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NICE looks set to back ‘triple therapy’ diabetes drug

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The National Institute for Health and Care Excellence has provisionally recommended dapagliflozin for treating type 2 diabetes in “triple therapy”.

Under its final draft guidance, dapagliflozin (Forxiga) can be added as a third drug if a diabetes patient is already taking two drugs but they are not controlling their blood glucose.

“This guidance plans to recommend dapagliflozin in triple therapy”

Carole Longson

Once final guidance is published, dapagliflozin will join two other similar drugs, empagliflozin (Jardiance) and canagliflozin (Invokana), as options for triple therapy.

All three drugs are already recommended for use on their own if a patient cannot use metformin or other specific drugs, or in combination with metformin as dual therapy.

This final draft guidance is now with consultees, who have the opportunity to appeal against it, said NICE.

Until it issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments. If subsequently recommended, the NHS must make sure the drug is available within three months of the guidance publication date.

Professor Carole Longson

Professor Carole Longson

Professor Carole Longson

Professor Carole Longson, director of the NICE centre for health technology evaluation, said: “Tailoring treatments for type 2 diabetes to each person’s individual needs is essential and having a range of drug options makes this easier.

“This guidance plans to recommend dapagliflozin in triple therapy – only in combination with metformin and a sulfonylurea – which will widen the choice available,” she said.

“We’ve been able to speed up this appraisal, going straight to final draft stage because we plan to recommend dapagliflozin,” said Professor Longson.

She added: “This should help final guidance to be published sooner, and so benefit people more quickly.”

About dapagliflozin

Dapagliflozin (Forxiga), manufactured by AstraZeneca, is a selective sodium-glucose cotransporter 2 (SGLT-2) inhibitor. It blocks the reabsorption of glucose in the kidneys and promote excretion of excess glucose in the urine. The drugs empagliflozin (Jardiance) and canagliflozin (Invokana) are also SGLT-2 inhibitors.

The recommended dosage is 10mg dapagliflozin orally once daily for monotherapy and add-on combination therapy with other glucose-lowering medicinal products including insulin.

The list price of dapagliflozin is £36.59 for a 28-tablet pack of 5mg or 10mg tablets (excluding VAT). The cost of a course of treatment over one year is around £475.

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