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Basaglar is a long-acting insulin glargine analog approved to improve glycemic control in adults with type 1 or type 2 diabetes and children as young as six with type 1 diabetes. It became widely available in 2016 as the first “follow-on” biosimilar to Lantus, offering a lower-cost option and the convenience of once-daily dosing.

Even so, the price of Basaglar can still be significant for some. According to Eli Lilly’s pricing information page, the list price of Basaglar is $326.36 for a five-pack of 3-mL pens (1,500 units). Because of these cost concerns and because some people want different dosing options or reduced risk of side effects, many ask about alternatives to Basaglar.

This article explores several insulin products that can be used in place of Basaglar. We also summarize major clinical trials comparing these insulins with Basaglar or other basal insulins and discuss what to expect when switching from Basaglar.

Basaglar alternatives at a glance

Insulin option Active ingredient Dosage form & strength Usual dosage frequency FDA-approved indications
Semglee Insulin glargine-yfgn Prefilled pens 100 units/mL (3 mL each) and 10 mL vials Once daily Type 1 and type 2 diabetes in adults; type 1 diabetes in children
Lantus Insulin glargine 3-mL SoloStar pens (100 U/mL) and 10-mL vials Once daily Type 1 diabetes in adults and children 6 years and older; type 2 diabetes in adults
Toujeo Insulin glargine 300 U/mL SoloStar pen 1.5 mL (300 U/mL); Max SoloStar pen 3 mL (300 U/mL) Once daily at the same time Type 1 and type 2 diabetes in adults and children 6 years and older
Tresiba Insulin degludec FlexTouch pens 100 U/mL (3 mL), 200 U/mL (3 mL), and 10-mL vials Once daily; dosing time flexible for adults Type 1 and type 2 diabetes in adults and children at least 1 year old
Levemir Insulin detemir FlexTouch pens 100 U/mL (3 mL) and 10-mL vials Once or twice daily Type 1 and type 2 diabetes in adults and children
Humulin N Human insulin (NPH) 3-mL KwikPen and 10-mL vial (100 U/mL) Usually once or twice daily Type 1 and type 2 diabetes in adults and children
Novolin N Human insulin (NPH) FlexPen prefilled pens (3 mL, 100 U/mL) and 10-mL vials Once or twice daily Type 1 and type 2 diabetes in adults and children

Note: Only a qualified healthcare professional can determine which insulin regimen is appropriate for you. Do not make changes to your insulin without talking with your prescriber.

Best Basaglar alternatives

Multiple long-acting and intermediate-acting insulins can serve as alternatives to Basaglar. These include:

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1. Semglee (insulin glargine-yfgn)

Semglee is a biosimilar insulin glargine produced by Viatris/Mylan. It contains the same active molecule as Basaglar and Lantus, and is the first interchangeable biosimilar insulin to Lantus. It’s available as 3-mL Semglee pens and 10-mL vials, both contains 100 units/mL of insulin glargine.

It’s approved to improve glycemic control in adults with type 1 or type 2 diabetes and children with type 1 diabetes. It is not indicated for children with type 2 diabetes.

The dosing is once daily at the same time every day. Like Basaglar, the injection may be given in the abdomen, thigh, upper arm, or buttocks, and injection sites should be rotated.

Effectiveness

Semglee was studied in a series of randomized controlled trials known as the INSTRIDE program, which compared insulin glargine-yfgn with reference insulin glargine (Lantus).

INSTRIDE 1, involving adults with type 1 diabetes, found that after 24 weeks, the mean change in A1c was 0.14% for Semglee versus 0.11% for Lantus, demonstrating non-inferiority. Fasting plasma glucose, basal insulin dose, and incidence of hypoglycemia were similar between the groups.

INSTRIDE 2 studied adults with type 2 diabetes and showed that A1c decreased by 0.60% with Semglee and 0.66% with reference glargine.

The INSTRIDE 3 switching study randomized patients to continue Lantus or switch between Lantus and Semglee. The mean A1c change was identical (difference 0.01) and within the non-inferiority margin, indicating that switching did not affect efficacy or safety. These trials support that Semglee has comparable effectiveness and safety to Lantus.

