Friday, June 28, 2013

On RSS Readers, Divorce and Marriage

In just a few days, Google Reader will be history.  I've used it to create over 18,000 Tweets, so yes, I will miss Google Reader.  The end has pushed me into a divorce (or maybe it's just a separation?!) — from Google.  I describe my Google divorce as kind of like when a married couple with children decide to separate … they still have to see their exes for the sake of the kids (and I still have my blogs with Google's Blogger, for now anyway), and it may be a cordial, but not quite blissful separation, but is still necessary.

A number of my fellow diabetes blogging peers have already migrated from Google's Blogger to Wordpress (which offers its own RSS reader, incidentally) over the years because of the expanded functionality there.  I've actually thought about doing that, too, and I've had a Wordpress account for several years (mostly to claim the user name), so it remains theoretically possible that I could someday move my blogs there (I have another blog called "Harvest Gold Memories" which shares the sstrumello.com domain name, the difference being that's at "HGM" rather than "Blog" at the beginning, in other words http://hgm.sstrumello.com, rather than http://blog.sstrumello.com), but I've got so much going on right now, I don't want to deal with trying to import my customized blog templates over to Wordpress, so I'll stick with Blogger right now.  Down the road, all bets are off.


By the way, feel free to skip around this post; there's a lot of stuff here.  For example, you can read about my marriage in the last paragraph.  I've included headings of what I cover, and you can always come back!

iGoogle: i'm History

My Google separation began late last year.  It all started when I had to start looking for alternatives to my web start page, iGoogle, which the company will officially be retiring on November 1, 2013.  I don't understand why they're keeping this product around for so long as the announcement was almost a year ago, but I can keep using it until its gone.  I've found one (actually I've found several alternatives, and signed up with all of them for redundancy) that's perfect for my needs and I've gotten it all configured so its ready to use now (indeed, I've been trying to transition myself to that already so that I'm ready when Google officially cuts the cord on iGoogle).  That part of the transition, once I did all of the work to set it up the alternatives and configure them properly, was pretty seamless for me.

Google's reasoning for killing iGoogle (see the official announcement at http://goo.gl/GZRWm) is as follows:

"We originally launched iGoogle in 2005 before anyone could fully imagine the ways that today's web and mobile apps would put personalized, real-time information at your fingertips. With modern apps that run on platforms like Chrome and Android, the need for iGoogle has eroded over time, so we'll be winding it down. Users will have 16 months to adjust or export their data."

No offense, but I don't especially like looking at content from a microscopic smartphone screen; that's not how I want to consume and certainly not how I plan to share content.  iGoogle enabled me to see my top news stories, all the diabetes blogs I follow, gave access to a few, very frequently used links, as well provided instant access to stuff like Google Music (now branded Google Play Music) at a single place.  The experience on a phone just isn't the same (and my eyesight isn't what it used to be), and frankly, I don't want to use up my phone's batteries doing stuff like that.  For me, those tasks are better suited from a genuine computer with a real keyboard.

"We're not Google's customers. We're Google's product."

That raises an interesting issue: John Simpson, director of the privacy project at Consumer Watchdog, an advocacy group put it this way: "People need to understand the fundamental business model of Google. We are not Google's customers. We're Google's product."

Well, maybe so, but when Google kills the stuff I came to them for, I'm no longer their product.  The logic of killing iGoogle escapes me because I was a captive user of most of Google's services with it, but now I'm kind of cutting them out of the equation.  Oh well … that's not really my problem, its Google's.

Goodbye Google Reader



Then, to add insult to injury, Google also announced it would discontinue Google Reader as part of its spring cleaning exercise, which means that effective July 1, 2013 (see http://goo.gl/ePgrf for details), Google Reader will be gone, and their speed in killing this app was remarkably quick; as they're shutting the service down only about 6 months after the announcement, so they really didn't give Google Reader users very much in the way of advance notice, which annoyed the hell out of me.  That decision really pissed me off a lot more than killing iGoogle did, and I, like a lot of other people called journalists, who used Google Reader quite extensively as a giant mailbox to gather news content from all over the web (and from all over the world) enabling me to quickly sift through all of it, but apparently, Google couldn't turn RSS readers into a profitable revenue stream (see http://bit.ly/ZRySDr).

