Could one daily pill narrow the diabetes treatment gap in the Global South?

Résumé détaillé

Globally, one in nine people lives with diabetes, as blockbuster injectable drugs begin making way for tablets instead.

Medication that has been a lifeline for patients with uncontrollable diabetes is now slowly shifting from injections to pills, a move that could fundamentally alter treatment for the disease – and who can access it.

This shift could also affect the treatment of obesity, a long misunderstood condition once associated with overeating and laziness, rather than the metabolic disorder it is now recognised as.

GLP-1 (glucagon-like peptide-1) receptor agonists therapy isn’t new. The first FDA-approved drug, Exenatide, hit the market in 2005 and was followed by Liraglutide in 2009, which was seen as a revolutionary alternative to insulin.

But the market has until recently been dominated by weekly injections like Ozempic and Wegovy (semaglutide), and Mounjaro (tirzepatide). These drugs have also proved successful for weight loss.

Now, once-daily oral GLP pills are emerging as an alternative, especially for the diabetes-stricken Global South.

Oral once-daily pills of the same wonder drug could make access more affordable, and less reliant on the cold chain that GLP-1 injections and insulin depend on – and that are harder to secure in emerging economies.

One in nine people in the world between the ages of 20-79 lives with diabetes, and one in eight people globally is obese.

The GLP injections come with a high price tag and are often not covered by insurance companies, which treat them as an elective drug.

In the United States, Eli Lily’s Mounjaro costs about $500 for a month’s worth of doses; in the UK, about 199 pounds ($264); and in Saudi Arabia, 1,261 riyals ($336). In India, the brand is locally manufactured and available at 14,766 rupees ($157). In Pakistan, the imported Mounjaro is a whopping 220,000 rupees ($723), while the locally manufactured Tirzepatide from Getz Pharma costs 17,000 rupees ($61).

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