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Bangladesh gets game-changing diabetes treatment

Semaglutide works by stimulating the body’s own production of insulin, a hormone deficient in people with diabetes, and reducing appetite

Novo Nordisk, the world’s biggest insulin maker, yesterday announced the rollout of once-a-week semaglutide injection for the treatment of type 2 diabetes in Bangladesh.

Semaglutide works by stimulating the body’s own production of insulin, a hormone deficient in people with diabetes, and reducing appetite, an attribute that has garnered it the label of being a game-changing drug in bringing about weight loss in patients with obesity in the US.

In a clinical trial published in the New England Journal of Medicine, researchers at Northwestern University in Chicago tested semaglutide at a much higher dose as an anti-obesity medication.

Nearly 2,000 participants, at 129 centers in 16 countries, injected themselves weekly with semaglutide or a placebo for 68 weeks. Those who got the drug lost close to 15 percent of their body weight, on average, compared with 2.4 percent among those receiving the placebo.

More than a third of the participants receiving the drug lost more than 20 percent of their weight. Symptoms of diabetes and pre-diabetes improved in many patients, reports The New York Times.

Those results far exceed the amount of weight loss observed in clinical trials of other obesity medications, experts said.

Being able to offer a medicine such as once-weekly semaglutide with its superior blood glucose control, reduction in body weight and proven cardiovascular benefits, is a huge step forward in the management of this complex condition, said AK Azad Khan, president of the Diabetic Association of Bangladesh (BADAS), at the launch of the revolutionary drug marketed as Ozempic at the capital’s Hotel InterContinental.

However, its price might be a hindrance to the success of semaglutide in Bangladesh.

At Tk 14,259 a shot, its price is too steep in a country where the per capita income is in the neighbourhood of Tk 1.75 lakh and the current monthly insulin solutions cost one-third the price.

This is not entirely new territory for the Danish drug giant.

For years, the 98-year-old company put all its eggs in one basket: with a single-minded focus, it went about making insulin better and better and charging customers more and more for each now improvement.

The strategy worked, boosting profit margins and swelling the company’s stock price as diabetes, an incurable disease, morphed into a global epidemic in the past decade.

Then at one point, Novo Nordisk’s customers globally realised they do not want to pay more for another wave of better insulin as they deemed the established versions to be adequate, thus settling an example of commercial limits to innovation.

Of late, the Danish drug giant has been walking on a tight rope globally in pricing its latest versions of insulin.

Over in Bangladesh, a country with about 8.4 million diabetic patients, Novo Nordisk has managed to sidestep such a problem thus far.

Since 2012, Novo Nordisk, in partnership with Eskayef Pharmaceuticals, a leading pharmaceutical company owned by Transcom Group, has been manufacturing insulin in Bangladesh. Transcom Distribution distributes the insulin across the country.

Novo Nordisk is playing a vital role in introducing research and development based innovative diabetes treatment to the diabetic patients of this country, said Winnie Estrup Petersen, the Danish ambassador to Bangladesh.

It has been working closely with the Diabetic Association of Bangladesh in creating nationwide awareness and education to address the burden of diabetes, said Md Sayef Uddin, secretary-general of BADAS.

More than half of the people living with type 2 diabetes in Bangladesh do not have their condition in control, according to Khan.

On average, they spend more than seven years uncontrolled on oral medication before treatment is intensified, he said.

Clinical data shows that semaglutide provides unsurpassed efficacy in terms of blood glucose and weight reduction, helping up to 80 per cent of the patients reach treatment target, said Jay Thyagarajan, vice-president of Novo Nordisk Business Area Southeast Asia.

SUSTAIN, the global clinical development programme for semaglutide that comprised 10 published phase 3 trials, encompassed more than 10,000 adults with type 2 diabetes.

The programme involved a broad range of people with type 2 diabetes, including some with high cardiovascular risk profiles and people with and without renal disease.

The results showed greater reductions in both blood sugar and body weight compared with commonly used treatments for type 2 diabetes, as well as cardiovascular benefits, in people with type 2 diabetes, the press release adds.

In 2018, the annual sales of human insulin in Bangladesh were Tk 702.19 crore, according to data by the IQVIA, an American multinational company that conducts clinical research.

In Bangladesh, the number of diabetic patients is estimated to rise to 11.4 million by 2030 and 15 million by 2050.

(DT)

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