A prescription for an insulin that is being discontinued: what the dispensing team does

Why this matters

Most of the time a prescription for a patient's usual insulin is routine: dispensed, checked and handed to someone who has used the same product for years. That routine is about to change for one group of patients, and the dispensing team is often the first to notice the prescription that should have been changed and has not been.

A National Patient Safety Alert issued on 1 October 2026 covers the discontinuation of insulin detemir, sold as Levemir. It asks for every patient who uses it to be moved to a different insulin by the end of November 2026, before stocks run out at the end of December. Dispensing staff will see these prescriptions every week until then.

What the alert says

• It is a National Patient Safety Alert, reference NatPSA/2026/006/DHSC, issued on 1 October 2026 by the Department of Health and Social Care through the Central Alerting System.
• It covers both presentations of insulin detemir: the pre-filled pen and the cartridge, each 100 units/ml in 3 ml.
• Both are being discontinued at the end of December 2026, and the alert says stocks are expected to have run out by then.
• No new patients should be started on the product from now on.
• Existing patients are to be switched to an alternative insulin as soon as possible, and by 30 November 2026 at the latest, following local plans.
• Community pharmacists are asked, when a prescription for the product is presented, to first make sure the patient has enough insulin and then refer the patient back to their prescriber for a switch.
• The alert points to the NHS Specialist Pharmacy Service Medicines Supply Tool for the current position on alternative insulins, and asks that prescribing is spread across several alternatives so that no single product runs short.

This alert follows three earlier medicine supply notifications about the same discontinuation, the first in June 2025. It has been upgraded to a National Patient Safety Alert because the deadline is now close and some patients have still not been switched.

What a National Patient Safety Alert is

National Patient Safety Alerts are the highest level of safety alert in the NHS. They are issued through the Central Alerting System by accredited bodies and set actions that organisations must complete by a deadline. For this alert, actions should be underway by 5 October 2026 and complete by 30 November 2026. Your pharmacy should have a record of what it did in response.

What the dispensing team does

1. Know the product. Add it to your mental list of items that need a second look, as you already do with valproate or a high strength insulin.
2. When a prescription for insulin detemir comes in, do not simply dispense and bag it. Flag it to the pharmacist before supply, because the alert asks for a conversation with the patient and a referral back to the prescriber.
3. Help the pharmacist establish how much insulin the patient has at home and how long it will last. The alert's first concern is that nobody runs out while the switch is arranged.
4. Check your own stock position. Note what you hold, what you can still order and the expiry dates, so the pharmacist has the facts when deciding whether to supply.
5. Record the referral in the way your pharmacy has agreed, so the next team member who sees that patient knows a switch is in progress.
6. When the new prescription for an alternative insulin arrives, treat it as a new item: a different device, possibly a different strength, and probably different needles or ancillaries. Check that the prescription names the brand where the alert says it must, and raise it with the pharmacist if it does not.
7. Expect questions. Patients who have used one insulin for years are often anxious about changing. Reassure them that the change is planned and being managed, and pass clinical questions to the pharmacist.

The brand prescribing point

One alternative prescribers are likely to use is insulin glargine, and the alert makes a specific point about it: insulin glargine comes in two strengths, so it must be prescribed by brand to reduce the risk of the wrong product being selected. For the dispensing team this is a plain accuracy point. If a prescription for insulin glargine arrives written generically, or the brand named does not match the strength, stop and ask the pharmacist rather than choosing. Insulin errors involving the wrong strength or device are well recognised as a cause of serious harm.

When to involve the pharmacist

• Every prescription for insulin detemir presented from now until the product is gone
• Any patient who says they are running low, has already run out, or cannot get an appointment with their prescriber
• Any patient who asks what they will be changed to, whether the dose will be the same, or how to use a new pen
• Any prescription for an alternative insulin that is not written by brand, or where the brand and strength do not match
• Any sign that a patient has been given a new insulin but not the right needles, cartridges or device training

PPets learning connection

Responding to safety alerts, high risk medicines and supporting patients through changes to their treatment are covered in the Level 3 Diploma for pharmacy technicians. Our guide to how medicines recalls work explains how alerts reach your pharmacy and the record you should keep.

Record this as CPD

Registered pharmacy technicians can use this article towards GPhC revalidation, as an unplanned CPD entry or as the starting point for a reflective account. Pharmacy assistants and trainees can use it as evidence of reflective practice. Note down three things:

1. What you learned from this article
2. How you have applied it, or will apply it, in your own role
3. The benefit to the people who use your pharmacy's services

Sources and further reading

• National Patient Safety Alert NatPSA/2026/006/DHSC: Levemir (insulin detemir) FlexPen and Penfill discontinuation, Central Alerting System
• Full alert document (PDF attachment to the CAS alert)

Related from PPets

• Level 3 Diploma for pharmacy technicians
• Free resources

This article is for general educational purposes only. It is not legal advice, professional regulatory advice or clinical advice about an individual patient. Always follow your pharmacy's SOPs and check current official guidance and product information.

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