Sanofi launches Toujeo at Lantus price in UK

Sanofi has launched its new insulin treatment Toujeo in the UK, and says it will be priced at the same level as its big seller Lantus.

The pricing decision matches Sanofi's approach in the US market, but analysts say this strategy will make it hard for the new drug to gain traction.

Toujeo is the next generation, longer-acting version of Lantus (insulin glargine) which is facing growing competition from rivals and biosimilar versions. Lantus is the world's biggest selling diabetes treatment, earning nearly $7 billion last year, but lost patent protection in February.

Sanofi says Toujeo offers a similar blood glucose reduction to Lantus, with the added bonus of fewer cases of confirmed hypoglycaemia in patients at night – however this benefit was only observed in type 2 patients, not type 1 patients.

Toujeo's European marketers have more to work with than their US counterparts: the European label includes claims of fewer night-time hypoglycaemia events, but these were not permitted by the FDA.

Switching from Lantus to Toujeo is also not easy, as the drugs are not bioequivalent. The firm says patients would have reduce their dose by 20 per cent, with close monitoring required during the transition – a clear barrier for doctors or patients wanting to switch.

For that reason, Sanofi is said to be focusing on those newly diagnosed as well as those struggling to maintain safe blood glucose levels.

Speaking to pharmaphorum, David Williams, Medical Director of Sanofi UK said the pricing of Toujeo reflected the firm's understanding of restricted health budgets. He added that Toujeo allows patients greater flexibility, allowing them to take their once-daily injection within a three-hour window, instead of the stricter timing required with Lantus.

Williams said doctors should look out for existing patients complaining about compliance problems to identify who might benefit from the drug.

There are 3.3 million people in the UK currently diagnosed with diabetes, with an estimated 630,000 people with the disease but currently undiagnosed. The total number of patients is expected to rise to five million people by 2025.

Data released this week shows that diabetes medicines now account for a tenth of the annual primary care prescribing bill for the first time ever.

In 2014/15 the Net Ingredient Cost (NIC) for managing diabetes was £868.6 million according to the Health and Social Care Information Centre (HSCIC), with 6.7 million insulin items prescribed at a cost of £334.7 million, representing 14 per cent of all items prescribed.

Rivals closing in

Sanofi's rivals in the insulin field are nipping at its heels – Lantus sales dipped 5 per cent in the first half of 2015, and analysts don't expect Toujeo to make up for its decline.

Novo Nordisk is the firm's biggest competitor, and its rival insulin analogue Levemir is increasing sales.

Meanwhile, a biosimilar version of Lantus has been launched in a handful of Eastern European markets at a discount of 15-20 per cent to Sanofi's brand price. Biosimilars are expected in Western Europe shortly: Lilly and Boehringer Ingelheim's Abasaglar is due for a UK launch next month at a similar discount level.

Sanofi recently had encouraging phase III results for Lixilan, its combination of Lantus and GLP-1 drug Lyxumnia. The trial results showed Lixilan produced better results than either of the two drugs separately, and is now on course for filing with US and Europe. Analysts predict the combination could earn $850 million by 2020.

Sanofi's David Williams said the firm was fortunate to be able to offer an 'end-to-end' solution within the injectables market. He added that the firm is providing an holistic service to health professionals and patients, including its Toujeo Coach programme, which provides information for patients and nursing support.

However launching a new diabetes treatment in England isn't easy. NICE and NHS England issue national guidelines, but neither will review Toujeo, which means the company must approach each of England's local 211 Clinical Commissioning Groups (CCGs) in order to secure market uptake, a task made difficult by huge variation in how services are organised.

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