E-DRUG: 4 Diabetes Drugs Are Seen Raising Hope and Profit (2)
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[Copied from Ip-health]
Hi Jamie
In response to your question, a lot would depend on the benefits that
might accrue from such new antidiabetics. If we focus only on the type 2
variant, our experience in recent years with new classes has been less
than exciting - the alpha glucosidase inhibitor acarbose (sold here by
Bayer as Glucobay) has a marginal place in management; the thiazolidinediones such as pioglitazone (Eli Lilly's Actos) and rosiglitazone (GSK's Avandia) are expensive add-ons to conventional therapy and are associated with worrying liver toxicity; the meglitinides, such as nateglinide (Novartis' Starlix) and repaglinide (Novo's NovoNorm) are expensive alternatives to the sulphonylureas. In our market, there are
generic equivalents of metformin (used here for many more years than in
the US, where registration was delayed) and many of the sulphonylureas (such as glibenclamide (glyburide in the US), gliclazide and even glimepiride). Only glipizide (Pfizer's Minidiab) has no generic competition at present. Prices are keen, in the region of $6 to $10 per month (single exit price to all sellers apart from the State; i.e. before pharmacy mark-up, which is in transition at present, but would not exceed 36%) for generics and perhaps twice that for innovator brands. The meglitinides cost twice that again.
We would first have to consider the impact on hard outcomes (death,
development of complications), the incremental gains in relation to
conventional therapy and then the incremental costs involved. That said,
I would expect many of these new agents to be registered in South Africa
almost as soon as in the US, catering for a particular segment of the
insured market (at most 14% of the population). The public sector will,
however, not adopt this new technology until the data to support such a
move are available and the prices reasonable. If the gains are not worth
it clinically, no price will be low enough.
regards
Andy