Table of Contents
Innovations in the Management of Diabetes
Executive Summary 8
Introduction 8
Currently marketed innovatives 9
Future drivers of growth and innovation 10
Key companies and pipelines 11
Future trends and implications 12
Chapter 1 Introduction 14
Summary 14
Introduction 15
Disease description 15
Type 1 diabetes 15
Type 2 diabetes 16
An increasing global health concern 17
Increasing patient population 17
Underdiagnosed and undertreated 17
Economic burden 18
Chapter 2 Currently marketed innovatives 20
Summary 20
Introduction 21
Current growth drivers 21
Insulins 23
Leading marketed innovatives within insulin 23
Exubera 26
Oral anti-diabetics (OADs) 28
Leading marketed innovatives in OADs 29
Other diabetic drugs 31
Leading marketed innovatives in other diabetic drugs 32
Chapter 3 Future drivers of growth and
innovation 38
Summary 38
Introduction 39
Unmet need 39
Key events in the global diabetes market 41
ACCORD trial halted 18 months early 41
Inhaled insulins fail to impact market 42
FDA considers stricter rules for diabetes drugs 42
Toward the prevention and further treatment of diabetes 43
Non-invasive forms of insulin via new drug delivery technologies 43
Inhaled insulins 43
Future potential of inhaled insulins 44
Oral insulins 47
Future potential of oral insulins 47
Insulin patches 49
Future potential of insulin patches 49
Emerging new drug classes: targeting underlying causes 50
Incretin mimetics: GLP-1 agonists and DDP-IV inhibitors 51
GLP-1 agonists in development 52
Novel GLP-1 agonists addressing unmet need 56
DDP-IV inhibitors in development 57
Novel DDP-IV inhibitors addressing unmet need 59
PPAR agonists 60
PPAR agonists in development 62
Novel PPAR agonists addressing unmet need 64
Sodium glucose co-transporter (SGLT) inhibitors 65
SGLT inhibitors in development 66
Cannabinoid-1 (CB1) receptor antagonists 67
CB-1 receptor antagonists in development 67
Glucokinase activators (GKA) 68
Glucokinase activators in development 69
Other novel drugs in development 70
Protein tyrosine phosphatase 1B (PT1B) inhibitors 70
Glycogen synthase kinase-3 (GSK-3) inhibitors 71
11-beta-hydroxysteroid dehydrogenase (11beta-HSD1) inhibitors 71
GPR119 agonists 72
Cell transplantation and innovative therapies 73
Chapter 4 Key companies and pipelines 76
Summary 76
Introduction 77
Leading competitive strategies 77
Lifecycle management 77
Diversification 78
Franchise development 78
New market entry 79
Leading players 79
Novo Nordisk 82
Currently marketed innovatives profile 82
R&D/innovatives profile 83
Takeda 85
Currently marketed innovatives profile 85
R&D/innovatives profile 86
Sanofi-Aventis 87
Currently marketed innovatives profile 87
R&D/innovatives profile 88
GSK 90
Currently marketed innovatives profile 90
R&D/innovatives profile 91
Lilly 93
Currently marketed innovatives profile 93
R&D/innovatives profile 94
Merck. 96
Currently marketed innovatives profile 96
R&D/innovatives profile 97
Chapter 5 Future trends and implications 100
Summary 100
Introduction 101
Future market growth 101
Competitive strategy and future potential 104
Chapter 6 Appendix 108
IMS data 108
Index 109
List of Figures
Figure 3.1: Unmet needs in diabetes, 2008 40
Figure 3.2: Innovative diabetes pipeline, 2007 51
Figure 3.3: Addressing unmet need of novel GLP-1 agonists versus insulin 56
Figure 3.4: Addressing unmet need of novel DDP-IV inhibitors versus TZDs 59
Figure 3.5: Addressing unmet need of novel PPAR agonists* versus TZDs 64
Figure 4.6: Competitive dynamics of the leading players in the diabetes market, 2007 81
Figure 5.7: Drivers and resistors of growth in the innovative diabetes market, 2007 102
Figure 5.8: Forecast sales growth for the global diabetes market, 2007-12 103
Figure 5.9: Outlook for leading pharmaceutical companies in the innovative diabetes market 104
List of Tables
Table 2.1: Breakdown of the global diabetes market by drug class, 2003-07 22
Table 4.2: Leading diabetes companies*, 2006-07 79
Table 4.3: Novo Nordisk’s currently marketed innovative diabetes profile, 2003-07 82
Table 4.4: Novo Nordisk’s diabetes R&D/innovatives profile 83
Table 4.5: Takeda’s currently marketed innovative diabetes profile, 2003-07 85
Table 4.6: Takeda’s diabetes R&D/innovatives profile 86
Table 4.7: Sanofi-Aventis’ currently marketed innovative diabetes profile, 2003-07 87
Table 4.8: Sanofi-Aventis’ diabetes R&D/innovatives profile 88
Table 4.9: GSK’s currently marketed innovative diabetes profile, 2003-07 90
Table 4.10: GSK’s diabetes R&D/innovatives profile 91
Table 4.11: Lilly’s currently marketed diabetes innovative diabetes, 2003-07 93
Table 4.12: Lilly’s diabetes R&D/innovatives profile 95
Table 4.13: Merck’s currently marketed innovative diabetes profile, 2003-07 96
Table 4.14: Merck’s diabetes R&D/innovatives profile 97