Lilly Diabetes BAQSIMI (glucagon) nasal powder, which received FDA-approval on July 24, 2019, is an alternative to the glucagon emergency kit.

Image: Lilly
I had the opportunity to jump on a conference call today with July Settles, US Medical Lead, and Tony Azell, US Vice President, to learn more about Lilly Diabetes BAQSIMI (glucagon) nasal powder, which received FDA-approval on July 24, 2019.
Please note: I am not being compensated by Lilly Diabetes to share this information or to participate in the conference call. I participated because I was interested in the product and had questions.
We have religiously filled our prescription for and carried the traditional “glucagon emergency kit” (the red box) since Q was diagnosed with type 1 diabetes over a decade ago. We keep one kit at school with the nurse, Q carries one kit in her supply bag, and we keep one kit at home in our preparedness kit.
Each year that Q was in elementary and middle school, we met with her teachers to train them on her diabetes management. Each year the teachers’ faces would change, sometimes going white, when I showed them how to use the glucagon kit. Many teachers are afraid of needles. (Get over it, right?!).
In an emergency situation, if a child’s blood sugar is so low that they are having a seizure or are unconscious, would you as a parent or would caregivers and teachers remember all the steps? Would they do it correctly?
(Read “Training School Staff,” an excerpt from my book Kids First, Diabetes Second.)
Nasal glucagon is a game-changer in that it removes the many steps of preparing a glucagon injection.
(Note that in addition to BAQSIMI nasal glucagon, another pharmaceutical company is also developing a glucagon auto-injector.)
BAQSIMI™ (glucagon) nasal powder 3 mg, approved for the treatment of severe hypoglycemia in people with diabetes ages 4 years and above. BAQSIMI is the first and only approved nasally administered glucagon.
Here are my takeaways from the conference call today about BAQSIMI. (And thank you to the other bloggers who were on the call who asked some of these questions.)
BAQSIMI FAQ
- 6.3 million people use insulin and, for many of them, their biggest concern is about severe hypoglycemia
- BAQSIMI is approved for people four years old and up.
- BAQSIMI solves many of the problems of current glucagon: no reconstitution is required, it is stable at room temperature, and it’s small enough to carry in your pocket.
Two Biggest Questions
There were two common questions that Lilly was asked while they were developing their product.
What if I am passed out?
BAQSIMI is passively absorbed, meaning you don’t have to inhale it. The person giving it to you just has to push the plunger until the green line disappears to know that 100% of it has been dispersed.
What if I have a cold?
They studied this, and it didn’t have an effect.
Stability
It can be stored up to 86 degrees. It does not need to be refrigerated. But you need to keep the shrink wrapping on the tube until you use it.
It expires after 18 months.
Availability and Cost
Tony stated that Lilly is “trying to make it affordable and accessible to all people with diabetes who need it.”
Yes, I know, this coming from one of the three insulin-producers who have set list prices crazy high. Insulin pricing is complex, the system is broken, and there isn’t currently a solution.
For people with commercial insurance, there is a copay card available that makes the price $25 for one two-pack or two one-packs. The copay card is good for a year, and you can use it as many times as needed.
If you don’t have commercial insurance, call the Lilly Diabetes Solution Center (1-800-LillyRX) to ask how they can help you access it. Tony says that there is “a solution for any patient in need between patient assistance and the copay card.”
They realize that it’s back-to-school and that parents are filling their glucagon kits now. It takes about a month to get newly approved medicines into retail. You can go to baqsimi.com to sign up for updates about availability. So while you might be able to get a prescription for it, your pharmacy may not have it for a few more weeks.
About that prescription… Doctors are learning about the approval at the same time patients are. Your doctor might not know anything about this. When they write a prescription for it, make sure they write it for “BAQSIMI” or “nasal glucagon,” otherwise you will probably get the traditional glucagon emergency kit (i.e., red kit with the needle). And the pharmacist may have no idea what you are talking about either!
Q&A
Here are answers to some of the questions asked on the call today:
Asthma
The powder is all captured in the nose. It doesn’t go into the lungs so it wouldn’t affect someone with asthma. It is not inhaled; it is “nasally administered.”
Kid vs. Adult Dose
There is no child dose and adult dose like the glucagon emergency kit. Everyone age four and over uses a 3 mg dose.
Glucagon “flips the switch” and tells your body to dump all the sugar available. This doesn’t change “whether you are 150 pounds or 250 pounds.”
Mini Dose
While some people use the traditional glucagon rescue kit as a mini dose, BAQSIMI cannot be used for a mini dose. Rather it is a “rescue dose” only. Lilly’s goal was to create a simple product for rescue. There is not partial dosing. You give all of the powder in the single dose.
Traditional Glucagon Emergency Kit Availability
Lilly has no plans to take the traditional glucagon rescue kit off the market. It is still needed for patients under the age of 4.
Simplicity
You do not need to reconstitute BAQSIMI. There are so many steps in the traditional kit, and it is easy not to do it right. In their studies, Lilly said that there is a 90.9% of people are successful in administering BAQSIMI … without training.
Training
Lilly says that it’s so easy to use that you won’t need an app to tell you how to use it. But they are working on a video, which you will be able to share with caregivers and teachers.
What do you think? Will you be giving BAQSIMI Glucagon Nasal Powder a try?
More Resources on D-Mom Blog
More posts about glucagon
Back to School with Diabetes: Lots of information and links!