Very Inexpensive Lantus Biosimilar - may work better than Lantua

Discussion in 'Acromegaly / IAA / Cushings Cats' started by phil94028, Jan 29, 2022.

  1. phil94028

    phil94028 New Member

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    Jun 13, 2021
    Mylan now has a generic Insulin Glargine, which is identical to to Semglee, their on brand, which went crazy expensive at the end of 2021.

    Costco member price is $83 (USA) for 5x3mL pens. This is half even the Lantus Canadian import price and less than 20% of US Pharmacy pricing.

    Insulin Glargine-yfgn 5x3mL Syringe Carton. The NDC is 49502-394-75. The 10 mL vial is available as well. Technically a new prescription should not be needed but pharmacists do not always understand this.

    My cat is well over 2 years in from an Acromegaly dx. This biosimilar for reasons unknown seems to produce a much flatter 12 hr BS curve than Lantus and *way* better than the Baslagar/Lilly product.

    This is just on a sample of one cat but who is on a Freestyle CGM with backup Accutrak, so quite accurate data and also with repeated switching of the brand. The Mylan version, in Cats, seems to be active for more than 12hrs. The doses overlay and no wild ride up or down.

    The dosing for this cat is currently 14U bid but has been as high as 38U bid with similar results.

    Hope it helps other people getting through a lot of Insulin!
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Any chance you have a spreadsheet showing your cat's blood sugar test results? That would make the claims of much flatter curves easier to see.

    A lot of cats on higher doses end up on Levemir, because the Lantus (or other glargine biosimilars) acid base stings at higher doses. Levemir often gives flatter cycles too.
     
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  3. phil94028

    phil94028 New Member

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    Post was more about insulin pricing in case it helps people. I think most cats on these crazy doses are more limited by cost, so they do not survive.

    Sample of one cat would be meaningless for treatment/drug choices, this is just anecdotal data. You need a controlled trial for anything useful. For this cat, it is pretty clear there are significant differences between the biosimilars. They were never tested on cats anyway for equivalence at the faster metabolic burn rates. More an observation that the cheaper ones may not be less effective than the branded. This may not be general, everyone else may get different results.

    As to the alternates, the cat has done a consult with a national/global expert feline diabetes and Acromegaly on the dose and insulin choice. His advice was to stick with Lantus and he as seen the doses get up to beyond 100U per day. In this case (and again may not be general) the cat does not even notice getting the shot. His warning was to watch out for tumor secretion to drop unexpectedly, as that is often fatal at the very high doses.

    Levemir USA goodRx pricing is six times more expensive than the generic Glargine so at a 50U bid dose would be $800 a month more expensive.
     
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    I agree, it's great to see there are cheaper insulin options available, if your cat is one that can tolerate glargine. In Canada, Lantus and Levemir are very similar prices, and quite close to what you are paying for the generic glargine in the US. Most people in the US buy their Levemir from Canada.

    I've seen doses here of more than 100U per day, though not common. And the ones I saw were on Levemir.
     
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  5. phil94028

    phil94028 New Member

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    It sounds like there must be some better sources in Canada than I have found? Marks Marine Pharmacy in Vancouver where I got the last 15mL carton of Lantus from a few weeks ago is $165 (plus $40 shipping at your own risk).
    Insulin Glargine-yfgn (Mylan) is $83 (plus sales tax) at Costco - which is way more convenient! Finding the new NDC to order it was the hard part - hence the post.
     
  6. Pamiam

    Pamiam New Member

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    Is the $83 vial from Costco price per vial? The Lantus from Marks Marine is multiple pens. Just trying to figure this out.
     
  7. phil94028

    phil94028 New Member

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    Hi - per the original post the NDC is for a carton of pens (5x3ml) for $83 USD total. You have to be a costco member to get this price. I have found that much easier than vials but know everyone has a preference.

    I *think* a 10mL vial at costco will be $65 USD but stress I have not tried to order that. You would want to check the NDC code for it and make sure costco orders that rather than the *much* more expensive but identical Semglee.

    I had lots of fun getting the prescription written correctly and walking the pharmacist through ordering it. The reps at GoodRx were very helpful in explaining the mysteries of this and the messed up prescription drug business but ultimately much more expensive than costco. The NDC is the important bit of information you need. You can look it up on the FDA website.

