Long-Acting Basaglar and the New Era of “Biosimilar” Insulin

By Payal Marathe and Lynn Kennedy

What you need to know about the new insulin, its cost, dosing, and beyond!

On December 15, Basaglar became the first “biosimilar” insulin available in the US. Produced by Lilly and BI, it is injectable insulin glargine modeled after Sanofi’s basal insulin Lantus, with the same core protein sequence. Importantly, Basaglar offers another insulin option for people with diabetes – one that comes at a lower cost and with very similar glucose-lowering effects compared to Lantus. It is available in a disposable, pre-filled pen (called the KwikPen) and is approved for people with type 1 and type 2 diabetes.

Basaglar’s December 2016 launch date was highly-anticipated because it actually received FDA approval a full year before, but shipments to US pharmacies were delayed until a legal settlement was reached with Sanofi.

[Editor’s Note: The FDA does not consider Basaglar a “biosimilar” drug for regulatory reasons; but it can essentially be thought of as an alternative form of Lantus.]

Now that Basaglar has finally arrived, what does this mean for diabetes treatment? What are the major advantages? What does it cost? How should it be used? What does it mean to be “biosimilar,” and how might biosimilar insulin change care for people with type 1 and type 2 diabetes? Read on to find out!

Lower Costs in A New Age of Biosimilar Insulin?

So, what’s the point of having two similar insulin glargine products out there?

One important reason is that a biosimilar medicine will usually be priced lower than the original product – the idea is similar to “generic” medications taken as pills, like statins. Compared to Lantus, Basaglar’s list price offers an approximately 15% discount.

Some big names in insurance (like UnitedHealth) are now covering Basaglar instead of Lantus, hopefully translating to lower out-of-pocket costs for people with diabetes. As an example, for those paying cash or who have high deductible health plans, diaTribe estimates that people taking an average of 50 units of basal insulin per day would save approximately $50 per month if they took Basaglar instead of Lantus.

Whenever there’s competition, with more than one company selling insulin, people have more options for treatment (a good thing!). diaTribe would like to see a healthy diabetes ecosystem as well as greater access, and will be eagerly watching to see if wider availability does result in better access. We look forward to doing more research on this front in the future.

The Need-to-Know on Basal Insulin (Biosimilar or Otherwise)

Not all insulins are alike. There are some key frequently-asked questions about Lantus and Basaglar, and insulin glargine and other basal insulins.

• How long will Basaglar lower blood sugar? When should I take it? Like Lantus, Basaglar has its peak effect about 12 hours after injection – after this 12-hour mark, the effect of basal insulin glargine (whether Basaglar or Lantus) will slowly start to wear off, which means glucose levels could start to rise. Basaglar is labeled to be taken once-daily, at the same time every day – for instance, every night before bed at 10 pm or every day first thing in the morning at 9 am. For some people, however, the glucose-lowering effect may last less than 24 hours. If this happens to you, speak with your doctor about adjusting your dose or looking into other basal insulin options that may be longer lasting, such as Tresiba or Toujeo. Some people with diabetes find it helpful to split their basal insulin dose, taking a portion of their dose in the morning and a portion in the evening. The insulins are not approved for this use, so speak to a healthcare provider about doing this safely.

• I am taking Basaglar. What should I do if my blood sugar is high? If higher blood sugar persists at the same time each day (e.g., in the morning), Basaglar may need to be taken at a higher daily dose or at a different time in the day. If your high glucose seems to be related to meals or happens at different times, it could be more related to food choices, other diabetes medications being taken, or bolus (mealtime) insulin.

• I am taking Basaglar. What should I do if my blood sugar is low? If blood sugar is consistently low, the daily Basaglar dose may need to be lowered or taken at a different time of day. Talk to your healthcare provider.

• How can I save on Basaglar? Beyond the 15% list price discount when compared to Lantus, there are other ways to save on a Basaglar prescription. Lilly and BI are offering a traditional savings card for those eligible. Basaglar will also be included in Lilly’s recently-announced discount insulin program, which will offer up to 40% savings on any of the company’s insulin products to eligible individuals without health insurance or those on a high-deductible health plan. diaTribe will continue to research opportunities for affordable care – stay tuned.

Learn More

Lilly and BI released a new website with an overview of its biosimilar insulin, helpful tips for switching to the new basal insulin, and options for saving money. For visual learners, the new website features a video with instructions on how to prepare, prime, dose, inject, and clean up the Basaglar KwikPen. The video also provides troubleshooting tips – for example, if the dose knob is hard to push, try pushing more slowly, or put on a new needle and prime the pen again. There is also a mobile app called “Beginning BASAGLAR” which includes this instructional video along with an interactive guide for people starting on Basaglar for the first time. iPhone and iPad users can get it here. Android (Google Play) users can get it here.
 

[Photo Credit: Lilly/BI]