The type 2 diabetes therapy market will steadily expand over the 2019-2029 study period, fueled by increasing prevalence and high unmet need for drugs that can effectively control the disease in the long term. A rich pipeline of novel agents is expected to launch, promoting sustained market growth. However, these novel therapies predominantly represent later-to-market entrants from existing drug classes or novel combination therapies of existing compounds. Among the drug classes expected to undergo the fastest growth are the sodium/glucose cotransporter 2 (SGLT 2) inhibitors—due to the cardiovascular (CV) benefit demonstrated by Jardiance—and the glucagon-like peptide 1 (GLP 1) receptor agonists—due to their efficacy, potential for weight loss, and the CV benefit associated with Victoza and Ozempic. However, these therapies will face major challenges in uptake, including reimbursement hurdles and an increasingly stringent regulatory environment.

QUESTIONS ANSWERED

  • Following Jardiance’s positive CV results, will SGLT 2 inhibitors surpass the dipeptidyl peptidase (DPP) IV inhibitors as the most valuable oral drug class?
  • Boosted by positive CV data, will Victoza continue to lead the GLP 1 receptor agonists in the face of once-weekly agents such as Trulicity and Ozempic?
  • Will investments by the pharmaceutical industry in novel FDCs such as Xultophy and Soliqua reap rewards?
  • What do key opinion leaders think about emerging therapies such as sotagliflozin, ITCA-650, and oral semaglutide?

Geographies covered

  • United States, EU5, Japan

Primary Research

  • 19 country-specific interviews with thought-leading endocrinologists and diabetologists. Supported by survey data collected for this and other DRG research

Epidemiology

  • Prevalence of T2D by country with population-specific diagnosed and drug-treatment rates

Forecast

  • 10-year, annualized, drug-level sales and patient share of key T2D therapies through 2029, segmented by brands/generics

Emerging therapies

  • Phase III/PR: 7 drugs; coverage of select preclinical, Phase I, and Phase II products

