Type 2 Diabetes | TreatmentTrends | US | 2015

Publish date: November 2015

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Type 2 diabetes (T2D) is a chronic, progressive metabolic disease in which the body becomes resistant to insulin, most often as a result of obesity and sedentary lifestyle. The primary goal of treatment of T2D is to achieve and maintain glycemic control, to reduce the risk of both microvascular complications (, diabetic neuropathy, retinopathy, nephropathy) and macrovascular complications (, myocardial infarction, stroke). Due to the progressive nature of T2D, the number of antidiabetic medications used increases over time. Physicians and treatment guidelines acknowledge the role of metformin as the gold-standard first-line therapy in treating T2D. Further therapies (primarily oral agents such as DPP-IV inhibitors, SGLT-2 inhibitors, and sulfonylureas) are typically added as second- and third-line agents to help maintain long-term glycemic control. A significant number of patients will also require additional treatment with injectable therapies such as the GLP-1 receptor agonists and insulins. Using physician survey data, this report analyzes the use of key therapies in T2D patients. The report provides an analysis of treatment patterns and share by line of therapy between both endocrinologists and primary care physicians (PCPs). The report also investigates the importance of various clinical and performance attributes on choice of therapy, as well as sales representative performance and knowledge of emerging therapies.

Questions Answered in This Report:

  • Understand the T2D population: How many prediabetics and T2D patients are physicians treating and how does it differ between physician type? What is the prevalence of comorbidities (e.g., obesity, hypertension, dyslipidemia) within the T2D population? How many patients are referred to surveyed endocrinologists, at what point is the referral (e.g., lab values at referral), and what is the PCP’s relationship with the patient post-referral?

  • Understand the diagnosis and standard of care for patients with T2D, and discover how therapy decisions differ based on disease presentation and specialty of treating physician: What drug classes are most frequently prescribed in combination? What comorbidities (e.g., obesity, hypertension, dyslipidemia) influence prescribing decisions? How does the preference for certain drug classes or brands differ by physician specialty?

  • Understand the satisfaction with current therapies, potential for new pipeline products, and unmet needs in the management of T2D: How does each product in the study perform against competitors on various product attributes? How do the ratings differ between endocrinologists and PCPs? What is the familiarity, interest, expected line of treatment, and percent of patients likely candidates for products in development for T2D?

Scope:

Physician research: 45-minute online quantitative survey, fielded between August 26 and September 7, 2015, with several open-ended questions for qualitative feedback completed by 100 U.S. endocrinologists and 90 U.S. PCPs.

Screening criteria: In practice between 2 and 30 years; over 75% of time spent on patient care; endocrinologists have treated at least 100 patients with type 2 diabetes in the past year; PCPs have treated at least 50 patients with type 2 diabetes in the past year.

Deliverables: Report in PowerPoint format; complete set of frequency tables, summary statistics, and cross tabulations can be provided upon request; access to analyst team for presentation or to address questions.

Key Drugs Covered:

- SGLT-2 inhibitors (Invokana, Farxiga, Jardiance)

- GLP-1 analogues (Victoza, Byetta, Bydureon, Tanzeum, Trulicity)

- DPP-IV inhibitors (Januvia, Onglyza, Tradjenta, Nesina)

- Thiazolidinediones (pioglitazone, rosiglitazone)

- Long-acting insulins (Lantus, Levemir, Toujeo)

- Short-acting insulins (Afrezza, Apidra, Humalog, Novolog)

- Other products, including products in late-stage development

Author(s): Eamonn O'Connor, Ph.D.