Lantus/Toujeo

[miguel81]

Went to my doctor this morning to renew my prescriptions for 12 months. Here, 12 months supply is patched into the chip on your health card.

He told my that the Health Authority were no longer prescribing Lantus, instead we would get Toujeo. I was to use the same dosage as with Lantus.

When I did an internet check I found that Sanofi would lose their patent in a couple of years time on Lantus and so they were introducing Toujeo so that they could still rake in the money. Several worrying things came up. 1. Toujeo is more concentrated than Lantus so why is the dosage the same? 2. In the necessary run-up to getting the appropriate certificate of safety clinical tests indicated that many on the test had to actually take more than their normal dosage of Lantus in order to maintain stability. 3. Whilst one gets 5 pens per pack of Lantus Toujeo only contains 3 pens. Here we have to pay for all medicines so Sanofi are going to rake in more. More because you have to use more, more because you only get three pens instead of five and yet the price is the same.

Does anyone have any further information that may be of help? Maybe Toujeo hasn't hit the UK yet, I don't know.

 

[Lucy Honeychurch]

I was on Toujeo but recently switched to Levermir so I can split the dose. Toujeo can only be taken in one hit and I had problems with early am hypos but high bgs in the day. Levermir suits me much better, but that's just my experience. Sorry I can't comment on the Lantus as I have no experience of it. I see you are in Spain so have no idea how things work there, but it seems wrong to me that they are just changing it with no consultation with you. Can you appeal it?

 

[Robin]

Answering question 1, yes, Toujeo is more concentrated, but it comes in its own disposable pens, where the amount of active insulin in each unit is the same, but the amount of liquid dispensed in each unit is smaller. I believe it was developed mainly to be more comfortable for people who have to take massive doses of basal.
Lantus is still available, and there are now copycats such as Abasalgar, which are cheaper. As you have to pay for your own prescriptions in Spain, it sounds as if someone has made the decision to maximise profit somewhere down the line.

 

[miguel81]

I was on Toujeo but recently switched to Levermir so I can split the dose. Toujeo can only be taken in one hit and I had problems with early am hypos but high bgs in the day. Levermir suits me much better, but that's just my experience. Sorry I can't comment on the Lantus as I have no experience of it. I see you are in Spain so have no idea how things work there, but it seems wrong to me that they are just changing it with no consultation with you. Can you appeal it?

No, it is not the doctor that makes the decisions it is the Health Authority of the Junta - they don't brook appeals. Medicines change all the time as they buy the cheapest brand and substitute what you are used to with a cheaper brand - for instance they just changed my Crestor which I have been on for 12 years to Rosuvastatina, no consultation it just happened. It's a take it or leave it situation so, of course, you take it.

 

[Lucy Honeychurch]

I see, so you just have to get on with it. What happens if it doesnt suit you? I've only been dx a year and am on my third basal to find one that suits me. Having said that this also happens in the UK, my son is asthmatic and his ventolin inhaler was switched to a cheaper brand.

 

[miguel81]

I still have 2 pens of Lantus left so I will have to wait until that runs out and then get the Toujeo and see how I get on. If I do have a bad reaction then I will be back to see the doctor but I will have to wait and see how he and the health authority react.

 

[Lucy Honeychurch]

Talk about playing fast and loose with your health, and I thought the NHS was bad!

 

[Copepod]

Either this January or the one before, at my annual review, I refused to accept my consultant's suggestion that I changed from Humalin I to Toujeo, as I didn't want to use disposable pens because of increased waste and taking up much more space in fridge. He said no other patient had ever cited environmental considerations when chosing which insulin to use, which I found disappointing.

 

[Radders]

Either this January or the one before, at my annual review, I refused to accept my consultant's suggestion that I changed from Humalin I to Toujeo, as I didn't want to use disposable pens because of increased waste and taking up much more space in fridge. He said no other patient had ever cited environmental considerations when chosing which insulin to use, which I found disappointing.

