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Drugmakers angle for advantage in treating diabetes

Jun 29, 2011, 8:50 a.m.

By Deena Beasley

SAN DIEGO (Reuters) - Obesity and longevity have helped make diabetes an epidemic in much of the world, and drugmakers are jockeying to make sure their medicines are used early and often.

Companies including Sanofi and Eli Lilly aim to introduce new classes of drugs that could further extend treatment options, and potentially their market share.

Once diagnosed, people with type 2 diabetes are commonly treated with generic drugs, followed by several different classes of branded pills, injected medicines and eventually insulin.

Some major pharmaceutical players are trying to gain an earlier foothold in that succession of treatment as the market for such drugs has grown dramatically, with global incidence of diabetes reaching nearly 350 million cases over the last 30 years.

At the American Diabetes Association meeting in San Diego this week, Boehringer Ingelheim Pharmaceuticals and Lilly promoted their new oral drug, Tradjenta, as a better option for a patient's next line of defense after generics. Tradjenta, also known as linagliptin, is a member of a class of oral drugs known as DPP-4 inhibitors.

"Our focus is to be the first product to be added to metformin," said John Smith, head of clinical development and medical affairs at Boehringer. Metformin is the generic pill initially prescribed for many diabetes patients.

That goal may be helped by the fact that another class of branded diabetes drugs may be falling out of favor. Since patients now live for decades with diabetes, the safety profile of treatments has become even more important. Drugmakers face increased scrutiny of cardiovascular and cancer risks.

"Patients with type 2 diabetes are living longer, so there is a higher incidence of other problems," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York.

CONCERNS

Top-selling diabetes drug Actos, marketed by Takeda Pharmaceutical Co , is a high-profile example of the safety concerns. Recent data on the drug, with nearly $5 billion in annual sales, linked it to increased risk of bladder cancer if used for more than a year.

U.S. health officials added that information to the drug's label, while France and Germany suspended Actos sales.

Actos is a thiazolidinedione -- shortened to TZD or glitazone -- designed to lower the body's insulin resistance, the underlying problem for people with type 2 diabetes.

Earlier versions of glitazones caused serious liver damage for some people and were withdrawn from the market. Avandia, a member of the same class sold by GlaxoSmithKline , has been linked to heart risks.

For Actos, "it is too early to say" whether the preliminary findings have had an impact on sales, said Dr. Robert Spanheimer, Takeda's vice president, medical and scientific affairs. He said full results from the Actos safety trial will be available in 2013.

ORAL DRUGS SEEN AS MOST CONVENIENT

Global sales of diabetes medicines totaled $35 billion last year and could rise to as much as $48 billion by 2015, according to research firm IMS Health, driven by increased prevalence and treatment, especially in countries such as China, India, Mexico and Brazil.

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