Do we Need New Therapies for Diabetes?

Abstract

Diabetes research and practice cluster (drug developers, payers, regulators and physicians) often (and especially in recent times) question the need of new therapies. Why would we need new therapies nowadays, when we have 9 classes (insulins, sulfonylureas, biguanides, meglitdes, thiazolidnediones, alpha-glucosidase inhibitors, DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists),1 rapidly increasing number of biosimilars2 and uncountable number of generics? Reasonable question. Does it make sense to invest billions of dollars in messy global cardiovascular outcomes trials (as requested by diabetes drug development guidelines3) or to play love attraction games with payers4 so they “fall in love” with the “new” pill (most often combo with the good old metformin)?
Well….I believe someone is missing in this picture. Obviously, those four players forget the Patient. And the ability to ask a bit more simple and rational questions, such as “Do we have adequate glycemic control of diabetes in the presence of all those therapies”?