Once or twice daily injections of s.c. anticoagulants for prolonged periods of time can be bothersome and unacceptable for the patient. Use of a once weekly exchanged s.c. port, called Insuflon, can make longer-term s.c. anticoagulant therapy easier and more tolerable.
The number of needle sticks can be decreased by using a s.c. port, called Insuflon, to administer the drug. This device is the same as the one used by patients with diabetes to administer insulin s.c.. Insuflon is a small, plastic catheter/port that can be placed s.c. with a needle once every seven days. The catheter is secured to the body with an adhesive bandage and is small enough to be discrete and not hinder daily activities. The anticoagulant can then be injected through the port, without having to stick the skin. Thus, there is no pain and discomfort with the injection. These ports have gained a huge acceptance among patients with diabetes for injection of insulin.
Not all that much has been published about the use of these ports in patients on s.c. anticoagulants. However, a recently completed study of 21 patients showed that absorption of low molecular weight heparin was reliable when given via the once weekly exchanged Insuflon ports [ref 1]. And patients liked it: The majority of patients (83 %) expressed satisfaction with the port and stated that they would like to continue to use it [ref 1]. Also, a number of pediatric hematologists have used these ports for years to give s.c. anticoagulants to pediatric patients [ref 2].
Administration Instructions and Animated Tutorial
Further information on the port, including pictures and a nice animated instruction video on how to use it can be found here.
How to Get an Insuflon Port
For a patient to get an Insuflon port, a prescription is needed. The patient then has two options how to obtain the device:
1. The simplest is to contact one of the Home Delivery Suppliers listed below. They will process the prescription, bill the insurance company, and ship directly to the patient. Home Delivery Suppliers:
- Advanced Diabetes Supply, a division of Northcoast medical; go to their website or call toll free: 1-866-422-4866.
- Edgepark Medical Supplies, go to their website or call toll free: 1-800-321-0591.
- Manufacturer Representative from Intra Pump Infusion Systems: go to their website or call toll free: 1-866-211-7867
2. Alternatively, the Insuflon port may be made available through CVS Pharmacy, but it is by special order. The patient can contact the manufacturer representative below for assistance with this route.
If the patient has any problems obtaining the Insuflon device, he/she can contact Robin McDowell, Intra Pump Infusion Systems, directly at 630-845-7867 or email her at firstname.lastname@example.org.
Do Insurance Companies Pay for the Insuflon Port?
The Insuflon port should be covered under the Rx plan of the patient’s insurance. As insurance plans and contracts and providers differ throughout the country, billing methods can vary. Generally it is billed using the ‘HCPCS’ code A4211. The NDC# is 08423.1621.26. On occasion, insurance may cover under the DME part of your insurance plan. In this case the ‘HCPCS’ code is E1399. Sometimes a ‘Letter of Medical Necessity’ from the physician may be helpful if at first insurance denies coverage.
A once weekly needle stick from the port rather than once or twice daily sticks from the LMWH syringes is attractive for some patients on longer-term s.c. anticoagulants; and as absorption of the LMWH is reliable as determined by plasma anti-Xa levels [ref 1], I have no hesitations recommending the use of the Insuflon device to my patients. However, the port might not be a good choice for the patient with cancer who is receiving chemotherapy that leads to neutropenia and an increased risk for infection.
- Moll S et al. Once weekly subcutaneous ports for the administration of low molecular weight heparin: a prospective pharmacodynamic study. J Thromb Thrombolys 2011,31:375 (abstract).
- Dix D et al. The use of low molecular weight heparin in pediatric patients: a prospective cohort study. J Pediatrics 2000;136:439-445.
Disclosures: Intra Pump provided Insuflon ports free of charge for the 21 patient study referenced above [ref 1]. They did not provide any additional financial support. I have not received consulting fees / honoraria from Intra Pump.
Last updated: May 14th, 2013
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