#1 Selling pen needles just got even better.1,2*

Patient-preferred BD Nano™ 2nd Gen Pen Needles2*

Patented features include:2,3

Wider outer cover easier to attach to pen device

Larger, green, inner needle shield easier to grip and remove before an injection

4 mm x 32G

BD Nano™ 2nd Gen Pen Needles

#: 08290-3205-50

Pen Needles will replace BD Nano™ Ultra-Fine™ Pen Needles

Contoured needle base provides greater comfort and compensates for injection force variability, supporting more reliable subcutaneous injections

The unique features of BD Nano™ 2nd Gen 4mm Pen Needles offer a number of potential benefits, including:

• Reduction in injection pain6†

• Less force required to deliver the full dose4‡

• Greater confidence that the full dose has been delivered compared to other pen needles studied4§||

Compatible with widely used pen injection devices7 Covered completed 6 pairs of abdominal injections of 0.3 mL sterile saline in random order and utilized a Likert Scale where ratings range from -2 to 2; positive scores reflect less thumb force for BD Nano and negative scores reflect less thumb force for the comparator pen needle. Scores of 0 indicate no difference. BD Nano™ 2nd Gen 32Gx4mm contoured hub 5-bevel extra thin wall demonstrated superiority vs each comparator group for less injection force. [(P <0.01) (Artsana 33Gx4mm mean +0.80, 95% CI, +0.62 to +0.98); (Artsana 34Gx3.5mm mean +0.98, 95% CI, +0.80 to +1.16); (Comfort EZ 33Gx4mm mean +0.31, 95% CI, +0.13 to +0.49); (Terumo 34Gx4mm mean +0.21, 95% CI, +0.07 to +0.35)]. §198 patients with diabetes were included in this prospective, multicenter, randomized, open-label, 2-period, crossover study to evaluate differences in confidence that the full dose of insulin was delivered between the participants’ usual pen needle (PN) and the corresponding extra-thin wall (XTW) PN. Confidence in delivering the full dose of insulin was assessed with the use of a visual analog scale (VAS). Confidence results would be considered statistically significant if the 95% CI for the mean VAS score was either positive (XTW preferred) or negative (current PN preferred). XTW PNs had statistically significantly increased confidence that the full dose was delivered by 24.4mm ([95% CI, 19.7-29.1] [P<0.001]). ||Single-blind, randomized, control trial of 154 patients with diabetes where each completed 6 pairs of abdominal injections of 0.3 mL sterile saline. Leakage was measured with a calibrated analytical scale. The occurrence of leakage from the needle tip and the injection site (measurements combined) was defined as wet weight equivalent to ≥5% of the injection volume, [equivalent to ≥0.015 g (0.015 mL)]. Leakage frequency for BD Nano™ 2nd Gen 32Gx4mm contoured hub 5-bevel extra thin wall was 0.4% vs 3-bevel posted hub (Artsana 33Gx4mm, 6.2%; P<0.001); (Artsana 34Gx3.5mm, 18.8%; P 0.026); (No significant difference vs Comfort EZ 33Gx4mm). ¶Fingertip Formulary, as of 1/27/2022.

1. IQVIA XPT Device Retail TRx Data. United States, Nov 2020- Oct 2021. 2. Whooley S, Briskin T, Gibney MA, et al. Evaluating the User Performance and Experience with a Re-Engineered 4 mm x 32G Pen Needle: A Randomized Trial with Similar Length/Gauge Needles. Diabetes Ther. 2019;10(2):697-712

3. Rini CR, Roberts BC, Morel D, Klug R, Selvage B, Pettis RJ. Evaluating the Impact of Human Factors and Pen Needle Design on Insulin Pen Injection. J Diabetes Sci Technol. 2019; doi: 10.1177/1932296819836987.

