Basaglar insulin pen

If you’ve been using a long-acting insulin like Lantus or Levemir, you might have heard about a friendly competitor called Basaglar which is a newer basal insulin option.  To get to know Basaglar better, here are some details you’ll want to be aware of.

Basaglar vs Lantus

What is the difference between Lantus and Basaglar?

The key question many people ask about these two types of insulin is whether Basaglar is the same as Lantus. Because of strict definitions that the Food and Drug Administration (FDA) uses to classify drugs as brand, generic and biosimilar, it’s not technically correct to say that Basaglar and Lantus are the same.  However, the amino acid sequence that makes up the chemical compound of both drugs is identical, and both are given the same chemical name of glargine.

To be exact, they are not the same, but to be practical, they are different brands of the same drug – glargine.

When looking at any insulin product, the key features to know are the drug’s onset, peak action, and duration of action.  In simple terms, when does it start working, when is it working at its highest level, and how long will it have an effect in my body? These characteristics of both Basaglar and Lantus are very similar – the onset is around one hour, there is no distinct peak, and the duration is 24 hours, although some patients may see the effects wear off slightly shorter than 24 hours.

Basal or long-acting insulins can be thought of as water sprinklers that deliver a small amount of insulin at a steady pace throughout a day.

Basaglar vs Lantus dosing

The dosing of Basaglar vs Lantus is identical. If a person is using Lantus as their long-acting insulin and wants to switch to Basalgar, a conversion of 1:1 or unit for unit is used.  When changing between any insulin products, it is not unusual to experience some variation in blood sugar control when a switch is made. This is normal and can be managed by more frequent glucose checks during the first few days following a switch.  Now that Basaglar has been in widespread use for more than a year, some people are reporting that higher doses of Basaglar are needed to achieve the same glucose control they had with Lantus. This doesn’t change the initial dosing conversion of 1:1, but does suggest that careful monitoring and dosing adjustments could be necessary.

Basaglar vs Lantus cost

At most pharmacies, there is a small difference between the cost of Basaglar vs Lantus. For a box of 5 pens, Basaglar will cost roughly $50 less than Lantus.  In most cases, a box of Lantus pens is around $280 while a box of Basaglar pens is about $230. For the cash paying patient, this difference may not feel significant, but insurance companies often negotiate even lower prices and then make one of the options their “preferred” drug.

Switching from Lantus to Basaglar

Basaglar is commonly substituted or interchanged for Lantus based on the lower cost and ease of dosing conversions. With the identical onset, peak and duration between the products, switching is seamless in most cases. You should definitely let your healthcare provider know if you experience a noticeable change in level of glucose control after the switch so that the variation can be addressed.

Basaglar vs Levemir

What is the difference between Levemir and Basaglar

While it might be only a small stretch to say that Basaglar and Lantus are the same, it is not correct to say that Basaglar and Levemir are the same. One difference between Basaglar and Levemir is that they are different long-acting insulins. We know that Basaglar is another name for glargine, but Levemir’s generic name is detemir.  Levemir doesn’t have the same onset, peak and duration as glargine, but they are both considered long-acting insulins. Basaglar has a duration of action of about 24 hours, but Levemir’s effects last for about 20-22 hours. Levemir also has a slight peak, whereas glargine products do not. Basaglar can be substituted or interchanged with Levemir, but careful monitoring is advised.

Basaglar vs Levemir dosing

Basaglar vs Levemir dosing usually starts out with a 1:1 or unit for unit conversion, just like Lantus. This is true when Levemir is used as a once-daily injection.  BUT, Levemir is sometimes dosed twice a day to get longer acting insulin coverage.  When it is used twice a day, the total starting dose of Basaglar may be reduced by 20% initially. This way, it can be monitored and increased as needed. For example, if someone was using 20 units once a day of Levemir, their dose would be 20 units of Basaglar. If they were using 20 units twice a day of Levemir, a Basaglar starting dose might be 32 units. Your healthcare team would make this decision based on your level of blood sugar control. 

Basaglar vs Levemir cost

The cost of Levemir is higher than Basaglar. The current cash price for a box of Levemir pens is about $450, but insurance formularies may have designated Levemir their preferred long-acting insulin. Basaglar is less expensive than Levemir, but still not affordable for most people paying cash for their medications.

Switching from Levemir to Basaglar

Most switches from Levemir to Basaglar are due to cost or mandates by insurance formularies.  Remember that if you were taking Levemir twice daily and are switching to once daily Basaglar, bigger dosing adjustments will be made, and more frequent blood sugar checks to watch your response are advised.

Bottom line

Having less expensive insulin products can only be a good thing.  Unfortunately, a 20% decrease in price is not enough to make a big difference in access to this life-saving drug, but the door opening to competitors is a step in the right direction.  The similarity of Basaglar to Lantus or Levemir in terms of safety and potency should lead to a relatively smooth transition for people making the switch.

Have you ever switched between insulin products?  If you’ve used Basaglar, tell us your experience.

 

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