This is the tenth treatment to help lower blood sugar levels that people with type 2 diabetes are now guaranteed access to following approval by NICE.

Professor Carole Longson, Director, Centre for Health Technology Evaluation at NICE said: “Treatment needs can vary from person to person which means clinicians need access to a number of drugs if they are to successfully control type 2 diabetes. With this new positive recommendation for canagliflozin, we have added another clinically and cost effective option to the armoury of anti-diabetic drugs.”

Canagliflozin is an oral, once-daily medication belonging to a class of drugs called sodium glucose co-transporter (SGLT-2) inhibitors. It works by blocking the reabsorption of glucose in the kidneys which is instead passed out of the body in the urine.

Canagliflozin is recommended when used in combination with other anti-diabetic drugs, including insulin, for the treatment of type 2 diabetes.

All drugs recommended for lowering blood sugar are shown in the managing type 2 diabetes pathway on the NICE website.

Ends

For more information call the NICE press office on 0845 003 7782 or out of hours on 07775 583 813.

Notes to Editors

Diabetes key facts

• There were approximately 2.6 million people in the UK aged 17 or over with type 2 diabetes in 2011. However, there are many people with undiagnosed type 2 diabetes so the true number could be considerably higher.
• The UK prevalence of type 2 diabetes is increasing because of rising levels of obesity, decreased physical activity and increased life expectancy after diagnosis because of better cardiovascular risk protection. Type 2 diabetes is particularly prevalent in people of African, South Asian and Caribbean family origin.
• Life expectancy is reduced by up to 10 years in people with diabetes.

About the guidance

1. NICE recommends the following blood glucose-lowering therapies for type 2 diabetes: metformin, sulfonylurea, sitagliptin, vildagliptin, pioglitazone, dapagliflozin, liraglutide, exenatide, rapid-acting insulin secretagogues and insulin. All guidance can be viewed on the managing type 2 diabetes pathway.
2. The guidance says:

• If a person needs to take 2 antidiabetic drugs, canagliflozin is recommended as a possible treatment for people with type 2 diabetes when taken with a drug called metformin, only if the person cannot take a type of drug called a sulfonylurea oris at significant risk of hypoglycaemia or its consequences.
• If a person needs to take 3 antidiabetic drugs, canagliflozin is recommended as a possible treatment when taken with either metformin and a sulfonylurea, or metformin and a type of drug called a thiazolidinedione.
• Canagliflozin is recommended as a possible treatment taken with insulin, with or without other antidiabetic drugs.

1. According to the British National Formulary (April 2014), the drug’s price (excluding VAT) is £39.20 for canagliflozin 100 mg (30 tablets) and £49.99 for canagliflozin 300 mg (30 tablets). The expected annual cost of canagliflozin is £476.93 for the 100 mg daily dosage and £608.21 for the 300 mg daily dosage. Costs may vary in different settings because of negotiated procurement discounts.
2. The recommended starting dosage of canagliflozin is 100 mg once daily. In patients tolerating canagliflozin 100 mg once daily who have an estimated glomerular filtration rate (eGFR) of at least 60 ml/min/1.73 m2 or creatinine clearance (CrCl) of at least 60 ml/min and need tighter glycaemic control, the dosage can be increased to 300 mg once daily.