Diabetes drug market

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Dan Pan

Diabetes is the syndrome of having excess blood sugar due to low levels of insulin or insulin resistance. Approximately 21 million individuals in the U.S. have diabetes, and this number is growing at 10% a year, or over 1.5 million new cases annually.^[1] Age and obesity are both risk factors, and contributes to this number.

According to a new report published by Transparency Market Research (http://www.transparencymarketresearch.com/diabetes-devices-market.html) The Global Market for Diabetes Management accounted for USD 40 billion in 2010 and is expected to attain a market size of around USD 114 billion following a growth rate of 13.5% CAGR. The major products in this market consists of glucose meters, test strips, lancets, continuous blood glucose meters, syringes, insulin pumps, insulin and other insulin delivery devices and anti-diabetic drugs. However, insulin, test strips and anti-diabetic drugs are the most revenue generating products.

While diabetes often cannot be cured, drugmakers and biotech companies make glucose monitors, insulin delivery devices, and drug products to help manage the condition. It is estimated that the total market for diabetes products and related care is worth $92 billion in the U.S.^[2] Diabetes is especially important to Amylin, Novo Nordisk, Insulet, and DexCom, which focus on this market.

Managing diabetes

The diabetes treatment market consists of three related but distinct submarkets that address different aspects of the condition.

Glucose monitoring

• Self-monitor blood glucose (SMBG) - Diabetics need to constantly monitor their blood sugar levels. This is usually done several times daily with a traditional finger-prick test, which require a small blood sample. Roche, LifeScan (a division of Johnson & Johnson), Bayer, and MediSense (a division of Abbott Laboratories) account for over 90% of this $8 billion market. ^[3]

• Continuous glucose monitoring systems (CGMS) - New technology has made this task much easier. A CGM sensor continuously takes subcutaneous blood glucose readings, which are relayed to a electronic monitor worn by the patient. CGMS have the advantage of being able to instantly warn the patient of low or excess blood sugar levels. However, the cost of CGMS is often not covered by health insurance policies, so patients must pay out of their own pockets. Abbot, Medtronic, and DexCom manufacture devices for this $250 million market. ^[4]

Insulin delivery

• Injected insulin - The most traditional method of insulin replacement is an injection several times a day. There are an enormous variety of delivery options, including a traditional syringe, insulin "pens", and jet injectors. The major players in the $7 billion market of human insulin are Novo Nordisk, Eli Lilly, and Sanofi-Aventis.^[5]

• Insulin pumps - Since diabetics cannot produce sufficient insulin, they must administer insulin injections to maintain proper proper blood glucose levels. An alternative to traditional insulin injections by syringe are insulin pump systems, which are devices worn by the user and deliver a continuous dosage of insulin. Insulin pump therapy reduce the insulin spike associated with a traditional injection, and are more convenient for type 1 patients and select type 2 patients who are more susceptible to insulin fluctuations. Insulin pump therapy is fully reimbursed by insurance companies, and the market is $750 million in the U.S. ^[6] Johnson & Johnson, Medtronic, , Roche, Insulet, and Sooil manufacture insulin pump systems.,,,,,

Drugs

A number of drugs are available to help manage type 2 diabetes. Depending on the severity of the condition, drugs are usually used in conjunction with other monitoring and treatment options.

The non-insulin oral diabetes drug market is estimated to be $8.4 billion.^[7] Eli Lilly and Amylin's Byetta first entered the market two years ago and signals the pancreas to produce more insulin. Glaxo's Avandia and Takeda's Actos work by reducing insulin resistance. Merck's Januvia is the newest of the diabetes drugs and has the potential to become a blockbuster. It successfully controls blood sugar levels in type 2 patients and has few reported side effects.^[8]

Studies at the University of California - Berkley successfully reduced and preventing type 1 diabetes with a rate of 80% using two cancer drugs, Gleevec by Novartis and Sutent by Pfizer. ^[9]

Diabetics often take other drugs not directly related to diabetes to help manage the risks of the condition. For example, doctors may prescribe a cholesterol drug such as Pfizer's best-selling Lipitor to help lower the risk of heart disease, which diabetics are at risk for.

Health insurance companies lose from reimbursements

Since diabetes is a life-threatening condition, insurance providers usually reimburse most costs of diabetes management. Health insurance companies such as Aetna (AET), UnitedHealth Group (UNH), WellPoint Health Networks (WLP), and AFLAC (AFL) may be hurt by the increased incidence of diabetes because reimbursement costs will increase.

Continuous blood glucose systems are not commonly covered by policies.

What is diabetes?

The food we eat is converted to glucose to be used by the body. After a healthy person has a meal,the pancreas secretes the hormone insulin which signals to the body to accept the glucose. Diabetes is the syndrome of having excess blood sugar due to low levels of insulin or insulin resistance. The condition is classified into two types:

• About 5-10% of diabetics have type 1 diabetes, which is a very serious condition that refers to the body's inability to produce insulin. Almost all type 1 patients are dependent on insulin, and mismanagement of one's blood glucose levels may be fatal. Because type 1 is often hereditary, the patient population tends to be younger.

• The remaining 90-95% of patients have type 2 diabetes, which is also know as insulin resistance. The body is able to produce insulin, but does not respond to the effects of insulin well. As a result, type 2 patients also need external insulin sources to maintain blood glucose levels.

While diabetes itself can usually be controlled with modern medical advances, the condition leads to a number of more serious diseases. Prolonged high blood glucose levels can cause diabetic retinopathy (blindness due to deteriation of the retina), neuropathies, kidney disease, and cardiovascular symptoms. Diabetics have a higher risk of heart disease and stroke, which accounted for 65% of deaths among diabetes patients. ^[10]

Disease risk factors and drivers

The causes and triggers of diabetes are not fully understood. It is likely that a wide range of environmental factors contribute to the disease. Some of the known major risk factors for diabetes are:

• Genetics - Patients with a family history of diabetes are more likely to develop the syndrome

• Age - Individuals between 40 and 60 have a 10% chance of having diabetes, while those over 60 have double the risk.^[11]

• Obesity and a sedentary lifestyle - Being overweight and lack of exercise increases the risk of type 2 diabetes. The American Diabetes Association recommends regular exercise and a diet modest in fats and high in whole grains.

• Diet - Consumption of high-sugar and highly processed foods increase the risk of diabetes. This is especially a problem in developed countries.

References

1. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
2. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
3. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
4. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
5. ↑ http://www.in-pharmatechnologist.com/news/ng.asp?id=65276
6. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
7. ↑ http://money.cnn.com/2007/05/17/news/companies/diabetes/index.htm
8. ↑ http://www.cnn.com/2007/HEALTH/conditions/10/31/diabetes.drugs/index.html
9. ↑ Physorg.com "Two cancer drugs prevent, reverse type 1 diabetes, study shows." 18 Nov 2008.
10. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.
11. ↑ Canaccord Adams. Diabetes 2007 and Beyond: Innovation, Demographics and Lifestyle Trends Drive Industry Growth. August 2, 2007.