Provider Briefing: Toujeo Availability in 2026

If your patients have been reporting difficulty filling Toujeo prescriptions, you're not imagining it. While Toujeo (Insulin Glargine U-300) is not listed as formally in shortage by the FDA, the Insulin Glargine supply chain has been under significant pressure since early 2025 — and the effects continue to be felt in clinical practice.

This article provides a clinical-level overview of the current Toujeo supply situation, prescribing considerations, cost and access information, and practical tools you can use to help patients stay on therapy.

Timeline: How We Got Here

Understanding the current landscape requires looking at the sequence of events that disrupted the Insulin Glargine market:

January 2025: Semglee Discontinuation

Semglee (Insulin Glargine-yfgn, U-100), manufactured by Biocon/Mylan, was phased out in January 2025. Semglee had been a key biosimilar option for many formularies and was widely prescribed as a lower-cost alternative to Lantus. Its removal from the market shifted a substantial volume of prescriptions to other Insulin Glargine products.

Q1-Q2 2025: Formulary Realignment

Major payers — including Blue Cross NC and others — responded by adding Toujeo and Tresiba to preferred tiers, in some cases removing prior authorization requirements. While this improved theoretical access, it also created sudden demand spikes at pharmacies that hadn't historically stocked Toujeo in volume.

2025-2026: Ongoing Supply Chain Normalization

The ASHP has continued to track Insulin Glargine supply issues with updates through January 2026. While Sanofi has maintained manufacturing output, wholesale distribution patterns and pharmacy-level inventory have been slower to fully normalize. The result is intermittent, regional availability gaps rather than a systemic national shortage.

Prescribing Implications

For clinicians managing patients on Toujeo, several practical considerations arise:

Dose Conversion Complexity

Toujeo is Insulin Glargine at 300 units/mL (U-300), three times the concentration of Lantus and its biosimilars (U-100). When patients need to switch between formulations, the dose conversion is not 1:1. Clinical data suggest that patients switching from Toujeo to Lantus may need a 10-20% dose reduction initially, with titration based on blood glucose monitoring.

Therapeutic Advantages of U-300

Toujeo's concentrated formulation provides a flatter, more prolonged pharmacokinetic profile compared to Insulin Glargine U-100. Clinical trials (EDITION program) demonstrated:

• Comparable A1C reduction to Lantus
• Lower rates of nocturnal hypoglycemia
• More stable blood glucose control over 24 hours
• Potential for fewer injection-site reactions due to smaller injection volume

For patients who were specifically placed on Toujeo for these clinical advantages, switching to a U-100 formulation may not provide equivalent outcomes.

When to Consider Alternatives

If Toujeo is persistently unavailable for a patient, evidence-based alternatives include:

• Tresiba (Insulin Degludec) — Ultra-long-acting (up to 42 hours), flexible dosing window, favorable hypoglycemia profile. Available in U-100 and U-200.
• Lantus (Insulin Glargine U-100) — Same molecule, lower concentration. Requires dose adjustment from Toujeo. Has biosimilars available (Basaglar, Rezvoglar).
• Basaglar (Insulin Glargine U-100 biosimilar) — Often the most cost-effective option. Interchangeable with Lantus at the same dose.
• Levemir (Insulin Detemir) — Long-acting alternative that may require twice-daily dosing. Less commonly initiated in new patients but remains effective.

For a patient-facing version of this information, see Alternatives to Toujeo.

Current Availability Picture

The availability landscape in early 2026 can be summarized as follows:

• Toujeo SoloStar and Max SoloStar: Actively manufactured by Sanofi. Available through major wholesalers but with intermittent stock-outs at the pharmacy level, particularly at high-volume chain pharmacies.
• Unbranded Insulin Glargine U-300: Sanofi's authorized generic (Insulin Glargine U-300 SoloStar / Max SoloStar) is also available and eligible for the same savings programs. This can serve as a direct substitute.
• Regional variation: Availability varies significantly by geography, with urban areas generally having better access than rural regions.

Cost and Access Considerations

Cost remains one of the most significant barriers to insulin adherence. Here's the current pricing landscape for Toujeo:

Retail Pricing

• Toujeo SoloStar (1 pen, 1.5 mL): approximately $175-$200 cash price
• Toujeo Max SoloStar (2 pens, 3 mL each): approximately $450-$550
• Monthly costs without insurance: $350-$550+ depending on dose

Savings Programs

• Sanofi Insulins Valyou Savings Program: $35 per 30-day supply for uninsured or cash-paying patients. Covers both branded Toujeo and unbranded Insulin Glargine U-300.
• Sanofi Copay Card: Commercially insured patients may qualify for $0 copay.
• Sanofi Patient Connection: Free insulin for eligible uninsured/underinsured patients meeting income criteria. Apply at sanofipatientconnection.com or call 888-847-4877.

Insurance

• Most commercial plans and Medicare Part D cover Toujeo (typically Tier 3-4)
• Medicare Part D out-of-pocket cap of $2,000/year applies as of 2025
• Some plans have removed prior authorization requirements in response to supply disruptions

For a comprehensive savings breakdown to share with patients, see How to Save Money on Toujeo.

Tools and Resources for Providers

Several tools can help you and your patients navigate Toujeo availability:

Medfinder for Providers

Medfinder offers real-time pharmacy availability data. You or your care team can search for Toujeo availability by location, helping patients identify pharmacies that currently have stock. This is significantly more efficient than having patients call pharmacies individually.

ASHP Drug Shortage Database

The ASHP Drug Shortages Resource Center provides up-to-date tracking of Insulin Glargine supply status, including specific NDC-level detail for Toujeo SoloStar and Max SoloStar products.

Sanofi Provider Resources

Sanofi's HCP portal at toujeopro.com provides prescribing information, savings program details, and patient education materials.

Looking Ahead

The insulin market is gradually normalizing after the disruptions of 2025. Key trends to watch:

• Supply stabilization: As pharmacy-level inventory systems adjust to new demand patterns, spot shortages should decrease through 2026.
• Biosimilar landscape: New Insulin Glargine biosimilar entries (including Rezvoglar) are expanding options for the U-100 market, which may indirectly reduce pressure on Toujeo by giving patients more switching options.
• Policy developments: The Medicare $2,000 out-of-pocket cap and continued state-level insulin price caps are improving affordability.

Final Thoughts

While Toujeo is not in a formal FDA shortage, the practical reality of intermittent availability creates real challenges for patients and clinicians. Proactive prescribing — including having a documented backup plan, leveraging savings programs, and using tools like Medfinder — can help ensure your patients maintain uninterrupted access to the basal insulin they need.

For a practical workflow guide on helping patients find Toujeo, see our companion article: How to Help Your Patients Find Toujeo in Stock.