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England Missed Out on Biosimilar Insulin Glargine Savings, Study Says


Investigators said the English health care system has realized only a sliver of the potential savings potential from biosimilar insulin glargine and that uptake is widely uneven across health care centers.

A study of biosimilar insulin glargine uptake in England found huge missed savings over a 4-year period starting with the reference product’s loss of exclusivity in 2014.

The study, published in the current issue of Diabetes Care, said the savings generated from biosimilar use totaled just $1.1 million and the missed savings amounted to $32.1 million, “indicating that only 3.42% of the potential savings were achieved.”

Investigators also noted a large variation in uptake of insulin glargine biosimilars across Clinical Commissioning Groups (CCGs), which serve to facilitate health care services between patients, physicians, and community groups.

Insulin glargine market shares between these groups ranged from 0% to 53.3% in December 2018, according to the study.

“These results may encourage decision makers in England to promote the use of best-value treatments in primary care and to reevaluate variation across CCGs,” authors of the study wrote.

To conduct the study, investigators collected information on all insulin glargine products prescribed by general practitioners up through December 2018. They then calculated total costs of insulin glargine and uptake rates of biosimilars.

They estimated what it would have cost to have filled all of the prescriptions with the reference product versus the actual cost of biosimilar and reference insulin glargine. The missed savings amount was based on what it would have cost to supply all of the patients with biosimilar forms of the drug.

Investigators described the study as the first to analyze adoption rates for insulin glargine biosimilars in the primary care environment in England and calculate the savings achieved and missed. The reference product that formed the basis for the study was Lantus.


Agirrezabal I, Sánchez-Iriso E, Mandar K, Cabasés JM. Real-world budget impact of the adoption of insulin glargine biosimilars in primary care in England (2015—2018). Diabetes Care. 2020;43(6):dc192395. doi:10.2337/dc19-2395

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