The FDA approval for Fiasp with Omnipod Dash

Type 1 & LADA
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A press release from Insulet this (2019) October states that the FDA has approved the use of Fiasp in Omnipod Dash:

Insulet states that this is the first FDA approval for Fiasp use with a pump although based on other posts here it has been used in pumps outside the US (or without FDA approval) for some years now.

This is particularly relevant to me because my healthcare insurer just informed me that they will no longer cover Humalog and the only fast acting insulin on the list they provided is Fiasp!

Anyway, seems like a good time to change; I don’t like and rarely achieve the post-bolus-pre-meal delay so invariably go high (temporarily) after eating.

Nevertheless I have one question. I use the Humalog Kwikpen to avoid having to have both a vial and a box of unused Kwikpens (for backup in case of Omnipod system failure). The newer Insulet needles barely penetrate the Kwikpen seal; I push the needle in then dial 150IU out of the pen, if I don’t push hard on the syringe while doing this I can’t force insulin into it. Has anyone out there done this with the Sanofi Flextouch pen? Either for Fiasp or Novolog or, indeed, anything else because I guess they use the same pen. I don’t want to end up with a pen I can’t use.

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That is odd they only cover Fiasp but will not also cover Novolog.

Fiasp does not work well for everybody.

We like it (Fiasp in vials) and have used it off-label in our Tandem X2 or about a year and a half now.

We also have Fiasp in pens that we will use for corrections in various situations.

But we have never tried extracting the Fiasp from the pen for any other purpose and only use the pens for normal injections.

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I had the same reaction, since the three choices they gave were all Sanofi products, but technically they did not say that (the list below was bulleted, so it stated there were three [alter]natives):

Please see the list below for cost-effective alternative
drug(s)[sic] similar in safety and efficacy that may be an option for you:

o Novolog/Novolin    o Fiasp    o Novolin/Novolog

So it’s a dumb list; basically incomprehensible, so I checked up on Fiasp, hence the post.

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My son didn’t like Fiasp, but would switch to Novolog without an issue. You can certainly try Fiasp, nothing wrong with that, but a more 1:1 switch would be Humalog to Novalog. I would raise a stink if they won’t cover either Novalog or Humalog.

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Can you share details? Or if you have already posted it, can you share a thread link?

BTW, I also did not like it. Not as consistent over 3 days and site irritation. And the supposed speed difference was not apparent at all.

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Yeah for my son there was no discernible difference in speed, and we tried a few experiments to figure that out, additionally it stung when injected, and since there was no perceivable benefit for him we went back to Humalog. We are grateful however, to the nice forum member who shall remain nameless that provided the vial.

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I telephoned moda today and, so far as we could work out Fiasp and Novolog are covered in 2020 (and this year) just as Humalog is covered this year. I.e. I pay the inflated price ($500/month) until I have paid out $6000 then moda pays everything.

I suspect Humalog will also still be covered the same way; it’s an EPO plan but it’s not clear that “non-preferred” drugs have a higher out-of-pocket-max. I would probably just reach it faster.

I’m going to talk to my doctor about a Fiasp prescription tomorrow. It won’t cost me anything and if it doesn’t work I can just swap to Novolog; they are all available in pens. I think there’s also the possibility of using a generic, at least for Humalog (Lispro). It flashed up at one point on the moda prescription lookup web pages but then I couldn’t find it again. However it’s not a true generic; it’s just Humalog relabelled.

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I think the problem for me was that I did it before it was FDA approved.

Now that it has been approved, I am sure it will be much better.

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So we switched to Fiasp from regular novolog in omnipod this week for my almost 16 yo son and so far it is rockin’. I’m appreciating the tips on potential downsides (stinging, site reactions) I’m seeing here and we’ll watch for those, but our pediatric Endo suggested we try it after I was joking at his last appointment about how he can finish a sandwich while the pump is still clicking (in other words, he does not do the low carb thing and he finds pre bolusing consistently difficult, I guess I would too if I ate in a lunchroom…). We can really tell a difference in post prandial spikes due to difference in speed of onset. We verified this weekend that it cannot defeat the spike caused by inhalation of a Krispy Kreme donut while pump is still clicking (it ain’t magic, in other words) but for more rational healthy complex carbs we can really see it, or as my husband said today “he ate a bean burrito that must have weighed two pounds and I can’t even see it on the dexcom!”. So, for us so far, seems a good fit. I’m also thinking it will allow us to get the carb ratios right rather than making them too stiff trying to defeat the initial high, then ending up with a low. But time will tell.

I noticed a couple of comments about concern for more lows with Fiasp, anyone experience that?

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