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2. Lantus (insulin glargine U-100)

Lantus was the first long-acting insulin analog approved in the US, and it served as the reference product for Basaglar and Semglee. It contains insulin glargine at 100 units/mL and is supplied in 3-mL SoloStar pens and 10-mL vials. It is designed to provide a steady insulin level over 24 hours.

Lantus is approved to improve glycemic control in adults and children aged six years and older with type 1 diabetes and adults with type 2 diabetes. It is not intended for diabetic ketoacidosis.

It is administered subcutaneously once daily at the same time each day, typically at night.

Effectiveness

Because Basaglar contains the same active ingredient as Lantus, clinical trials have focused on proving that Basaglar is non-inferior to Lantus.

In a phase III trial of Chinese adults with type 2 diabetes, patients who added either Basaglar or Lantus achieved similar HbA1c reductions (1.27% vs 1.23%). The proportions of patients reaching HbA1c targets (<7 % or not more than 6.5 %) were comparable, and rates of hypoglycemia and weight gain were similar.

The ELEMENT 2 trial, conducted in insulin-naïve adults with type 2 diabetes, also showed that Basaglar and Lantus produced almost identical decreases in HbA1c (difference 0.052%) and comparable fasting plasma glucose and hypoglycemia rates.

Toujeo DoubleStar
Toujeo SoloStar Pen

3. Toujeo (insulin glargine U-300)

Toujeo is a high-concentration version of insulin glargine. Each milliliter contains 300 units of insulin glargine, which is triple the concentration of Basaglar or Lantus.

The drug comes in a 1.5-mL SoloStar pen and a 3-mL DoubleStar pen. The same total dose is delivered in a smaller volume, making it useful for people who require larger daily insulin doses.

It is approved for adults and children aged six years and older with diabetes. It is not used to treat diabetic ketoacidosis and is not recommended for children younger than six.

Toujeo is injected once daily at the same time each day.

Effectiveness

Toujeo has not been directly compared to Basaglar in clinical trials, but it has been compared to Lantus. The InRange trial and other studies comparing glargine U-300 to glargine U-100 found similar HbA1c reductions but suggested differences in hypoglycemia patterns.

Observational studies have suggested that switching from Lantus U-100 to Toujeo may require a higher daily dose to maintain similar control. Conversely, switching from Toujeo to Lantus may require reducing the dose to about 80% of the Toujeo dose to avoid hypoglycemia.

Tresiba FlexTouch 100
Tresiba FlexTouch 200

4. Tresiba (insulin degludec)

Tresiba is an ultra-long-acting basal insulin containing insulin degludec. It forms slow-releasing clusters when injected under the skin, resulting in a half-life of about 25 hours and a duration of action exceeding 40 hours.

It’s available as U-100 and U-200 prefilled FlexTouch pens (3 mL each) and 10-mL vials (U-100). The U-200 pens deliver up to 160 units per injection, which can reduce the number of injections for people requiring high doses.

Tresiba is approved to improve glycemic control in adults and children aged one year and older with type 1 or type 2 diabetes. It should not be used for diabetic ketoacidosis.

Adults may inject Tresiba once daily at any time of the day, as long as there are at least eight hours between doses, while children should inject at the same time each day.

Starting doses are individualized based on previous insulin therapy, weight, and blood glucose. Doses should not be increased more frequently than every three to four days.

Effectiveness

Several randomized controlled trials have compared insulin degludec with insulin glargine. The SWITCH 2 trial, for example, included 721 adults with type 2 diabetes at high risk for hypoglycemia.

Results showed that insulin degludec significantly reduced rates of hypoglycemia compared with insulin glargine U-100 during the maintenance period. There were 185.6 episodes of overall symptomatic hypoglycemia per 100 patient-years with degludec versus 265.4 episodes with glargine. The rate ratio was 0.70, indicating a 30% reduction.

Nocturnal symptomatic hypoglycemia was also lower with degludec (55.2 vs 93.6 episodes per 100 patient-years, rate ratio 0.58). Glycemic control, as measured by HbA1c, was similar between the treatments.

