I am on Methotrexate injections and have been for a number of years. I had pre-filled syringes delivered to me by Pharmaxo.Ten syringes in one plastic packet and a box of needles separately. A few months ago , because of a shortage of syringes I was supplied with Metoject pre-filled syringes,each one boxed individually.I can’t help but think think that these large Metaject must be considerably more expensive that the humble simple plastic syringe that I had supplied previously Also there is all that extra cardboard packaging.
I have therefore requested to go back to a syringe and needle hopefully to save the NHS money and do my bit for the planet by not having all that cardboard packaging. I think I now sound like some eco warrior(I’m not) but has anyone else found themselves in the same situation
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Pythagorus
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Not in the same situation other than using a pen but you’ve got a point about packaging and plastic pens. It would solve the difficulty of undoing the packaging too. I’m going to discuss it at my next appointment. Ty 🙏
Without knowing exactly which brand you were using I can’t say for sure, but broadly speaking, there’s relatively little in it cost wise for the NHS, and the syringes can actually work out more expensive than any of the pens. With the exception of medications that are being accessed via deals made with the manufacturer, where the price is usually kept confidential, the cost of every med available on the NHS is documented online on the BNF website. The BNF is the formulary all UK medics use to prescribe medication, and you’ll find the information under the link ‘medicinal forms’ on the relevant drug page. In the case of mtx, a 25mg metoject pen costs the NHS £16.13. The equivalent dose pre-filled syringe costs between £14.10 and £16.64 depending on brand. The link to the mtx medicinal forms page is:
I don't know about MTX but Etanercept came in pens and I asked to go to syringes as far less painful. So nice neat easy syringe was great. No issues, then got changed to Abatercept its the most complicated syringe that is so over engineered its hard to see just why? its spring loaded to withdraw needle back again just why ? the pack came with cotton wool balls, a set of badges to track the use, compression pads and the box of 4 is large a bit like an Easter Egg it promises much, but inside but the contents are disappointing. I understand it needs protection but the packaging could be halved and the pads, dressings etc have gone to Ukraine. No nurse around here uses compression dressings after an injection nor a plaster. I'd say its a justification for the huge cost this stuff incurs the NHS. I'm grateful but think I'd like the bare minimum of packaging without a huge glossy brochure and a two tone spring loaded gadget plus paper to put the syringe on whilst wiping the skin. It's odd but I have clean surfaces, a diary and cotton wool even plasters if required and I'd bet so do most other people.
I can tell you the Metoject are much more expensive. When I was on MTX I got some rather cheap looking syringes and a took a couple and got worse than normal side effects. I complained to my Rheumy and he prescribed Metoject specifically and things were better again, in fact the colour of the MTX in the Metoject was paler. Over the years I have seen big variations in generic drugs, I even had 2 batches of Omeprazole from different syuppliers and 1 batch worked far better than the other.
I don't inject now as I'm on JAK inhibitors, but do remember thinking at the time when I did inject just how much single use plastic, and other material was being used in a metojet pen. Then there is the difficult to open packaging and glossy information ...I'm not sure if the majority of people would be willing to use an 'old fashioned' needle and syringe. But it would certainly reduce wastage.
The advantage of the pen type syringes is that you, and anyone caring for you like a nurse, avoids needle sticks. Much safer for nurses and healthcare professionals.
I have Benipali pens which my hands can cope with. Previously I had prefilled Methotrexate syringes and now down the line my hands and fingers can't cope. I'm so pleased to have pens regardless of the cost. I hold the pen, no skill or strength needed and push down. Sorted.
The problem I have with Metoject pens is an endless argument with hospital pharmacist over sharps bins. Pens too large for the bins and last time I was called a liar when I said 12 would not fit in bin! My hands are so badly damaged that I could no longer use an injection that I used to have. The cost is a lot less for MTX tablets!
I don't know the size of your pens but I'd say Benipali is like a thick marker but longer. I get supplied a meduim size bin with a wide opening. Takes loads. When I was on Methotrexate tablets swapping to the injections meant I could have a lower dose.
I have no problem with Benepali. A lots smaller and bins supplied by Sciensus are large and never a problem. The ones for Mtx pens are purple top as cytoxic.
How frustrating for you. If I didn’t think it wasn't a daft thing to do I'd be tempted to save up 12 used pens, take them to the pharmacy & ask them to show you how they can deposit 12 pens in (what I take to be) a 1L sharps bin. From one extreme to the other my current bin is 24L, but they are provided by my Surgery so they know better!
I decided not to go on methotrexate, when they said you have to go for a lung function test. I had my under control for over a year ,and I didn't want to take any chances . I am going to start on sulfasalazine on the the 26th April
Not quite the same but changed from a biologic to a JAK inhibitor which comes in tablet from. In my fridge I have 4 unused syringes and I’m the cupboard two yellow boxes full of syringes. I have made endless calls to Sciensus and written emails to ask what I should be doing with these to no avail!
They aren't my favourite at the moment. Rearranged a delivery for yesterday as away from tomorrow then had a text to say cancelled. No explanation nothing. Even they didn't know why! Fortunately I have a spare pen. Although could have caused a problem. Now under investigation
In a way, yes, but not quite the same form as you. I lived in Spain when I first started injecting MTX but it was by an individually packaged pre-filled syringe, I didn't need to fit the needle. I got on well with them, I could easily push the needle in & depress the plunger, best of all at my own speed. It was when I returned to the UK & eventually had all my meds reinstated that I had to have an appointment to be shown how to inject, with the biologics nurse for some reason.
The Rheumy knew I’d been injecting 3 years but I was told I still had to be shown, I chose to believe it was to prove I’d been doing it correctly, there was no mention of a different delivery method, it was only when I attended I realised this. Once I'd demonstrated I could do it (albeit somewhat awkwardly but they were happy!) I asked if I could have pre-filled syringes instead because I found depressing the release button more awkward with having little strength in my thumb. I was told they weren’t available in the UK, which I accepted, as you would, & toddled off with my 3 months worth of pens. It was years later I found what I’d been told to be an untruth shall we say, I didn’t think to question in at the time, well you'd believe a biologics nurse wouldn't you?!
One advantage of pens is avoidance of needlestick injuries but only when being administered by someone else. When you inject yourself I don't see it as an advantage over syringes, more so when you have weak thumbs.
Whilst my preference at the time wasn’t due to the extra cost, extra plastic, extra cardboard between the two I would nevertheless have been happy in hindsight saving all that plastic, cardboard etc all these years since had I not been told (incorrectly) no back in 2013. However, I can't say it would have saved the NHS much money as the DT price between the two was minimal at the time crazy as it may seem. It may change as they're updated monthly but I doubt the margin would be much different even now to back then.
When I first switched to injections the vials came in one black bag and I had to order needles when required. I had to unscrew a red top on the vial and the screw a needle on, I thought this was stupid with RA fingers. I was then switched to a different brand and every single injection came in an individual box. I was told by my specialist nurse that the particular brand of mtx I had been receiving had not been licensed for RA so I had to switched to one that was. I found the newer one much more user friendly.
I happy to say that my fingers are good and no problem with dexterity. I guess we should be assessed before prescriptions are made up and sent to us.Ten syringes in a grey plastic bag and needles to attach separately is ok for my methotrexate but I appreciate it is not so easy or everyone🙂
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