A Free Diabetes Drug   (April 12, 2010)

A supermarket chain in the Midwest United States, Meijer, has just announced that they will be giving away metformin at their pharmacies. Their program will include the 500mg, 850mg and 1000mg tablets of the immediate-release version of metformin. Of course, their pharmacies will want a doctor's prescription.

They're not the only ones: Publix, another supermarket chain, also recently announced a similar program of free metformin. These announcements surpass the pricing at Walmart and Target, both of whom have been selling metformin (and several sulfonylurea diabetes drugs) at $4.00 for sixty tablets. Walmart and Target do sell the extended-release version at this price, whereas Meijer's free offer excludes the extended-release form (and apparently excludes other diabetes drugs). By comparison, 90 metformin tablets cost between $17 and $20 at Medco by Mail, and probably more at your local bricks-and-mortar pharmacy.

Metformin, sold under brand names such as Glucophage and Glucophage XR, has been available for many years, and is the best-selling diabetes medication, and is considered to be first-line therapy for type 2 diabetes. Indeed, last year an Expert Panel suggested starting metformin therapy at the time of the diagnosis of diabetes.

Metformin is available both in an immediate-release version, which is usually prescribed to be given in several doses a day, and extended-release versions, which can be given only once daily, and may have less gastrointestinal side effects. It's even available in a liquid form, with the brand name Riomet.

Metformin does cause gastrointestinal distress, and rarely, a life-threatening complication called lactic acidosis. There are other warnings about it, such as not using it if there is impaired kidney function, or if undergoing X-Rays using contrast material, or if major surgery is about to be performed. On the good side, metformin may allow weight loss to proceed more readily in motivated people. And it doesn't cause hypoglycemia when given as the only diabetes drug.

What's the catch?

There is none. These pharmacies have already been giving away other prescription medications (such as common antibiotics). They have reached the business decision that they can give away inexpensive prescription drugs as a loss-leader to drive more traffic to their stores. The fact that they are only giving away the immediate-release version of metformin would mean some inconvenience for the consumer if he/she was previously on the extended-release version, as they will give up the convenience of once-daily dosing, and might perhaps have gut side effects after the transfer.

For the patient who is on metformin, it sounds like a winner.