FiercePharma | Eric Palmer
Everybody knows that diabetes
is an epidemic in this country that is costing lives and money. New stats from
the U.S. Centers for Disease Control and Prevention (CDC) peg at 29.1 million
the number of people in the U.S. who have either Type 1 or Type 2 diabetes,
with roughly 9 million of those undiagnosed. Most have Type 2 diabetes, which
is more prevalent among minorities. On the other hand, a study found that
non-Hispanic white children are diagnosed more often with Type 1 diabetes than
other groups. And that is just in the U.S. The rest of the world also is
developing diabetes at what many see as alarming rates.
Pharma, seeing opportunity,
has responded. There are pills as well as injected drugs. Many are incretin
mimetics. There are now 12 classes of drugs, including the GLP-1 class drugs
like AstraZeneca's Byetta and Novo
Nordisk's blockbuster Victoza, and DPP-4
inhibitors like Merck's Januvia, Eli
Lilly and Boehringer Ingelheim's Tradjenta/Trajenta and AstraZeneca's Onglyza.
These widely used drugs, some
of which are on this list, have stirred safety concerns. The FDA and European
regulators announced in February that a new round of safety reviews found
little evidence that they cause pancreatitis or pancreatic cancer, as some have
suggested. But criticism persists, and this month consumer advocacy group
Public Citizen again asked the FDA to pull Victoza from the market, saying the
FDA's review of adverse reports was not as extensive as its own.
What is perhaps becoming a
bigger deal for Big Pharma, however, is that with so many treatment options,
and more coming, the market has gotten crowded and doctors and patients a bit
confused. That has led to some studies to sort out which drugs work the best,
and that in turn has led some researchers to suggest that for all of the extra
money U.S. patients are paying for new treatments, little benefit is being
seen. A Yale study, recently cited by Bloomberg, says that many patients have
made the switch to analogs and are now spending much more on them than older
drugs. But it found little change in the number of episodes of low blood sugar
at night, one of the conditions doctors most want to control.
Dr. Silvio E. Inzucchi,
director of the Yale Diabetes Center, speaking to The New York Times, asked
rhetorically whether patients are any better off with all of the new drugs, then
answered his own question this way: "You can control glucose with generics
for $4 a month or some new ones that are $8 or $9 per pill. Some medicines are
100 times more expensive, but they're certainly not 100 times as effective. In
fact, they're probably equal for most people."
On this list of the best
sellers, you will find a mix of the old and new. According to data from
EvaluatePharma, one of the big dogs of big pharma data, these top 10 drugs had
more than $28 billion in sales last year. All of them, even number 10, were
blockbusters. King Lantus alone turned in $7.6 billion in revenue, more than
the next two drugs combined and still selling strong. Revenues grew about 20%
each of the last two years. Sanofi has
been able to be aggressive with its pricing, particularly with the FDA decision
to delay approval of potential rival Tresiba pending more safety data.
1. Lantus
2. Januvia
3. NovoLog/NovoRapid
4. Humalog
5. Victoza
6. Levemir
7. Human insulin and devices
8. Janumet
9. NovoMix 30
10. Humulin R
2. Januvia
3. NovoLog/NovoRapid
4. Humalog
5. Victoza
6. Levemir
7. Human insulin and devices
8. Janumet
9. NovoMix 30
10. Humulin R