Diabetes drug awaits Govt nod

By MARTIN JOHNSTON health reporter

A drug just approved in New Zealand could help tens of thousands of people with diabetes if it is approved for a Government subsidy.

Avandia was recently launched in Britain where it could help 400,000 diabetes patients but will add to the National Health Service's costs by about $NZ330 million a year.

The drug, which has been available for a year in the United States where it is used by one million diabetics, is being launched in Germany and Britain and has been licensed throughout Europe.

The market for the tablets, made by SmithKline Beecham, could be even bigger, running to one in four of the population who have health problems associated with being overweight.

A SmithKline New Zealand manager, Vicki Stynes, said the Ministry of Health approved the drug last month and an approach would now be made to Pharmac for a subsidy.

The drug would not be launched and promoted here unless a subsidy was granted, although it would be available on prescription in four to six weeks to patients prepared to pay the full price.

She did not know what the price would be.

In Britain, it costs $NZ1053 to $2106 a year per patient, depending on the dose.

The launch of Avandia, four days before the British Government unveils its national plan for the NHS, highlights the pressures on the service from scientific advance.

Avandia was billed as a turning point in the treatment of a disease which is a leading cause of blindness, heart disease and strokes.

Avandia is a treatment for people with type 2 diabetes, which mostly affects overweight adults in middle age and accounts for 90 per cent of all cases of the disease (the remainder with type 1 are mostly children). Scientists believe it could also prevent diabetes and reduce heart disease in the 25 per cent of the population with "insulin resistance." Research to test this will take a decade.

An estimated 137,000 New Zealand adults are diagnosed with type 2 diabetes, in which blood glucose levels can rise dangerously.

In Britain there are an estimated two million people with the disease but half are unaware of it.

The disease can initially be controlled by adjusting the diet, but many patients also need drugs and as it progresses these become less effective.

Avandia is made from rosiglitazone, one of a new class of agents - glitazones - which have been shown in trials to reduce blood glucose levels in a similar way to insulin when given in combination with existing treatments.

An earlier version called troglitazone, launched in Britain two years ago, was withdrawn after it was found in the US to cause liver failure in one in 60,000 patients.

No case of liver failure has been reported in the US with Avandia.

Tony Barnett, professor of medicine at Birmingham Heartlands Hospital, who has run trials of Avandia, said glitazones were the "first new agents since the mid-50s in Europe for the management of type 2 diabetes."

He added that "it would be incredible" if it could be shown that they prevented the disease.