Novo Nordisk will be celebrating news that more patients could be given routine access to its diabetes drug Victoza if draft guidance by the National Health Service cost watchdog is passed.

Victoza (liraglutide) is a stable analogue of the natural human hormone glucagon-like peptide-1 (GLP-1) and is in the same class as Eli Lilly/Amylin’s blockbuster diabetes drug Byetta (exenatide), although Novo says its therapy provides better blood glucose control than Byetta and offers the advantage of one injection per day instead of two.

The drug was rolled out in the UK last July to much fanfare over its ability to stimulate the body’s own insulin secretion when blood sugar levels are too high as well as induce weight-loss by inhibiting gastric emptying and reducing appetite and food intake.

Furthermore, early evidence suggests that GLP-1 could preserve or even boost the number of insulin-secreting cells in the pancreas, but thus far this has only been shown in animal models and the duration of this effect is undetermined.

As previously reported, the National Institute for Health for and Clinical Excellence has deemed the use of Victoza on the NHS cost effective in patients with type 2 diabetes as part of triple therapy regimens (together with metformin and sulfonylurea, or metformin and a thiazolidinedione) when control of blood glucose is inadequate, but only when body mass index is greater than 35kg/m2 (for Europeans, adjusted for other ethnic groups) and there are specific psychological or medical problems associated with high body weight.

In addition, the Institute has also recommended the drug as an option for patients with a BMI _ 35 kg/m2 in whom insulin therapy would have “significant occupational implications, or weight loss would benefit other significant obesity-related comorbidities”.

Following the submission of extra data by Novo during the consultation period, NICE has now also widened the scope of patients allowed access to Victoza, by recommending its use as part of dual therapy regimens for patients who would normally be given metformin and a sulphonylurea but cannot tolerate either one of these medicines.

High dose rejected
On the down side for the firm, the Institute has stuck with its decision to endorse only the 1.2mg form of Victoza, which costs around £954.84 per patient per year, rejecting the 1.8 mg dose, which carries a price tag of around £1432.26 per year, as its independent Appraisal Committee felt that clinical data showed only a marginal benefit from using the higher dose and so its use on the NHS could not be justified.

Carole Longson, Health Technology Evaluation Centre Director at NICE, said the cost regulator is pleased to be able to recommend Victoza “as a clinically effective option”, particularly as “the incidence of type 2 diabetes is on the increase in England and Wales - and sadly so too are the complications of the disease”.

Diabetes and its complication already cost the NHS a whopping £1 million an hour and, with the current surge in rates of the disease across the UK, there is an urgent need for new and effective therapies to treat the condition.

The Scottish Medicines Consortium issued a green light for use of the drug on NHS Scotland in December last year, and final guidance from NICE is expected in October.