4. Aronson R, Gibney M, Oza K, Berube J, Kassler-Taub K, Hirsch L. Insulin pen needles: effects of extra-thin wall needle technology. Clin Ther. 2013;35(7):923-933 go.embecta.com/pharmacypartner embecta, formerly part of BD. BD is the manufacturer of the advertised products. embecta and the embecta logo are trademarks of Embecta Corp. BD and the BD Logo are trademarks of Becton, Dickinson and Company. All other trademarks are the property of their respective owners. © 2022 Embecta Corp. All rights reserved. U.S. Patent Nos. D787054, D825749, D804023 and other patents pending. 2203772033N1SADDSN that healthcare consumers see most frequently, is ideally suited to support people with diabetes selfmanagement, helping them finetune their medication or insulin treatment plan. They can also help identify the best tools for patients based on their technology skills, health literacy and numeracy skills. “The pharmacist can help people get off to a strong start with their chosen technology tools, then using the resulting data with them to optimize care,” MacLeod said.

5. Hirsch L, Gibney M, Berube J, Manocchio J. Impact of a modified needle tip geometry on penetration force as well as acceptability, preference, and perceived pain in subjects with diabetes. J Diabetes Sci Technol. 2012;6(2):328-335. 6. Gibney M., Fitz-Patrick D., Klonoff D., Whooley S., Lu B., Yue W., Glezer S. User experiences with second-generation 32-gauge × 4 mm vs. thinner comparator pen needles: A Prospective Randomized Trial. Current Medical Research and Opinion, DOI: 0.1080/03007995.2020.1803248, 2020. 7. BD Compatibility Confirmation for Pen Needles and Pen Injector Manufacturers, Document Number: 149OTH-0004-20, Ver S, Dated 3 February 2021.

These professionals can help with instructing patients, too. There is increased focus on educating people with diabetes about injection technique, injection site rotation and lifestyle management, according to Tom Blount, president of North America for Embecta.

“Pharmacists are an important partner in these efforts,” he said.

As the incidence of diabetes increases, poorly managed diabetes creates a cost burden for patients and the healthcare system. “By making it easier for people with diabetes to manage their care consistently, using effective tools and proper techniques, we can help them maintain their long-term health and decrease the risk of other health issues that are related to poorly managed diabetes care,” Blount said.

Formerly part of BD, Embecta introduced pen needles in 1991. Over the years the design innovations have focused on enhanced comfort and safety, with smaller and thinner cannulas. The company’s BD Nano 2nd Gen Pen Needles feature ergonomic enhancements to make the needle shield easy to grip and remove, and a contoured needle base for more reliable injection depth and comfort.

The brand is in the process of developing a patch pump product for Type 2 diabetes under the FDA’s Breakthrough Device designation. “People with Type 2 diabetes make up 90 percent of the population of people living with diabetes,” Blount said. “They have different needs than those with Type 1 diabetes, so we’re developing a tubeless pump designed with their needs in mind.”

People with both types of diabetes are seeking innovative devices, so manufacturers are developing more advanced CGMs. Dexcom recently launched the G7 CGM system, a low-profile, all-in-one wearable system that is 60% smaller than its predecessor. “The desire for simple and easy-to-use technology is especially true for the millions of people living with diabetes who rely on medical devices like CGM to manage their chronic condition 24/7,” said Dexcom CEO Kevin Sayer.

Barriers and solutions

Supply chain constraints are affecting every industry, including diabetes care. “People living with diabetes are facing supply challenges like we’ve never seen before,” said Casey Pflieger, director of retail sales for Owen Mumford, which makes Unifine pen needles. “You are seeing patients forced to search multiple pharmacy locations for their injectables and supplies.”

One unusual challenge is that there is an unanticipated surge in demand for certain medications. People with diabetes and people without diabetes are both seeking GLP-1 agonists, such as liraglutide and semaglutide. “When drugs like Wegovy were hailed as miracle weight loss treatments, manufacturing couldn’t keep up with heightened demand and the offlabel use of Ozempic exploded,” Pflieger said. “Suddenly the drugs many T2D’s relied on to manage their condition became scarce.”

Even CGMs are in demand among people who do not have diabetes, because they are using the

Source: Centers for Disease Control and Prevention, National Diabetes Statistics Report 2022 systems for weight loss or to analyze and improve athletic performance. “Movement of these devices from prescription-only to OTC should also significantly improve access, assuming the demand doesn’t outpace forecasting,” Pflieger said.

