Persistence with Insulin Glargine 300 IU/ml Compared with Other Basal Insulins—A Canadian Retrospective Cohort Study

Introduction: Insulin glargine (300 units/mL) is a long-acting insulin approved in Canada on 28-May-2015 for once-daily administration in the treatment of T1DM or T2DM requiring basal insulin therapy. Made of the identical molecule as insulin glargine (100 unit/mL), insulin glargine (300 units/mL) delivers the same amount of insulin in one third of the dose. Four pivotal trials compared GLA-300 to GLA-100 with changes in HbA1C from baseline to 6 months. However, persistence is another important medication metric. Persistence with antihyperglycemic therapies have been associated with positive clinical outcomes and reduced health care costs. Objective: To assess 12-month persistence on neutral protamine Hagedorn (NPH), insulin detemir, and insulin glargine using Canadian private claims data. Methods: The study utilized longitudinal private drug plan claims data from IQVIA’s Canadian Private Drug Plan Database. The study was performed looking at persistence for T1DM and T2DM patients combined, without any treatment cessation or change to a different basal insulin. Patients were indexed on their first claim for any of the basal insulins of interest between May 28th 2014 and June 30th 2016, patients’ basal insulin therapy was tracked for 12 months plus a 3 month look-forward period. Patients who did not have continuous coverage or with fewer than 3 claims for an insulin were excluded from the analysis. Results: At 12 months using a 90 day grace period, 63% of insulin glargine 300 IU/ ml (Toujeo®) patients persisted with therapy compared to 54% of insulin glargine 100 IU/ml (Basaglar), 50% for insulin glargine 100 IU/ml (Lantus), 45% insulin detemir 100 IU/ml (Levemir) and 29% of NPH patients. Conclusion: A retrospective cohort study of real-world claims data demonstrated insulin glargine 300 IU/ml (Toujeo ®) had the highest persistence among all basal insulins.