Table of contents

  • Type 2 Diabetes - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • Q2 2021
        • April 2021
      • Q1 2021
        • March 2021
        • February 2021
        • January 2021
      • Q4 2020
        • November 2020
      • Q3 2020
        • September 2020
      • Q2 2020
        • June 2020
      • Q1 2020
        • March 2020
    • Key Findings
      • Type 2 Diabetes - Key Findings - November 2020
        • March 2020
    • Market Outlook
      • COVID-19: Areas of Potential Forecast Impact
        • Market Drivers and Constraints
          • What Factors Are Driving the Market for Type 2 Diabetes?
          • What Factors Are Constraining the Market for Type 2 Diabetes?
        • Drug-Class-Specific Trends
          • Annual Sales of DPP-IV Inhibitors in Type 2 Diabetes: 2019-2029
          • Patient Share of DPP-IV Inhibitors in Type 2 Diabetes in the United States: 2019-2029
          • Patient Share of DPP-IV Inhibitors in Type 2 Diabetes in Europe: 2019-2029
          • Patient Share of DPP-IV Inhibitors in Type 2 Diabetes in Japan: 2019-2029
          • Annual Sales of SGLT-2 Inhibitors in Type 2 Diabetes: 2019-2029
          • Patient Share of SGLT-2 Inhibitors in Type 2 Diabetes in the United States: 2019-2029
          • Patient Share of SGLT-2 Inhibitors in Type 2 Diabetes in Europe: 2019-2029
          • Patient Share of SGLT-2 Inhibitors in Type 2 Diabetes in Japan: 2019-2029
          • Annual Sales of DPP-IV/SGLT-2 Inhibitors in Type 2 Diabetes: 2019-2029
          • Patient Share of DPP-IV/SGLT-2 Inhibitors in Type 2 Diabetes in the G7: 2019-2029
          • Annual Sales of GLP-1 Receptor Agonists in Type 2 Diabetes: 2019-2029
          • Patient Share of GLP-1 Receptor Agonists in Type 2 Diabetes in the United States: 2019-2029
          • Patient Share of GLP-1 Receptor Agonists in Type 2 Diabetes in Europe: 2019-2029
          • Patient Share of GLP-1 Receptor Agonists in Type 2 Diabetes in Japan: 2019-2029
          • Annual Sales and Patient Share of GLP-1/GIP Receptor Agonists in Type 2 Diabetes: 2019-2029
          • Annual Sales of Long-Acting Insulin Analogues in Type 2 Diabetes: 2019-2029
          • Patient Share of Long-Acting Insulin Analogues in Type 2 Diabetes in the G7: 2019-2029
          • Annual Sales of Rapid-Acting Insulin Analogues in Type 2 Diabetes: 2019-2029
          • Patient Share of Rapid-Acting Insulin Analogues in Type 2 Diabetes in the G7: 2019-2029
          • Annual Sales and Patient Share of Long-Acting Insulin/GLP-1 Receptor Agonist Fixed-Dose Combinations in Type 2 Diabetes in G7: 2019-2029
      • Forecast
        • Market Forecast Assumptions
        • Market Forecast Dashboard
      • Etiology and Pathophysiology
        • Epidemiology
          • Introduction
            • Key Findings
          • Epidemiology Populations
            • Disease Definition
            • Methods
            • Sources Used for Total Prevalent Cases of Type 2 Diabetes
            • Number of Total Prevalent Cases of Type 2 Diabetes in the Major Pharmaceutical Markets: 2019-2029 (thousands)
            • Number of Total and Diagnosed Prevalent Cases of Type 2 Diabetes in the Major Pharmaceutical Markets: 2018-2028 (thousands)
            • Number of Diagnosed and Drug-Treated Prevalent Cases of Type 2 Diabetes in the Major Pharmaceutical Markets: 2018-2028 (thousands)
        • Current Treatment
          • Key Findings
            • Treatment Goals
              • Key Endpoints Used in Clinical Trials for Type 2 Diabetes
            • Key Current Therapies
              • Overview
              • Mechanism of Action of Key Current Drug Classes Used for Type 2 Diabetes
              • Current Treatments Used for Type 2 Diabetes
              • Market Events Impacting the Use of Key Current Therapies in Type 2 Diabetes
              • Advantages and Disadvantages of Sitagliptin
              • Advantages and Disadvantages of Saxagliptin
              • Advantages and Disadvantages of Vildagliptin
              • Advantages and Disadvantages of Linagliptin
              • Key Results from Select Clinical Trials Investigating Linagliptin for the Treatment of Type 2 Diabetes
              • Advantages and Disadvantages of Alogliptin
              • Expert Insight: DPP-IV Inhibitors
              • Advantages and Disadvantages of Liraglutide
              • Advantages and Disadvantages of Dulaglutide
              • Key Results from Select Clinical Trials Investigating Dulaglutide for the Treatment of Type 2 Diabetes
              • Advantages and Disadvantages of Semaglutide
              • Key Ongoing Clinical Trials of Semaglutide SC in the Treatment of Type 2 Diabetes
              • Advantages and Disadvantages of Oral Semaglutide
              • Key Ongoing Clinical Trials of Oral Semaglutide in the Treatment of Type 2 Diabetes
              • Advantages and Disadvantages of Exenatide/Exenatide LAR
              • Advantages and Disadvantages of Lixisenatide
              • Expert Insight: GLP-1 Receptor Analogues
              • Advantages and Disadvantages of Dapagliflozin
              • Advantages and Disadvantages of Canagliflozin
              • Advantages and Disadvantages of Empagliflozin
              • Advantages and Disadvantages of Ertugliflozin
              • Expert Insight: SGLT-2 Inhibitors
              • Advantages and Disadvantages of Metformin
              • Expert Insight: Biguanides
              • Advantages and Disadvantages of Sulfonylureas
              • Expert Insight: Sulfonylureas
              • Advantages and Disadvantages of Thiazolidinediones
              • Expert Insight: Thiazolidinediones
              • Advantages and Disadvantages of Insulin Glargine
              • Advantages and Disadvantages of Insulin Detemir
              • Advantages and Disadvantages of Insulin Degludec
              • Advantages and Disadvantages of Insulin Glargine U300
              • Expert Insight: Long-Acting Insulins
              • Advantages and Disadvantages of Short- and Intermediate-Acting Insulins
              • Expert Insight: Short- and Intermediate-Acting Insulins
              • Advantages and Disadvantages of Insulin Lispro
              • Advantages and Disadvantages of Insulin Aspart
              • Advantages and Disadvantages of Insulin Aspart Ultra-Rapid
              • Advantages and Disadvantages of Insulin Glulisine
              • Advantages and Disadvantages of Insulin Technosphere
              • Expert Insight: Rapid-Acting Insulins
              • Advantages and Disadvantages of Insulin Aspart/Insulin Degludec
              • Advantages and Disadvantages of Insulin Degludec/Liraglutide
