$60 billion market size! Market analysis of diabetes therapeutics

Multiple indications of the same drug seem to be another secret of success for pharmaceutical companies, such as semaglutide.

According to the 2022 annual report of Novo Nordisk, the GLP-1 business of semaglutide had an annual revenue of 83.371 billion Danish kroner (about 11.812 billion US dollars), an increase of 56% year-on-year, which is a "blockbuster" drug.

The huge market imagination has completely ignited the enthusiasm for research and development in the global drug circle: recently, the clinical phase 2 data of Maslactide, which is jointly promoted by Cinda and Eli Lilly, also made positive progress for the indication of weight loss.

However, in fact, semaglutide has been approved for type 2 diabetes in China.

Hypoglycemic drugs, a "big cake" comparable to the diet drug market, are emerging.

The "fight" against sugar,

It's been going on for hundreds of years

diabetes was first recorded in the medical books of ancient Egypt in 1550 BC. In the history of medicine, Aletes from Rome was probably the first doctor to use diabetes to record a wasting disease of heavy urination.

The relationship between the pancreas and diabetes began to be discovered in 1900, when German scientists Merlin and Minkowski found that dogs who had been removed the pancreas developed all the symptoms of diabetes and died soon after.

In 1921, Sir Grant and Best replicated the experiments of Merlin and Minkowski, and they further demonstrated that injection of islet extracts from healthy dogs into diabetic dogs could cause them to recover.

"It was not until 1922 that the first diabetic patient received an effective treatment - insulin injection therapy." "Said Dr. Yongsheng Liu, Medical Director of Hejinger.

Metformin was successfully synthesized in the 1820s, but it did not attract much attention due to the use of insulin.

Until the 1950s, people found the limitations of insulin, and metformin came back to people. After clinical verification, metformin was marketed in 1957 as a biguanide hypoglycemic drug.

In 1976, Damon invented the insulin pump, a portable device that regularly delivers insulin to patients.

Up to now, a variety of oral and injectable hypoglycemic drugs have been introduced.

10 billion market size,

Analysis of oral antidiabetic drugs

According to statistics, the global diabetes market has maintained a single-digit growth rate in recent years, between 3% and 7%.

In 2022, with the addition of GLP-1 receptor agonists and SGLT2 inhibitors, it quickly exceeded 10%, with a market size of nearly 60 billion US dollars.

From the perspective of domestic data, China is the largest country of diabetes in the world, and the number of patients is the largest in the world.

According to Frost & Sullivan data, the prevalence of diabetes in Chinese adults was 10.8% in 2016 and reached 11.9% in 2020, accounting for about 10% of the total population in China, ranking first in the world.

With the huge market demand, hypoglycemic drugs have developed rapidly.

"In the treatment of diabetes, lifestyle intervention is mainly used in the early stage, and oral hypoglycemic drugs represented by metformin are used to control blood glucose in the early stage. "When patients have glycated hemoglobin levels above 7% despite high doses of oral antidiabetic drugs, insulin therapy is needed." "Dr. Liu said.

With the increasing trend of non-insulin drugs, traditional drugs are still the mainstream in the treatment of diabetes, and insulin is just needed.

Currently, there are 8 classes of oral antidiabetic drugs for diabetes mellitus, including biguanides, α-glucosidase inhibitors, thiazolidinediones, SGLT2 inhibitors, sulfonylureas, glinide, DPP-4 inhibitors, GLP-1, etc.

At present, there are many types of antidiabetic drugs, and although there are relatively perfect and standardized treatment guidelines, the clinical application of antidiabetic drugs is not standardized based on the large population base and large patient population in China.

"At present, the medical level cannot cure diabetes, it can only be controlled by corresponding means." Dr. Liu thinks.

Dr. Liu mentioned that with the aging of the population, the significantly longer life expectancy of the population, and the complicated diseases, the research and development of hypoglycemic drugs need to think about how to better cooperate with the treatment of concomitant diseases, reduce the antagonistic effect between drugs, strengthen the synergy of efficacy or reduce the number of drugs to enhance compliance, which can achieve twice the result with half the effort. And it can greatly reduce the burden on patients and national health services.

Fortunately, with the success of diabetes treatment drugs around the world, diabetes patients are seeing the light of day.

One of the milestones in diabetes treatment was the FDA approval in November 2022 of Teplizumab, a CD3 monoclonal antibody, to delay or prevent clinical type 1 diabetes in adults and those older than 8 years.

"After 24 years of development, Teplizumab is proof enough that we believe that with the continuous development and marketing of this type of diabetes drug, hundreds of millions of people with diabetes will benefit from it." "Dr. Ye said.

In fact, in addition to drug control and delaying the process of the disease, many new therapies/drugs have made good progress.

"For example, diabetes gene therapy drugs are in the clinical stage, RISPRTherapeutics and ViaCyte's VCTX210, Genprex's GPX-002, and others." Dr. Lo mentioned.

In addition to gene therapy, stem cell therapy for diabetes is also worth looking forward to.