New drugs offer hope for better diabetes treatment
The recent film “Contagion” depicts the world descending to chaos due to the spread of an extremely deadly virus. But in reality, one of the most serious epidemics doesn’t come from an infectious agent but from people’s life choices.
Diabetes currently affects 26 million people in the United States, with Type 2 diabetes making up the bulk of the epidemic and expected to exact tremendous costs to the U.S. economy as it expands over the next several decades. But while healthier lifestyles ultimately are the best way to combat the Type 2 diabetes epidemic, a number of companies are developing drugs to treat it.
Among these is dapagliflozin, a treatment developed by Bristol-Myers Squibb and AstraZeneca. “Physicians are enthusiastic about this drug’s novel mechanism of action — the drug promotes urinary excretion of excess glucose — because it carries a very low risk of hypoglycemia, even when used in combination with other antidiabetic drugs, and causes modest amounts of weight loss,” said Decision Resources analyst Christine Helliwell, noting that hypoglycemia often is a limiting side effect of diabetes drugs.
But whether the drug will receive approval remains in doubt, as a Food and Drug Administration advisory committee recommended against its approval in July, raising the possibility that the FDA might decline to approve it. However, this wouldn’t be the end of the road, as there may still be steps that BMS and AstraZeneca can take to win approval.
Novo Nordisk is developing the long-acting insulin analogue degludec, which Helliwell said may be more suitable for elderly or fragile patients due to its lower risk of hypoglycemia. Meanwhile, Bydureon (exenatide), a long-acting version of the Type 2 diabetes drug Byetta — made by Eli Lilly, Amylin Pharmaceuticals and Alkermes — is expected to do well.
Caregivers likely to be nonadherent
About half of people who provide care and support to loved ones said they are more likely to be nonadherent to their own personal medication regimen than to neglect providing medications to those they are caring for, according to a study by researchers at Harvard University, Brigham and Women’s Hospital, and CVS Caremark. Given this, there’s a significant opportunity for pharmacists and doctors to identify and work with caregivers to improve medication adherence and chronic disease management.
For the study, published in the Journal of the American Pharmacists Association, the research team conducted an online survey of 2,000 retail pharmacy customers of which 38%, or 762 respondents, described themselves as caregivers. Of that group:
45% said they somewhat or strongly agreed that they are more likely to forget to take their own medications, even though they provide family members with their medicines; and
When comparing caregivers with noncaregivers, caregivers said they are 10% more likely to forget taking their medicines, 11% are likely to stop taking their medications if they feel better and 13% said they are likely to forget to fill their refills.
More than 65 million Americans describe themselves as caregivers, and as the U.S. population ages, that number is expected to grow.
Dispense-as-written Rxs exacerbating healthcare costs
“Dispense-as-written” prescriptions are exacerbating medication nonadherence and costing the U.S. healthcare system up to $7.7 billion annually, according to a study by researchers at Harvard University, Brigham and Women’s Hospital, and CVS Caremark.
Researchers estimated that patients in the study would have saved $1.7 million and health plans would have spent $10.6 million less for the medications if effective generic alternatives had been provided in place of brand-specific medications. Assuming a similar rate of dispense-as-written requests for the more than 3.6 billion prescriptions filled in the United States annually, patient costs could be reduced by $1.2 billion, and overall health system costs could be reduced by $7.7 billion.
Researchers also found that when starting new essential therapy, particularly among chronically ill patients with dispense-as-written prescriptions, patients were 50% to 60% less likely to actually fill the more expensive brand-name prescriptions than they were to fill generics.
The study reviewed 5.6 million prescriptions adjudicated by CVS Caremark for 2 million patients from Jan. 1 to 31, 2009.