Many plan members with diabetes struggle with adherence to daily insulin injections and research has found the majority of patients wish they could achieve the same control over their condition with fewer injections, said Jacob Bonafiglia, medical science liaison with Novo Nordisk Canada Inc., during a panel discussion sponsored by Boehringer-Ingelheim Canada, Merck Canada Inc. and Novo Nordisk at Benefits Canada’s 2023 Face to Face Drug Plan Management Forum in December.
“We know that poor insulin adherence can worsen glycemic control and increase hospitalizations, health complications and costs. One of the strategies to improve adherence is to reduce dosing frequency.”
New weekly dosed basal insulins have been developed and will offer similar or even better blood sugar control compared to daily insulins and have a low hypoglycemia risk, while studies indicate it has reduced treatment burden and improved treatment satisfaction.
A weekly dose will benefit a variety of patients, said Bonafiglia, adding physicians are also excited about the potential benefit to patients who need assistance administering daily insulin injections.
Also speaking on the panel, Melissa Kim, medical advisor and medical lead at Boehringer-Ingelheim Canada, said there’s a new treatment coming for generalized pustular psoriasis, a distinct, rare psoriasis subtype. While plaque psoriasis is characterized by redness, scaling and thickness on the skin, generalized pustular psoriasis also includes pustules or fluid filled blisters on the skin, in addition to systemic inflammation through multi-system organ involvement such as inflammation of the eye or joints.
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Spevigo (spesolimab) has recently been approved by Health Canada for the treatment of generalized pustular psoriasis. In clinical trials, 54 per cent of patients saw their pustules clear in eight days and this clearance was maintained for up to 12 weeks. “So instead of waiting months to get that resolution, it’s a matter of days, which could reduce absenteeism and get them moving on with their daily lives.”
Flare-ups of generalized pustular psoriasis are unpredictable and can cause an incredible strain on patients’ mental health, she said, adding their quality of life is significantly affected and they’ll often disengage from social and physical activities due to their condition.
Von Hippel Lindau Disease is a rare, heritable condition that can cause tumours in multiple organs, explained Dr. Shereen Ezzat, professor of medicine and oncology at Princess Margaret Cancer Centre, University Health Network, also speaking on the panel.
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Because this condition mimics symptoms of many other diseases, it’s not easily diagnosed and usually by the time of diagnosis, the disease has already spread. Radiation and drugs that are used for other cancers aren’t effective and the tumours return following surgical removal.
Belzutifan (welireg) is a novel, effective and safe oral treatment for Von Hippel Lindau Disease that can shrink tumours by more than 50 per cent and reduce the need for multiple surgeries, he said, adding the treatment must be continued as a maintenance therapy to sustain positive health outcomes.
“We didn’t have any therapy specific to this disease until recently. Through the power of genetics, a drug has been developed that turns off the switch that allows an abnormal accumulation of oncogenes that cause cells to misbehave.”
Read more coverage of the 2023 Face to Face Drug Plan Management Forum.