The ongoing concern that some diabetes meds - such as Byetta and Januvia - are linked to pancreatitis and, possibly, pancreatic cancer - is having an effect how doctors view the meds and their subsequent prescribing habits. The latest example involves a recent study in Gastroenterology that examined FDA adverse event reports in which the authors reiterated that caution is needed (read here).
And so a newly released survey finds that 20 percent of doctors expect to decrease prescribing for Byetta, which is sold by Amylin Pharmaceutical, and 11 percent expect to decrease their prescribing for Januvia, which is sold by Merck, as a result of the study. The survey was conducted last month by dtw Marketing Research Group, which queried 104 doctors, who were evenly split between endocrinologists and primary care physicians.
However, the reaction among physicians who prescribe Byetta varied. While 10 percent of endocrinologists expect to decrease usage, 31 percent of primary care docs expect to write fewer prescriptions. The difference may suggest a greater familiarity among specialists with ongoing concerns about links between the meds and potential problems in the pancreas. In other words, specialists appear less concerned since they presumably have been more aware of prior reports.
In any event, 39 percent of doctors overall plan to change how they advise patients when they prescribe Byetta. More specifically, 56 percent of primary care docs and 21 percent of endocrinologists will alter their approach. In general, 29 percent of doctors will change how they advise patients when prescribing Januvia, with 40 percent of PCPs and 17 percent of endocrinologists taking a different tack.
Although 26 percent of the docs had patients ask them about the study results, 86 percent are undecided or uncomfortable with the reliability of the results. On a 5-point scale, with one equaling not at all reliable and 5 equaling highly reliable, 52 percent provided a rating of 3. The reaction may reflect skepticism about relying on FDA adverse event reports to draw even preliminary conclusions. In addition the study also noted that additional research is needed.
"Whenever preliminary study results come out, it's not surprising that doctors aren't making a very quick decision about how they prescribe or the impact on their prescribing," David Rittenhouse, who runs analytic services at dtw. "At this point, until there's further investigation done the drug manufacturers are probably going to have very little to say about it. They're not going to be counteracting results." In other words, the drugmakers may not want to draw further attention to such findings, until they are backed into a corner.