Here's the official word from Google about killing Google Reader (see http://goo.gl/ePgrf for details):

"We launched Google Reader in 2005 in an effort to make it easy for people to discover and keep tabs on their favorite websites. While the product has a loyal following, over the years usage has declined. So, on July 1, 2013, we will retire Google Reader. Users and developers interested in RSS alternatives can export their data, including their subscriptions, with Google Takeout over the course of the next four months."

To be sure, RSS is far from dead as some are suggesting.  RSS was developed in 2000 and provides a format for simple and structured, standardized disclosure of changes on websites such as news sites, blogs and other sites.  Once you've subscribed to an RSS feed, whichever feed reader you use searches in specified intervals (Google's Reader was great for that, updating content constantly).  Relax, RSS isn't going anywhere because it works so efficiently, but its akin to your local post office being closed even while the U.S. Postal Service still operates.  To send your mail after your local post office disappears means you'd need to trek to a post office located someplace else which is still in operation.  Its a hassle, but the postal system doesn't stop just because a local post office is gone.

Twitter: Not a Viable Alternative to RSS Readers

I already follow most (not quite all, as not everyone has migrated) of the entities I have in my RSS feed on Twitter (I did that very early on), but contrary to what Google may be implying, Twitter and social media outlets like it are NOT perfect replacements because using Twitter  means I have to stay glued to those networks all the time or else sift through all of the Tweets for each of the over 1,700 entities I follow separately, which is slow and cumbersome (especially if they respond or retweet someone else) — a real pain in the @$$ and most of the software apps out there don't make the task any easier, and certainly no faster.  I prefer the bare-bones aspect of RSS readers because I can make a decision on whether to read an article in a matter of seconds, rather than opening something, waiting for the damn article to load up, only to learn its irrelevant junk.  Through its various incarnations, Google Reader has remained a solid and reliable tool for those of us want to ensure we're getting the content from our favorite sections of the Internet.

For the record, my Twitter feed wouldn't even exist if it weren't for an RSS reader, whether its Google's, Yahoo's or some other provider's.  I use an RSS reader to sift through literally hundreds of articles daily (several thousand weekly), so finding suitable replacements was very important to me, and I should note that I sort through an awful LOT of junk, so I actually filter out the most relevant news for my Twitter followers (lucky you!).  Most of the recommended alternatives like Feedly (which has a cloud reader accessible from the web at http://cloud.feedly.com/) and Flipboard were not at especially well-suited to my needs because they are designed exclusively for use of consuming media on mobile devices, and while I've adopted Feedly for use on my mobile devices (phone/tablet), I honestly don't love it.

Let me go on record as saying I don't really like smartphone apps for sifting through a LOT of content like I subscribe to, I prefer a real computer (I did migrate to a laptop, but even that took some getting used to and I still plug in a mouse, and I'm not crazy about the small, built-in keyboard, either).  As much as I like my tablet computer for consuming media content (and maybe if I were like twenty years old, I might enjoy looking at a 3 inch screen all day long, but my middle-aged eyes find that annoying as hell).  Using a smartphone, whether from Apple or otherwise, is NOT where I want to be spending my whole day.  Also, I hate typing on a virtual keyboards (whether its on an iPad or an Android device, those things still suck!), and don't even start me on autocorrect!


After looking around and sampling the different options, I found that a number of the alternatives for Google Reader suggested by magazine and newspaper reports (see http://nyti.ms/10rOfVn)  seem to be designed for people who are in love with Instagram and their mobile phones, and those people probably can't read (or spell), with annoying graphics and designs that are supposed to look like magazines from a phone, but they really just take up too much bandwidth and are cumbersome, clunky and inefficient to use.  Those apps aren't at all suited for my needs - they stink.

Viable Replacements: The Old Reader, NewsBlur, AOL Reader, Digg Reader, G2 Reader and Bloglines

There are a few replacements for Google Reader I've been experimenting with.  Below is a quick summary of the options:

Free RSS Readers

Bloglines http://www.bloglines.com/.  This RSS reader pre-dates Google's reader (since 2003, Google Reader wasn't launched until 2005), but has a new lease on life.  It was announced that MerchantCircle is planning to keep Bloglines up and running after facing a near-death experience in 2010.  The functionality here is excellent, but there's no mobile apps … yet.  Still, its a very solid replacement and its free. [Author P.S. February 2015: It appears Bloglines is no more; the site has quietly been disabled.  No news as to whether it will be resurrected.  Its not my favorite reader anyway, but another classic reader is gone.]

