lNATIONAL FUNDING/ACCESS DECISIONS
All Wales Medicines Strategy Group (AWMSG) Decisions
TheAll Wales Medicines Strategy Grouphas advised
(October 2016 ) that insulin degludec (Tresiba®)isnot
recommended for use within NHS Wales for the treatment
of diabetes mellitus in adolescents and children from the
age of 1 year.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for injection
▶Tresiba FlexTouch(Novo Nordisk Ltd)
Insulin human (as Insulin degludec) 100 unit per 1 mlTresiba
FlexTouch 100 units/ml solution for injection 3 ml pre-filled pen| 5 pre-
filled disposable injectionP£ 46. 60 DT = £ 46. 60
Insulin human (as Insulin degludec) 200 unit per 1 mlTresiba
FlexTouch 200 units/ml solution for injection 3 ml pre-filled pen| 3 pre-
filled disposable injectionP£ 55. 92 DT = £ 55. 92
▶Tresiba Penfill(Novo Nordisk Ltd)
Insulin human (as Insulin degludec) 100 unit per 1 mlTresiba
Penfill 100 units/ml solution for injection 3 ml cartridges|
5 cartridgeP£ 46. 60 DT = £ 46. 60
eiiiiF 454Insulin detemir
(Recombinant human insulin analogue—long
acting)lINDICATIONS AND DOSE
Diabetes mellitus
▶BY SUBCUTANEOUS INJECTION
▶Child 2–17 years:According to requirementslINTERACTIONS→Appendix 1 : insulins
lSIDE-EFFECTS
▶UncommonRefraction disorder
lPREGNANCYEvidence of the safety of long-acting insulin
analogues in pregnancy is limited, therefore isophane
insulin p. 457 is recommended where longer-acting
insulins are needed; insulin detemir may also be
considered where longer-acting insulins are needed.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for injection
▶Levemir FlexPen(Novo Nordisk Ltd)
Insulin human (as Insulin detemir) 100 unit per 1 mlLevemir
FlexPen 100 units/ml solution for injection 3 ml pre-filled pen| 5 pre-
filled disposable injectionP£ 42. 00 DT = £ 42. 00
▶Levemir InnoLet(Novo Nordisk Ltd)
Insulin human (as Insulin detemir) 100 unit per 1 mlLevemir
InnoLet 100 units/ml solution for injection 3 ml pre-filled pen| 5 pre-
filled disposable injectionP£ 44. 85 DT = £ 42. 00
▶Levemir Penfill(Novo Nordisk Ltd)
Insulin human (as Insulin detemir) 100 unit per 1 mlLevemir
Penfill 100 units/ml solution for injection 3 ml cartridges|
5 cartridgeP£ 42. 00 DT = £ 42. 00
eiiiiF 454
Insulin glargine
(Recombinant human insulin analogue—long
acting)lINDICATIONS AND DOSE
Diabetes mellitus
▶BY SUBCUTANEOUS INJECTION
▶Child 2–17 years:According to requirementslINTERACTIONS→Appendix 1 : insulins
lSIDE-EFFECTS
▶Rare or very rareMyalgia.sodium retention.taste altered
lPREGNANCYEvidence of the safety of long-acting insulin
analogues in pregnancy is limited, therefore isophane
insulin is recommended where longer-acting insulins are
needed; insulin detemir may also be considered.
lPRESCRIBING AND DISPENSING INFORMATIONInsulin
glargine is a biological medicine. Biological medicines
must be prescribed and dispensed by brand name, see
Biological medicinesandBiosimilar medicines, under
Guidance on prescribing p. 1. Dose adjustments and close
metabolic monitoring is recommended if switching
between insulin glargine preparations.
lNATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) Decisions
TheScottish Medicines Consortiumhas advised that
Lantus®preparations (April 2013 ) andToujeo®(August
2015 ) are accepted for restricted use within NHS Scotland
for the treatment of type 1 diabetes:
.in those who are at risk of or experience unacceptable
frequency or severity of nocturnal hypoglycaemia on
attempting to achieve better hypoglycaemic control
during treatment with other insulins
.as a once daily insulin therapy for patients who require a
carer to administer their insulin
It isnotrecommended for routine use in patients with
type 2 diabetes unless they suffer from recurrent episodes
of hypoglycaemia or require assistance with their insulin
injections.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Solution for injection
▶Abasaglar(Eli Lilly and Company Ltd)A
Insulin human (as Insulin glargine) 100 unit per 1 mlAbasaglar
100 units/ml solution for injection 3 ml cartridges| 5 cartridgeP
£ 35. 28 DT = £ 37. 77
▶Abasaglar KwikPen(Eli Lilly and Company Ltd)A
Insulin human (as Insulin glargine) 100 unit per 1 mlAbasaglar
KwikPen 100 units/ml solution for injection 3 ml pre-filled pen| 5 pre-
filled disposable injectionP£ 35. 28 DT = £ 37. 77
▶Lantus(Sanofi)
Insulin human (as Insulin glargine) 100 unit per 1 mlLantus
100 units/ml solution for injection 3 ml cartridges| 5 cartridgeP
£ 37. 77 DT = £ 37. 77
Lantus 100 units/ml solution for injection 3 ml pre-filled SoloStar pen|
5 pre-filled disposable injectionP£ 37. 77 DT = £ 37. 77
Lantus 100 units/ml solution for injection 10 ml vials| 1 vialP
£ 27. 92 DT = £ 27. 92
▶Toujeo(Sanofi)
Insulin human (as Insulin glargine) 300 unit per 1 mlToujeo
300 units/ml solution for injection 1. 5 ml pre-filled SoloStar pen|
3 pre-filled disposable injectionP£ 33. 13 DT = £ 33. 13eiiiiF 454Insulin zinc suspension
(Insulin zinc suspension (mixed)—long acting)
lINDICATIONS AND DOSE
Diabetes mellitus
▶BY SUBCUTANEOUS INJECTION
▶Child:According to requirementslINTERACTIONS→Appendix 1 : insulins
lSIDE-EFFECTSHypokalaemia.weight increased
lPREGNANCYEvidence of the safety of long-acting insulin
analogues in pregnancy is limited, therefore isophane
insulin p. 457 is recommended where longer-acting
insulins are needed; insulin detemir above may also be
considered.
lPRESCRIBING AND DISPENSING INFORMATIONA sterile
neutral suspension of bovine and/or porcine insulin or of
human insulin in the form of a complex obtained by the
addition of a suitable zinc salt; consists of rhombohedralBNFC 2018 – 2019 Diabetes mellitus 459
Endocrine system6