I was given disposable pens once in error. I refused to accept them at the pharmacy for exactly the reason you said.

 

[miguel81]

Forgive my ignorance but I am confused by the term 'disposable pens'. Lantus comes in pens that, once emptied, are disposed of, as are the Novorapid pens. Am I missing something? I remember that when I was first diagnosed and put on insulin I was given vials of insulin and I filled a pen from the vial. Eventually of course the pen had to be disposed of when the needle became blunt. I'm also more concerned about not being able to split the Toujeo injections as stated on here. Why not? I have 8 units of Lantus each evening and 9 the following morning. This procedure has proved highly effective for me as I have had loads fewer nocturnal hypo's since I started the regime. I'm worried now.

 

[khskel]

You can get cartridges of insulin to go in a re usable pen such as the NovoPen Echo I use fot my Novo Rapid.

 

[miguel81]

You can get cartridges of insulin to go in a re usable pen such as the NovoPen Echo I use fot my Novo Rapid.

Oh, I see. Thank you for that information, one lives and learns.

 

[Bloden]

Hi Michael. 🙂 Can you change to Tresiba or Levemir instead? I'm in Asturias, as you prob know - I was offered Toujeo but, after a bit of research, asked for Tresiba instead. (I could've carried on with Lantus, but was having problems with it - it wasn't 'discontinued' by the local health authority). 🙂

 

[miguel81]

Bloden, thanks. I asked for Levemir last year but was told that it is not available in Andalucia. Tresiba is new to me. I only take 17 units of Lantus every 24 hours - 8 at night and 9 in the morning. It is the splitting of Toujeo (or the lack of the opportunity) that worries me the most. I have sufficient Lantus to carry on for the next few weeks and then when I move to Toujeo I'll see what happens. Can't for the life of me think why splitting the Toujeo would be a problem, and I can't find any reason on the Internet not to do so. Perhaps I will email Sanofi and ask what the problem is, or might be.

 

[Bloden]

How annoying not to be able to choose, Michael. I didn't want Toujeo cos I got the impression it was similar to Lantus, which was not really working out for me anymore. A lot of people are happy with Toujeo. Let us know how you get on.🙂

 

[miguel81]

Lantus, split into two doses, worked really well for me - just goes to show how different we all are. I emailed Sanofi this afternoon, just have to wait for their reply. Sanofi in Barcelona are incredibly good and have, in the past, proven to be extremely attentive and efficient. I'll let everyone know how I get on. Now 8 pm and time for Lantus, Crestor and bed. I really need my 11 hours a night sleep! Sad old thing that I am.

 

[mikeyB]

No, it is not the doctor that makes the decisions it is the Health Authority of the Junta - they don't brook appeals. Medicines change all the time as they buy the cheapest brand and substitute what you are used to with a cheaper brand - for instance they just changed my Crestor which I have been on for 12 years to Rosuvastatina, no consultation it just happened. It's a take it or leave it situation so, of course, you take it.

I wouldn't worry about that too much. Rosuvastatin is simply the generic version of Crestor. Same drug, just a cheaper version which will work just the same. A simple case of patent expiry. Exactly the same thing happens in the NHS, which rather confusingly can cause a different colour pack every time you pick up the prescription as prices change in the market.

 

[miguel81]

Just had two very helpful and informative conversations with Sanofi in Barcelona. They agree that whilst Lantus could be split into two injections over 24 hours (she said that Lantus was usually considered as having a 12 hour period of effectiveness) Toujeo is definitely a 24 hour, one shot treatment and should not be split, she also said that of course all diabetics are different and it would need a consultant to determine any deviation from their recommendations. I told her that some people on the forum had written that they needed more than their Lantus dosage. She once again said that all diabetics are different and their needs must be evaluated on an individual basis. I found her attitude and information to be enormously different to some of the responses so-called experts have given members of this forum She was very refreshing and I thanked her for it. I'll give Toujeo a fair crack of the whip but any problems and I'll start shouting from the rooftops.