It would be even more ethical if the patient got a copy of the prescribing information with every prescription. Not the dumbed down version, but a translation into English (or their native language) of the actual prescribing information.
That way if their doctor forgot that they have some condition or were taking some other medication that could be very dangerous to the patient, they'll have another way of finding out. They would also see the list of side effects and be more likely to recognize important ones, like muscle pain with statins, that doctors are prone to ignore.
why would lantus BID be 'off label'?- since lantus has no signifigant peak, taking it BID would be functionally equivalent to taking it once a day- the only context that this makes sense to me is to control temporal spikes, but then anyone who has temporal spikes on a lantus QD regimen probably just needs a short acting bolus to control the spike, rather than changing to a lantus BID 'bolus' to control the spike
The reason it's off-label is sanofi-aventis' decision not to run studies on Lantus that compare the efficaciousness of once-daily vs. twice-daily dosing and to put that information into the label.
And if I asked to were to guess why not, perhaps it might be that they don't want to dilute their message that it's a once-daily drug?