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Generic Dapagliflozin: Converging Paradigms towards Gliflozins

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Dr KK Aggarwal    14 November 2020

The management of diabetes demands an equal emphasis on the dual goals of treatment i.e. effective glycemic control and prevention or slowing down the progression of complications. This can be achieved by considering treatments that work effectively and safely by controlling blood glucose levels, and at the same time have independent action on diabetes-associated comorbidities.However, there is a paucity of affordable treatments that offer extra glycemic benefits.

The relatively novel oral antidiabetics, SGLT2 inhibitors are now at the forefront of the therapeutic options for diabetes owing to their ability to help stave off adverse cardiovascular and renal events in patients with type 2 diabetes mellitus (T2DM). But only a small proportion of people who could benefit from these drugs take them, while for many these drugs are beyond their budget. With an increased risk of complications and adverse events in patients with diabetes, one’s adherence to therapy mustn’t fall by the wayside. The recent launch of generic dapagliflozin at almost one fourth of the price has paved the way for affordable and effective diabetes care to reduce the burden of complications and adverse events.

Dapagliflozin has demonstrated benefits for blood pressure lowering, reduced risk of cardiovascular death and hospitalization for heart failure, and all-cause death in patients with T2DM.1, 2 It also reduces the risk of renal failure in patients with CKD with or without T2DM.3

The cost of management of these complications is huge in terms of finance and deterioration of the patient’s quality of life. Prevention of even one adverse cardiovascular or renal event can considerably reduce this burden. Low-cost generic dapagliflozin will allow clinicians to bring a greater pool of patients under the ambit of evidence-based cardio- and reno-protection. The steeply reduced prices of dapagliflozin further render it superior over remogliflozin, which was until now the most economic gliflozin though with sparse evidence to support its efficacy. Overall, diabetes is associated with tremendous individual and system burden, largely due to the increasing load of comorbidities and costs of their management. The entry of low-cost generic dapagliflozin in the market now offers assured utility with demonstrated clinical benefits for reduction of risk of cardio-renal complications that too at prices even lower than remogliflozin. Dapagliflozin is also about 70-75% economical in terms of cost as compared to other available gliflozins.

 

References

  1. Dhillon S. Dapagliflozin: a review in type 2 diabetes. Drugs. 2019;79(10):1135-46.
  2. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2019;380(4):347-57.
  3. Heerspink HJ, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in patients with chronic kidney disease. N Engl J Med. 2020 ;383(15):1436-46.

 

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

 

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