Levemir FlexTouch Pens (Insulin Detemir)
Levemir Cartridge
Levemir Vial

5. Levemir (insulin detemir)

Levemir contains insulin detemir, a recombinant human insulin analog that binds to albumin, providing an intermediate duration of action longer than NPH but shorter than glargine. It is sold in 100 units/mL FlexTouch pens (3 mL each) and 10-mL vials.

Levemir was approved in 2005 but has been discontinued in the US, with supplies expected to be exhausted by the end of 2026, on a global scale.

Levemir is indicated for adults and children with type 1 or type 2 diabetes. It can be administered once daily with the evening meal or at bedtime, or in two divided doses. Injection sites should be rotated. Levemir should not be used for diabetic ketoacidosis or in insulin pumps, and it should not be mixed with other insulins.

Effectiveness

Randomized trials have compared insulin detemir with insulin glargine. In a 24-week treat-to-target trial involving insulin-naïve adults with type 2 diabetes, participants received either once-daily insulin glargine or twice-daily insulin detemir.

Both groups achieved similar HbA1c reductions (1.46% for glargine vs 1.54% for detemir). More detemir-treated patients reached HbA1c <6.5 %, but glargine produced a larger reduction in fasting plasma glucose. Hypoglycemia rates were similar (~30% of patients), but weight gain was lower with detemir (0.6 kg vs 1.4 kg for glargine).

These results suggest that detemir and glargine have comparable glycemic efficacy, though detemir may require higher daily doses and cause less weight gain.

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6. Humulin N (NPH insulin)

Humulin N is a human insulin suspension containing neutral protamine Hagedorn (NPH). NPH insulin is intermediate-acting. After injection, it forms crystals that dissolve slowly, producing a pronounced peak at about 4 to 12 hours and a duration of roughly 14 to 24 hours.

It’s available in 10-mL vials and 3-mL prefilled pens at a concentration of 100 units/mL. Unlike analogs, NPH insulin must be gently rolled or inverted to resuspend the insulin before injection.

Humulin N is indicated for adults and children with type 1 or type 2 diabetes. It is typically injected once or twice daily. When used in type 1 diabetes, NPH is often combined with a rapid-acting insulin at meals. Dosing is individualized and may start at 0.2 units/kg/day.

Injection sites include the abdomen, thigh, upper arm, or buttocks, and they should be rotated to avoid lipodystrophy. You also need to follow the instructions on resuspending the cloudy suspension.

Effectiveness

Older studies compared NPH insulin with insulin glargine. In a randomized trial among patients with type 2 diabetes, three groups were assigned to morning glargine, bedtime glargine, or morning NPH.

All groups had similar HbA1c improvements with a 0.1-0.3 % difference, and there were no significant differences in nocturnal hypoglycemia. However, weight gain was greater with glargine (+3.1 kg for the morning glargine group or +1.7 kg for the bedtime glargine group) than with NPH (decreased by 0.2 kg), and pre-supper hypoglycemia was more common with morning glargine.

These findings suggest that NPH can achieve comparable glycemic control at a lower cost, albeit with a more pronounced insulin peak and shorter duration.

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7. Novolin N (NPH Insulin)

Novolin N is another NPH insulin made by Novo Nordisk. Like Humulin N, it contains human insulin complexed with protamine and zinc. Novolin N is available in 10-mL vials and 3-mL FlexPen prefilled pens. The concentration is 100 units/mL, and the solution is cloudy due to the suspension.

Novolin N is approved for adults and children with type 1 or type 2 diabetes. It is injected once or twice daily, often in combination with short-acting insulin for meals.

For type 1 diabetes, dosing typically includes a basal dose of NPH and bolus doses of rapid-acting insulin. The injection should be given into the abdomen, thigh, upper arm, or buttocks, with rotation of sites.

Novolin N can be mixed with Novolin R (regular insulin) in the same syringe, though the mixture must be injected immediately.

Effectiveness

Data comparing Novolin N specifically with Basaglar are limited, but because it is the same molecule as Humulin N, similar conclusions may apply. Studies comparing NPH insulin (as a class) with glargine show comparable HbA1c reduction but greater weight gain with glargine and no difference in nocturnal hypoglycemia.

