Brand of the Year: Januvia - Pharmaceutical Executive

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Brand of the Year: Januvia


Pharmaceutical Executive


Taking the long view

As mentioned at the outset, the challenge for patients with diabetes is to focus on the long-term, and to prevent negative outcomes in the future by making good decisions now. But this problem isn't unique to diabetics. Adherence rates are poor across numerous disease areas, particularly when skipping a dose doesn't come with immediate consequences. The problem isn't even unique to patients—business and government aren't so good at foregoing immediate rewards for the sake of perpetuity—there are powerful cognitive biases that get in the way. Regulators measure drugs by their ability to extend lives, but we make decisions every day—not to exercise, not to eat well—that are likely to shorten them. What new funding models will support the long-term propositions and additional clinical trials needed to bring new drugs to market? What governments will continue to support pre-clinical research that won't pay off for decades?

In the diabetes community, "something on the order of 50 percent of patients drop off therapy within six to seven months, and that's across different diabetes therapies, but particularly in Type 2," says El-Dada. No one wants to have to take medicine every day, and to some extent science can be brought to bear on the adherence issue. "So far none of the therapies we have are truly disease modifying, and diabetes is a progressive disease," says Thornberry. "We know that new therapies can't just be incrementally better…the bar is higher now, so in earlier development we're looking at mechanisms that have substantial benefit over the standard of care." But no amount of science can force patients, governments, businesses, and everyone else to make decisions that put tomorrow on an equal footing with today. That is what's needed most for better outcomes of all kinds. That and ever better medicines.

Ben Comer is Pharm Exec's Senior Editor. He can be reached at
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