We only use pens for non-formulary insulins as to not confuse the RNs even more than they already are confused when it comes to all these different insulins.  Our "workhorses" are Apidra (dont ask why, I ask all the time), and Lantus, both in vial form.  We have Levemir in pen form so the RN does not confuse Lantus and Levemir.  We find that the vials are a better cost savings than the pens.  Hope that helps!

Thanks for your input, Judy. It will be interesting to see what happens in the future. I believe the reason for the 300unit Humalog vials for hospitals is to prevent waste if there is a dedicated vial of insulin for each patient. Since hospital stays are short these days, it prevents waste.
       I have some patients who use the 300 unit penfill cartridges at home to carry with them if they are not on high doses of insulin. That way they can carry the vials with them and not exceed the days of use when potency of the insulin is no longer  assured according to the guidelines for the specific insulin.  It's a lot better than carrying around a 1,000 unit vial.  It might be a good idea to have insulin come in 500unit vials for use at home (just my idea...not a reality at this time)

Thanks Patricia, I wonder how they got to the conclusion that the 300 unit vial was a way to go versus 500 units?  We do not have dedicated vials per patient in our acute care setting, we only have dedicated pens per pateint. The vials are floor stock and usually each locked med cart has a vial. We have a cassette exchange system where the cassettes are exchanged every morning so if we had a dedicated vial per patient then the people delivering the cassettes would have to go into every cassette and exchange, it just becomes to cumbersome.  Thanks for your input!

I thought maybe the rationale behind the 300 unit vials has something to do with pediatrics who may not use more than 300 units in a month. Roxy