The Countdown

The Countdown

As everyone knows tomorrow is the PUDFA date for the long-acting once-a-week version of Byetta. Diabetic Investor suspects the folks at Amylin (NASDAQ:AMLN), Lilly (NYSE:LLY) and Alkermes (NASDAQ:ALKS) are like a nervous husband awaiting the birth of their child. While the folks at Novo Nordisk (NYSE:NVO) are wondering if the LAR approval will provide them a ray of sunshine or put another nail in the Victoza® coffin.

For the record Diabetic Investor continues to believe that the FDA will approve LAR. We further believe LAR will not come with the dreaded black-box warning that came with the Victoza® approval. More than likely there will some language in the label regarding thyroid cancer; however there is no evidence to suggest that LAR has the same issues Victoza® had when they went through the approval process.

Whatever the outcome we won’t have to wait much longer and will soon find out who’s right and who’s wrong.

To help everyone pass the time while we await this announcement Diabetic Investor has come across a variety of announcements that deserve some coverage. First there was the announcement that CVS (NYSE:CVS) is working with academic leaders to develop ways to encourage medication adherence and to better understand why consumers choose branded medications over generics. According to CVS press release; “These research partners will team with CVS Caremark to develop insights into consumer actions around health challenges by studying the issues through the lens of behavioral economics and social marketing.”

The release goes on to state -“This partnership represents another step in our effort to learn more about how we can help patients understand that effective pharmacy care can impact overall medical costs,” said Dr. Troyen A. Brennan, MD, MPH, Executive Vice President and Chief Medical Officer of CVS Caremark. “While we know there are many reasons people stop taking their medicine – cost, forgetfulness, side effects and others — this research will help us counsel consumers to make the right decision regarding their health,” Brennan said.”

It’s interesting that Mr. Brennan failed to mention education as a reason why patients fail to be compliant with their therapy regimens and speaks volumes as to why diabetes patients in particular are not compliant. For all the talk about costs and side effects a major factor for therapy non-compliance is lack of patient education. The fact is when patients are educated on how a drug works, what it is supposed to do and what its side effects may be they are more likely to remain compliant. Or put another way there are no surprises, the patient understands what should and should not be happening. Far too often patients are not made aware of this information and stop taking their medications when an unexpected, yet normal, event occurs.

Just by way of example it’s fairly common for patients taking metformin to experience gastrointestinal issues when they first start taking the drug. This is a very common side effect of metformin and in the majority of patients dissipates over time as their bodies adjust to the drug. Think if someone who was new to metformin therapy started taking the drug without knowing this. It’s only natural that this patient would question whether or not to continue taking the drug.

The announcement from CVS concludes with the following; “Among the matters to be studied by the partnership are:

  • Providing Appropriate Incentives: Research how appropriate financial incentives – in the form of lower copays and immediate up-front rewards – motivate consumer decisions to help improve health care behavior.
  • Developing education tools: Determine how education materials and programs targeting consumers can be applied to persuade positive behavior that will affect meaningful change for patients.
  • Tailoring Communications: Studying how specific messages resonate with individuals to promote improved health outcomes, adherence and personal care.”

So if Diabetic Investor understands this correctly, CVS and their distinguished partners are doing a study to see if incentives, education and tailored communications work. Granted Diabetic Investor is not the sharpest tack in the box, however our memory is still intact and all of these issues have been studied extensively already; studied enough to know that incentives, education and tailored communications work.  Why CVS is spending more time and more money to study something that has already been studied and proven to work boggles the mind. What they want to be really, really, really sure it works before actually doing something?

Next a story comes from the San Diego Business Journal published this past Monday entitled “Meditech Pioneers New Tools for Monitoring, Diagnosing Diabetes”. The story is about a company called Freedom Meditech, which is based in the lovely city of San Diego. For those with short memories Freedom Meditech is yet another company seeking the Holy Grail for glucose monitoring, the non-invasive glucose monitor.

The story quotes the company’s CEO Craig Misrach who states; “It is completely noninvasive. We just have light that shines across the eye.” Mr. Misrach goes on to state; “Freedom Meditech aims to revolutionize the way we screen for, diagnose and manage diabetes, through the development of technologies that identify and diagnose patients earlier, improve daily glycemic control, and reduce the economic and personal costs of long-term complications of the disease.” Why Mr. Misrach left out the part about that device can also cut through an aluminum can and still slice a tomato is anyone’s guess.

About the only partially accurate statement made in the article was the comment “We just have light that shines across the eye.” The only problem here is that light is actually shinning in the eyes of any investor dumb enough to invest in these companies. That light that they see as the road to riches will end up blinding investors when the company comes back and asks for a few more millions as they are ooh so close.  

When it comes to these snake oil salesmen who call themselves non-invasive glucose monitor companies Ken Hubbard hit the nail on the head when he said; “A fool and his money are soon spotted.”