To assess the change in HbA1c after initiation of biosimilar follow-on insulin (Basaglar) or reference insulin (Lantus) among patients with type 2 diabetes. We also compared treatment adherence, safety events and costs at 1 year after initiation of insulin.
Materials and Methods
Using claims data from a large US health plan during 2016-2020, we identified adults with type 2 diabetes who initiated either Basaglar or Lantus. Generalized linear regression modelling assessed the differences in outcomes between the two groups. A 0.4% margin was used to determine non-inferiority for HbA1c.
The study included 1136 Basaglar users and 6304 Lantus users. Both Lantus and Basaglar groups showed more than 1% reduction in HbA1c over 6 months and over 12 months. Reduction in HbA1c with Basaglar was similar (non-inferior) to that with Lantus, with an adjusted difference of Basaglar to Lantus of 0.14% (95% CI −0.02 to 0.30) over 6 months and 0.17% (95% CI 0.02 to 0.32) over 12 months. Rates of adverse events were similar for both hypoglycaemia and vascular events. The Basaglar group showed higher adherence in terms of proportion of days covered (adjusted difference 0.06, 95% CI 0.04 to 0.08). Medical costs were similar, but the cost of Basaglar was lower (adjusted mean cost difference −$462, 95% CI −$556 to −$363) after adjustment.
In patients with type 2 diabetes, Basaglar provided similar glycaemic control compared with Lantus, had a similar safety profile and lower drug costs, and showed more favourable adherence.
CONFLICT OF INTEREST
TTP, XC, RH and ADV are full-time employees of Anthem. JB is a full-time employee of HealthCore, a subsidiary of Anthem. JA is a full-time employee of IngenioRx, a subsidiary of Anthem.
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Table S1. A1c change results after excluding extreme values at 1st and 99th percentiles
Table S2. Baseline patient characteristics after propensity score-matching*
Figure S1. Distribution of propensity scores pre-and post-matching
Table S3. Propensity score-matched* outcomes
Table S4. Code list for Baseline Conditions
Table S5. Drug Codes
Table S6. Code list for Adverse Events
Table S7. Baseline patient characteristics for Basaglar and Lantus pens subgroup
Table S8. Insulin doses, adverse events, and treatment adherence for Basaglar and Lantus pen subgroup
Table S9. HbA1c change results for Basaglar and Lantus pen subgroup
Table S10. All-cause medical and pharmacy costs after insulin initiation for Basaglar and Lantus pen subgroup
Table S11. Insulin doses, adverse events, and treatment adherence for Basaglar and Lantus subgroup with at least two diagnoses for Type 2 diabetes and excluding Type 1 diabetes
Table S12. A1c change results for Basaglar and Lantus subgroup with at least two diagnoses for Type 2 diabetes and excluding Type 1 diabetes
Table S13. All-cause medical and pharmacy costs after insulin initiation for Basaglar and Lantus subgroup with at least two diagnoses for Type 2 diabetes and excluding Type 1 diabetes.
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