The product became available to the public this past April. Diabetic patients all over the country and at Good Samaritan now have access to a safe and convenient administration device for the use of U-500 insulin. “We strive to promote new knowledge and innovation within the hospital,” said Rob McLin, President and CEO of Good Samaritan. “The teamwork and compassion exhibited by our pharmacy department illustrates how dedicated our employees are to our patients. Good Samaritan is continuously working to achieve safe patient care and this is just one example of how we always put the patient first.”

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