NICE backs funding for MSD's diabetes drug Steglatro

NICE has recommended that England’s NHS should routinely fund Merck, Sharpe, and Dohme’s type 2 diabetes drug Steglatro in a final decision, after the company undercut rivals from the same class.

The cost-effectiveness body recommended Steglatro (ertugliflozin), a sodium-glucose contransporter-2 (SGLT-2) inhibitor as monotherapy for adults with type 2 diabetes, for whom metformin is contraindicated or not tolerated, or as part of a two-drug combination with metformin.

MSD, known as Merck & Co in the US, said it had priced the once-daily drug at £29.40 for 28 days, which the company said is the lowest acquisition cost compared with other SGLT-2 inhibitors.

MSD is competing in the UK against three drugs from the same class, which NICE recommended in a catch-all ruling almost three years ago.

These drugs are Johnson & Johnson’s Invokana (canagliflozin), AZ’s Forxiga (dapagliflozin) and Jardiance (empagliflozin) from Boehringer Ingelheim/Eli Lilly.

However all three of the above have data to support their use to reduce likelihood of cardiovascular events in high-risk patients.

Jardiance was the trail blazer in this class, becoming the first diabetes drug to show a dual effect of reducing risk of nonfatal stroke, nonfatal heart attacks and cardiovascular death in high-risk patients in the landmark EMPA-REG OUTCOME trial.

The other drugs may have a short-term advantage over MSD’s newcomer as a result – but MSD is studying the cardiovascular outcomes of Steglatro in the ongoing VERTIS CV study.

This trial includes 8,237 patients and is scheduled to be complete later this year.

There are other classes of drugs that can help people with diabetes control their blood sugar levels that can be considered competitors.

In the GLP-1 class there are several options from manufacturers such as Novo Nordisk and Eli Lilly, and DDP-4 inhibitor drugs such as MSD’s own Januvia (sitagliptin) are well established.

Cliff Bailey, professor of clinical science at Aston University, Birmingham, UK said: “As the diabetes population continues to grow, so does the need for new therapies.

“There are nearly four million people in the UK with diabetes and each patient has different considerations for choice of therapy based on disease progression, age, lifestyle and co-morbidities.

“Another therapeutic option that increases flexibility to improve diabetes management is welcomed. Ertugliflozin is one such option which NICE has found to be efficacious and cost effective.”

Louise Houson, managing director, MSD UK & Ireland, said: “Ertugliflozin adds to MSD’s existing portfolio of treatments for diabetes, an area we have worked in for more than a decade since the launch of Januvia in 2007. The decision by NICE shows MSD’s commitment to meeting the needs of a growing population of people with T2DM.”