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Novel Agents Contribute to Rapid Growth of Both the Type 2 Diabetes and Obesity Markets

BURLINGTON, Mass., Nov. 19, 2015 /PRNewswire/ -- Decision Resources Group finds that, according to analyses of U.S. longitudinal patient-level claims data in the Treatment Algorithms: Type 2 Diabetes report, the use of SGLT-2 inhibitors and GLP-1 receptor agonists is increasing in the treatment of type 2 diabetes (T2D). According to the TreatmentTrends (US): Type 2 Diabetes and Pharmacor: Type 2 Diabetes reports, the use of these classes is expected to further increase within the next six months and beyond. These drug classes are notable for their demonstrated efficacy in reducing body weight, and as such are also being used off-label in the treatment of obesity. Survey data analyzing physician prescribing behavior for obesity confirms the increased use of these agents; physician-reported off-label prescribing of the GLP-1 receptor agonists matches their use of approved anti-obesity agents Belviq and Contrave, with further increases in off-label use predicted (US Physician and Payer Forum: Obesity report).

Insights from Decision Resources Group's Type 2 Diabetes and Obesity research: 

  • Rapid growth is expected in the market size for both T2D and obesity: The T2D and obesity markets are expected to increase from $35 billion to over $71 billion and from $530 million to $3.2 billion, respectively, from 2014 to 2024. The SGLT-2 inhibitors and GLP-1 receptor agonists are expected to become the highest grossing drug classes in the treatment of T2D by 2024, with sales of approximately $15 billion for each class. Sales of Saxenda (Novo Nordisk's liraglutide 3.0 mg) and off-label use of additional GLP-1 receptor agonists are expected to contribute over $1 billion in 2024 sales to the obesity market, with SGLT-2 inhibitors making more modest (refer to Pharmacor: Obesity report for more detail).
  • The ability to address comorbidities is increasingly influential in prescribing: Surveyed physicians report that the ability to reduce weight is highly valued for antidiabetic therapies, and improvement of glycemic control independent of weight loss is an advantage for obesity therapies. Reducing the occurrence of cardiovascular (CV) events remains a major unmet need for management of T2D and obesity. Following the positive results of the EMPA-REG OUTCOME trial with Jardiance (Boehringer Ingelheim/Eli Lilly's empagliflozin), uptake of the SGLT-2 inhibitors is expected to dramatically increase. In contrast, no GLP-1 receptor agonist or weight loss therapy has thus far demonstrated CV benefits similar to Jardiance.
  • Access to drug therapy remains a major barrier to uptake for both indications: A substantial proportion of surveyed physicians prescribe off-label therapies for obesity due to reimbursement issues for approved agents. Physicians report over 50 percent of commercially-insured patients are required to pay for obesity therapies completely out-of-pocket due to lack of coverage, with a considerable number of patients failing to receive an obesity therapy due to formulary decisions. Similarly, in T2D, surveyed physicians indicate that the GLP-1 receptor agonists and SGLT-2 inhibitors perform considerably worse on cost and reimbursement relative to other key therapies used in the treatment of T2D. Physician recall of sales representative's key message lists cost of therapy and insurance coverage as major parts of their communication, highlighting the influence of these features on prescribing and patient access for T2D.

Comments from Decision Resources Group Analysts Eamonn O'Connor, Ph.D., and Tim Blackstock M.B., Ch.B.:

  • "Two key factors will contribute to the increase in use of GLP-1 receptor agonists, namely the increased availability of once-weekly formulations, which reduce the dosing burden with earlier analogs. More importantly, the anticipated emergence of the first non-injectable formulations will result in earlier adoption in the treatment algorithm for T2D. Growth in the use of SGLT-2 inhibitors will benefit massively from the EMPA-REG results, while novel fixed-dose combinations with DPP-IV inhibitors will also contribute significantly."
  • "Antidiabetic agents make up a substantial proportion of the off-label drug use for weight loss, owing to the blurring of pathophysiology between type 2 diabetes and obesity. GLP-1 receptor agonists, and increasingly SGLT-2 inhibitors, are recognized as providing weight loss, with Novo Nordisk's Saxenda already approved for weight loss in the U.S. and European markets."

Additional Resources:

  • Decision Resources Group Analysts Eamonn O'Connor, Ph.D., and Tim Blackstock M.B., Ch.B., are conducting a live open webinar entitled "The converging treatment landscape for type 2 diabetes and obesity: An overview of key trends" on December 2, 2015. To register for this webinar, please click here.

For more information on purchasing any of the reports referred to in this press release, please email

About Decision Resources Group
Decision Resources Group offers best-in-class, high-value data, analytics and insights products and services to the healthcare industry, delivered by more than 900 employees across 14 global locations. DRG provides the pharmaceutical, biotech, medical device, financial services and payer industries with the tools, insights and advice they need to compete and thrive in an increasingly complex and value-based marketplace.

Media contact:

SHIFT Communications
Theresa Masnik

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