Global Diabetes Drugs Market to 2024

Market Overview, Key in-line Products, Market Share Distribution, Competitive Dynamics, Regulatory Outlook, Pipeline Development, Growth Catalysts & Challenges, Leading Market & R&D Trends, Partnership & Deals Analyses, Global Sales forecast of in-line and pipeline products, Fast Growing Private Companies, Management Perspectives, Commentaries, Market Outlook & Summary Conclusions

Global diabetes drugs market was valued at $33.5bn in 2015 and is forecast to grow at a strong 7.6% CAGR between 2015 and 2024, resulting in 2024 global sales of $69.8bn.

Diabetes refers to a group of metabolic diseases that affect the way a person’s body uses blood glucose. Diabetes is characterized by high blood glucose levels over prolonged periods of time. There are two basic forms of diabetes: Type I and Type II. Type I diabetes is caused by pancreatic inability to produce insulin and Type II diabetes occurs when the patient’s pancreas does not produce enough insulin to keep blood glucose levels normal.

As per a new report from IDF, there are an estimated 415m people worldwide with diabetes in 2015. The number of diabetes cases worldwide is expected to reach 642m in 2040. In the U.S., there are an estimated 29m people afflicted with diabetes, representing around 8% of the population.

“Leading Diabetes Drug Classes”

The key drug classes that are used in the treatment of diabetes include DPP-IV inhibitors, GLP-1 analogs, SGLT2 inhibitors, insulin, sulfonylureas, and glitazones,

Insulin remains the cornerstone of diabetes treatment. The insulin market is projected to show healthy growth driven by novel products, fixed dose combinations, increased penetration and favorable demographics. Sanofi’s Lantus is the leading basal insulin but sales are declining given new launches of novel insulins and biosimilar competition.

The emergence of DPP-IV segment in the last few years has accelerated the growth momentum of diabetes treatment. DPP- IV has become successful add-on therapies, primarily in the early stages of diabetes in combination with metformin. The category reported 2015 sales of $7.5bn. However DPP-IV category sales are expected to decline through 2024 due to lack of CV benefits and uncertainties around once-weekly compounds.

Latest entrants to the oral diabetes treatment portfolio are SGLT-2s inhibitors. J&J’s Invokana has enjoyed first mover advantage and AstraZeneca’s Farxiga is experiencing a solid uptake despite limited differentiation.

GLP-1 receptor agonists are injectable therapies commonly used post failure of oral drugs (generic metformin, DPP-IV & SGLT-2). The projected growth for the class is primarily driven by recent CV benefit shown by LEADER and SUSTAIN6 trials. Novo Nordisk’s Victoza and AstraZeneca’s Byetta franchise have dominant positions in the GLP-1 space. These agents face direct competition to the oral therapies as they provide superior glycemic control and weight control. However the injectable mode of administration limits their use and hence these drugs are often prescribed after oral therapy has failed.

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Global Diabetes Drugs Market, By Drug Class, 2013 - 2024 (USD Million)

The sulfonylureas and glitazone classes are currently highly genericized. They are widely prescribed but are declining due to unfavorable clinical profile.

“Treatment Algorithm for Diabetes”

Early stage diabetes is managed with oral antidiabetics (metformin, sulfonylurea, thiazolidinedione, DPP-IV, SGLT-2), while more advance stages require either injectables (GLP-1, pramlintide), exogenous insulin or both. The use of injectables is increasing as novel devices streamline administration and oral agents fail to get patients on goal. Patients with type I diabetes produce little or no insulin and are dependent on insulin injections for survival. For patients with extremely unstable diabetes, pancreas transplantation can be a viable option.

“Product Innovation”

In early 2015, Boehringer Ingelheim and its partner Eli Lilly’s first-in-class SGLT-2/DPP-4 combination (Glyxambi) was approved by the FDA. AstraZeneca filed a similar combination (saxagliptin+dapagliflozin) but received a complete response letter in late 2015. SGLT-2 class offer oral route of administration, strong HbA1c efficacy data antihypertensive action and reduction in body weight.


The biosimilar insulin space is going to heat up in next 5-10 years and both developed and emerging markets offer significant commercial opportunity. Boehringer Ingelheim /Lilly launched biosimilar Lantus in the EU with the U.S. launch expected by year end 2016. Merck has also filed a biosimilar insulin in both E.U. and the U.S. Mylan has partnered with the Indian biotech major Biocon for biosimilar insulin with a potential launch in 2018.

Optima Insights’ KOLs view the GLP-1 class as more efficacious than DPP-IV given improved HB1Ac control, superior body weight loss as opposed to DPP-IV which is weight neutral. Lilly’s Trulicity (dulaglutide) is the latest entrant in the space and offers a strong clinical profile and user-friendly device. Novo Nordisk is developing an oral GLP-1 agent (semaglutide) and if approved could be a game changer.

"Eli Lilly, Novo Nordisk, Sanofi, Merck, AstaZeneca, Boehringer Ingelheim, J&J and Novartis are some of the key players in diabetes drugs market"

In 2015, Novo Nordisk, Sanofi, Merck, and Eli Lilly led the $33.5bn global diabetes drugs market. In 2024, AstraZeneca is projected to dominate the $69.8bn market, driven by strong product growth in GLP-1 and SGLT-2 classes.

Given CV benefit showed by GLP-1 and SGLT-2 in multiple pivotal trials, we expect a significant growth for both classes, likely at the expenses of DPP-4 which have failed to show a CV benefit.
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