The Old Reader http://theoldreader.com/.  The Old Reader feels a lot like Google Reader.  Its experiencing some major growing pains right now so it took a really, really  long time for my feeds to upload when I did it a number of months ago and they'll likely have the same issue when the flood of Google Reader users start to panic soon.  But I enjoy using this product, and while there are a few quirky things I've encountered with it, they're nothing major.  There's no mobile apps (yet), although the developers promise those are coming in the future.  Author P.S. as of July 29, 2013:  It looked like the developers were close to shutting the public site down (slated for August 12, 2013, see http://goo.gl/EUNWaJ for details, but then, on August 3, 2013, the news was looking decidedly better, see http://goo.gl/wrUIZK for that).  I enjoy using the mobile app gReader which uses The Old Reader's API, and the interface is pretty much a resurrection of Google Reader's with a few minor differences.  Fortunately, if you aren't into Feedly's app (and you can count me among them), you can actually use Feedly's Cloud Reader with the gReader app on your Android mobile device(s), which makes it much easier for some of us to use.

AOL Reader http://reader.aol.com/.  This one was a very, very pleasant surprise for me.  AOL Reader is another new reader hoping to cash in on Google's exit.  This one came as a surprise, but keep in mind that these days, Arianna Huffington whose Huffington Post was acquired by AOL is now a big executive at the company.  AOL Reader is fast, and the layout is familiar yet slightly modernized.  On the topic of speed, my full Google Reader subscription library was uploaded in just a few minutes compared to a process that took well over a  week with The Old Reader.  There was some speculation that the AOL reader might be a subscription-based product, and perhaps the launch version will be.  But the company is really no longer a subscription-based business, but an ad-driven business (much like Google).  The beta reader was gratis, and I've been impressed with it so far.  Native Android and iOS clients are promised for the near future, but right now it's web-only on both mobile and desktop.

Digg Reader http://digg.com/reader.  This one has been hyped ever since Google first announced plans to kill its RSS reader.  It launched officially on June 26, 2013, but beta tester reviews were few and far between.  I finally received my invite on June 26, so I've had only a day or so to try it.  So far, I've been impressed.  The speed and interface are very easy-to-use, and its an uncluttered looking RSS reader which is also appealing to me, too.  They say it will be a 'freemium' product, which means they'll have a paid version of the product, which is less likely to be killed off, so maybe this one can be included in both the "free" and "paid" categories?  Digg described the 'freemium' aspect HERE.

So far, my assessment is that this reader has indeed been worth the wait.  Speed and ease of transferring my Google Reader library couldn't have been easier.  The interface is clean and easy to use.  Supposedly they've built a an accompanying mobile app for both iPhone and Android, although I don't believe those haven't launched yet, but we can expect them soon.  Either way, Digg Reader is definitely worth a look.

G2 Reader http://www.g2reader.com.  This one is, right now, my personal favorite.  It resembles Google Reader in layout and function, and it gives accurate counts of unread posts in each folder you create.  The biggest downside is that updates can lag a little, so the latency issue (if you rely on it for breaking news) may be an issue.  But if you use it to aggregate content that doesn't have to be as fast as a story or press release breaks, its ideal.  There's no mobile app for it, but they do have a special mobile version of the site (making it more conducive to small screens without mouse access).

Paid RSS Readers

I guess Digg Reader could (potentially) fit into this category, but details on the paid product have not yet emerged.  But, the key is they say paying customers have a different relationship with them, so there might be a benefit.  For example, its possible mobile apps will be available only to paid customers, so stay tuned!

NewsBlur http://www.newsblur.com/.  This one is a bare-bones but highly-functional product.  Its not free (it is if you follow less than 65 blogs or news feeds), but the cost is cheap enough ($24/year) to justify itself.  There are also a few nice features, such as the ability to save articles to read in the future.  I don't especially love this reader, but I do like the fact that it already has mobile apps, and its fast, plus I've paid for it, so I don't think they'll be cutting me off as Google did.

Privacy?  For Free?!

The broader issue of privacy has been bugging me a bit lately.  Late last year, I heard American Public Media's Marketplace program (see http://bit.ly/V6W7n1) which talked about how pervasive data snooping is online, and rather than resign myself to passive submission, I realized I don't have to let big web data miners know everything I'm doing, nor do I even want to.  I didn't mind it when I got something in exchange, but when Google kills some stuff I happen to like, all bets are off.  The relationship exists as long as its mutually beneficial.

