Are Actos and Avandia to blame for rising diabetes costs?

Matthew Mintz takes exception to the criticism that Actos and Avandia are taking. This class of diabetes medication, known as thioglitazones, have been much maligned due to possibly dangerous adverse outcomes combined with only a modest benefit.

Dr. Mintz wonders why the newer insulins aren’t scrutinized as carefully:

The TZDs (Avandia and Actos) did peak in 2005 at 34%, but their use in 2007 is now the same as it was back in 2001 and prescribed at 28% of visits. The money spent doubled from about $1.9 billion in 2001 to $4.2 billion in 2007.

Per the study’s estimates TZD’s, Lispro and Lantus all cost $160, $156 and $123 respectively, which is not that much different. Thus, of the extra $5.8 billion dollars we are paying more for diabetes, $2.3 billion is coming from the TZD’s, and $1.9 billion is coming from the newer insulins.

One reason is that the branded insulins are not associated with the adversity that Avandia has brought to the thioglitizones. The long-acting insulins like Lantus and Levemir also provide a convenience factor for patients, which helps with compliance.

The jury is still out on the cost-effectiveness of Januvia and Byetta. The weight loss component of Byetta is appealing, but these drugs are still too new to make a decision on whether they are worth the price or not.

topics: diabetes, avandia

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