Fourteen years ago, Harvard researchers revealed that insurance companies were big-time investors in tobacco companies. The seemingly hypocritical position prompted outrage and calls for them to divest.

But when the same scientists recently re-examined the matter, they found the industry had failed to kick the habit.

By reviewing SEC filings and news reports from 2008, J. Wesley Boyd and colleagues determined that US, UK and Canadian-based insurance companies owned at least $4.4 billion worth of stock in companies whose subsidiaries produce cigarettes, cigars, chewing tobacco and related products.

“Despite calls upon the insurance industry to get out of the tobacco business by physicians and others, insurers continue to put their profits above people’s health,” Boyd told Medical News Today. “It’s clear their top priority is making money, not safeguarding people’s well-being.”

The World Health Organization estimates that tobacco products contribute to 5.4 million deaths per year worldwide.

New Jersey-based Prudential Financial Inc., which markets life and disability insurance, has holdings in tobacco firms like Reynolds American and Philip Morris, that total $264 million.
 
These numbers are dwarfed by Toronto-based Sun Life which sells health, disability, life and long-term care insurance. It owns just north of $1 billion in tobacco company stock.

Meanwhile, London-based Prudential Plc, which offers disability, health and long-term care insurance, holds $1.38 billion in British American Tobacco and other such companies.

“Insurance firms have figured out ways to profit from both… investing in tobacco (and) selling life or health insurance. (They) exclude smokers from coverage or, more commonly, charge them higher premiums. Insurers profit - and smokers lose - twice over,” wrote the authors.

Boyd’s group first reported on the matter in a 1995 Lancet article.

Ever since a 2007 trial of Avandia raised concern that newer generation diabetes-fighters raised cardiovascular risk, sales of the drugs have crashed and investigators have scurried to provide follow-up data one way or the other.

Now, Bristol Meyers Squibb scientists have raised hope that a diabetes drug in the pipeline may actually cut cardiovascular risk.

The drug is saxagliptin, a dipeptidyl peptidase-4 (DPP4) inhibitor.

At the ADA meetings last month, Robert Wolf and colleagues reported the results of a meta-analysis, in which they pooled results from 8 phase II and III trials of the drug.

They found major adverse cardiovascular events to be 55% less common in saxagliptin-treated patients than in those receiving either placebo or metformin.

If confirmed with prospective trials, this cardioprotective effect “would be a very important advance,” Wolf told MedPageToday.

The meta-analysis combined 4,607 adverse events reported during 3,758 patient-years of study in 8 randomized, double-blind trials of saxagliptin in type 2 diabetes.

The incidence of major adverse cardiovascular events, which include cardiovascular death, nonfatal MI, and nonfatal stroke was 0.7% in saxagliptin-treated patients and 1.4% in the other groups.

Saxagliptin was found to cut CV risk in high-risk subsets as well. For example, among those with a prior history of cardiovascular disease, the incidence of major adverse CV events was 9.2% in saxagliptin-treated patients versus 46.3% in other groups.

Equally impressive reductions were seen in populations with at least one CV risk factor beyond diabetes, at least 2 risk factors in addition to diabetes, in men, and in those at least 65 years old.

The drug’s codevelopers, BMS and AZ, have submitted an NDA to the FDA, which is expected to rule on the matter later this month.