Switching from Basaglar to another insulin

Switching between basal insulins requires careful planning to maintain blood glucose control and avoid hypoglycemia or hyperglycemia. A 2021 review on the practical guidance on the initiation, titration, and switching of basal insulins provides useful recommendations.

When switching from Basaglar (insulin glargine U-100) to another basal insulin:

  • Monitor blood glucose frequently in the first weeks after the switch. The guidance recommends increasing monitoring frequency and communicating more often with your healthcare team.
  • Same-dose conversions: If switching to other insulin glargine U-100 products (Basaglar, Semglee, or unbranded glargine) or insulin degludec (Tresiba) U-100 or U-200, you can generally start at the same total daily dose. For example, if you currently inject 20 units of Basaglar daily, you would start Tresiba at 20 units.
  • Switching to Toujeo (U-300): Begin with the same number of units, but be aware that a higher daily dose may eventually be needed to achieve similar glycemic control. Conversely, when switching from Toujeo back to Basaglar or another U-100 insulin, use 80% of the Toujeo dose to avoid hypoglycemia.
  • Switching to Levemir (detemir): Start with the same total daily dose, but because detemir has a shorter duration, you may need to split the dose into twice-daily injections.
  • Switching from NPH to basal analogs: When switching from twice-daily NPH to Basaglar or another basal analog, start with 80% of the total NPH dose to reduce the risk of hypoglycemia. For once-daily NPH, a unit-for-unit (1:1) conversion to Basaglar is usually recommended.

In all cases, you should work closely with your healthcare provider to adjust doses, monitor blood glucose, and watch for signs of hypoglycemia or hyperglycemia. Insulin dose adjustments may also depend on other medications, diet, physical activity, and body weight changes.

Summary

Finding the right basal insulin requires balancing cost, dosing convenience, and personal response. Basaglar provides a reliable long-acting option and is often less expensive than Lantus, yet it may still be costly for people without generous insurance coverage.

When evaluating alternatives, consider factors such as insurance coverage, pharmacy discounts, duration of action, risk of hypoglycemia, and personal lifestyle. Always talk with a healthcare provider before making changes to your insulin regimen.

Frequently Asked Questions

Both are long-acting insulin glargine products used to control blood sugar. The main difference is that Lantus is the original brand, while Basaglar is a “follow-on” (biosimilar) version with very similar effectiveness and safety. They are not technically identical but are clinically comparable. Minor differences may exist in delivery devices and cost.

Basaglar itself is not a true generic but a biosimilar to insulin glargine. Other insulin glargine products, like Semglee, are considered interchangeable with Lantus in some regions. These options work in nearly the same way in the body. Availability depends on local approvals and pharmacy supply.

Neither is universally better since both provide similar blood sugar control and safety profiles. The choice often depends on cost, insurance coverage, and device preference. Some patients may respond slightly differently, but most can use either effectively. Your provider may recommend one based on your specific needs.

Yes, many patients can switch between them under medical guidance. Dosing is often similar, but your doctor may adjust it slightly based on your response. Monitoring blood sugar closely during the transition is important. Never switch without professional advice.

There is no single best option for everyone. Long-acting insulins like Tresiba, Lantus, and Basaglar all provide steady glucose control. Tresiba lasts longer and has more flexible dosing, which some patients prefer. The best choice depends on lifestyle, cost, and medical history.

All modern insulins are considered safe when used as prescribed. Long-acting options like Lantus, Basaglar, and Tresiba tend to have a lower risk of low blood sugar compared to older insulins. Safety depends more on proper dosing, monitoring, and adherence. Your healthcare provider will match the safest option to your condition.

Tresiba lasts longer (over 24 hours) and offers more flexible dosing than Basaglar. Some studies show lower rates of nighttime hypoglycemia with Tresiba. However, both are effective for blood sugar control.

Basaglar is not widely reported as discontinued, but availability can vary by country or pharmacy. Some markets are shifting toward interchangeable biosimilars like Semglee. If you have trouble finding it, your pharmacist or doctor can suggest alternatives. Supply changes are often related to market competition, and not safety issues.

