Insulin degludec (Tresiba)

Hi all,

Anyone try this new insulin yet? My PCP yesterday gave me a pen of this to try out and feedback (also in response to my discussing my possibly developing reaction to levemir - though he also gave me 5 pens of levemir (physician sample! - that’s a month’s supply and a big cost saving - am going to send him a couple of good bottles of wine in thank you / for Christmas)…

Tresiba looks interesting… the half life is 24 - 25 hours, the total duration of action about 42 (and about 3 days to reach steady state). Compares to half life for levemir of 5 - 6 hours… Levermir I need to take 2x/day to get a fairly flat profile. This one looks like it would be pretty flat over 24 hours, so really will be a once a day insulin. The info sheet says less incidents of lows that other insulin analogues, though only marginally (unusually, i woke up at 2 am @ 51 last night, even though I went to bed on target), would like less risk of lows. No idea of the cost comparison to Levemir yet. Will ask when i next go to the drugstore.

I am going on holiday in a few days, so won’t try this one until I am back on normal routine and schedule. Will feed back my experience after that…

I’ve been interested in this for a long time. Didn’t realize the FDA had finally allowed it in the country.

I am in Philippines, not US. But while researching on Tresiba, I saw that it was approved by FDA last September 25 or so. Thus, I assume it will be available in US sooner than later.

I found this in a Medscape article published on September 25, 2015:

The reputation of Tresiba was sullied last year when the German Institute for Quality and Efficiency in Healthcare reported no additional benefit of insulin degludec over existing insulins for adult patients with either type 1 or type 2 diabetes. In July, Novo Nordisk announced that it would stop distributing Tresiba in Germany by the end of September because it failed to negotiate a satisfactory price for the drug with the country’s association of statutory health insurance funds.

If this is true, it doesn’t appear to look like an improvement for the average person with diabetes. The idea of a longer duration basal insulin is appealing but I wonder about the additive effects when overlap occurs. Maybe the best thing would to be to try it.

I just started a sample pen. I do MDI and am hoping this provides a more stable overnight profile than I get with Levemir; theoretically this should be able to do that. I’m not unhappy with Levemir, but while I continue to put off a pump, I’m always looking for the thing that works best for me. You can get degludec pens in U100 or U200. I’m in the US and it remains to be seen if my insurance will cover it.

The results in terms of treatment appear fairly similar. But I do like the idea of a longer acting basal, with only 1 injection a day, that will give a flatter profile. I would think that the longer action would also make things smoother.

Please feedback on how you do with it. I will start my sample pen in mid-January after I am back from Holidays.

I have had a good experience so far – it seems at least as stable as Levemir if not more so, and it’s nice to have a 1x/day injection (I do 2x/day with Levemir). I also like the U200 option as it reduces the volume of injected insulin. However, the ever-generous folks at my insurance company denied coverage for Tresiba, so I won’t be able to report based on any significant duration of use.

It’s new, so the answer is probably “no” . . . but I have to ask in the interest of due diligence: does anyone know whether Medicare intends to cover it?

Do they cover every other product made my novo nordisk? I’m pretty sure they’re big enough to know the right strings to pull to get drugs covered, as it’s pretty key to their business…

For the past month, I have been using Tresiba. My endo gave me a few free pens and I have received a few more. It works really well for me, especially for keeping my morning BG’s under good control. Over the past year, I have cycled through a few basal insulins with varying results. The latest being Levimir. I have had sensitivities to the older basal insulins as well as to the older bolusing insulins. Had to go off the pump due to skin infections. Since using Tresiba, I have been able to lower my overall dose of basal insulin. My insurance company will not cover it (United HealthCare) and it would cost me in the range of $600 to buy it monthly. The manufacturer’s discount card can only be used if the drug is approved by insurance. UHC will not accept a letter of medical necessity from my endo, as has happened with my current bolus (Apidra) insulin as well as the Levemir. Has anyone had experience with challenging their insurance company?

1 Like

I have always been happy with Levemir, but I have been waiting for years for the FDA to approve Tresiba. Now that they finally have, I am hearing only good things about it. I think there’s some Tresiba in my future.

Has anyone NOT had experience challenging their insurance company? Success is another matter. I also have insurance from United Healthcare, and they gave me trouble at every level and on almost every prescription that is D-related. My allergy to something in Humalog was finally accepted as a reason for them to approve Apidra. Levemir was approved at the Tier 3 copay, though the manufacturer’s copay card helped. Apidra has been only via mail order , so I couldn’t take advantage of the copay card :frowning:.
Lantus would have been Tier 2 and Humalog Tier 1. I am currently on a pump, so don’t have to worry about Levemir; however, some of what I’ve heard about the results from Tresiba could make me interested in trying it – though I’m not up for yet another battle with UHC. :angry:

1 Like

My insurance is provided by United Healthcare (under the AARP tent), and it was a matter of mere seconds to determine that it isn’t in their formulary, yet. Sigh. I could get it but I’d have to pay retail. So much for that.

Thanks for your feedback. Not sure how to proceed. I have further reduced my dose of Tresiba, as it is working so well.

A lot of the times your doctors office should be able to do most of the battle for you— although it’s harder for them when a patients chart says things like “great results with levemir” to justify to an insurance company that something other than what they’ve had great results with for years is medically necessary…

My wife often jokes that she fills out prior authorizations for insurance companies for a living…

I have been fighting United Healthcare for two months now and filed two appeals with my doctor’s office and they still denied it. This medicine is bringing down my A1C better than all the other long-acting insulins I have tried without the side effects I have experienced in the past. UHC does not care what is better for the patient or what the doctor thinks you should be on, only their bottom line. They explained they dont have an agreement with that drug company.

I have been fighting United Healthcare for two months now and filed two appeals with my doctor’s office and they still denied it. This medicine is bringing down my A1C better than all the other long-acting insulins I have tried without the side effects I have experienced in the past. My sugars were going low at night if I took it at night. However, when I switched to taking in the morning when I woke up my sugars have been almost spot on and maintains levels all day. The length of effectiveness is longer, so it has helped me alot.

UHC does not care what is better for the patient or what the doctor thinks you should be on, only their bottom line. They explained they dont have an agreement with that drug company.