Looking for an excuse/reason not to pay $100-200/month for diabetic medicine?
Among the expensive diabetic medicines is Avandia, or rosiglitazone. This summer FDA hearings determined that, at least for some patients, taking Avandia may increase the risk of heart attack.
What? You’re taking a drug to control your blood sugar and thus stave off heart attacks, and your medication may actually have the opposite effect?
Apparently so. Now the FDA has advised doctors not to use Avandia unless it is the only effective option to control a patient’s diabetes (and there are always alternatives.)
Avandia had been a favorite among doctors because, in the long run, it keeps blood sugar levels better controlled. For patients, this may mean avoiding insulin.
But does better sugar control translate into fewer long-term consequences of diabetes?
Not necessarily. The various diabetic medications do not lower blood sugar by the same mechanisms. They each have different side-effects, which is to say, they have effects within the body besides lowering blood sugar, some of which are simply unknown.
Certainly Avandia lowers blood sugar, but if the rate of heart attacks is increased, overall the risks may outweigh potential benefits. Actos, another drug in the same class, has not been shown to have the same risk.
So as a doctor, what will I do? For the patients I have on Avandia who are doing well, I will discuss the options of other oral diabetic medicines and/or insulin. Some patients may choose to switch to Actos, but as a physician I have to wonder if newer data may implicate this drug as well. At this point I will not be starting new patients on Avandia.
As for saving money, if you’re already on Avandia and find the cost a burden, this would be a great opportunity for you to talk with your doctor about switching to a less expensive drug. Several sulfonylurea drugs as well as metformin run as little as $4 a month. Even if you had to take both, that would be only $8 monthly, still saving a thousand bucks a year.
To read more about the investigation of Avandia, check out the articles listed below.
© Cynthia J Koelker, MD – All rights reserved