    For a "normal" diabetic cat needing much less insulin, I think costco will sell you one pen at a time but not verified this. Walgreens will for sure but the price may be an issue.

    Phil
     
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  8. MisterBillie

    MisterBillie Member

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    This is U-100, right?

    I added a tab for this to the Insulin Cost Spreedsheet in my signature. If all this is true, then this is a fraction of the price of Levemir from Mark's Pharmacy.

    So what do we need to do to figure out if this stuff works for cats? How does this compare to Levemir?
     
    Last edited: Jun 19, 2022
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    We have cats using it now. It is a biosimilar to Lantus. I haven't seen any difference in it's action compared to the name brand Lantus. And we've had people do comparisons with Basaglar with no noticeable difference. Without a spreadsheet from the poster, no way of seeing the differences they are seeing.

    Lantus and the generic are glargine. Levemir is determir insulin. Two different but both long lasting insulins. This post describes some of the differences. What is the Insulin Depot?
    The biggest difference for a higher dose cat is that Lantus (and the biosimilars) is made with an acid base that can sting at higher doses. That's the main reason a lot of people switch to Levemir. There are some cats that are fine on Lantus and higher doses.
     
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  10. MisterBillie

    MisterBillie Member

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    Sting, meaning the cat feels visibly uncomfortable when doing the shot?
     
  11. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Yes. That’s what it means. I have heard human diabetics complain about the Lantus burn. This was one reason why my vet discouraged me from using it. We did end up trying Lantus anyway. My cat Darcy did not flinch when I gave him pretty large doses of Lantus; I don’t know if that was just because he was being sweet or it didn’t bother him. He was a very sweet and compliant cat.
     
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  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Neko would occasionally try to walk away from the Lantus shot. She purred during the Lev one. For some cats it’s extreme enough to be a personality change. With TiMousse, the caregiver had to stop insulin until I suggested she try Levemir. He snarled at shot time. Somewhere on the Think Tank forum is a thread about how cats reacted differently with the two insulins. Not all cats that react are high dose.
     
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  13. MisterBillie

    MisterBillie Member

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    So why is there no activity in this thread?Why isn't everyone buying this? I'm about to run out of Levemir, should I try this insulin from Costco or?

    Are you sure the math/pricing is right? You're telling me the price when calculated out is $5.50 per pen for the generic version of this $100+ Semglee pen on Chewy?: https://www.chewy.com/semglee-insulin-glargine-yfgn/dp/515406

    Going to call Costco tomorrow to figure this out.
     
    Last edited: Jul 27, 2022
  14. MisterBillie

    MisterBillie Member

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  15. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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  16. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    At Mister's size of dose, there is a strong chance that Lantus/glargine's acid base will sting him. That's one of the main reasons people switch to Levemir with higher dosed cats.

    The original poster said $83 US for a pack of 5 pens, or about $16.60 each pen. Given the exchange rates between US and Canada, this is not much different from the OTC price of glargine in Canada. Note, Marks the pharmacy does "mark" the price up to ship to the US.

    FDA has said the biosimilar glargine is identical to Lantus/glargine. The poster doesn't have a spreadsheet so we have no way of verifying the claims of better insulin action. We have seen people switch from Lantus to Basaglar, and seen absolutely no difference on the spreadsheets. I'm a "show me the evidence" kind of person. ;)

    Summary, there are now cheaper options for Lantus and it's biosimilars in the US. But it might not be a good solution for Mister.
     
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  17. MisterBillie

    MisterBillie Member

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    OP = original poster of the thread. In other words, the person who created the thread.

    @Wendy&Neko I just confirmed with my local Costco the following pricing:
    The price of each pen is $17.49.
    1 box (five 3ml pens) is $75.

    This is WAY cheaper than Levemir. To the point where it'd save me thousands potentially over a year. Should I buy a pen and see how much it stings? Can I stick with the same dosing as Levemir?
     
  18. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Eddie is currently on 15u Lantus and he's starting to give a low growl of annoyance at shot time, which is just as he's finishing his meal. I've been concerned to have him associate the shot with meal time, which should be a moment of enjoyment...
     
  19. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Our guidelines for switching from one depot style insulin to another, ie. Lantus to Levemir or vice versa, is start at 70% of the dose of the original insulin, which would be around 24 units. Some cats have a strong reaction to the insulin switch, so it's for safety. You can increase quickly after if you see it's not doing anything, but do post for help as you need some time to let the new insulin depot build. A pen has 300 units in it, so that would give you 10-12 shots for the experiment. If it stings, you can go back to the original dose of Levemir.
     
