PharmaTimes Digital talks to Chris Boulton, Director of Marketing at AstraZeneca, about diabetes and what the drugs giant is doing to improve treatment outcomes.

PT: Is diabetes enough of a national priority?

CB: There are almost three million people living with type II diabetes in the UK today. This number is expected to rise to five million by 2025 and the total costs are projected at nearly £40 billion in twenty years’ time. This is staggering, but I think the worst part of it is that so much of this is avoidable, whether it is obesity, unwarranted variation in treatment or avoidable complications.

It is therefore critical that a bold and multi-faceted approach is taken to address issues arising from childhood on education, diet and lifestyle, diagnosis rates and consistency and boldness of treatment strategies that can address later complications of diabetes.

PT: What must be done nationally to improve the management of diabetes and therefore treatment outcomes?

CB: Approximately half of people with type II diabetes fail to achieve and maintain their glucose goal, despite available treatment options. There is considerable variation across the country when it comes to access to medicines, even when they have been endorsed by NICE or the SMC, and have well established benefit-risk profiles. Treatments also tend to be used too late when patients are already out of control. Patients need access to the right medicine, at the right time in their disease. One of the goals of the PPRS is to ensure that this happens.

When looking at what the NHS spends on treating diabetes, 80% is spent on treating the complication of diabetes and just 20% is spent on medications that can help to control it. The complications associated with diabetes are steadily increasing, and it is this upward trend that should be of particular concern to healthcare leaders and policy makers.

PT: Can pharma play a bigger role in improving diabetes management and outcomes?

CB: Aside from providing innovative medicines, AZ and the industry as a whole has a legitimate role to play in tackling diabetes to help improve patient outcomes. In addition to offering educational support for clinicians and patients, we have significant scientific and commercial expertise that can be of great value to the NHS. For example, we have just launched our new patient website, www.talkingtype2.co.uk. Aside from providing background information about type II diabetes in multiple languages, the website also offers some practical tools to patients, such as an interactive goal setter that can help with weight and diet management.

AZ is also involved in joint working initiatives where we pool skills, experience and knowledge with the NHS and share a commitment to successful delivery. In terms of diabetes, we are partnering with the NHS and other third parties to support type II diabetes prevention, professional education and advanced care for patients at all stages of their disease. Two diabetes-specific projects are currently underway with the Eastern Academic Health Science Network and North West Surrey Clinical Commissioning Group.

PT: What are your thoughts on NICE’s type II diabetes draft guideline?

CB: As per our position statement, while AZ agrees with many elements of the draft guideline, it shares the concerns of others in the diabetes community that the section on ‘Blood Glucose Management’ is flawed. 

For one, as the guidelines stand, pioglitazone is recommended as the principal second line therapy with metformin. “This means that, should clinicians follow the algorithm, the vast majority of people with type II diabetes requiring second-line therapy would be given a treatment associated with an increased risk of fractures as well as weight gain and fluid retention”, AZ argues.

We put the same questions to Greg Jones, Diabetes Consultant, Honorary Associate Professor Diabetes Centre, Gartnavel General Hospital, Glasgow, which will be published in Friday’s PharmaTimes Daily News.