Type 2 diabetes (T2D) is a complex metabolic disorder characterized by a declining ability to produce or utilize insulin. The chronic and progressive nature of the disease, as well as its complications and comorbidities, often results in patients requiring multiple medications. The T2D therapy market is a crowded one, but despite the number and variety of T2D therapies available, patients typically follow a well-defined treatment progression, beginning with oral therapies and then adding injectable agents as the disease progresses. The lack of any disease-modifying agents and the inability of current agents to maintain patients' target HbA1c levels over the long term remain areas of substantial unmet need. The cardiovascular (CV) safety of T2D agents has long been a concern because CV-related deaths account for about 50% of diabetes-related mortality. Fortunately, there have been advances in CV safety; the T2D therapies Jardiance and Victoza now offer CV benefits compared with the standard of care. Over the next few years, several fixed-dose combinations comprising a range of drug classes, including SGLT-2 inhibitors, GLP-1 receptor agonists, and insulins, will launch; drug developers are increasingly focusing on these combinations in hopes they will offer greater efficacy and reduce the medication burden for T2D patients, many of whom are elderly and are being treated for comorbidities. As these new agents compete for positioning and uptake, physicians must consider how best to incorporate them into their treatment while keeping the cost to the patient in mind.
Even with a broad range of treatments available and recent advances in CV safety, the unmet need in T2D treatment is considerable, and, as the prevalence of the disease grows, there is significant market opportunity. This content provides quantitative insight into 60 U.S. and 31 European endocrinologists’ perceptions of key treatment drivers and goals and the current level of unmet need in T2D. We analyze the commercial opportunities in T2D treatment and how emerging therapies can capitalize on these opportunities.