Another phenomenon, Pflieger said, is that pharmaceutical and device manufacturers are engaging in aggressive contracting with payors that promise massive rebates for exclusivity arrangements. Pflieger noted that while Owen Mumford is successfully planning to and bringing in safety stock to help ensure continuity of supply for customers and patients, payors and buyers should be mindful of and avoid the pitfalls of sole-sourced supply. “Otherwise access to therapy and medication adherence suffers.”

Convenience can help boost adherence, and automatic blood glucose testing can help. Intuity Medical introduced POGO Automatic Monitor and Cartridges, the first and only FDA-cleared blood glucose monitoring system with 10-test cartridge technology, eliminating the need for separate lancets and glucose strips. Patients click the cartridge door open, pop the multitest cartridge into the monitor and close the cartridge door. They press the power button, place their finger on the test port, and hold it there until the image on the screen tells them to lift their finger. Then, POGO Automatic analyzes the sample and displays the reading.

Connectivity is another feature that can help people with diabetes adhere to their treatment plans. “Diabetes care management can be a demanding task,” said Badia Boudaiffa, divisional vice president of U.S. commercial operations for Abbott’s diabetes care business. “Connected technology allows people living with diabetes to have a more seamless experience.” The company is working with partners to collaborate on new advancements in connectivity, such as smartphone app integration, remote monitoring smart insulin pens and automated insulin delivery systems that connect with CGMs.

Abbott makes the FreeStyle Libre portfolio, which Boudaiffa said is the most affordable CGM in pharmacies today. The company is working with partners, including sponsoring the American Diabetes Association’s Health Equity Now platform, to tackle barriers so all people living with diabetes can access the latest medical technologies, no matter their income level, race or background.

Meeting other needs

Comfort is another consideration. Last year, HTL-Strefa, which makes medical sharps, introduced the Droplet Micron 34-gauge pen needle, which is 3.5 mm long and is the shortest, thinnest available. “It’s all about comfort and reducing the anxiety associated with having to deliver an injection,” said Chris Woeste, vice president of sales North America. “It improves the injection experience.”

The bigger trend, Woeste said, is that more companies are entering the diabetes products category, a change from the old pattern of having only a few big players in certain segments. “The increased competition in the space benefits retailers and patients alike by driving down costs and improving efficiency,” he said.

Innovations are also appearing from companies that offer other products. Simply Good Foods Company makes Atkins and Quest products, including new Atkins Nacho Cheese Flavor Protein Chips with 13 grams of protein and 4 grams of net carbs and Quest Cheese Crackers with 10g of protein and 5g of net carbs. “Fresh, low sugar and high protein are the most common perceptions of what’s considered healthy,” said Colette Heimowitz, vice president of nutrition and education for Simply Good Foods. “When you remove carbs, you have room for protein and fiber and that’s satiating.”

The brands’ recipe pages are the most often visited on the website, Heimowitz said, and the recipes were prepared by the company’s nutrition department and based on recommendations from the American Diabetes Association. While she agrees that pharmacists can play an important role in diabetes education, retailers should also build wellness sections featuring these nutrition-related products and reinforce the message that a low carb, high protein diet can help people with diabetes maintain their health.

Wound care is another important segment, and the need for these products is increasing as healthcare costs rise. “Unaffordable healthcare is leading people living with diabetes towards more self-care wound care treatments,” said Geolyn Gonzalez, vice president of sales and marketing for Total Resources International.

Another trend, Gonzalez said, is a preference for the convenience of pre-organized kits and bundled products or services. TRI recently launched the Be Smart Get Prepared diabetic wound care line, designed to enable people living with diabetes to rapidly and successfully care for and treat their wounds at home or while traveling. Retailers can engage with these consumers by setting up an Infection Prevention section, and by providing information and making the products easy to find on shelves.

“With diabetes being such a complex and demanding disease, encouraging and educating people living with diabetes to be more proactive instead of reactive is key in helping them get ahead of their wound care management,” Gonzalez said. dsn g w h h a s a a c s ch o ogy Unifine Ultra has reinvented the pen needle.

• smooth: La g s g fo m o g a ha g

• comfortable: F a a fo m s g o ha c h j c o x c

• secure: ock-ou f a u fo s cu ha g a s osa

• versatile: Universally fits major b a j c o s a a a ab w b a s a a a ab w a g of s z s