Biosimilar noninferior to insulin glargine with lower cost in type 2 diabetes
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Among adults with type 2 diabetes, biosimilar insulin was noninferior to insulin glargine for lowering HbA1c, had similar safety and cost less, although not significantly, according to data.
The goal of the study was to evaluate change in HbA1c after initiation of biosimilar follow-on insulin (Basaglar, Eli Lilly) or reference insulin (Lantus, Sanofi) among adults with type 2 diabetes and to compare treatment adherence, safety events and costs 1 year after insulin initiation.
Timothy T. Pham, PhD, a senior researcher at Enterprise Health Services Research, Anthem, in Indianapolis, and colleagues used claims data from a large U.S. health plan collected from 2016 to 2020 to identify adults with type 2 diabetes who initiated Basaglar or Lantus.
Overall, 1,136 Basaglar users and 6,304 Lantus users were included in the study.
At 6 and 12 months, both groups had lowered their HbA1c by more than 1% from baseline.
Compared with Lantus, Basaglar was associated with a noninferior reduction in HbA1c; specifically, the adjusted difference of Basaglar to Lantus was 0.14% (95% CI, –0.02 to 0.3) at 6 months and 0.17% (95% CI, 0.02-0.32) at 12 months.
Similar rates of hypoglycemia (Basaglar, 1% vs. Lantus, 1.5%; adjusted OR = 0.88; 95% CI, 0.46-1.7) and vascular events (Basaglar, 7.6% vs. Lantus, 9.4%; aOR = 1.13; 95% CI, 0.8-1.46) were reported between groups.
Medication adherence, or adjusted proportion of days covered, was higher for the Basaglar group (adjusted difference, 0.06; 95% CI, 0.04-0.08). Although medical costs did not significantly differ between groups, the cost of Basaglar was lower after adjustment (adjusted mean cost difference, –$462; 95% CI: –556 to –363).
“Basaglar was similar to Lantus in safety and effectiveness; Basaglar showed more adherence and generated savings in drug costs,” the researchers wrote.
They noted that as more biosimilars, such as Semglee (Mylan), are introduced, increased price competition may lead to lower costs.
“While costs are in part determined by contractual agreements among manufacturers, health insurers and/or pharmacy benefit managers, savings introduced by these medications may be passed on to the consumer,” the researchers wrote. “Our study results highlight the potential that biosimilar/follow-on biologics offer in terms of expanding patient access and improving affordability.”
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