Semglee biosimilar as the best value insulin glargine biosimilar.
Semglee is the best value, preferred long-acting insulin glargine product in Dorset. In line with NHSE recommendations, PCN teams are asked to ensure that biosimilar insulin glargine (Semglee) accounts for at least 50% of all insulin glargine prescribing in primary care.
Clinical appropriateness should always be considered, and any switches should be discussed and agreed with patients through shared decision-making.
Exclusion criteria:
- < 18 years of age
- Patients prescribed Lantus 100units/ml 10ml vials
- Patients prescribed Lantus 100units/ml solution for injection 3ml cartridges
- Patients prescribed Abasaglar 100units/ml solution for injection 3ml cartridges
- Patients prescribed Toujeo 300units/ml solution for injection pre-filled pens
- Patients who are pregnant or planning to become pregnant
- Patients who have their insulin administered by a district nurse
- Patients who have not had a HbA1c blood test or diabetes review in the last 12 months
- Documented intolerance or allergy to any excipient listed in the Semglee SPC or have failed a previous trial of Semglee
Extra care should be taken when considering Semglee switch for patients living with cognitive impairment, learning disability, dementia or Alzheimer's.
- Biosimilar insulin glargine (Semglee) is now available in the UK and is significantly cheaper than Abasaglar, Lantus and generic originator insulin glargine products
- A biosimilar medicine is a biological medicine which has been shown not to have any clinically meaningful differences from the originator medicine in terms of quality, safety and efficacy. Where NICE has already recommended the originator biological medicine, the same guidance applies to a biosimilar. NHS England aims to drive a step change in the uptake of biosimilar medicines by integrated care systems (ICS)
- Biosimilar insulins offer a cost-effective alternative to prescribing originator insulin products
- Switching to insulin biosimilars will help PCN teams care for patients within their NHS England financial envelope and hence,release funds to improve unmet needs in prevention.
- Early switching is recommended to maximise cumulative in year cost savings
Notify community pharmacy colleges of the intention to switch to Semglee biosimilar.
Work with community pharmacy colleagues to ensure sufficient stock of Semglee is available to support the switching programme and minimise disruption to patients, GP and community pharmacy teams.
Run the SystmOne searches provided to identify existing patients prescribed Lantus, Abasaglar and generic insulin glargine pre-filled pen products other than Semglee pre-filled pens.
Dorset SystmOne GPs>PINH 26 27> 4a Biosimilar insulin>4d Work to do: T2DM with Insulin glargine prefilled pens RPT consider switching to Semglee biosimilar prefilled pens
Dorset SystmOne GPs>PWNH 26 27> 4a Biosimilar insulin>4d Work to do: T1 diabetes with Insulin glargine prefilled pens RPT consider switching to Semglee biosimilar prefilled pens
A risk management approach should be taken, to any batch-switching arrangement, which includes safeguards which enable patients to have a review, should they have any queries or changes to their condition.
Agree a patient-centred process for switching patients within the practice and convert patients accordingly.
Switch patients to the appropriate Semglee device as below:
| Originator insulin | Switch to equivalent biosimilar insulin product |
|---|---|
| Lantus Solostar (insulin glargine) 100units/ml solution for injection 3ml pre-filled pens | Prescribe Semglee 100units/ml solution for injection 3ml pre-filled pens |
| Generic insulin glargine 100units/ml solution for injection 3ml pre-filled pens | Prescribe Semglee 100units/ml solution for injection 3ml pre-filled pens |
| Abasaglar KwikPen 100units/ml solution for injection 3ml pre-filled pens | Prescribe Semglee 100units/ml solution for injection 3ml pre-filled pens |
Ensure all insulins including biosimilar insulins are prescribed by brand name and provide the strength or the provided insulin.
Switching a patient to Semglee can be done unit-to-unit based on the previous long-acting insulin dose.
Check patients get the intended insulin and are trained on how to use it.
Patients should continue to monitor their blood glucose as usual and continue to use their current insulin needles.
Encourage patients to use up existing insulin supplies prior to starting their new biosimilar insulin.
Safety net the patient to report any concerns about glucose levels to the practice diabetes team.
Update the repeat prescription template and summary care record.
Update the patient's insulin passport.
For further information and advice for healthcare professionals when starting treatment with a biosimilar, the MHRA has guidance on minimising the risk of medication error with high-strength, fixed combination and biosimilar insulin products, which ensures the risk of medication errors with insulins is minimised. Biosimilar insulins are black triangle drugs. Report any suspected adverse effects to the MHRA via the Yellow Card reporting scheme.
Provide appropriate counselling where appropriate.
How to communicate this to patients:
Use the template patient text message and letter in SystmOne to notify patients of the change.
Text message:
"NHS Dorset have asked GP teams to review prescriptions for insulin glargine (lantus or abasaglar) pre-filled pens and switch to a new pre-filled pen Semglee. Semglee is a biosimilar insulin used to help with cost-effectiveness and availability. Semglee is considered clinically interchangeable with other insulin glargine pens. The dosage will not change, and the insulin will work in the same way. Please use up your existing insulin supply prior to starting the new Semglee pen. Please read the patient information leaflet provided and if you have any questions regarding this change, please discuss with your Community Pharmacist or GP practice team. "
Template patient letter:
References:
NHS England » What is a biosimilar medicine?
NHS England » Biosimilar medicines
Biosimilar uptake patient letter template
NHS Dorset Biosimilar documents can be found on the front page of the Dorset Formulary
Dorset adult insulin formulary for type 1 & type 2 diabetes
NICE NG17: type 1 diabetes in adults: diagnosis and management
Tracking achievement:
Numerator divided by Denominator from SystmOne searches x 100 for %
