Type 2 diabetes
Type 2 diabetics and their physicians now have another option when choosing medications to treat the disease. The Food and Drug Administration recently approved Januvia, the first in a new class of medicines that increase the body’s ability to lower its own blood sugar levels. While it is touted as having fewer side effects than diabetes drugs already on the market, it is also more expensive.
Endocrinologist Julie Hendrix, M.D., says Januvia is noteworthy because it addresses diabetes treatment in an entirely different way than current drugs, but different doesn’t necessarily mean better.
“It is great any time we have an alternative to medications we have been prescribing, but physicians still have to determine the best option for individual patients,” she says. “Some patients can’t tolerate existing medications or suffer side effects from them. The great thing about Januvia is the side effect profile is extremely low.”
Patients taking Januvia in trials reported no weight gain and experienced fewer episodes of excessively low blood sugar than those on other diabetes medications. In addition, Hendrix says, Januvia can be prescribed with kidney disease and heart disease, conditions diabetes patients often have. Some diabetes medications currently being prescribed can’t be taken by patients with those and other diseases.
Januvia treats only type 2 diabetes, in which either the body does not produce enough insulin or the insulin that is produced is not used correctly. Insulin is needed to process sugar. Januvia increases the level of a hormone that triggers more insulin production and at the same time signals the liver to stop making glucose. More than 20 million people in the United States have diabetes and 90 percent of those are type 2 diabetics.
The cost of Januvia may be a deterrent for patients, as initial reports indicate it will cost between $3 and $6 a day. Some older diabetes drugs may cost only 50 cents a day, but Hendrix says despite its higher price, Januvia may be cost effective for some patients.
“It is definitely more costly than generic medications, but the cost factor also depends on dosage and how patients use it,” she says. “Two bottles of insulin would cost more than this drug, but if you use a smaller dosage of a generic, then Januvia would be more expensive.”
Williamson Medical Center Pharmacy Director Neill Little, D.Ph., says it is not uncommon for new drugs, especially new classes of medications, to be significantly more expensive than those already on the market.
“It costs a drug company at least half of a billion dollars to get a new medication on the market, and it can be more,” Little says. “The prices are set to recoup some of that cost.”
He adds not all of the medications that companies develop hit the market, as they may discover side effects or other issues. That expenditure is sometimes covered in the cost of drugs that are approved by the FDA and distributed.
Typically, a company has nine to 10 years, Little says, to recoup cost before generics are produced. However, some medicines are so expensive to produce that generics may never be available. While both Hendrix and Little say cost is somewhat of a factor in whether Januvia will be mass-prescribed, how well the drug works also carries weight.
“The success of a new drug is dependent on how much better it treats conditions compared to other drugs out there,” Little says.
While Januvia joins several classes of drugs that are used to treat diabetes, diet and exercise is still the best treatment for type 2 diabetes, Hendrix says.
Free glucose screenings for Diabetes Awareness Month
It is estimated that more than 6 million people in the United States have diabetes but don’t know it. While textbook symptoms of type 2 include excessive thirst and urination, fatigue and blurred vision, those symptoms typically do not occur until later stages of the disease and after many have been diagnosed.
Long-term complications of diabetes include eye disease, nerve disease, kidney disease and coronary artery disease, although these complications can be avoided or the risk can be reduced by controlling blood sugar levels.
Could you have diabetes?
Williamson Medical Center is offering free glucose screenings in November at CoolSprings Galleria.
• Screenings will be near the food court.
• Results will be available within 10 minutes.
• Screening participants are not required to fast.
• Diabetes educators will be on hand to answer questions.
• Reservations are not required.
• Screenings will be:
o Saturday, Nov. 11, 1 – 3 p.m.
o Sunday, Nov. 12, 2 – 4 p.m.
o Saturday, Nov. 18, 1 – 3 p.m.
o Sunday, Nov. 19, 2 – 4 p.m.
