Type 2 diabetes 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 common comorbidities, often lead to patients requiring multiple medications. The type 2 diabetes market represents a crowded treatment landscape, but recent advances in efficacy and safety benefits over current therapies have been limited, which also contributes to polypharmacy. Increasing pill burden is linked to reduced treatment compliance and consequently worse outcomes. As a result, drug developers are increasingly focusing on novel therapies that offer greater ease of use and reduction in medication burden in a bid to achieve greater treatment compliance. Over the next few years, new long-acting dipeptidyl peptidase-IV (DPP-IV) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, alongside several fixed-dose combinations (FDCs) comprising a range of drug classes, including sodium glucose cotransporter-2 (SGLT-2) inhibitors and insulins, are expected to launch. As these new agents compete for positioning and uptake, physicians and MCOs must consider how best to incorporate them into their respective treatment and reimbursement strategies as they seek to optimize value for money.

Questions Answered in This Report:

  • Understand U.S. PCPs’ and endocrinologists’ perceptions and attitudes toward currently marketed antidiabetic therapies, and uncover prescribing trends. What are clinicians’ views of the currently available antidiabetic treatments, and what key unmet needs do they identify? How will medical practice for the treatment of type 2 diabetes change in light of the new therapies poised to enter the U.S. market? For which lines of therapy do physicians typically prescribe approved therapies, and what factors, including reimbursement and prescribing restrictions by MCOs, most strongly influence and constrain physician prescribing of these agents?

  • Learn how prescribers plan to integrate next-generation long-acting antidiabetic agents and novel FDCs into their treatment plans. What are U.S. clinicians’ and payers’ perceptions of the safety and side-effect profiles of the new diabetes drugs? How will the new drugs’ safety, efficacy, and tolerability profiles set them apart from each other and from currently available drugs? Which drug and patient characteristics will most influence prescribing decisions by clinicians and formulary positioning by payers? What value do prescribers and payers place on greater convenience and treatment compliance compared with efficacy and safety?

  • Gain insight into the changing dynamics of the U.S. managed care reimbursement environment as they pertain to pharmacotherapy for type 2 diabetes. What are payers’ and prescribers’ expectations for the efficacy, safety and tolerability, and delivery of novel antidiabetic drugs? What kind of reimbursement restrictions will be applied to novel long-acting agents and FDCs? How do PDs/MDs for commercial and Medicare prescription drug plans assign tier positioning for new diabetes market entrants? How will the price of novel agents influence formulary placement?


This U.S. Physician & Payer Forum reveals physicians’ and payers’ insights into the changes in prescribing practices in the United States for novel long-acting agents and FDCs in the treatment of type diabetes. This report is based on a survey of 141 physicians, including 71 endocrinologists and 70 PCPs, as well as 33 MCO PDs/MDs.

- Markets covered: United States.

- Primary research: Online survey of 71 endocrinologists, 70 PCPs, 18 MCO PDs, and 15 MCO MDs.

- Epidemiology: 2013–2023 prevalent cases of type 2 diabetes.

- Emerging therapies: Phase III: 4 drugs; preregistration: 2 drugs; registered: 1 drug.

Author(s): Tim Blackstock, M.B., Ch.B.

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