Real-World Evaluation of Dosing in Patients Converted From Insulin Glargine (Lantus) to Insulin Glargine (Basaglar)

Abstract

Background: Basaglar, insulin glargine (BGlar; Eli Lilly, Indianapolis, IN), a follow-on biologic, was developed after the patent for Lantus, insulin glargine (LGlar; Sanofi-Aventis, Paris, France) expired. Objective: To compare the dosing and hemoglobin A1C (A1C)-lowering effects of BGlar compared with LGlar in a real-world setting. Methods: Adult patients, at 5 clinics, with type 1 (T1DM) or type 2 diabetes mellitus (T2DM) who were converted from LGlar to BGlar were included in this retrospective observational study. The primary outcome compared mean basal insulin dose (U/d) from the date of conversion to 6 months. Basal insulin and total daily insulin doses were also compared from baseline to 3- and 12-months postconversion, as also change in A1C, body weight, and estimated monthly acquisition costs of basal insulin. Results: Of the 225 patients included, 56% were male, and 81% had T2DM. The mean conversion dose (U/d) of LGlar was 46.3 ± 32.7. There was no significant difference in the mean BGlar dose (U/d) at 6 months (45.9 ± 33.5; P = 0.52), nor was there a statistical difference at 3 or 12 months. There were no significant differences in change in A1C at any time point. The estimated monthly acquisition cost of BGlar was significantly less than that for LGlar at conversion ($286 vs $341, P < 0.001) and 6 months ($290 vs $351, P < 0.001) respectively. Conclusion/Relevance: The results of this retrospective study suggest that BGlar resulted in similar glycemic outcomes compared with LGlar in a real-world setting and may be a preferable option in a value-based health care environment.

Comparison between Continuous Regular Insulin Infusion and Single Dose Subcutaneous Long Acting Insulin Injection in Intensive Care Unit

“…In contrary to our results, Pitlick et al (29) conducted a retrospective observational study including adult patients with type 1 or 2 DM who were changed from Lantus (LGlar) to insulin glargine (BGlar) at five clinics. They showed that the findings of this retrospective analysis indicate that BGlar produced comparable glycemic outcomes in a real-world scenario when compared to LGlar, and that it would be a better alternative in a value-based health care system.…”

Effectiveness, safety and treatment adherence of biosimilar follow‐on insulin in diabetes management

“…Change in HbA1c for Basaglar and Lantus was −1.29% and −1.34% from baseline to 6 months, respectively, in the trial, and we observed similar magnitude of reduction in our study 11 . One real‐world study in the United States examined the HbA1c‐lowering effect of Basaglar compared with Lantus among 225 patients with type 1 diabetes or type 2 diabetes who converted from Lantus to Basaglar 21 . At 3 and 12 months postconversion, the authors found no significant differences in change of HbA1c, while also reporting that the monthly acquisition cost of Basaglar was significantly less at conversion date (16% less, $286 vs. $341, P < .001) and 6 months (17% less, $290 vs. $351, P < .001).…”

Real-World Impact of Switching From Insulin Glargine (Lantus®) to Basaglar® and Potential Cost Saving in a Large Public Healthcare System in Saudi Arabia

“…Basaglar ® , which is a biosimilar insulin glargine of the reference biologic (Lantus ® ), has shown comparable safety and efficacy profiles to Lantus ® among patients with type 1 and type 2 diabetes in different industry–sponsored randomized clinical trials ( 24 , 25 ). Moreover, a recently published study that examined the interchangeability between Basaglar ® and Lantus ® in real–world settings found no difference in the glycemic outcomes among the 225 adult patients who were retrospectively recruited from five clinics affiliated with three different healthcare systems in the United States ( 27 ). Similar findings were observed in this study since no difference in the A1C levels was found between the baseline (e.g., before Basaglar ® treatment) and after 12 months of follow–up.…”

“…Nonetheless, some observational studies have shown no difference in terms of a change in the glycated hemoglobin levels (A1C) or daily insulin units. Moreover, the switch from Lantus to Basaglar resulted in significant cost savings according to a recently published retrospective observational study that included 225 patients from five different clinics affiliated with three different healthcare systems in the State of Iowa, United States ( 27 ).…”