Launch Excellence in the Diabetes Market: Lessons from - IMS Health
Launch Excellence in the Diabetes Market: Lessons from - IMS Health
Launch Excellence in the Diabetes Market: Lessons from - IMS Health
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WHITE PAPER | DIABETES LAUNCH EXCELLENCE<br />
Several comb<strong>in</strong>ation products that have recently launched have struggled because <strong>the</strong><br />
convenience of <strong>the</strong> comb<strong>in</strong>ation was simply not great enough for patients. Merck’s<br />
Juvasync (sitaglipt<strong>in</strong> and simvastat<strong>in</strong>) is a case <strong>in</strong> po<strong>in</strong>t. Patients still have to also<br />
take metform<strong>in</strong> along with it, and so it is no more convenient to take Juvasync plus<br />
metform<strong>in</strong> than to take Janumet and a separately adm<strong>in</strong>istered stat<strong>in</strong>. It could also be<br />
that patients and physicians prefer a regimen consist<strong>in</strong>g of Janumet and a separately<br />
adm<strong>in</strong>istered stat<strong>in</strong>, s<strong>in</strong>ce more recent stat<strong>in</strong>s (such as atorvastat<strong>in</strong>) may be preferred<br />
(and are now generic).<br />
Although differentiation of <strong>the</strong> follower products has not worked for <strong>the</strong> DPP-IVs, <strong>in</strong><br />
<strong>the</strong> <strong>in</strong>jectable GLP-1 segment of <strong>the</strong> diabetes market, <strong>the</strong> follower product, Novo<br />
Nordisk’s Victoza ® , has <strong>in</strong> fact done better than <strong>the</strong> first to market agent,<br />
Amyl<strong>in</strong>/Lilly's Byetta. Here, Victoza had some clear po<strong>in</strong>ts of differentiation to Byetta,<br />
<strong>in</strong>clud<strong>in</strong>g once daily adm<strong>in</strong>istration because of a longer half life, less risk of<br />
immunogenicity because it was fully humanized, and a superior performance <strong>in</strong><br />
lower<strong>in</strong>g blood-sugar levels <strong>in</strong> head-to-head trials. The lesson here is that<br />
differentiation of <strong>the</strong> follower can work if it is seen as cl<strong>in</strong>ically mean<strong>in</strong>gful by<br />
prescribers and payers and if benefits cannot be taken as a “class effect,” shared by all<br />
members of that class.<br />
Four more DPP-IV <strong>in</strong>hibitors are <strong>in</strong> late-stage development. The lessons of <strong>the</strong> first<br />
four products strongly suggest that, unless <strong>the</strong>re is true differentiation backed up with<br />
a very effective campaign across stakeholders, <strong>the</strong>y are likely to be chas<strong>in</strong>g ever<br />
decreas<strong>in</strong>g portions of <strong>the</strong> market <strong>in</strong> most countries, and at best will achieve limited<br />
success <strong>in</strong> certa<strong>in</strong> markets, such as <strong>the</strong> market<strong>in</strong>g company’s home market.<br />
Given <strong>the</strong> size of <strong>the</strong> global diabetes market, even patient niches represent<br />
valuable opportunities.<br />
FUTURE DIABETES CLASSES: FAMILIAR GROUND<br />
There are many companies with up-and-com<strong>in</strong>g treatments for Type II <strong>Diabetes</strong> <strong>in</strong> <strong>the</strong><br />
pipel<strong>in</strong>e; all should be look<strong>in</strong>g to apply <strong>the</strong> lessons of recent launches, as history tends<br />
to repeat itself given similar circumstances. And it does seem that <strong>the</strong> circumstances<br />
surround<strong>in</strong>g <strong>the</strong> next major class of drugs about to launch, <strong>the</strong> sodium-glucose<br />
transporter <strong>in</strong>hibitors (SGLT-2s), will give us déjà vu...<br />
Products <strong>in</strong> this class are likely to experience market dynamics that mirror those of <strong>the</strong><br />
DPP-IV <strong>in</strong>hibitors. Multiple examples of <strong>the</strong>se molecules are <strong>in</strong> late-stage<br />
development and are expected to launch around <strong>the</strong> same time. As with <strong>the</strong> DPP-IV<br />
<strong>in</strong>hibitors, <strong>IMS</strong> Key Op<strong>in</strong>ion Leader <strong>in</strong>terviews suggest <strong>the</strong> SGLT-2 <strong>in</strong>hibitors may not<br />
be clearly differentiated <strong>from</strong> one ano<strong>the</strong>r <strong>in</strong> <strong>the</strong> eyes of prescribers and payers <strong>in</strong><br />
terms of safety, efficacy, or convenience. The first-to-market product will <strong>the</strong>refore, as<br />
with Januvia, have a significant advantage, and European approval for AZ/BMS’s<br />
dapaglifloz<strong>in</strong> suggest that this agent will enjoy this role; however it may still be<br />
possible for late-to-market products to succeed if <strong>the</strong>y learn <strong>the</strong> lessons of <strong>the</strong> DPP-IVs.<br />
<strong>IMS</strong> HEALTH | LAUNCH EXCELLENCE IN THE DIABETES MARKET 8