Diabetologists prefer multi-drug therapy

EPP News Bureau - Mumbai

Though the anti-diabetes market in India indicates a growing preference for combination therapy, diabetologists — the mainstay of the anti-diabetic prescribing population, prefer to co-prescribe oral hypoglycemic agents (OHAs), according to a report by ACNielsen ORG-MARG Pharma.

Despite the widespread availability of combinations, diabetologists tend to recommend sulphonylurea (glibenclamide/glimepride) in conjunction with a biguanide (metformin) and glitazone (pioglitazone/rosiglitazone). The surge in the average number of brands prescribed per prescription by diabetelogists from 368 per 100 prescriptions to 414 per 100 prescriptions reflects this trend, release added.

Multi-drug therapies are witnessing in a powerful growth trend for plain OHAs despite the emergence of combinations. Even a new molecule like Pioglitazone has witnessed an eight fold growth in co-prescriptions (from 10,800 to 82,000) despite being available in a combined form with Metformin, the base therapy for diabetes.

The new glitazones are mainly co-prescribed along with metformin and a sulphonylurea or a combination of the two. This allows a diabetologist to titer dosage and strengths before arriving at a right combination to stabilise blood glucose levels for each individual patient allowing for a greater degree of flexibility in customising therapies for different patients.

The share of combinations, especially those that combine pioglitazone and glimepride with metformin appear on the rise. Pharma companies in India, constantly monitoring prescription trends within growing categories are increasingly becoming aware of the gradual shift towards combination therapy as doctors reduce their preference for prescribing plain OHAs, the release stated.