during the next decade, the type 2 diabetes market will not experience a fundamental shift

With close to ten percent of the world’s population currently living with type 2 diabetes, this chronic disease is clearly the pandemic of the 21st century.

The skyrocketing growth in the prevalence of this silent killer is attributable to increased life expectancy and an increasingly sedentary and stressful lifestyle.

The amount of people diagnosed with type 2 diabetes is expected to almost double in the next ten years, so it is no wonder that the pharmaceutical market in this space is blossoming.

According to GlobalData’s epidemiology-based market forecast, the global type 2 diabetes pharmaceutical market (including the 7MM, Brazil, China, and India) in 2012 was valued at $28.1bn, including sales of both branded and generic drugs.

In the next ten years this market will reach $68.8bn in 2022 at a CAGR of 9.4%. In the emerging markets, uptake of branded drugs will increase due to rapid economic growth.

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First-line therapy

The type 2 diabetes market in the 7MM, Brazil, China and India is very mature; it is crowded with inexpensive generics and marked by a late-stage pipeline filled with me-too drugs.

"The global type 2 diabetes pharmaceutical market (including the 7MM, Brazil, China, and India) in 2012 was valued at $28.1bn."

The oldest antidiabetic drug, metformin, has long been and will remain the first-line therapy for type 2 diabetes due to its low cost, physicians’ familiarity with it and the availability of long-term data.

In contrast, sulfonylureas, another old and front-line therapy, will gradually be replaced by novel therapies with improved side-effect profiles.

Nevertheless, during the next decade, the type 2 diabetes market will not experience a fundamental shift in the classes of drugs that are preferred by physicians.

Rapid uptake of drugs from the novel class of SGLT-2 inhibitors will occur with the global sales for whole class in 2022 reaching £4.8bn; however, DPP-4 inhibitors and GLP-1 receptor agonists will continue to dominate the non-insulin type 2 diabetes space because SGLT-2 inhibitors will more often be used as a third-line treatment.

Of all currently marketed classes, GLP-1 receptor agonists will experience the fastest growth, growing at a CAGR of 13.4% and reaching total peak sales of £9bn in 2022, thanks to their weight-loss effects and another burgeoning epidemic – obesity – a disease closely linked with type 2 diabetes.

Global sales for the whole class of DPP-4 inhibitors will continue growing at a slightly slower rate (CAGR of 8.9%) and reach a staggering $16.9bn in 2022.

The insulin segment of the type 2 diabetes market will continue to grow at relatively fast pace (CAGR of 8.1%) and will reach the value of almost $25bn in 2022, accounting for both branded and biosimilar insulins and insulin analogs.

Reaching the market / ‘me-too’ drugs

Despite a well-populated research pipeline, none of the drugs slated to reach the market during the next ten years will significantly diminish the level of unmet need in type 2 diabetes.

"During the next decade, the type 2 diabetes market will not experience a fundamental shift in the classes of drugs that are preferred."

All currently available treatments for type 2 diabetes are initially effective and reduce complication rates, but they lack the ability to maintain glycemic control in the long term because of the progressive nature of pancreatic ß-cell dysfunction; this represents one of the highest unmet needs in the type 2 diabetes space.

In addition to glycemic control, patients with type 2 diabetes should manage other cardiovascular risk factors, including obesity, hypertension and dyslipidemia.

Control of these factors is less than optimal in most patients, and current therapies are only partially addressing these problems.

As the late-stage pipeline is dominated by me-too drugs and by drugs belonging to novel classes that are not very different from the marketed classes, most of the unmet needs will remain unfulfilled in the foreseeable future.

Therefore, despite the high number of marketed therapies, this market has a significant growth opportunity for new patent-protected products.

Tailored treatments for type 2 diabetes

"The insulin segment of the type 2 diabetes market will continue to grow at relatively fast pace (CAGR of 8.1%)."

Even in the absence of a revolutionary new treatment, pharmaceutical companies still have an opportunity to achieve considerable success in this market.

Indeed, even fourth or fifth-to-market me-too drugs will garner significant sales, thanks to the rapidly expanding patient population and the emphasis of the latest therapeutic guidelines on a patient-tailored treatment approach. In the future, companies may elect to develop more tailored treatments for certain patient segments, discarding the traditional blockbuster approach and focusing on niche drugs that are aimed at smaller groups.

Eli Lilly, for example, has already embraced this new business model and focuses on individualised solutions for patients.

On the other hand, companies such as Sanofi may choose to shift their focus from therapeutic value towards competitive pricing.

Given the stiff competition in the mature type 2 diabetes space and cost pressures that many countries’ healthcare systems face today, competing on price is likely to become an essential strategy for many current and future leaders in this therapy area.

While these strategies will seemingly diminish the cash inflow for pharmaceutical companies, the rapidly increasing type 2 diabetes market size will support the survival of any company that has fingers in this space.

Key opinion leaders interviewed by GlobalData believe most type 2 diabetics are not going to have sufficient control over their lifestyles, will continue to overeat, under-exercise and gain weight, and these patients’ need for medications will therefore increase.

For drugmakers, the sky is the limit on the value of the type 2 diabetes market.

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