Diabetes Launch Exellence - Lesson Learnt

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more to come.

In the five years since, DPP-IVs have captured 33 percent of worldwide sales of

non-insulin, anti-diabetic products. And in the mature eight markets, DPP-IVs

account for 58 percent of the value growth in diabetes treatments.

JANUVIA: FIRST TO MARKET TAKES ALL

Januvia now dominates sales of DPP-IV products in developed markets. In 2011, the

brand accounted for approximately 80 percent of worldwide sales for plain DPP-IV

inhibitors. Later launches in the class—such as Onglyza and Galvus—have been unable

to unseat Januvia from its leadership position.

In the U.S., Januvia enjoyed three years of exclusivity in its class before

AstraZeneca/BMS introduced Onglyza. During this time, Januvia used strong

promotion to gain early buy-in from stakeholders and to build a positive brand image.

It secured its place as “the” gliptin, an image that AstraZeneca/BMS was unable to

change despite heavy U.S. promotional investment.

Similar market dynamics occurred in Europe where Januvia was launched in 2007.

Here, the next plain DPP-IV inhibitor to be launched was Galvus, in 2008. Since then

Galvus has achieved sales of just 12 percent of those seen for Januvia in Europe.

Januvia’s success is particularly meaningful because the brand has not demonstrated

any clinically relevant differentiation over other products in the class1. This suggests

that the variance in performance within the class was aided by Januvia’s position as

first in class. Januvia was in the right place at the right time, and when subsequent

entries came along, physicians generally did not move from their first gliptin choice.

FOOTNOTE:

1

Januvia’s 100mg “non-inferiority” compared to Onglyza 5 mg. Source: IMS interviews with Key Opinion Leaders as part of IMS’s Therapy

Prognosis research program.

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FIXED-DOSE COMBINATIONS: A SECOND CHANCE TO BE FIRST

Whilst it has been standard for plain oral agents to be followed by their combination

with metformin, for TZDs these products were very much second brands. With the

gliptins, the launch of the combination has been an opportunity to gain competitive

advantage.

In the major European markets, Novartis launched its combination product, Eucreas®

(vildagliptin/metformin), concurrently with its plain product, Galvus. So, while

Galvus was the second-to-market plain product, Eucreas was the first launched

combination DPP-IV product. (See Fig. 1).

FIGURE 1: LAUNCH OF FIRST COMBINATION DPP-IVs IN THE EU

2008 2009 2010

Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Eucreas launched 2 yrs ahead of Janumet in UK

In contrast, Merck delayed launching its fixed-dose combination product, Janumet®

(sitagliptin/metformin) until a year after Januvia, its single-compound product, was

on the market. This meant that Janumet was the second-to-market combination

product. In fact, it lagged behind Eucreas by a full two years in the U.K.

Uptake of Eucreas did not match that of Janumet across the top five European

countries—likely because Janumet benefited from Januvia’s established patient base.

(See Fig. 2.) However, within Novartis’s product family, Eucreas performed

significantly better than Galvus in most European markets. This is most apparent in

Spain where in 2011, Eucreas and Galvus accounted for 34 percent and 3 percent of

the DPP-IV inhibitor market, respectively. Sales for Eucreas amounted to 83% of

Janumet sales, far exceeding Galvus’ performance. The lesson here is that it might

well be worthwhile to give as much—if not greater—focus to the launch of the

combination product as to the launch of the plain product.

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FIGURE 2: DPP-IV SALES/SHARE FOR SINGLE AND COMBINATION PRODUCTS IN EU

SHARE OF SALES BY COUNTRY* 2011 IN US$

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CUMULATIVE