Basaglar typically works for about 24 hours. It provides a steady, peakless release of insulin to help control blood sugar throughout the day and night. Some people may experience slightly shorter or longer coverage. It is usually taken once daily at the same time each day.

Sources

Blevins, T. C., Barve, A., Sun, B., & Ankersen, M. (2018). Efficacy and safety of MYL?1501D vs insulin glargine in patients with type 1 diabetes after 52?weeks: Results of the INSTRIDE 1 phase III study. Diabetes Obesity and Metabolism, 20(8), 1944–1950. https://doi.org/10.1111/dom.13322

Blevins, T. C., Barve, A., Sun, B., Raiter, Y., Aubonnet, P., Muniz, R., Athalye, S., & Ankersen, M. (2018). Efficacy and safety of MYL?1501D versus insulin glargine in patients with type 2 diabetes after 24 weeks: Results of the phase III INSTRIDE 2 study. Diabetes Obesity and Metabolism, 21(1), 129–135. https://doi.org/10.1111/dom.13495

Matli MC, Wilson AB, Rappsilber LM, Sheffield FP, Farlow ML, Johnson JL. The First Interchangeable Biosimilar Insulin: Insulin Glargine-yfgn. J Diabetes Sci Technol. 2023 Mar;17(2):490-494. doi: 10.1177/19322968211067511. Epub 2021 Dec 31. PMID: 34971335; PMCID: PMC10012380.

Yan, K., & Sommi, A. (2022, April 19). FDA Propels Insulin Affordability with Semglee. DiaTribe. https://diatribe.org/diabetes-medications/fda-propels-insulin-affordability-semglee

Feng W, Chen W, Jiang S, Du L, Zhu D. Efficacy and safety of LY2963016 insulin glargine versus insulin glargine (Lantus) in Chinese adults with type 2 diabetes: A phase III, randomized, open-label, controlled trial. Diabetes Obes Metab. 2021 Aug;23(8):1786-1794. doi: 10.1111/dom.14392. Epub 2021 May 27. PMID: 33783964; PMCID: PMC8361736.

Rosenstock, J., Hollander, P., Bhargava, A., Ilag, L. L., Pollom, R. K., Zielonka, J. S., Huster, W. J., & Prince, M. J. (2015). Similar efficacy and safety of LY2963016 insulin glargine and insulin glargine ( L antus®) in patients with type 2 diabetes who were insulin?naïve or previously treated with insulin glargine: a randomized, double?blind controlled trial (the ELEMENT 2 study). Diabetes Obesity and Metabolism, 17(8), 734–741. https://doi.org/10.1111/dom.12482

Wingrove, P. (2023, March 16). Sanofi to cut US price of its most-prescribed insulin by 78%. Reuters. https://www.reuters.com/business/healthcare-pharmaceuticals/sanofi-cut-price-its-most-prescribed-insulin-by-78-us-2023-03-16/

Mehta R, Goldenberg R, Katselnik D, Kuritzky L. Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care. Ann Med. 2021 Dec;53(1):998-1009. doi: 10.1080/07853890.2021.1925148. PMID: 34165382; PMCID: PMC8231382.

Wysham, C., Bhargava, A., Chaykin, L., De La Rosa, R., Handelsman, Y., Troelsen, L. N., Kvist, K., & Norwood, P. (2017). Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 2 Diabetes. JAMA, 318(1), 45. https://doi.org/10.1001/jama.2017.7117

Swinnen, S. G., Dain, M., Aronson, R., Davies, M., Gerstein, H. C., Pfeiffer, A. F., Snoek, F. J., DeVries, J. H., Hoekstra, J. B., & Holleman, F. (2010). A 24-Week, randomized, Treat-to-Target trial comparing initiation of insulin glargine Once-Daily with insulin detemir Twice-Daily in patients with Type 2 diabetes inadequately controlled on oral Glucose-Lowering drugs. Diabetes Care, 33(6), 1176–1178. https://doi.org/10.2337/dc09-2294

Hsia, S. H. (2010). Insulin glargine compared to NPH among insulin-naïve, U.S. inner city, ethnic minority type 2 diabetic patients. Diabetes Research and Clinical Practice, 91(3), 293–299. https://doi.org/10.1016/j.diabres.2010.11.028