One recent example of how big data snoopers are now mining your web browsing history in creepy ways is that airlines now base the pricing they extend to you on flights based on the sites you've visited in your browser's cache file, which I find kind of creepy.  That means you're likely to get worse prices for things like airline tickets booked online because the sites you've visited by using your browsing data determine prices for you, and even if you empty out your browsing history folder, they still know where you've gone thanks to partners they buy data overlays from.  (see the USA Today article about that practice at  http://usat.ly/13PFdn5).  

My unease was further validated when I listened to "On The Media" in January, see http://wny.cc/WkkG0q to listen to that particular program, and I grew even less comfortable with just how much data I had allowed Google (and many others I wasn't even aware of) to access.  They do most of it behind the scenes, so the result may not be obvious.  I know Google has a corporate saying of "Do no evil", but I still think its a bit too "big brother" for my tastes (in Orwellian terms, that is), plus Google really pissed me off with those 2 moves to get rid of some services I had used pretty faithfully each day, multiple times per day for years, so I decided to separate myself from Google.

Diversify Your Online Presence

The lesson for me was a reminder not to put too much of my online existence in the hands of any particular provider (like Google).  I've learned over the years that online, very little (online) lasts forever (does anyone remember search engines like Excite.com or HotBot.com?  I didn't think so, although both still exist), so I'm diversifying my risk of relying on a single provider by having multiple backups.  This exercise forced me to find several suitable replacements for both iGoogle and Google Reader, so today, I'm not worrying about the shutdowns for either, but my usage of Google products has plunged, too.

As I've hinted, I'm open to good alternatives.  All alternatives.  Multiple alternatives.  The only thing is, Google won't be playing a very big role.  Too bad for Google!

Naturally, I have preferences for the interface and mechanics of certain alternatives.  Let me also remind my readers that I do NOT publish my contact information anywhere online, and sometimes I think I'm one of the few who doesn't.  True, mobile tracking has really just begun, but its pretty much leading to the same place.  Google makes most of its money from advertising, even more than media giants like Viacom, for example.  It's also doing its Orwellian big brother act from your mobile devices, so just keep that in mind.

Ghostery Cuts Google (and others) Off, New Search Engines Help, Too

To gain a sense of control over my online usage, last year, I started using a software application Ghostery to cut off Google and many other snoopers (I wasn't aware how many others were even looking at my online behavior, but there were lots and LOTS of them) from using all of my browsing history (the app runs in Chrome, but they also have ones that run in Mozilla Firefox).  Perhaps not coincidentally, the nonprofit developers of the Mozilla Firefox browser which ultimately unseated Microsoft's Internet Exlorer (before ceding the top spot to Google's Chrome) have also announced (see the news at http://wapo.st/14iXxBc) plans to enable users to block the most common forms of Internet tracking, allowing hundreds of millions of users to limit who watches their movements across the Web.  Says Brendan Eich, chief technology officer for Mozilla, "We're trying to change the dynamic so that trackers behave better."

I liken my adoption of Ghostery to cut out snoopers to returning the favor to Google management for shutting down some of my favorite Google apps, but I also like the fact that I am controlling (slightly more) who sees what I do ... virtually.  Beyond that, however, is that its actually expedited my web searches.  I've discovered that all those third-party snoopers adding cookies tends to slow my search results down quite a bit.  You will have to enable these things to permit certain social media sites or other sites to work properly, but I'd say its been a good move.


I've also been more willing to switch search engines lately in part because of Microsoft's effective Scroogled ads, but I'm using not just biggies like Yahoo! and Microsoft's Bing, but some lesser-known providers like DuckDuckGo.com [http://duckduckgo.com/], which is a Pennsylvania startup which claims that it doesn't track users (yet, see http://donttrack.us/ for details on their policy) and Startpage.com [http://startpage.com/], which is based in Europe and must adhere to Europe's tighter privacy standards.


The bottom line for me is that I'm more than willing to diversify my online business with others because the Google relationship had been very one-sided, with Google getting most of the benefit, which I didn't mind when they offered the apps I liked, but when they killed those, it bothered me.  Google made a strategic decision to eliminate services I liked, rather than something that was mutually beneficial (such as offering them for a fee), so I've returned the favor.  For the immediate future, I will still be using Google's Blogger and YouTube, and while I do have an Android phone and tablet (Nexus) computer, I realize that I simply cannot rely on a single company to provide all that I want or need online, so Google won't be seeing ALL of my online behavior, which is just fine with me.  To be sure, I am composing this on Google Drive's Write document, but I'm actually very happy for Google to read every word of this, not that it would change the outcome.

