Cheapest Emergency Glucose Replacement Option Among Gvoke, Zegaloge, and Baqsimi
Based on the most recent cost data from 2023, traditional injectable glucagon powder with diluent for reconstitution is the cheapest emergency glucose replacement option at $249 NADAC, followed by nasal glucagon (Baqsimi) at $270 NADAC, and prefilled pen/syringe glucagon (Gvoke) at $285 NADAC, while dasiglucagon (Zegaloge) has no available NADAC data but has the highest AWP at $371. 1
Cost Comparison
According to the American Diabetes Association's 2024 Standards of Care, the National Average Drug Acquisition Cost (NADAC) for emergency glucose replacement options are:
When considering Average Wholesale Price (AWP), the cost ranking remains the same:
Clinical Considerations Beyond Cost
While traditional injectable glucagon is the cheapest option, it requires reconstitution before use, which can be challenging during an emergency situation 1
Ready-to-use formulations like nasal glucagon (Baqsimi) and prefilled pens (Gvoke, Zegaloge) are preferred due to their ease of administration, resulting in more rapid correction of hypoglycemia 1
Studies show that caregivers and non-medical personnel can administer nasal glucagon within 1 minute compared to 1.3-5 minutes with intramuscular glucagon, which may be critical during severe hypoglycemic events 2, 3
In simulation studies, the success rate for administration was significantly higher with nasal glucagon (89.5%) compared to injectable glucagon (26.3%) 3
Insurance Coverage Considerations
Health insurance providers may prefer only select glucagon products, so it's important to check individual insurance coverage and prescribe formulary products whenever possible 1
Out-of-pocket costs will vary depending on insurance coverage, formulary tier placement, and whether the patient qualifies for assistance programs 4
Practical Recommendations
For patients with limited financial resources and good manual dexterity or trained caregivers, traditional injectable glucagon powder remains the most cost-effective option 1
For patients or caregivers concerned about ease of use during emergencies, the slightly higher cost of nasal glucagon (Baqsimi) at $270 NADAC may be justified by its simpler administration 5, 6, 7
All glucagon products should be stored according to specific product instructions and replaced when they reach their expiration date to ensure safe and effective use 1
Patients should be educated on proper storage and use of their chosen glucagon product, and caregivers should be trained on administration techniques 1