Interpretation of the Diabetes Drug Market: Increasingly Monopolized, but Still Vibrant

Diabetes is a global public health problem. The global diabetes patients according to the statistics of the World Health Organization reach as high as 400 million. The diabetes incidence in many developing counties including China, etc. is far higher than the world average level. One in every ten people in China has diabetes, and this incidence is experiencing "explosive" growth, showing a very severe situation. The huge base of diabetes patients decides a huge diabetes drug market. There are countless companies and institutions conducting diabetes drug development, but statistical data show that the overall market becomes increasingly monopolized, in spite of the countless companies developing diabetes drugs and countless drug categories.

Table I Top 5 pharmaceutical enterprises by 2016 diabetes drug sales

The top 5 pharmaceutical enterprises by 2016 global diabetes drug sales were separately Novo Nordisk, Sanofi, Merck, Eli Lilly and AstraZeneca, with total sales of more than USD 30 billion, occupying most of the diabetes drug market shares. The rankings of those companies have been high, and the places have hardly changed in recent years. Japan Takeda Pharmaceutical created USD 4.2 billion diabetes drug sales in 2011, ranking fourth in that year, but the sales of the company continued to decline thereafter, and from that year on, positions of top 5 pharmaceutical enterprises in diabetes drug market have not be shaken.

Table II Categories of main diabetes drugs

Seen from categories of diabetes drugs, the sales of insulin hypoglycemic drugs have been far ahead of other diabetes drugs, being the leader in the diabetes drug market. However, DPP4 inhibitor, GLP-1 agonist and SGLT2 diabetes drugs have grown strongly in recent years, especially, the DPP4 inhibitor and GLP-1 agonist have been achieved great breakthroughs in recent years, with the sales having been rapidly growing.

Table III Top 5 diabetes drugs by sales

From the perspective of single diabetes drugs, the top 5 by 2016 sales were separately insulin glargine, sitagliptin, liraglutide, insulin aspart, and insulin lispro, wherein, as a star insulin hypoglycemic drug under Sanofi, insulin glargine has been staying the top of diabetes sales rankings for many years, being the first choice of many diabetes patients for treatment; and as the first DPP4 inhibitor hypoglycemic drug approved by FDA, the sitagliptin developed by Merck has maintained sales of about USD 4 billion in recent years, being a blockbuster hypoglycemic drug; liraglutide and insulin aspart separately ranking third and fourth are both developed by Novo Nordisk: the former is a glucagon-like peptide-1 (GLP-1) analog, and can play a role similar to GLP-1, thereby to promote the release of insulin inside human body; liraglutide and insulin aspart and other blockbuster hypoglycemic drugs have established the long leading position of Novo Nordisk in the diabetes drug market; in addition, insulin lispro, ranking fifth, is also an insulin hypoglycemic drug, and belongs to Eli Lilly. Of particular interest is that the categories of the top 3 hypoglycemic drugs are the top 3 in the list of categories of hypoglycemic drugs, reflecting the market trend of the hypoglycemic drugs to an extent.

Positions of top-ranking pharmaceutical enterprises are almost unshakeable and they have monopolized the market to an extent, from the perspective of the overall development trend of the diabetes drug market. Not only do those pharmaceutical enterprises possess existing blockbuster hypoglycemic drugs, but they also possess strong R&D strength and base. Novo Nordisk has recently submitted new drug applications for one new hypoglycemic drug—Semaglutide to FDA and EU, which is a new GLP-1 receptor agonist and has been shown by existing studies that its effects would be better than existing marketed drugs including insulin and it could effectively reduce the risks of developing cardiovascular diseases in diabetes patients. To be sure, Semaglutide will be another blockbuster drug in the diabetes drug market and will shore up Novo Nordisk’s leading position. However, it's worth pointing out that the diabetes patients have a huge base and constitute a huge market, and the top-ranking companies occupy huge market shares, but the hypoglycemic drugs developed by other companies with annual sales of above USD 100 million are also countless. It is the huge market that has made the existing situation of the contending and vibrant diabetes drug development.