BC Pharmacare to cover SGLT-2 inhibitors and to delist the Lantus brand of insulin glargine U100

Announcements, Living With Diabetes | Drugs, insulin, living with diabetes, medications, sglt2

Author: Dr. Tom Elliott

Yesterday BC Minister of Health Adrian Dix announced Pharmacare coverage of the SGLT-2 inhibitor class represented by empagliflozin (Jardiance). Although BCDiabetes would have preferred that all three SGLT2 inhibitors on the Canadian market be covered, the long overdue announcement was most welcome news. Our readers will be aware of the long-running BCDiabetes advocacy campaign for SGLT-2 coverage. Special thanks to all for your support: this includes 1500+ signatories to our on-line petition. BCDiabetes client Mark Schacter deserves special mention – he was interviewed 6+ times by the media in the last 24 months.

In the same announcement Minister Dix gave notice that on November 25 the Lantus brand of insulin glargine U100 would no longer be covered by Pharmacare; the 24% less-expensive brand of insulin glargine U100, Basaglar, will be covered instead. The decision to delist Lantus is part of Pharmacare’s initiative to embrace biosimilar injectable medication to cut costs. Ironically the cost cutting achieved through delisting Lantus paid for the coverage of SGLT2 inhibitors.

BCDiabetes supports the Minister’s decision to move to biosimilars: it is good science and good business – it will create cost savings that can be passed on to British Columbians living with diabetes and other chronic diseases. Such cost savings may well fund CGM/flash and other drugs/devices on the BCDiabetes Pharmacare coverage wish-list.

Re SGLT2 inhibitors: If you are currently paying out of pocket for your SGLT-2 inhibitor (empagliflozin, canagliflozin or dapagliflozin) and you have met the Pharmacare deductible you will be covered for empagliflozin with one or two further steps…..

The first step is for your physician’s office to complete a Pharmacare Special Authority form like this hand-written one for empagliflozin to prove that a set of conditions has been met.

The second step applies only if you are currently prescribed canagliflozin or dapagliflozin, the two SGLT2 inhibitors not covered by Pharmacare: If you wish to take advantage of Pharmacare coverage of empagliflozin contact your doctor and request a prescription for empagliflozin to replace canagliflozin or dapagliflozin (BCDiabetes recommends the dose of empagliflozin as 25 mg ½ tablet daily). Although it might be argued that either of these two other SGLT2 inhibitors may have advantages over empagliflozin, all three of the drugs in the SGLT2 inhibitor class are excellent & from a practical standpoint little or nothing will be lost by converting to empagliflozin from either dapagliflozin or canagliflozin.

Re Lantus delisting: BCDiabetes wishes to reassure every current user of Lantus affected by the Minister’s announcement that the change from the Lantus brand to the Basaglar brand of insulin glargine U100, although an inconvenience & unwelcome to many, will have no adverse health effects. Lantus and Basaglar are essentially the same insulin: they have the same sugar-lowering effectiveness and the same slow release characteristics. The dose of Basaglar will be the same as the dose of Lantus. The insulin-delivery pens are subtly different – users of Basaglar will have no difficulty adapting to the new mechanism.

Your pharmacist will likely be aware of this change but to ensure a seamless transition from the Lantus brand of insulin glargine U100 to the Basaglar brand of insulin glargine U100 for individuals who opt to make the change and avoid additional cost, it is recommended that a request be made of their physician to write a prescription providing the option of the Basaglar brand. After November 25th prescriptions for the Lantus brand of insulin glargine U100 will receive zero subsidy from BC Pharmacare.