Drug provides new hope for diabetics and heart patients

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A drug launched yesterday could help at least 400,000 people in Britain with diabetes but will add to the National Health Service's financial burden by £150m a year.

A drug launched yesterday could help at least 400,000 people in Britain with diabetes but will add to the National Health Service's financial burden by £150m a year.

The market for the drug could be even bigger, running to one in four of the population who have health problems associated with being overweight.

The launch of Avandia four days before the Government is due to unveil its national plan for the NHS, highlights the pressures on the service from scientific advance. Avandia was billed yesterday as a "turning point" in the treatment of a disease affecting two million people in the United Kingdom and is a leading cause of blindness, heart disease and strokes.

The drug, which has been available for a year in the United States where it is used by one million diabetics, is being launched in Germany and Britain and has been licensed throughout Europe. It costs £320-£640 a year per patient, depending on the dose, and health authorities are forecasting a bill of £5m in the first year.

Avandia is a treatment for people with type 2 diabetes, which mostly affects overweight adults in middle age and accounts for 90 per cent of all cases of the disease (the remainder with type 1 are mostly children). Scientists believe it could also prevent diabetes and reduce heart disease in the 25 per cent of the population with "insulin resistance". Research to test this will take a decade.

There are an estimated two million people in Britain with type 2 diabetes, in which blood glucose levels can rise dangerously, but half are unaware of their condition. The disease can initially be controlled by adjusting the diet, but many patients also need drugs and as it progresses these become less effective.

Avandia is made from rosiglitazone, one of a new class of agents - glitazones - which has been shown in trials to reduce blood glucose levels in a similar way to insulin when given in combination with existing treatments.

An earlier version called troglitazone, launched in the UK two years ago, was withdrawn after it was found in the US to cause liver failure in one in 60,000 patients. No case of liver failure has been reported in the US with Avandia.

Tony Barnett, professor of medicine at Birmingham Heartlands Hospital, who has run trials of Avandia, said glitazones were the "first new agents since the mid-Fifties in Europe for the management of type 2 diabetes". He added that "it would be incredible" if it could be shown that they prevented the disease.

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