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  20. MisterBillie

    MisterBillie Member

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    Last edited: Aug 21, 2022
  21. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    I've emailed vet about this insulin. The article mentions the FDA. Does anyone know if it's available in Canada?
     
  22. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    Actually, I can get Levemir here but thanks for putting out the call.
    I thought the article was referencing another insulin that was twinned with Lantus/Glargine (the offending stinging insulin!).
     
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  23. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Okey Dokey :cat:
     
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  24. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    :cat:
     
  25. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    First, it's ECID if a high dose cat feels the sting of glargine. The insulin mentioned is a biosimilar or the same as Lantus - as per the FDA. Last I looked (been a few months), it was not yet available in Canada. I've seen Lantus/glargine acrocats over 25 units without sting. Though definitely the minority. I've also seen cats on small doses feel the sting. Second, the availability of this biosimilar insulin has been discussed a lot on the Feline Health forum, where we suggest new members post. I've posted the link to the same article there before. For people in the US, it's usually mentioned as a cheaper option. It's also mentioned in the Sticky Note on insulins on the top of the Lantus/Levemir/Biosimilars forum.

    @Diane Tyler's Mom Levemir is really expensive at Marks compared to over the counter at pharmacies in Canada. They "mark" it up quite a bit.
     
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  26. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    @Wendy&Neko
    I have to soon renew Eddie's insulin prescription (Lantus) and I'm thinking of switching to Levemir because he is getting quite reactive with the injection of 15.5u.
    Would you kindly remind me of the dosing protocol when making the switch from Lantus to Levemir? i'll have to convince the vet who responded to the FDA article discussed here saying he's never heard of this biosimilar and maybe I want to try Prozinc???
     
  27. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    See post #19. Why would you want to change to a biosimilar that will have the same acid base when you know Eddie already feels the sting from Lantus? The new product is a big deal in the US where Lantus is really expensive, not so much in Canada.
     
  28. Jodey&Eddie&Blue

    Jodey&Eddie&Blue Well-Known Member

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    I was under the impression that Levemir, contrary to Lantus/Glargine, does not sting as does Lantus in high doses. Is there not a different base to Levemir? If so, I've been mistaken.
     
  29. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Sorry, I thought you were interested in the biosimilar to Lantus, which is what this thread is about. Levemir is completely different and does not sting. And there are no Levemir biosimilars that I have heard of.
     
  30. MisterBillie

    MisterBillie Member

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    Been using this insulin for months, everyone on these forums should be using it.

    You can buy just one pen at Costco or Hy-Vee to try it to see if your cat doesn't mind "the sting". For mine, it is a non-issue.
     
  31. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    We've seen quite a few people on the Lantus/Biosimilars forum use it too. I haven't seen any difference between it's action and Lantus. And it looks like it's a lot cheaper if you live and buy insulin in the US.
     
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  32. MisterBillie

    MisterBillie Member

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    Yep, it saves you thousands of dollars per year potentially, see the Comparison Spreedsheet I made and cycle between the three tabs in the spreedsheet
     
  33. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    It looks like you have Mister into some good numbers lately. That’s very good to see after you struggled for so long. He is even in such good numbers now that you probably need to get used to doing more spot BG checks on him and even a before bed test at night. How does he seem overall in his demeanor? Does he seem to feel well? Is he feeling better in these lower numbers?
     
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  34. MisterBillie

    MisterBillie Member

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    It's been going well lately. I don't wanna jinx it because this happened before and then he went back into high numbers again.

    His demeanor has definitely improved, he has the zoomies more often now. He jumps up on the bed now everyday. When he was stuck in the 300s he would never do that and just slept on the floor instead. His appetite is more predictable, he eats his wet food without being picky anymore.
     
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  35. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    All good to hear!
     
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  36. MisterBillie

    MisterBillie Member

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    Wow, unbelievable numbers lately. Might start doing 2u decreases until I see higher numbers?
     
  37. Suzanne & Darcy

    Suzanne & Darcy Well-Known Member

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    Oh wow. This is exciting. Look at those greens! I do think reductions will be in Mister’s near future!
     
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