Actos vs Avandia

My MD has me on Actos. My insurance co-pay for Actos is $35. I asked him if there were another I
could take instead. He told me of Avandia. I checked with the pharmacy. My co-pay on it is $19.

Anyone know about Avandia; how it compares to Actos?

Hadrian@webtv.net wrote in message <25436-3F74905F-27@storefull-2136.public.lawson.webtv.net>... My
MD has me on Actos. My insurance co-pay for Actos is $35. I asked him if there were another I could
take instead. He told me of Avandia. I checked with the pharmacy. My co-pay on it is $19.

Anyone know about Avandia; how it compares to Actos?

Look at the P.I. (Prescribing Information) for the two drugs at the URL's shown below.

Actos: (click on Prescribing Information)

http://www.actos.com/sub_sec2_about_actos.asp

Avandia (goes to P.I. directly)

http://us.gsk.com/products/assets/us_avandia.pdf

Actos does a better job of improving the typically "lousy" Type 2 cholesterol and triglycerides, and
in clinical trials has produced superior improvements in average blood sugars (i..e HbA1c numbers)

The very good endo in our town favors Actos for his patients.

Regards
Old Al

On Fri, 26 Sep 2003 12:15:43 -0700 (PDT), Hadrian@webtv.net wrote:

>My MD has me on Actos. My insurance co-pay for Actos is $35. I asked him if there were another I
>could take instead. He told me of Avandia. I checked with the pharmacy. My co-pay on it is $19.
>
>Anyone know about Avandia; how it compares to Actos?
There are virtually interchangeable. My advice is try the Avandia. If it makes a difference fine,
but odds are it will not.

In general the difference between drugs of the same generation and same class are minimal. I.E. a
Thiazide diurectic is a Thiazide diuretic, and ACE inhibitor is an ACE inhibitor.

Hadrian,

Both are useful drugs.

The marketing hype from them is as follows:

Actos claims superior lipid lowering. Avandia claims it lowers the more harmful small dense LDL
better than Actos.

Both claim superiority as far as HbA1c lowering. IMHO, they are about the same.

If you ask Actos about why the 30mg dose was more effective that the 45mg dose they get
really quiet.

Avandia has some data to suggest a reduction in stent restenosis if you have a stent placed for
coronary artery disease. They also have some animal studies suggesting regeneration of beta cells.

Avandia was released first. In their haste to be first to market, they didn't initially apply for
the insulin + Avandia combination approval from the FDA.

In my experience, I have had more problems with edema and volume overload (CHF) with Actos than
Avandia. It can occur with either medicine, particularly when combined with insulin.

Actos made the false claim that they were safer than Avandia when used with insulin, which is the
opposite of my observations. This claim was based on Avandia's lack of FDA approval. Now that
Avandia has FDA approval for use with insulin, the Actos marketers have reverted back to their
lipid claims.

If copays are an issue, you can get combination Avandia / metformin tablets for a the same copay in
most instances. Actos has a combination Actos / Sulfonylurea in testing.

Actos claims to be the number one TZD class drug written by endos. I don't doubt that, the Lilly
reps are over us like flys on honey. Most of the claims back and forth seem to be a Madison Avenue
pissing contest at this point.

Avandia is less expensive than Actos in most markets.

As a result, I've been writing more Avandia than Actos, and it drives the Lilly guys nuts. I've
suggested a price drop to them, at which point they usually punt, and place the blame onto Takeda,
the manufacturer.

I would take any claims of superiority with a grain of salt at this point.

In general, most docs hate to make med changes based on which drug was the "low bidder" for your
Pharmacy Benefit Manager. Perhaps your doc doesn't have any strong feelings one way or another about
Actos vs Avandia and you can save the bucks.

Good luck,

William C Biggs, MD


<Hadrian@webtv.net> wrote in message news:25436-3F74905F-27@storefull-
2136.public.lawson.webtv.net...
> My MD has me on Actos. My insurance co-pay for Actos is $35. I asked him if there were another I
> could take instead. He told me of Avandia. I checked with the pharmacy. My co-pay on it is $19.
>
> Anyone know about Avandia; how it compares to Actos?

Geez Dr. Biggs, you should move to Miami, FL. I am going to be looking for an Endo in October to go
over the first three months of my treatment and I would be pleased if it was someone like you.
However, going all the way to Texas is a bit more of driving that I would like to do.

BTW, if it is possible could you recommend a couple of names of Endos in the Miami area. You can
send them to loanuniverse-spam-@loanuniverse.com

remove the -spam- before emailing.

I made a small error regarding Actos... here is my correction.

