Options? - Pharmacy Service Stopping Lantus Solostar

I just received a letter from my pharmacy service that it will no longer support Lantus Solostar after Jan 1, 2022.

Currently, I use 2 injections per day, one at 7 AM of 18 units, and another at bed, of 16 units.

Cost is not a concern, as it is covered, so wondering, in terms of usage, problems, quality of life, consistency - whatever - what do we think of these options?

Basaglar is a biosimilar to Lantus. I had to switch for the same reason awhile back, and my doses remained the same. It seemed to work the exact same.

There are pluses and minuses to the other two. I tried Tresiba for awhile, but it was very inflexible because it lasts for so long. I switched back to Lantus.

Hope one of these work alright for you!

2 Likes

I used Levemir, but when comparing it against Lantus, I disliked the Levemir pen - the injection quality was less certain - and the action of Lantus was a bit gentler or prolonged, so less risk of overnight lows.

I love Tresiba. I switched from Lantus to Tresiba several years ago. It works very well for me. I used to split my Lantus dose, but just take 1 daily dose of Tresiba.

1 Like

From what I remember, you have pretty tight control, e.g., < 6, so wondering if you use a pump. I’m thinking that your tight control makes Tresiba more tolerable. I might need a bit more flexibility to dose with 2 separate shots.

Let me know.

My control is quite tight usually around 5.1. I take 11 units of Tresiba when I wake up and Novolog before meals and as needed. I don’t use a pump.

I do wish Tresiba had 1/2 unit pens.

1 Like

Check the price for local pharmacy. Check the plan price, Good RX, Script Saver RA, and BlinkRX. Not all pharmacies use each discount card. Also do not forget the Lantus branded discount card.

Although I appreciate the willingness to help, as mentioned, price is not a concern. All of my copays are $15, even for a 3-month supply.

What i really need want to know is personal experience with any of my alternatives to Lantus, so anyone that has used any or all of the following, Tresiba, Levemir, or Basaglar…

Yeah, I think Levemir has more of a peak than Lantus. I’ve never used it though.

Dose changes with Tresiba weren’t visible for a really long time for me - longer than other people have reported. It took about 36 hours for the new doses to really be noticeable. You may not have this problem. If your basal needs are pretty steady from one day to the next, then you’d probably really like Tresiba.

Or you can use Basaglar if you just want to stick with what you already know (Lantus).

Hopefully some other folks will report their experiences.

1 Like

Tresiba gives me honest 24 hour coverage, which Lantus never did.

Strongly recommend Tresiba!

1 Like

I tried Levimer after my insurance company stopped letting me get Lantus which I had taken for years. Levimer is one of the few insulins I have used that didn’t work well for me. I can’t remember why. After trying Levimer I tried Tresiba. My insurance company eventually said that they wouldn’t cover Tresiba anymore and that I needed to take Basaglar. My GP told my insurance company that Tresiba worked extremely well for me, so the insurance company said that I can use it.

I rarely change my dose of Tresiba, because I find no reason to. My carbs, exercise and weight rarely change. I do change my Novolog but not my basal insulin. It may sound funny, but only taking one shot of Tresiba instead of 2 of Lantus is a very big deal to me even though I don’t mind taking many Novolog shots a day.

1 Like

Also don’t forget to check mail order prices from Canada. I believe they charge about $187 for a box of 5 Lantus pens

My experience with Tresiba is now five years old. That’s when I switched to DIY Loop. I was so impressed with its performance that I tried to do an “untethered” protocol when starting Loop. That didn’t last but it was not Tresiba’s fault.

If I decided to go on MDI, I would choose Tresiba as my basal insulin. One of the things I really liked about it was that you could forget taking a dose and still take it 8 hours later with no apparent disruption in your glucose control.

I took my daily dose in the evening and when I forgot, I could just take it the next morning and resume my evening dose that same day. Of course, your situation can differ and experimentation is the best teacher.

Then one thing I had to learn is that due to Tresiba’s 42-hour nominal duration, you had to let 2 or 3 days elapse when you increased/decreased your dose for better performance. The day to day overlap eventually produces a “steady state” for your basal. Patience is not my strong suit so this required some effort on my part.

3 Likes

You shouldn’t see any difference by using a biosimilar as katers mentions. Its structurally an identical molecule (pretty much).

2 Likes

Maybe someone can explain the benefit of pens.
I went from vials to pumping, where I still use vials.

I have vials of lantus for when I need for emergency or for swimming where I’m in the water a lot, vacation snorkeling etc.

I find a standard syringe very easy to use.
Is there something that is really good that makes vials and syringes pale?
I mean you need to change the needles correct?

I gave injections for well over 50 yrs before switching to pens. I love pens and wouldn’t want to go back to using vials and syringes. Pens are just so very easy and quick. Yes, the needles do need to be changed, which I found out the hard way, but I still don’t change them after every injection.

I use a very tiny needle and rarely feel the injection.
The pen takes up very little room in my purse, so it is just grab and go. Also using a pen is less noticeable to others than using a syringe when I am in a restaurant. Someday I hope to go to restaurants again.

3 Likes

One benefit of pens over vials+syringes, would be if you are taking a low dose, such that you never finish a vial before it’s “use within 28 or 30 days of opening” recommendation common for analog insulins.

A lot of us regularly broke the 30 day recommendation. For example my basal is 20 units a day or lower, so I was using the same 1000ml vial for 50 days. If I had been following the letter of the 28 day rule I would’ve been throwing away almost half the 1000 units in each vial.

2 Likes

Pen: super convenient and unobtrusive. Can carry in your pocket ready to use. Insulin is already loaded, saving you that step. Back when I was injecting many times a day, I would reuse my needle, perhaps changing half way though the pen fill. I have one pen that allows half-unit increments.

One thing I never did was inject through clothing. I would be concerned about introducing foreign material. But I did not alcohol swab and all that: just inject (5 seconds) and carry on with my life.

2 Likes

I have been injecting through my clothing for over 40 yrs and I have never had any kind of skin infection. I am pretty sure that I heard Dr Bernstein say that he does this also. Of course when I was first dx in 1959, I followed all the steps including using alcohol.

2 Likes

I used to inject through clothing but I would get little blood spots on my clothes.