Diabetes funding lifesaver
The breakthrough could extend the lives of 120,000 Kiwis battling the disease
New-generation diabetes drugs are set to be publicly funded — a breakthrough that could keep up to 120,000 New Zealanders in good health and alive longer.
Pharmac has announced it wants pharmaceutical companies to submit proposals for the supply of new medicines to help Kiwis battling type 2 diabetes.
A leading diabetes clinician says the drugs being considered are “lifechanging and life-saving” — but Pharmac’s proposal meant they would be used only for special cases or as add-ons to the existing poor standard of care.
“They must be funded for full open access, and as second and third-line treatments,” said Dr John Baker, chairman of the Diabetes Trust.
About a quarter of a million Kiwis have diabetes, and another 100,000 are thought to be undiagnosed. Around 90 per cent have type 2, the sort mostly brought on by lifestyle and linked to obesity.
Pharmac’s deputy medical director, Dr Peter Murray, said patients and clinicians had been asking for the new medicines to be funded.
“Evidence suggests these medicines do more than just reduce sugar levels in people with type 2 diabetes. They can also help address related complications like kidney and heart disease.
“We hope to fund at least one of these medicines by negotiating with medicine suppliers and running a competitive pricing process.”
The new medicines are called SGLT-2 inhibitors, GLP-1 agonists and DPP-4 inhibitors. Pharmac has issued a request for proposals (RFP), something done when more than one medicine is available to treat a condition, such as when there are multiple brands or when different medicines have a similar therapeutic effect. The process could take several months.
It comes after an ongoing Herald investigation into the growing toll of diabetes, with amputations now topping 1000 every year as clinicians and patients struggle with the worst range of funded diabetes drugs in the developed world.
Responding to those findings in October last year, Associate Health Minister Peeni Henare revealed talks with Pharmac about funding better drugs, and said he personally supported tough measures including a sugar tax and warning labels on junk food (a sugar tax has been ruled out by the Prime Minister).
Last night, Henare said Pharmac’s announcement was “a positive step in the right direction” and the medicines had the potential to benefit about 120,000 Kiwis living with type 2 diabetes and at risk of further complications. “The number of New Zealanders with diabetes is growing and the burden of this disease disproportionately falls on people living in deprived communities . . .” Henare said.
“A wide range of tools and approaches are needed, including prevention — lifestyle changes, diet, physical activity, and early intervention to turn this tide.”
Baker, who as well as chairing the Diabetes Trust is a specialist at Middlemore Hospital, said the medicines were the first of a new generation of drugs that reduce cardiovascular deaths and progression to renal failure.
“Currently funded medications do not do this. The new drugs are also associated with lower incidence of side effects. They cause weight loss — rather than weight gain — and they do not cause hypoglycaemia [low blood sugar]. Combined with being relatively cheap and easy to use, these drugs are life-changing and lifesaving.” However, Baker said Pharmac’s proposal was “devastating” because it would only allow the medicines to be used rarely and in addition to the current standard of care, which international diabetes associations had deemed third world.
“Pharmac should be under no illusion — after 20 years of waiting, clinicians will not accept an outcome where these medicines are funded only for special cases or only as adjuncts to the existing poor standard. They must be funded for full open access, and as second and thirdline treatments.”