Tying the Knot

So that's the first part of my post, the other big deal is that I tied the knot earlier this month (June 7, 2013 to be exact).  I'm kind of casually mentioning that because I've been with the same person for 11 years and we both felt the time was right to do something official.

Neither of us wanted to make a big production out of a wedding (that's a Bridezilla thing), so we decided we'll do something to acknowledge the occasion with family when the time is right (that will be in mid-July).  Unlike some diabetes bloggers who have shared stories of their elaborate wedding plans and hiding insulin pumps in wedding gowns, ours was a very low-key, private event.  However, I consider the diabetes online community like extended family, so I'm sharing the news.  As I noted, we'll be having a big party for our families when we're on vacation in July, and I expect that during that week, I'll have some time to experiment with all of the different replacement RSS readers, so if my Twitter feed is a bit erratic in the coming weeks, don't panic.

Anyway, that's my story about divorces, RSS Readers and marriages for today.

Monday, June 24, 2013

Coming Soon: Ever-More-Concentrated Varieties of Insulin. Buyers Beware!

Recently, Lilly held what it called its second diabetes social media summit, although in truth, the company did not fly anyone into Indianapolis for the first summit (that was a forum gathering at Friends for Life with people already there), so in reality, this was the company's first.  I was not invited, which frankly doesn't surprise me, because I've been critical of the company and I honestly think they're terrified of me - seriously, they were looking for people who wouldn't challenge them on much (like their decision to outsource some insulin manufacturing away from its own plant in Indianapolis to Hospira in McPherson, Kansas only to bring it back in-house this year), and that's probably not me.  I ask pharma difficult questions and they prefer bloggers who generally won't challenge them on such issues.

On Twitter, the hashtag #LDSummit13 has some of the Tweets from participants regarding the Lilly summit.  DiabetesMine covered it HERE.

Having said that, Lilly really just kind of danced around the topic of glucose-responsive insulin, and company executive David Moller made a point of noting that Lilly had an active research program on smart insulin, claiming "we are looking at the science that would allow us to pursue it in a smart way".  However, both he and David Kendall kind of bad-mouthed the concept saying "Smart insulin was 'aspirational' and over-hyped on timeframe."

See the following Tweet:

I responded that's a logical response for a company that doesn't have anything real in its pipeline for glucose-responsive insulin.  Lilly had to bring in Boehringer Ingelheim to offer a long-acting analogue to market -- they didn't have one that was anywhere close to market from their internal researchers.  That's because resource reallocation internally largely gutted the R&D in the diabetes business.  In other words, they had to bring the Germans in to help them develop a Lantus-like product.  Its worth noting that most of the company's brightest have moved elsewhere.  Insulin legends like John Galloway retired years ago, and countless others have left the company to start their own businesses or work for competitors.  Lilly pursued neuroscience in the 1990s which brought them blockbusters such as Prozac and Zyprexa while they invested little in diabetes.  The partnered with Amylin before dumping that partnership for one with Boehringer Ingelheim.

The company realized its diabetes business had not been prioritized and brought in a new executive named Enrique Conterno to turn the flagging business around.  He's done what was necessary, even though most of it has been to turn to partners to do what Lilly hadn't done on its own.

But this post isn't about Lilly specifically, but a trend Lilly and rival Sanofi Aventis are pursuing: selling ultra-concentrated versions of existing insulin products to market those products to the booming, insulin-resistant type 2 market.  On April 24, 2013, Lilly released its quarterly earnings to investors.  They realized net income of $1.55 billion, or $1.42 per share, which compared to $1.01 billion, or $0.91 cents per share at the same time last year. The company credited sales of its treatments for diabetes, depression and lung cancer. Among the insurance companies it had landed was the big Kaiser Permanente account, and it had become more aggressive in competing with Novo Nordisk on price. But the transcript of the recent conversation revealed another important take-away (see http://goo.gl/2hYGi for the full transcript).

Specifically, that Lilly had applied for FDA Approval to Sell U-200 Humalog (insulin lispro).

Philip Johnson, Vice President of Investor Relations said:

"We also submitted in lispro U-200 in the U.S. for type 1 and type 2 diabetes patients and we are pleased to announce that [indiscernible] patient with the FDA we received Fast Track designation and have initiated BLA submission for ramucirumab as monotherapy treatment for second-line gastric cancer."

