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Survey: Insulin Peglispro Poised to Become ‘Gold-Standard’ First-Line Therapy for Type 2 Diabetes

Improvements in hemoglobin reduction will drive formulary inclusion

Decision Resources Group, a health-care research firm located in Burlington, Mass., finds that insulin peglispro (Eli Lilly) is set to become the clinical “gold standard” in the treatment of patients with type 2 diabetes who are inadequately controlled with diet and exercise when metformin is not a therapeutic option.

Although metformin continues to dominate first-line treatment, a significant proportion of patients are initiated on alternative antidiabetic agents, the survey finds. Experts in the field and recent guidelines indicate that the type 2 diabetes treatment paradigm is shifting towards greater individualization of therapy. From a selection of current and emerging therapies, insulin peglispro appears to offer the best combination of efficacy, safety, and delivery attributes, according to the report.

Surveyed U.S. and European endocrinologists agreed that a therapy’s ability to reduce glycated hemoglobin A1c (HbA1c) is the attribute that most influences their prescribing decisions in type 2 diabetes.

Greater reduction in body weight was highlighted by endocrinologists as one of the most pertinent unmet needs related to the treatment of type 2 diabetes and is an issue associated with the use of insulins. Insulin peglispro has the potential to capitalize on this unmet need, as it is appears to demonstrate weight-neutral or modest weight-loss effects, the report says.

Surveyed U.S. payers indicated that improvements in the key efficacy attribute of greater reduction in HbA1c and in the key safety attribute of a reduced incidence of hypoglycemia will be chief drivers for formulary inclusion.

“As there are now a multitude of antidiabetic agents and a better understanding of the pathophysiology of the disease and the impact of its complications, physicians face a much more challenging decision about what antidiabetic agents to use and when to use them in their patients,” said analyst Tim Blackstock, MB, ChB, MPhil.

Source: Decision Resources Group; May 27, 2014.

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