‘One size does not fit all’ should not apply for diabetes treatment
NEW YORK Type 2 diabetes patients are similarly treated for their condition, despite possibly having different therapeutic responses, a consensus statement published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism noted.
The group, consisting of experts in diabetes epidemiology, physiology, genetics, clinical trials and clinical care, believe that care experts need insight on their patients’ response to certain therapies by researching their physiologic and genetic make-up. They suggested that individualized treatments for patients will:
- improve glycemic control
- maximize individual benefit, minimize risk
- reduce diabetes complications, and ultimately
- provide reductions in global health cost.
“The progress already seen has stemmed from combining discoveries of specific genetic susceptibilities with clinical observations. As we move forward, we should continue to incorporate these and additional clinical observations with new data on the physiology and genetics of diabetes to assess which patients will benefit most from specific treatments,” said Robert A. Vigersky, MD, president of The Endocrine Society. “The recommendations in this consensus statement highlight the need for the research community and industry to each play their part in improving our ability to individualize therapy so that patients can get the most accurate and appropriate treatment.”
The consensus statement included a series of recommendations for increasing understanding of the heterogeneity of diabetes and achieving the goal of individualizing therapy and improving treatment response. Statement recommendations include:
- Extend analysis of existing data and data sources — There are already a plethora of data and data sources that could be potentially valuable in individualizing therapy; however, to date, these have been largely underutilized. Pooled analyses or meta-analyses of such data may provide important insights into the relative effectiveness of specific interventions in subgroups of patients with Type 2 diabetes and advance our understanding of individualized therapy.
- Expand existing or develop new data registries — All new and existing diabetes registries should systematically collect data to address phenotypic and genetic heterogeneity measures. Not only should these registries collect material for future biomarker and genetic analysis, but registries should be designed to specifically address the heterogeneity of diabetes with hypotheses generated by examining existing data.
- Develop new clinical trials — Future randomized studies of diabetes therapies should, by design, collect phenotypic information relevant to response to therapy.
- Develop new technologies — Targeting therapy toward more appropriate subgroups of patients will require increasingly accurate and efficient methods to measure markers for diabetes heterogeneity and heterogeneous response to treatment.
- Expand basic research — Basic research is needed to explore numerous fundamental issues that underlie the heterogeneous response to diabetes therapies.
Increased drug sales may yield overall economy’s comeback
WHAT IT MEANS AND WHY IT’S IMPORTANT The uptick in prescription drug sales growth may or may not be yet another indicator of improvement in the U.S. economy, but it is, without a doubt, indicative of a return to growth for the prescription drug market and, by extension, an indicator of growth among retail pharmacies.
(THE NEWS: U.S. drug sales saw growth in 2009, IMS Health says. For the full story, click here)
When IMS Health reported that prescription drug sales had $300.3 billion in sales in 2009, a 5.1% increase over 2008, the figure included every distribution channel. But the bulk of those sales, $164 billion, were through retail channels, including retail pharmacy chains, independents and supermarket pharmacies.
The biggest increase between 2008 and 2009 was in chain stores, which saw a 3.6% increase in prescription drug sales, from $101.8 billion to $105.5 billion. Sales in supermarkets increased by 1.4%, from $20.9 billion to $21.2 billion. Meanwhile, independents had a 2.1% decrease, from $38.1 billion to $37.3 billion. A similar trend appears when figures for dispensed prescriptions are broken down by distribution channel, with a large increase in chain stores, a smaller increase in supermarkets and a decrease in independents.
Sales of specialty drugs went up as well. With $8 billion in sales, compared with $7.5 billion in 2008, monoclonal antibodies for treating cancer rank sixth in IMS’ list of the top 15 therapeutic classes, compared with their seventh-place ranking last year. Biotech drugs for treating arthritis and inflammatory diseases rank eighth and fourteenth, respectively, though erythropoietins, for treating anemia, had a $900 million decrease in sales.
IMS doesn’t have a specific category for the specialty channel, but it does have them for mail service and home health care, two channels used extensively by specialty pharmacies. Though drug sales through the home healthcare channel had a slight decrease, from $2.6 billion in 2008 to $2.5 billion in 2009, mail-service sales increased from $46 billion to $51.5 billion, placing the channel in second place, below retail pharmacy chains, even though it ranked last when measured by U.S. dispensed prescriptions, which also decreased slightly, from 238.4 million in 2008 to 237.5 million in 2009.
Strong efforts by retail pharmacy to boost offerings pay off
WHAT IT MEANS AND WHY IT’S IMPORTANT Serving as yet another indicator of the important role that retail pharmacists play in the U.S. healthcare system is the data conducted by Wolters Kluwer revealing that vaccinations jumped by double-digits this flu season.
(THE NEWS: Flu shot distribution by retail pharmacy increases 36%. For the full story, click here)
As the article states, seasonal flu shots administered by pharmacists grew 36% this flu season, capturing about 10% of the total administered nationwide, according to Wolters Kluwer data.
There are several drivers fueling the growth. First, there’s the fact that retail pharmacy — and the retail health clinics they may have in-store — offers patients a convenient solution for immunizations via an expansive network of immunizing pharmacists, nurse practitioners and physician assistants. And not only do many retail pharmacies set up and promote flu clinics, but several retail-based clinic operators have heavily promoted their services.
As previously reported by Drug Store News, both MinuteClinic, which is owned by CVS Caremark, and Take Care Health Systems, which is owned by rival Walgreens, broke new ground in the second half of 2008 with major ad campaigns promoting their service offerings and convenience.
In September 2008, CVS Caremark kicked off its "Flu Shots Made Simple" campaign to bolster awareness of the company’s integrated flu vaccination offering via MinuteClinic locations, pharmacist-administered shots and scheduled flu shot clinics within select stores.
Take Care Health Systems then announced in mid-October of that year the launch of a new multimedia brand and advertising program dubbed "Life Diagnosis." Similar to MinuteClinic’s campaign, the Take Care campaign had a specific focus on cough-cold-flu and coincided with the official start of cold and flu season, and all Take Care clinics beginning to offer flu vaccines.
Clearly, these efforts have helped shore up foot traffic at community pharmacy and retail-based health clinics.