In other words, they've applied for approval of U-200 Humalog, which is twice as potent as U-100. And, the FDA is fast-tracking it.  Lilly already sells U-500 Humulin R which has seen sales grow in recent years with almost no marketing.  That's supposedly for a product that's been described as a dinosaur (specifically regular insulin) in an era of ultra-rapid acting, patent-protected insulin analogues.  While some people with severe insulin resistance might benefit from that (although some might argue that point, but its irrelvant to my post).  The point is we can expect more-concentrated insulin varieties in the coming years.  There's zero new technology involved, its just an effort to sell more of an existing product - most likely for a higher price.

Lilly isn't alone.  Rival Sanofi just announced it, too, is looking at a more-concentrated variety of an existing insulin product.  Specifically, they've been toying with a U-300 version of Lantus.  (see the June 22, 2013 press release entitled "Sanofi Announces Positive Phase 3 Results for Investigational New Insulin U300" http://prn.to/11HtaTd).

Novo Nordisk is likely to move in this direction, too, although they've been much tighter-lipped about it.  But if big rivals do it, they'll undoubtedly launch a "me-too" version of its products.  They're still stinging from the fact that their latest generation "Lantus Killer" known as Tresiba (insulin degludec rDNA origin) was not approved a few months ago when the FDA demanded additional studies on cardiovascular disease risk.  The company once arrogantly predicted it would "likely" be sold in the U.S. by 2014.  But if the FDA fast-tracks double or even triple-strength  varieties for Lilly, why wouldn't the regulators do the same for Novo?

Let me remind you that back in 2011, there was some trouble with pharmacists. or far more likely, lower-skilled pharm-techs who may only have on-the-job-training depending on where they work.  In 2011, there were reports of many pharmacies mixing up U-100 Humulin R and U-500 Humulin R (both Lilly products), so the Institute for Safe Medication Practices (ISMP) reissued a safety warning about mixups (see http://www.ismp.org/Newsletters/ambulatory/archives/200708_2.asp)

This was the summary of ISMP's warning on mixups with the highly-concentrated U-500 insulin with standard U-100:

Mistakes have usually occurred when doctors accidentally selected U-500 regular insulin from computer screens instead of U-100. For example, sometimes the two dosage forms appear one line apart on the screen, which makes it easy to select the wrong one. Also, depending on the screen size, the prescriber may see only the first few words of the product listing, so the drug concentration may not be visible. And finally, since the use of U-500 insulin is not common at present, prescribers may just assume that the only regular insulin that's available is U-100 and not even look for the concentration on the screen.

ISMP suggested that the use of U-500 insulin may be increasing due to the higher prevalence of [insulin resistant type 2] diabetes, especially where patients are seriously overweight and may need higher insulin doses where they need U-500. The use of insulin pumps, and need for tight control of blood sugar in hospitalized patients are other reasons.

ISMP asked the major suppliers of drug information systems to add the word "concentrated" on their selection screens, immediately following the drug name and preceding "U-500", which they said should help solve the problem. The companies did agree to do that.

U-100, U-200, U-300, U-500 Will Soon Emerge

However, I have major concerns with U-100, U-200, U-300 and U-500 insulins on the market, the likelihood of mixups increases exponentially.  I, for one, intend to speak personally at the FDA on these approvals given the growing numbers of increasingly-concentrated insulin varieties and what safety issues need to be addressed.

Back in 2008, I wrote about what role color should play in insulin packaging.  I cited some meetings the FDA held back in 2005 on this subject.  See my post HERE for more background.  I would also remind my readers that in 1997, when Lilly gained approval for the first insulin analogue, they used a different color cap on the vials (purple instead of orange) intended to communicate there was something dramatically different about Humalog.  The other manufacturers did not do the same, but the point is, Lilly of all companies has experience with the use of color in packaging.  I expect the same with all the new varieties of insulin concentrations.

This is one area where I think patient safety could be a genuine issue because of how these Rx's are filled.  Put this on the "to-do" list for pending FDA applications.

Patients Should Ask the FDA the Following Questions:

  1. I expect the FDA gives consideration to revisiting the use of color in labeling.  Right now, color is voluntary.  It needs to be mandatory, will all companies adopting the same color-schemes.
  2. I think the companies also need to fund educational efforts to instruct patients to look for the correct concentration, and more importantly, education to all the pharmacy technicians about the potential for mixups and how they can avoid such mixups.

Both of these need to be part of any approvals IMHO, the risk is potential recipe for disaster unless the regulators  consider these issues when reviewing an drug application for approval.