Compared with Current and Emerging Non-Insulin Therapies, Does Metformin’s Clinical Profile Justify Its Dominant Position in Recommended Treatment Guidelines?
Affecting 30 million people in the Unites States alone, type 2 diabetes is a critical public health concern. Although diet and exercise are key initial and ongoing management strategies, drug treatment is inevitable for almost all patients. Due to the progressive nature of type 2 diabetes, insulin therapy is often required as a “last resort” therapeutic option for the treatment of this disease. Prior to the use of insulin, however, there are a number of non-insulin-based therapies that can be employed as effective therapies. Due to its prominent position in treatment guidelines, metformin (Bristol-Myers Squibb/Merck Serono’s Glucophage/Glucophage XR, Salix’s Glumetza, Shionogi’s Fortamet, generics) is most frequently the first-line drug therapy used in the treatment of type 2 diabetes. While metformin has demonstrated efficacy and safety as a treatment option for type 2 diabetes, its use as a first-line agent is often driven by its low cost and it may not be the best therapeutic option for certain patients. There is an increasing move toward individualizing therapy, which may lead physicians to seek alternatives to metformin as potential non-insulin therapeutic options for treatment of type 2 diabetes. With a broad and increasing range of treatments available and a growing prevalence of disease, there is a significant market opportunity for alternative non-insulin treatments.