Launch Excellence in the Diabetes Market: Lessons from - IMS Health

WHITE PAPER | DIABETES LAUNCH EXCELLENCE
Several combination products that have recently launched have struggled because the
convenience of the combination was simply not great enough for patients. Merck’s
Juvasync (sitagliptin and simvastatin) is a case in point. Patients still have to also
take metformin along with it, and so it is no more convenient to take Juvasync plus
metformin than to take Janumet and a separately administered statin. It could also be
that patients and physicians prefer a regimen consisting of Janumet and a separately
administered statin, since more recent statins (such as atorvastatin) may be preferred
(and are now generic).
Although differentiation of the follower products has not worked for the DPP-IVs, in
the injectable GLP-1 segment of the diabetes market, the follower product, Novo
Nordisk’s Victoza ® , has in fact done better than the first to market agent,
Amylin/Lilly's Byetta. Here, Victoza had some clear points of differentiation to Byetta,
including once daily administration because of a longer half life, less risk of
immunogenicity because it was fully humanized, and a superior performance in
lowering blood-sugar levels in head-to-head trials. The lesson here is that
differentiation of the follower can work if it is seen as clinically meaningful by
prescribers and payers and if benefits cannot be taken as a “class effect,” shared by all
members of that class.
Four more DPP-IV inhibitors are in late-stage development. The lessons of the first
four products strongly suggest that, unless there is true differentiation backed up with
a very effective campaign across stakeholders, they are likely to be chasing ever
decreasing portions of the market in most countries, and at best will achieve limited
success in certain markets, such as the marketing company’s home market.
Given the size of the global diabetes market, even patient niches represent
valuable opportunities.
FUTURE DIABETES CLASSES: FAMILIAR GROUND
There are many companies with up-and-coming treatments for Type II Diabetes in the
pipeline; all should be looking to apply the lessons of recent launches, as history tends
to repeat itself given similar circumstances. And it does seem that the circumstances
surrounding the next major class of drugs about to launch, the sodium-glucose
transporter inhibitors (SGLT-2s), will give us déjà vu...
Products in this class are likely to experience market dynamics that mirror those of the
DPP-IV inhibitors. Multiple examples of these molecules are in late-stage
development and are expected to launch around the same time. As with the DPP-IV
inhibitors, IMS Key Opinion Leader interviews suggest the SGLT-2 inhibitors may not
be clearly differentiated from one another in the eyes of prescribers and payers in
terms of safety, efficacy, or convenience. The first-to-market product will therefore, as
with Januvia, have a significant advantage, and European approval for AZ/BMS’s
dapagliflozin suggest that this agent will enjoy this role; however it may still be
possible for late-to-market products to succeed if they learn the lessons of the DPP-IVs.
IMS HEALTH | LAUNCH EXCELLENCE IN THE DIABETES MARKET 8