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Survey: Insulin Degludec/Liraglutide Set to Become ‘Gold Standard’ Among Fixed-Dose Combo Therapies for Type-2 Diabetes

Need remains for agents that can elicit greater weight loss

Decision Resources Group, a health care research firm located in Burlington, Mass., reports that insulin degludec/liraglutide (Xultophy, Novo Nordisk; formerly known as IDegLira), a fixed-dose combination (FDC) therapy, is poised to become the clinical “gold standard” among FDCs used to treat patients with type-2 diabetes.

According to the report, the competitive advantages that this long-acting insulin analogue/glucagon-like peptide (GLP)-1 receptor agonist has over other FDCs are due to the combined actions of the individual components on various measures of glycemic control.

“Given that type-2 diabetes patients are often treated with several agents, FDCs are a way to improve convenience and compliance for patients with a high pill burden,” said analyst Tim Blackstock, MB, ChB, MPhil. “The main drawback highlighted by interviewed thought leaders is the less-flexible titration offered by these combinations compared with individual agents.”

Surveyed U.S. and European endocrinologists agreed that a therapy’s ability to reduce glycated hemoglobin A1c is the attribute that most influences their decisions regarding prescribing for patients with type-2 diabetes.

A greater reduction in body weight was highlighted by U.S. endocrinologists as the major unmet need related to the treatment of type-2 diabetes. Interviewed thought leaders noted that the co-administration of a GLP-1 receptor agonist with insulin has the potential to mitigate the weight gain associated with insulin treatment and were therefore enthusiastic about combining these treatments.

Surveyed U.S. payers indicated that improvements in the key efficacy attribute of a greater reduction in body weight and in the key safety attribute of a greater reduction in the incidence of cardiovascular adverse events will be chief drivers for formulary inclusion.

Source: Decision Resources Group; July 7, 2014.

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