Lantus is a long-acting basal insulin which has been around since 2000. That’s about to change, but don’t panic. Essentially it’s just a name change.
Lantus is a U100 form of insulin glargine, made by Sanofi. Its patent protection eventually ran out, so new versions started appearing from other companies.
Lilly (who also make Humalog) now sell Basaglar (a “biosimilar” U100 insulin glargine) in the US, but it is not on the Australian PBS.
Back in October I wrote about the PBS introduction of Semglee, a U100 insulin glargine from Mylan. I think there has been pushback from medicos on the ability of pharmacists to do brand substitution on an as-important medication as insulin though. I don’t know anything about the sales figures.
Incidentally Toujeo is Sanofi’s U300 insulin glargine. Due to the higher concentration it has a longer life, as I described when it was added to the PBS in 2018.
A note about “SoloStar”
Some people (including doctors) have been very confused about this.
SoloStar is not a type of insulin!
SoloStar is Sanofi’s name for their disposable insulin pen cartridges. Just like Novo have their FlexPen and FlexTouch pens for various insulins, and Lilly have their KwikPen for Humalog and Basaglar.
Apidra (a quick-acting insulin) is available in Apidra SoloStar format.
There’s also Lantus SoloStar, and Toujeo SoloStar.
As as aside, I do know a story of one mistake where a doctor charted “SoloStar” for a hospital patient, and Apidra SoloStar was the first one that came up on the computer. It was only realised when the injection of an “evening dose” of >20U of Apidra was being administered. Luckily a medical crisis was averted, but it highlights the need for caution: SoloStar is not the name of an insulin!
Now Sanofi has introduced their Optisulin U100 insulin glargine. In their words:
OPTISULIN® is the same formulation as LANTUS® from the maker of LANTUS® and is available in the same familiar presentation and devices, including the SoloStar® pre-filled device and cartridges for use in either AllStar Pro® and JuniorStar® reusable pens.
Lantus is going away
Optisulin was listed on the Australian PBS as of the 1st of January 2020. And Lantus will be delisted from the PBS as of the 1st of July 2020. Prescriptions for Lantus will still work as it’s just a pharmacy substitution, but presumably prescriptions will start to be written for Optisulin instead.
Sanofi does say:
It requires no dose adjustment when transitioning from LANTUS® and patients transitioning to OPTISULIN® should continue to administer their dose at the same time of day and monitor their blood glucose levels as directed.
However, close blood glucose monitoring is recommended for all patients during the transition from LANTUS® to an alternative insulin glargine 100 units/mL and in the initial weeks thereafter.
No-one’s expecting any complications from changing to Optisulin, but as with any change to your treatment routine, monitoring is important!
Why the change?
I’m sure Sanofi has been under pricing pressure to reduce how much they charge the government for Lantus, especially with the availability of third-party versions. A cynic could point out that by rebranding the product they get to do this without actually dropping the price of Lantus. But I’m sure that’s a very simplistic point of view…
It was easy to distinguish Lantus and Toujeo even though they are both available in SoloStar pen format.
Lantus used a purple button and label edge (and purple on the tips of cartridges for refillable pens).
Toujeo has a light-green button and label edge.
Just to mix things up a bit, Optisulin pens seem to have a purple button and light-green label edge. Concentrate on the button colour and you shouldn’t get confused.
I don’t yet know what colour the cartridge tips will be.