'Ban on diabetes drug unjustified'

MUMBAI: Physicians, including diabetologists, have come out in strong defence of an commonly used anti-diabetes drug pioglitazone, banned by the Union health ministry two weeks ago.

Doctors believe the ministry’s concerns of the drug’s adverse effects like heart failure and bladder cancer are “exaggerated”.

Some from the medical community felt that the ban was too sudden and not completely justified. The drug pioglitazone, explained diabetologist Dr Vijay Panikar, was the best one to address insulin resistance, the main issue in type 2 diabetes. “We are a country of young diabetics where many a majority of the population

suffer from insulin resistance before diabetes. We need a drug that is economical, durable and efficacious,” he said. Three million Indians reportedly rely on the drug.

Pioglitazone is already banned in France and Germany but not the whole of Europe. “There is clearly no consensus about the drug being harmful, which is why the rest of Europe continues to use it,” said Dr Siddharth Shah, editor, Journal of the Association of Physicians of India (JAPI). “There is no denying that the drug has adverse effects but its judicious use can help curb the risk factors,” he added. Medical associations and experts, however, had little data to vouch for its safety. Among the adverse effects of the drug, the most debated are its role in increasing the risk of cardiovascular diseases and bladder cancer. Weight gain, too, has been associated with the prolonged use of the drug.

Diabetologist Dr Rajiv Kovil said that the correlation between the ailments and drug usage are yet to be conclusively established. But, at the same time, Kovil admitted that there was very little data to show otherwise. “The drug’s unavailability will push up insulin usage and also the use of more expensive molecules. For diabetics, the treatment cost may go up by three times,” he added. The ministry’s decision to ban pioglitazone and its combinations has hit the Rs 700-crore market, affecting six leading pharmaceutical companies. Three years ago, another drug from this family, rosiglitazone, was banned in the country, following a decision taken in Europe. In the US, pioglitazone is sold with a boxed warning. The Drug Controller General of India has also asked for detailed scientific data before thinking about revoking the ban.