KEY POINTS:
A new drug that can extend the life of Type 2 diabetes sufferers and reduce complications comes before a Pharmac advisory committee next month.
The drug, Januvia, lowers the blood-sugar level of a patient with early-stage Type 2 diabetes, decreasing the chances of the amputations, blindness and heart and liver disease brought on by the high blood-sugar levels that come with the disease.
It is also free of the common side-effects - hypoglycaemia (dangerously low blood-sugar levels) and weight gain - associated with the traditional drugs of its type.
The drug has the support of Diabetes New Zealand president Mike Smith and leading diabetes specialist Dr Brandon Orr Walker.
Expected to be able to improve the quality of life of 20,000 to 50,000 of the 180,000 New Zealanders with Type 2 diabetes, it had the potential to dramatically decrease the country's spending on the disease, Dr Orr Walker told the Herald yesterday.
Less than half New Zealand's Type 2 sufferers met their targeted blood sugar levels, he said. The resulting increase in glucose levels contributed to the wide-ranging, debilitating and often fatal complications of diabetes.
New Zealand's cases of Type 2 diabetes continued to increase 50 per cent faster than population growth, he said, with the financial burden to the country increasing with them.
With estimates suggesting that cost was well over $500 million a year, and would rise to nearly $2 billion a year by 2021, the need to add effective weapons to the treatment arsenal was essential.
He expected the drug, taken orally once a day, would lower the incidence of common diabetes-related complications within four to five years of the drug being publicly funded and widely prescribed. Within eight to 10 years the rates of diabetes-related heart attacks would begin to drop to a level lower than without the drug. Within 12 years the country would have less diabetes fatalities.
Januvia was approved for sale in New Zealand by Medsafe on February 28 this year, but has yet to get Pharmac funding.
An initial meeting with Pharmac in June to discuss the drug ended with the committee accepting its benefits but requesting further long-term evidence of its usefulness and safety.
Being such a new drug, the available data only stretch out two years. It shows no drop-off in effectiveness, and no increase in side-effects, its manufacturer Merck Sharpe and Dohme says.
Dr Orr-Walker accepted there was a lack of long-term data but said all the available evidence, including that from the patients he had seen using Januvia, showed it to be effective and without side-effects.
"We don't have 20 years of confidence but what we do see from two years is sustained glucose improvements without evidence of causing harm."
He said diabetes was seen as a disease of national significance, and it was important the tools doctors had to manage it were resourced properly.
He said common arguments that the disease was caused by bad habits and should therefore not receive funding increases missed the point.
All the disease's complications cost the taxpayer considerable money, and a drug that lowered those complications was therefore cost effective.
Without funding the drug cost $100 to $110 each month, depending on the pharmacy. There are 48 people funding their own course of the drug.
JANUVIA
Why is this drug important?
* The pancreas of a Type 2 diabetes patient doesn't work properly.
* That leaves the patient with less sugar in the blood.
* This creates problems, including gangrene, blindness and heart disease.
* The drug helps the patient's pancreas release more sugar into the blood.
* Improvements to early-stage diabetes patients' blood sugar levels gives them health benefits for the rest of their lives.
