- On Thursday, Sanofi's CEO, Olivier Brandicourt, predicted a slowdown in insulin use as new oral medications become easier to use. Sanofi's stock was down 5.5% after Brandicourt's comments but has recovered since then.
- Although Novo Nordisk offered a more upbeat outlook, largely because of strong sales of Tresiba (insulin degludec) in the E.U. and CEO Lars Sorensen's argument that Sanofi's prospects were dimming due to pressure from both Novo drugs and generics, its stock was also down on Thursday before bouncing back slightly on Friday.
- Sales of Sanofi's Lantus, known as the best-selling insulin in history, were down 11% overall this year, and 20% in the last quarter.
For many years, insulin has been considered the mainstay of therapy for patients with type 1 diabetes (and that probably won't change), as well as a treatment that most patients with type 2 diabetes eventually needed.
However, that paradigm has shifted as next-generation oral anti-diabetics have entered the marketplace, especially the SGLT2 inhibitors—including Lily's Jardiance (empagliflozin), which recently rocked the diabetes community be releasing data showing a cardiovascular benefit associated with this drug.
Add to that the impact of the introduction of the first biosimilar version of Lantus, Basaglar, co-marketed by Lilly and Boehringer Ingelheim, and it's clear that the domination of Lantus is ending. Last year, Lantus grossed $7 billion, but as the impact of Basaglar in the E.U. hit the bottom lines, sales have already started to decline. Plus, within the next year, Basaglar will launch in the U.S.—giving the 29.3 million American with diabetes a biosimilar insulin treatment option.
But there's another angle entirely: the advent of new delivery systems for drugs, which are associated with high levels of blood glucose control but only available as injectables. Currently there is an oral insulin and an oral GLP-1 analog being developed by Oramed, and a transdermal patch intended to treat hyperglycemia being developed by Prometheon Pharma.
It's a brand new era for diabetes therapeutics, which is changing the landscape of who wins—and who loses—in this very lucrative marketplace.