Baqsimi® - Treating Severe Sugar Lows with Administration through the Nose

Drug Review: Volume 21, Issue 6 - Download PDF

Diabetes is a chronic medical condition caused by the body’s inability to make and/or use insulin, a hormone that regulates the body’s blood sugar.  As of 2019, eleven million Canadians live with diabetes or prediabetes.  Medication options for diabetes depend on the severity of the condition and may include oral tablets, injectable medications, insulins, or a combination of all three.

While people with diabetes often take steps to treat their hyperglycemia (high blood sugar), some diabetics can also experience hypoglycemia (low-blood sugar).  Hypoglycemia is generally caused by: missing or delaying meals, extreme exercise without adjusting medication, alcohol consumption, or overdosing on diabetic medication.  Mild to moderate hypoglycemia is treated by ingesting 15 grams of glucose in the form of glucose tablets, 3 packages of sugar dissolved in water, or a half a glass of juice.   Severe hypoglycemia on the other hand, is a serious life-threatening complication of diabetes treatment that requires assistance from another person to treat because the low glucose levels cause neurological impairment.  Severe hypoglycemia is treated with glucagon (a hormone that raises blood sugar levels) and is administered via intramuscular injection in order to restore blood glucose levels to adequate levels.

Baqsimi is a new form of glucagon that is administered by inserting the tip of the device into the nostril and depressing the plunger to push the glucagon powder into the nostril where it is absorbed into the body.  This eliminates the need for injection associated with the traditional forms of glucagon treatment.

Clinical trials of Baqsimi demonstrate that Baqsimi is non-inferior to standard intramuscular glucagon injection (IMG).  Caregivers surveyed in real world studies agreed that administering Baqsimi would be less intimidating than IMG.  In addition, these real world studies demonstrated that when compared to IMG, more trained and untrained users were able to successfully administer Baqsimi than IMG.  These trials show that while Baqsimi is similar in efficacy to IMG, it is also easier to use compared to IMG.

Baqsimi has a list price of $131.60 per unit and will be Fully Covered under ClaimSecure’s standard Open & Managed formularies.

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Fully covered

ClaimSecure Inc. reserves the right to amend in part, or in its entirety, its Special Authorization guidelines.


  1. (2020). Funding accountability. [online] Available at: [Accessed 4 Mar. 2020].
  2. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1):S1-S325
  3. Ricketls et al. Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults with Type 1 Diabetes: A randomized Crossover Noninferiority Study.  Diabetes Care, 2016. 39(2): p.264-70