Formulary change: your thoughts on bolus and basal insulins?

But HEY - seen as somebody started this going down the road of generics and/or swapping this for that…

I get the joy of new insurance at the start of the year. Some brilliant person in HR thought the organization could save a couple bucks by making a whole lot of people switch insurance carriers. It is all self-funded anyway so it seems pretty stupid. Anyway…

The new formulary shows that Novolog is the preferred option for Humalog. We have been using Humalog since day 1. What are people’s thoughts on switching to Novolog from Humalog?

For long acting, the new formulary shows Lantus now has the preferred drugs of: Basaglar, Levemir, Tresiba. We have not used Lantus for years now since switching to the pump however we had this as a backup plan in case of pump failure. Thoughts on this switch should we need to do so?

Oh great. I also see they will want to switch us from the Contour Next back to the One Touch Ultra. Great. Well that is not happening. I will buy those on Amazon if need be.

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We switched the same way about a year ago and saw no difference. As a note, though, we were still in honeymoon.

Basaglar to us works exactly like Lantus, so it would be an easy one-to-one change. Levemir works the same way for some, but does not work as long for others. As for Tresiba, as I am sure you know it gives you hyper-stable basal, with fewer lows at night in particular, but may be more of an issue when you need to change basal often, since it remains active for about 2-3 days.

Imho, the easiest swap is to go to Basaglar, but Tresiba could be a great option.

My reply was left behind on the split. See the original thread for my comments.

Get the insurance covered strips and sell them on eBay to help offset the cost of the Contour strips…

I think Humalog and NovoLog are easily interchangeable. I don’t think you will have a problem with that.

Big difference with Lantus and Levemir. Not even close.

Basaglar is a fine alternative to Lantus. Or you can get Lantus from Canada for very cheap and have it as a backup. Since it’s a backup, it wouldn’t be too bad. One vial would last you for a long time and it’s only $110.

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Great - Thanks. I will let our Endo know at our upcoming appt but will not worry about this switch (Humalog to Novolog).

As for the long lasting - since we switched to the pump, I have not been following those conversations (regarding long lasting) so am very much ignorant. I will also discuss with our Endo but sounds from both @Michel and @Eric that the Basaglar would be the easiest switch from Lantus. At this point, we would only use the basal as an emergency backup in the case of pump failure and while waiting for a pump replacement.

Interesting checking prices on goodrx (dot com).
Novolog for 1 vial is $290
Humalog for 1 vial is $175

Our current insurance is paying about $275 per vial for Humalog.

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From Mark’s (in Canada)

(they also have pens for all of these)


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Same as what others have reported, I found no discernible differences between Humalog and Novolog when I compared them. Lantus and Levemir are significantly different.


@Thomas As others have pointed out, Lantus and Tresiba and Levemir are all totally different animals.

For that matter, and because I have been using Novolog exclusively for fifteen years, I would fight the insurance company tooth and nail if they tried to force me to switch to Humalog and/or back to Lantus.

And yes, that would be all the way to a court case if necessary. The insurance companies have no right to dictate your treatment. They are not doctors, and even doctors can’t make us do what we don’t agree with.


On Lantus I experienced the “3 a.m. drop” almost nightly. Yuk!

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What time were you taking it?

Between 10:30-11:00 pm. Have some still for back-up…

So you were seeing the drop when it started to kick in:


If you gotta do it again, consider taking it a little earlier in the evening.


That’s the front end cost that they pay, then the negotiated rebate is a “trade secret”. It’s impossible to know what your insurance is actually paying at the end of the day… my suspicion is that it’s nowhere near that


That is likely a safe bet.

Wouldn’t it be nice if the 20% copay was determined AFTER that rebate !

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But then it wouldn’t be a secret.

No difference. Max out of pocket was probably hit back in June.


Back on topic. I found slight differences between novolog and humalog, nothing insurmountable. While using Lantus I had “variable basal needs” and complained to my doctor about them, thought I was going to end up needing a pump but wanted to try simulating variable basals with varied doses of levemir first. Ended up on tresiba instead, despite my protests, but have never looked back… in that process became convinced that at least for me, my variable basal needs were a function of he insulin I was using, not an actual physiological phenomenon. This has been one of the most valuable lessons I’ve ever learned in diabetes management.


If I had to go back on MDIs, I think I’d try Tresiba!