Related Experiment Video
Updated: Jan 12, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Insulin Glargine Utilization and Spending Before and After the First Biosimilar Insulin Glargine: A Real-World Data
Jonathan H Watanabe1, Michael W Strand2, Weining Shen3
1Department of Clinical Pharmacy, University of California San Francisco, School of Pharmacy, San Francisco, CA, USA. Jonathan.watanabe@ucsf.edu.
Background:
Insulin glargine Lantus® has been a top 10 Medicare Part D medication by spending for multiple years and was the only glargine until 2015. In 2016, Basaglar®, the first biosimilar referencing Lantus® was released. In 2020, the first biosimilar to achieve FDA-interchangeable designation, Semglee®, became available. This is the first large health-system study of utilization, costs, and savings attributable to alternative glargines.
Objective:
Using the University of California Health Data Warehouse, we assessed utilization, costs, and savings before and after alternative glargines introduction to inform access and policy considerations for patients with diabetes.
Design:
Retrospective, observational, longitudinal study.
Patients:
110 659 glargine users with type I or II diabetes.
Main Measures:
Number and proportion of patients receiving Lantus®, Basaglar®, and Semglee® glargines daily, by age category with spending and savings estimates.
Key Results:
Lantus® user proportion reduction after Basaglar® availability was associated with monthly spending reduction from $191 to $147 for patients under 65 and from $191 to $158 in those 65 and older from January 2015 to January 2022. Glargine users increased from 8 541 to 39 536 from 2012 to 2022. Basaglar® users increased from 6 on January 1st 2017 to 6 010 on January 1st 2022. Semglee® users increased from 29 on January 1st 2021 to 207 on January 1st 2022. Number treated for $100 000 increased after biosimilar availability, from 132 to 171 among patients under 65 and from 124 to 151 among patients 65 and older from 2015 to 2022. Annual savings attributable to biosimilars was $19.05 million in 2022 in the study population.
Conclusion:
Basaglar® release was associated with spending reductions that accelerated after Semglee® availability. Biosimilar availability was associated with increases in glargine users and users per fixed-dollar amount. This study provides supportive evidence for biosimilar adoption policies.
Primary Funding Source:
None.
Related Concept Videos
Glucagon-like Receptor Agonists
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
Oral Hypoglycemic Agents: Glinides
Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Drug Products: Biologics, Biosimilars and Interchangeables
Insulin Formulations: Types and Delivery
Short-acting insulins are divided into...
Dipeptidyl Peptidase 4 Inhibitors

