Against the backdrop of the global diabetes epidemic, competition continues to intensify in this pharmaceutical market, as laboratories focus on both innovation and emerging markets in an attempt to offset the strong pressure on prices in the United States.
629 million diabetics in 2045
The numbers are alarming: last year, the world had more than 425 million diabetics, and their number could rise to 629 million by 2045, according to estimates by the International Diabetes Federation (IDF). Only half of them are currently diagnosed, and of these only 50% have access to treatment.
Also diabetes and its complications (cardiovascular and renal diseases, lower limb amputations …) kills 4 million people a year, according to the FIS.
Diabetes is a disorder of assimilation of sugars by the body, existing in two forms. Type 2 diabetes, which now accounts for 90% of cases and progresses the most, corresponds to a prolonged increase in blood sugar (blood glucose), often linked to obesity and a sedentary lifestyle.
As for type 1 diabetes, of genetic origin, it often appears in childhood and is characterized by the total absence of insulin, a hormone normally produced by the pancreas and which regulates blood sugar.
A $80 billion market
The global diabetes market in 2017 was worth about $ 80 billion, making it the second largest pharmaceutical market after cancer, according to data from Iqvia, a health specialist.
The United States alone accounted for 64% of this market last year, according to Iqvia.
But the epicenter of the diabetes crisis is now in the emerging countries of Asia, China and India in the lead, and the growth of the disease should be drawn in the future by Southeast Asia, the Africa and the Middle East, according to IDF.
In addition, the US diabetes market has been in the process of reconfiguring since 2015. The prices of antidiabetics, which had so far surged in the country, then began to be seriously revised downward by US insurers.
One of the triggering factors was the arrival on the market of Basaglar, the first biosimilar of Lantus, the long-acting insulin star of the French Sanofi, developed by its American competitor Eli Lilly and German Boehringer. Ingelheim.
The biosimilars are the original biological drugs what are the generics for drugs from synthetic chemistry.
Their manufacturers “make discounts almost equivalent to generics, at least 50% compared to the list price,” said Claude Le Pen, health economist and consultant at Iqvia, interviewed by AFP.
– Novo resists, Lilly leaps, Sanofi undergoes –
In 2017, the slump in Lantus sales continued (-17.5% at constant exchange rates, to € 4.6 billion). Sanofi’s entire diabetes franchise fell by 11.1% to 6.39 billion euros last year, and its decline continued in the first quarter of this year (-10%).
After a difficult year in 2016, also a victim of shaking in the United States, the Danish Novo Nordisk, world leader in the diabetes market, resists rather well: its sales in this activity increased by 3% last year, to more than 12 billion euros (+ 3%).
Those of Eli Lilly in the sector have jumped 25% in 2017, to 10 billion dollars (about 8.4 billion euros at the current rate).
Novo Nordisk and Eli Lilly benefit from their strong presence in the most dynamic segment of the market, GLP-1, which is currently growing by more than 20% a year, including in the United States.
However, this segment currently represents only 12% of the total diabetes market, against 44% for insulins and the rest for oral diabetes medications, prescribed at earlier stages of the disease.
Sanofi is also focusing on the GLP-1 class, with a new drug candidate, efpeglenatide, which he hopes to commercialize in 2021. He also places a lot of hope in a new generation of oral antidiabetic drugs. , sotaglifozine, which it licensed in 2015 from Lexicon’s US biotech, as well as emerging markets, where it is well positioned.