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Our Experience with Humalog vs. Novolog in the Pump

Discussion in 'Parents of Children with Type 1' started by Lizzie's Mom, Mar 2, 2011.

  1. Lizzie's Mom

    Lizzie's Mom Approved members

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    Elizabeth started pumping in November, and though we had been using Novolog on MDI, the Endo went ahead and started us on Humalog in the pump since her insurance would be changing us to Humalog in January anyway.

    We had a pretty normal pump start - a love/hate relationship with it for the first 6 weeks or so (ha!), until we got the basals ironed out. Love the pump now, btw. Understand why most folks never go back to MDI :).

    We went along with the Humalog for a couple of months, but after filling her prescription one day, I decided to use the leftover Novolog pens we had in the fridge to free up some space.

    A couple of things I immediately noticed after three days was that her 3-day-old site was not sore and red at removal. Her numbers had been noticeably steadier, and any highs she had came down faster. Hmmm.

    So I decided to go back and forth between Humalog and Novolog (I had about 1800 units of Novolog to work with, so a good sampling to get an idea if what I was seeing was indicative or incidental) and log when I used each to document any differences.

    After 10 sites, 5 with Humalog, 5 with Novolog, I had my answer: Novolog resulted in sites lasting longer, less or no soreness after site removal, steadier numbers, and the biggie: average numbers were 30 points lower. That's about a full A1C point.

    I asked for a PA (Prior Authorization) from the Endo for Novolog. They were hesitant, as PAs were not getting approved by our particular insurance. I said I was willing to advocate directly with the insurance company, and they went ahead, cautioning me not to get my hopes up.

    I called our pharmacy and found out that Humalog costs $115/vial, vs. $118/vial for Novolog. I called the PA rep for our insurance's prescription dept. and let them know they would be receiving a PA from our Endo, but wanted to have it on record why the PA was being requested. I relayed the observations I had made as well as telling her the difference in price between the two insulins as per our pharmacy.

    Two days later I had an approval.

    Picked up our new prescription for Novolog yesterday :D.

    Don't be afraid to advocate for a PA. Have your info lined up and documented as to why you're asking for the PA. I've gone to bat for PAs a couple of times, with number of strip restrictions (we now have a PA for 300/month) and now for Novolog. And E has state insurance.

    Just an encouragement to those of you trying for PAs for whatever . . .
     
  2. lynn

    lynn Approved members

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    Good job!

    We noticed similar things with Novolog vs. Humalog.
     
  3. dejahthoris

    dejahthoris Approved members

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    We had issues with Novolog. This was when United preferred it- last year. We had Humalog in the hospital at dx and were switched to Novolog by United when we went home. My son had severe issues, headaches, horrible itching all over his body and nausea. He was just dx so we had no clue what was going on. They said try benadryl, lotions, stop using alcohol wipes, etc etc. He really suffered until we could figure out what it was. ( I have never had an allergy or a child with an allergy before). Finally figured out it was the Novolog. Got a letter from the Doc, so we could switch to Humalog. Then of course United's preferred insulin became Humalog shortly after anyway! I think for most people it does not matter, the two insulins are interchangable. But for a few there is an allergic reaction, possibly to the preservative they use or something. I guess allergies like this are a bit rare, so like you said, you have to push.
     
  4. mamamccoy87

    mamamccoy87 Approved members

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    Great job with not only duking it out with insurance, but with your science experiment!! Not quite double blind, but very scientific none the less!!

    I have seen people say Novolog works better in the pump - add another to the list. Makes me think about changing from Humalog to Novolog:cwds:
     
  5. Lorraine

    Lorraine Approved members

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    Good for you!

    Caleb's endo has always claimed Novolog is more effective in pumps. I'm glad to have your experience to point to now when people ask me.

    We recently started Apidra in Caleb's pump. Initially it was fabulous, then site issues became a problem. Although I cannot say decisively yet if it's bc of the insulin change, after two months of eliminating other variables, I put Novolog back in the pump and things seem to be settling down a bit. I'll know more after another week or so.
     
  6. FatCatAnna \\^^//

    FatCatAnna \\^^// Approved members

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    Wondering?

    I've been a T1 since I was 7 (now 50) - and been on all types of insulins over the years and I keep on thinking with time that most of us "children" eventually develop resistance to insulins that make wierd things happen to your bodies like we've all experienced.

    I used NovoRapid in my pump - which I think is maybe same as Novolog for Americans? My worst reaction to an insulin so far has been Levemir when I was taking a pump break last year. Other then that - so far - touch wood - no problems as I became older.

    The other thing I had problems with my infusion sites which not sure if any of you have thought about - was when I used plastic cannula's - my sites got pretty irritated not just from the adhesive tape - but also where cannula is inserted under skin. Animas Canada said that there is teflon in the cannula - so they said I might have an allergy to that being introduced into my body. They sent me a box of Contact Detach - steel cannula - and I've had no problems since with site irritation or adhesive issues.

    Just wanting to throw a little bit of hope into your thoughts for your children - since I was once a little ;) squirt (still feel like one - refuse to grow up).
     
  7. virgo39

    virgo39 Approved members

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    What I find interesting about all this is that "technically", per the Patient Information for Humalog, it is to be replaced (along with the site) every 48 hours. http://pi.lilly.com/us/humalog-pen-ppi.pdf

    Do the insurers that "prefer" it provide more?
     
  8. ecs1516

    ecs1516 Approved members

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    Interesting, I am finding that on my younger son that the Apidra sites are going bad early on site change day. So, lasting about 2 1/2 days I guess. My other son is having no problems with the 3 day site changes. Strange.
    May have to go back to Novolog at least with younger son.
     

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