"William C Biggs, MD" <POTMYFKTOSUL@spammotel.com> wrote in message
news:f07db.13679$KJ4.1886@news1.central.cox.net...

> If you ask Actos about why the 30mg dose was more effective that the 45mg dose they get
> really quiet.

That should read

If you ask Actos about why the 15mg dose was more effective than the 30mg dose they get
really quiet.

WCB

R. loanguy wrote:
> Geez Dr. Biggs, you should move to Miami, FL. I am going to be looking for an Endo in October to
> go over the first three months of my treatment and I would be pleased if it was someone like you.
> However, going all the way to Texas is a bit more of driving that I would like to do.
>
> BTW, if it is possible could you recommend a couple of names of Endos in the Miami area. You can
> send them to loanuniverse-spam-@loanuniverse.com
>
> remove the -spam- before emailing.
>
>
I don't mean to jump on Reddy's prerogatives, but you may want to try:
http://www.aace.com/memsearch.php

Jim

Thanks Jim, going to use that tool on monday when I can print the list out and cross reference it
with my new insurance plan. Unfortunately, after being very happy with United Health Care for five
years, my employer is deciding to change to Humana on October 1st, and I have not heard anything
good about them. While I liked my general practicioner, when I told him about the change, he told me
that the practice did not take Humana. I even pleaded with the practice manager to at least accept
their PPOs, but no dice. Therefore, I am forced to seek a replacement and it might as well be an
specialist.

Once again thanks for the link.

"J.C. Hartmann" <jch@meadecom.com> wrote in message news:bl47rr$7ud26$1@ID-129294.news.uni-
berlin.de...
> R. loanguy wrote:
> > Geez Dr. Biggs, you should move to Miami, FL. I am going to be looking
for
> > an Endo in October to go over the first three months of my treatment and
I
> > would be pleased if it was someone like you. However, going all the way
to
> > Texas is a bit more of driving that I would like to do.
> >
> > BTW, if it is possible could you recommend a couple of names of Endos in
the
> > Miami area. You can send them to loanuniverse-spam-@loanuniverse.com
> >
> > remove the -spam- before emailing.
> >
> >
> I don't mean to jump on Reddy's prerogatives, but you may want to try:
> http://www.aace.com/memsearch.php
>
> Jim

R,

Sorry, but I don't have anybody to recommend for the Miami area.

I agree with Jim, the AACE directory is a good place to start.

ADA also has a directory, but only a small minority of professional members on that list are
endocrinologists. Their list includes dietitians, podiatrists, CDEs, nephrologists, researchers,
psychologists, and various sorts of PhDs.

I would point you to the online ADA list as well, but last time I checked it was in their "members
only" section.

IMHO, the ADA is a success at generating money for research and legislative advocacy, but a failure
as far as helping people in their day to day needs.....like helping find a doctor that can treat
their diabetes.

It's too bad that contractual issues sometimes cause patients and docs to part ways.

Depending upon how big your company is, you might have some influence on their choice of insurance
next year if you give some feedback to the personnel / human relations department. Most of the time
the people making the insurance decision have no clue as to the issues involved, unless you let
them know.

Good luck,

William C Biggs, MD



"R. loanguy" <NoSPAM@NOSPAM.com> wrote in message
news:tJhdb.51685$8j.37931@bignews4.bellsouth.net...
> Thanks Jim, going to use that tool on monday when I can print the list out and cross reference it
> with my new insurance plan. Unfortunately, after being very happy with United Health Care for five
> years, my employer is deciding to change to Humana on October 1st, and I have not heard anything
> good about them. While I liked my general practicioner, when I told him about the change, he told
> me that the practice did not take Humana. I even pleaded with the practice manager to at least
> accept their PPOs, but no dice. Therefore, I am forced to seek a replacement and it might as well
> be an specialist.
>
> Once again thanks for the link.
>
> "J.C. Hartmann" <jch@meadecom.com> wrote in message news:bl47rr$7ud26$1@ID-129294.news.uni-
> berlin.de...
> > R. loanguy wrote:
> > > Geez Dr. Biggs, you should move to Miami, FL. I am going to be looking
> for
> > > an Endo in October to go over the first three months of my treatment
and
> I
> > > would be pleased if it was someone like you. However, going all the
way
> to
> > > Texas is a bit more of driving that I would like to do.
> > >
> > > BTW, if it is possible could you recommend a couple of names of Endos
in
> the
> > > Miami area. You can send them to loanuniverse-spam-@loanuniverse.com
> > >
> > > remove the -spam- before emailing.
> > >
> > >
> > I don't mean to jump on Reddy's prerogatives, but you may want to try:
> > http://www.aace.com/memsearch.php
> >
> > Jim
> >
>