              • Advantages and Disadvantages of Insulin Glargine/Lixisenatide
              • Expert Insight: Long-Acting Insulin/GLP-1 Receptor Agonist Fixed-Dose Combinations
            • Medical Practice
              • Overview
              • Country-Specific Type 2 Diabetes Treatment Guidelines
              • Factors Influencing Drug Selection in Type 2 Diabetes
              • Treatment Decision Tree for Type 2 Diabetes: United States
              • Treatment Decision Tree for Type 2 Diabetes: Europe
              • Treatment Decision Tree for Type 2 Diabetes: Japan
          • Unmet Need Overview
            • Current and Future Attainment of Unmet Needs in Type 2 Diabetes
            • Top Unmet Needs in Type 2 Diabetes: Current and Future Attainment
          • Emerging Therapies
            • Key Findings
              • Pipeline Trends for Type 2 Diabetes
            • Key Emerging Therapies
              • Notable Developments in the Late-Phase Pipeline for Type 2 Diabetes
              • Key Therapies in Development for Type 2 Diabetes
              • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Type 2 Diabetes
              • Key Results from Select Clinical Trials Investigating Sotagliflozin for the Treatment of Type 2 Diabetes
              • Key Ongoing Clinical Trials of Sotagliflozin in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Sotagliflozin
              • Expert Insight: Sotagliflozin
              • Key Development Milestones for Sotagliflozin in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Sotagliflozin in Type 2 Diabetes
              • Key Results from Select Clinical Trials Investigating Bexagliflozin for the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Bexagliflozin
              • Expert Insight: Bexagliflozin
              • Key Development Milestones for Bexagliflozin in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Bexagliflozin in Type 2 Diabetes
              • ITCA-650 Profile
              • Analysis of the Clinical Development Program for ITCA-650
              • Expert Insight: ITCA-650
              • Key Development Milestones for ITCA-650 in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of ITCA-650 in Type 2 Diabetes
              • Efpeglenatide Profile
              • Key Ongoing Clinical Trials of Efpeglenatide in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Efpeglenatide
              • Expert Insight: Efpeglenatide
              • Key Development Milestones for Efpeglenatide in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Efpeglenatide in Type 2 Diabetes
              • Key Results from Select Clinical Trials Investigating Tirzepatide for the Treatment of Type 2 Diabetes
              • Key Ongoing Clinical Trials of Tirzepatide in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Tirzepatide
              • Expert Insight: Tirzepatide
              • Key Development Milestones for Tirzepatide in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Tirzepatide in Type 2 Diabetes
              • Key Results from Select Clinical Trials Investigating Insulin Icodec for the Treatment of Type 2 Diabetes
              • Key Ongoing Clinical Trials of Insulin Icodec in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Insulin Icodec
              • Expert Insight: Insulin Icodec
              • Key Development Milestones for Insulin Icodec in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Insulin Icodec in Type 2 Diabetes
              • ORMD-0801 Profile
              • Key Ongoing Clinical Trials of ORMD-0801 in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for ORMD-0801
              • Key Development Milestones for ORMD-0801 in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of ORMD-0801 in Type 2 Diabetes
              • Key Results from Select Clinical Trials Investigating Insulin Lispro Ultra-Rapid for the Treatment of Type 2 Diabetes
              • Key Ongoing Clinical Trials of Insulin Lispro Ultra-Rapid in the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Insulin Lispro Ultra-Rapid
              • Key Development Milestones for Insulin Lispro Ultra-Rapid in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Insulin Lispro Ultra-Rapid in Type 2 Diabetes
              • Expert Insight: Insulin Lispro Ultra-Rapid Acting
              • Key Results from Select Clinical Trials Investigating Imeglimin for the Treatment of Type 2 Diabetes
              • Analysis of the Clinical Development Program for Imeglimin
              • Expert Insight: Imeglimin
              • Key Development Milestones for Imeglimin in the Treatment of Type 2 Diabetes
              • Expectations for Launch and Sales Opportunity of Imeglimin in Type 2 Diabetes
            • Early-Phase Pipeline Analysis
              • Select Compounds in Phase II and Early-Phase Development for Type 2 Diabetes
          • Access & Reimbursement Overview
            • Region-Specific Reimbursement Practices
              • Key Market Access Considerations in Type 2 Diabetes: United States
              • General Reimbursement Environment: United States
              • Key Market Access Considerations in Type 2 Diabetes: EU5
              • General Reimbursement Environment: EU5
              • Key Market Access Considerations in Type 2 Diabetes: Japan
              • General Reimbursement Environment: Japan
          • Appendix
            • Key Abbreviations Related to Type 2 Diabetes
            • Brands, Marketers, and Generic Availability of Current Therapies Used for Type 2 Diabetes by Market
            • Type 2 Diabetes Bibliography

        Author(s): David Rees, Ph.D.; Joseph Granato, M.P.H.

        David Rees, M.Biochem., Ph.D., is a senior analyst on the Cardiovascular, Metabolic, Renal, and Hematologic (CMRH) Disorders team at DRG, part of Clarivate. He has authored reports on osteoporosis, pulmonary hypertension, and type 2 diabetes. Prior to joining DRG, he was a postdoctoral research associate at Imperial College London and the Institute of Cancer Research. For his doctoral research, he studied the structures of molecular machines in the Nobel Prize-winning laboratory of Prof. Sir John Walker at the University of Cambridge. Dr. Rees earned his undergraduate degree at the University of Bath.

        Joseph Granato, M.P.H., is a senior epidemiologist at DRG, part of Clarivate. Before joining DRG, he worked with the Monroe County Health Department on the surveillance of reportable diseases, including dengue fever. He received his M.P.H. from Des Moines University, where he worked on several population health projects, including tick-borne diseases. He also holds a B.S. in animal science from the University of Tennessee.


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