Doctors flay blanket ban on diabetes drug Pioglitazone

Mumbai: City-based doctors Wednesday flayed the ban on anti-diabetes drug Pioglitazone and requested the Centre to reverse its decision in interest of patients.

"The Government should reconsider its decision as the blanket ban (on the drug) is not appropriate. We are confident the authorities will review Pioglitazone ban once more clinical data is submitted to them.

"Affordability for the masses and lack of absolute substitute with similar efficacy are two favourable considerations for the drug," Siddharth Shah, ex-President, Association of Physician of India told reporters here.

Last week, Union Health Ministry banned sale of Pioglitazone as it is believed to cause urinary bladder cancer and heart failure. However, the medicine is still sold in the US and Europe with a boxed warning.

Having a market size of Rs 800 crore, over 30 lakh patients across India were using Pioglitazone medication.

Flooded with queries over the ban and its impact, leading physicians and diabetes experts from the city came together to allay concerns of the patients.

The doctors said the drug is currently used in most countries, including USA, UK and Japan, though it had been gradually phased out in France.

Pioglitazone is the 2nd/3rd line of treatment for type 2 diabetes and is one of the commonly prescribed medicines for the killer disease.

Shah said, "There are more than 60 million diabetics in India, of which over 95 per cent are type II patients. For such patients, insulin resistance is a major complication. Lifestyle modification can help only 20 per cent of these patients and others need medication.

"Pioglitazone allows the internal insulin to work in the body and has its own capacity to reduce glucose. Every drug has side effects. Doctors prescribe this low-cost drug after going through the patient`s history and risk factors."
Another physician, Vijay Panikar, said "Indians/Asians are made up of different phenotypes and genotypes. We are more inclined to have type 2 diabetes. Pioglitazone is the only drug that can act on the insulin resistance problem of Indians. Doctors are astutely prescribing this drug after understanding the benefits and risks involved."

Cost of alternatives available would be a major factor for several hospitals and society as Pioglitazone was priced as low as Re 1 to Rs 4 per tablet, he said.

Diabetes expert Rajiv Kovil emphasised on judicious prescription of the drug.

"Considering the patient profile before prescribing this drug is very important. Regulatory authorities such as EMEA and US FDA too have approved the drug with some riders. It should be noted that pioglitazone has several other benefits - it reduces cholesterol levels and acts as an inflammatory marker. All factors should be considered and the drug should be prescribed wisely," Kovil said.


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