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New medicine could help diabetics save Rs 10,000 per year


MUMBAI: A new anti-diabetes drug from the 'gliptin' family soon to be launched in India promises to lower treatment cost for patients by 55-60%. 

The launch of 'Teneligliptin' by Mumbai-based Glenmark Pharma under Ziten and Zita Plus brands at an affordable price could prove to be a game-changer with savings of over Rs 10,000 per year for diabetics. Treatment cost for the debilitating disease which gradually attacks and weakens all body organs may come down further over months, with possibly more domestic companies entering the market, experts said. 

Teneligliptin, a third-generation oral anti-diabetic drug manufactured by Gl
enmark, has received regulatory approval and is priced aggressively at nearly Rs 20 for a day's therapy (Rs 7,263 per year). As against this, all gliptins being sold in the market are priced around Rs 45 for a day, taking the cost of treatment for patients to nearly Rs 16,500 per year. (See chart) 

Most gliptins launched by MNCs in the country are currently imported. While manufacturing the drug entirely in the country, the pharma company has sought to connect its innovation to the Narendra Modi government's 'Make in India' programme. 


Diabetes is fast gaining the status of a potential epidemic in India with over 67 million individuals currently diagnosed with the disease (source: IDF 2014), while there is a huge undiagnosed diabetes population estimated around 35.4 million. 


The economic burden of diabetes is high in India as most patients pay out of their pocket for treatment due to the lack of medical reimbursement. The cost of treatment includes consultation, investigations, drugs and monitoring, and, due to the nature of the disease, the complications related to the disease may increase it substantially. 

Due to the high cost of therapy, patients from the lower socio-economic class tend to neglect it, or at times are forced to take loans, mortgage or sell property. 

Though the new class of drugs, gliptins (also called DPP-4 inhibitors), are increasingly emerging as a highly popular therapy, it is prescribed to only one in 10 diabetics in cities. Doctors say the price, particularly for economically-constrained patients, has always been an area of concern. 

"Cost of conventional treatment of diabetes is often prohibitive for most Indians; and addition of newer drugs (gliptins, SGLT-2 inhibitors), often needed to control blood sugar and prevent complications, makes it higher. In this respect, any drug of new category (gliptins) at half the price of available drugs of similar category is welcome in India," said Dr Anoop Misra, chairman Fortis-C-DOC Hospital for Diabetes. 


Overall, the oral anti-diabetic market in which Teneligliptin is the new entrant, is valued at approximately Rs 4,800 crore, increasing at 19% per annum (source: ORG-IMS MAT April 2015), while the gliptin family is at Rs 1,200 crore, growing at 27%. 

However, since the molecule has not been used extensively right now, its safety data needs more scrutiny, doctors say. "In general, gliptins tend to do well in Indians as we eat more carbohydrates and need lower doses. But we need more safety and outcome data on Teneligliptin coming from India," said Dr Shashank Joshi, endocrinologist and diabetologist. 

The drug, originally developed by Mitsubishi Tanabe Pharma, is approved for use mainly in Japan and Korea, and will be available in the country soon, said a Glenmark official. The company received approval from DCGI after conducting clinical trials on the molecule for over two years in India, he added. 

Globally, a recent study has dissipated a cloud that had been hanging over one of the gliptins, where it was found that there was no cardiovascular problems like heart failure associated with the use of these drugs, including Merck's Januvia. 


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