Diabetes Dialogue: Implications of SELECT Trial and Brenzavvy on Cost Plus Drugs

The summer of 2023 has been a whirlwind for the field of diabetes management without headlining news and the past 30 days have been no exception to this rule.

Following a historic meeting at the 83rd Scientific Sessions of the American Diabetes Association in late June, where the community got its first glimpse at what could become practice-changing agents, it took about 2 weeks for news in diabetes management to grab headlines when Mark Cuban’s Cost Plus Drugs platform announced it had reached an agreement to provide bexagliflozin (Brenzavvy) at a price of $47.85 plus shipping and handling for a 30-day supply of the agent. This move would allow bexagliflozin, which became the 5th SGLT2 inhibitor to receive approval from the US FDA in January 2023, to overcome what many have described as the greatest hurdle to SGLT2 inhibitor uptake: cost.¹

Staying on the topic of potentially cardioprotective, antihyperglycemic agents, a few weeks later the community received news of topline results from the long-awaited SELECT trial. Sponsored by Novo Nordisk and launched to explore the effects of GLP-1 receptor agonist use on cardiovascular outcomes in people with overweight or obesity without diabetes, results of the study suggested use of semaglutide 2.4 mg was associated with a 20% reduction in 3-point major adverse cardiovascular events. Announced by Novo Nordisk on August 8, 2023, the company noted the trial results will be used in an application for a label expansion to regulatory bodies and presented at a scientific congress later in 2023.²

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down to discuss the implications of both these events for the care team and people with diabetes.

1. Formulary Watch. New diabetes med, brenzavvy, available through Mark Cuban’s online pharmacy. Formulary Watch. July 13, 2023. Accessed August 15, 2023. https://www.formularywatch.com/view/new-diabetes-med-brenzavvy-available-through-mark-cuban-s-online-pharmacy.
2. Campbell P. Select trial shows semaglutide 2.4 mg could reduce cardiovascular risk. HCP Live. August 8, 2023. Accessed August 15, 2023. https://www.hcplive.com/view/select-trial-shows-semaglutide-2-4-mg-could-reduce-cardiovascular-risk.