Lilly, Howson two sugar-lowering drugs announced negotiations price reduction of more than 50% market pattern will change significantly

Before these two products entered medicare, only one GLP-1 agonist in the National Health Insurance Catalog, Liraglutide for No. and Nord, entered the Class B Health Insurance Catalog in 2017, and the price dropped from 723 yuan/branch to 410 yuan/branch, a 43% decrease, making it the only GLP-1 agonist included in the health insurance list at the time.
, how will the domestic diabetes drug market change when two GLP-1 agitants, which have fallen by more than 50%, enter the national health insurance directory? 01 Lilaglutide long-term unique source: "new diagnostic criteria and types of diabetes", Gao Yu Investment Research Center according to China's "new diagnostic criteria and types of diabetes", for diabetics diagnosis and treatment is divided into four stages, the first stage is single-drug treatment, if blood sugar control is not up to standard then enter the next step of treatment, that is, metformin plus diodes, triple therapy and even insulin multiple injections.
, metformin plus GLP-1 is one of the co-treatment options.
the discovery of GLP-1, like the PD-1 of cancer drugs, is destined to change the market landscape.
Unlike traditional diabetes medications, GLP-1 not only significantly reduces blood sugar, but also reduces weight, lowers blood pressure, and improves β cell function, significantly delaying the progression of diabetes and the potential for cardiovascular complications, while having a sugar-lowering mechanism that meets the patient's physiological needs and a lower risk of hypoglycemia.
, GLP-1 has been found to have caused a research and development boom, with a flood of money pouring in.
2011 No. and Nord's Liraglutide entered the Chinese market, but the high price of the original drug made the market small, until 2017 into the National Health Insurance Directory, the price from 723 yuan / branch to 410 yuan / branch, after which the profit Laglutide rapidly released sales in 2018 reached 530 million yuan, up 76.7% YoY, and in 2019 Liraglutide sales climbed further, with sales jumping to 940 million yuan, up 77.4% YoY.
and Nord reports that Liraglutide accounts for 92.8 per cent of the domestic GLP-1 market.
but 2020 may come to an end, and the future of the market is set to change as long-acting inhibitors enter the health-care catalog.
02 long-acting inhibitors enter, the market pattern will change as mentioned above, two GLP-1 agitants have entered the new version of the health insurance catalog, the price alone, less than 200 yuan / branch has been lower than liraglutide, and it is worth noting that these two GLP-1 are long-acting inhibitors, compared to the daily liraruptide significantly more patient compliance.
the logic industry for chronic drug use is well known, patient compliance and price are two core logics due to the need to take it for life, which is why liraglutide entered the health insurance catalog in 2017 to achieve rapid release.
but from a compliance point of view, oral injections, long-lasting and short-term effects are also competitive logic.
look at the two GLP-1s in the newly added health insurance catalog: the recommended starting amount for saccharides is 0.75mg once a week.
blood sugar control, the dose can be increased to 1.5 mg once a week.
recommended dose is 1.5 mg once a week.
The single-drug treatment of locena peptide is recommended for the recommended starting dose of 0.1 mg, once a week sub-abdominal subsoil injection, if the blood sugar control effect is not satisfied, can be increased to 0.2 mg, once a week;
, in terms of compliance, there is no doubt that the two newly promoted GLP-1s are superior to Lilaglutide.
then look at the price, if the monthly calculation according to 4 weeks, 149 yuan / branch of the monthly cost of saccharide peptide 596 yuan, according to the 70% reimbursement ratio of health insurance, patients only need to pay 178.8 yuan per month.
assumes that patients need 0.2mg per week, 187 yuan per unit of locena peptide monthly cost of 748 yuan, after medical insurance reimbursement of 224.4 yuan.
price is also significantly higher than the price after the 2017 health care negotiations (liraglutide was successfully renewed in 2019, the price is not disclosed).
data show that in China's GLP-1 sample hospitals, due to the short-acting GLP-1 market earlier, its market share dominated.
, liraglutide injection market share grew the fastest, from 37% in 2012 to 91% of Q1-3 in 2020.
Looking at the entire diabetes drug market, insulin and oral anti-sugar drugs (OAD) are still the mainstream drugs in domestic public hospitals, insulin accounted for 52%, oral anti-sugar drugs (OAD) accounted for 47%, almost all of the domestic market, and GLP-1 only 1% of the market size, there is still a lot of room for improvement.
With the 2018 GLP-1 was promoted to a two-way treatment program, while liraglutide was added to the health insurance list, and today two long-lasting GLP-1s are also included in the health insurance catalog, according to the monthly cost of about 200 yuan, the domestic GLP-1 market, and even the domestic diabetes drug market is set to change significantly.
, clinical evidence such as cardiovascular benefits will also play an increasingly important role in the market.
03 There is also a domestic GLP-1 is also new to health insurance, but it is controversial that this health care negotiations also have two domestic GLP-1 and a foreign GLP-1 into health insurance, the former is renren medicine 1 innovative drug Benalutide injection and Sansheng Pharmaceuticals introduced Essena peptide, the latter is Sanofi's Lisina peptide, the price has not yet been announced.
benaglutide is a starting dose of 0.1 mg (50 μl) three times a day, with subsurfed injections 5 minutes before meals, with an optional abdominal, thigh or upper arm at the injection site.
2 weeks of treatment, the dose should be increased to 0.2 mg (100 μl) three times a day.
recommended starting dose of 5 μg twice daily and given within 60 minutes of breakfast and dinner (or 2 meals per day, approximately 6h or more apart).
as the starting dose of 10 μg, once daily, applied for 14 days.
maintenance dose: start at 20 μg on the 15th day as a fixed maintenance dose, once daily.
the way the drug is given, the six GLP-1 products currently on the health insurance list, Benaglutide patients are significantly less compliant than the other five.
industry has previously proposed, "Yisheng Tai is actually GLP-1."
But because GLP-1 is a protein produced by the human body and will soon be degraded by THEP-4 enzyme, the drug is very short, with three injections a day, while liraglutides like Noro and Nord are actually GLP-1 similars that, by modifying the protein structure, can resist degradation by DEP-4, so liraglutide is injected once a day.
three injections a day, the average patient can't stand it.
", so what is the industry's question about the competitive advantage of benaglutide? At present, the domestic diabetes market competition has become increasingly white hot, in 2019, 2020 health care negotiations of the number of new sugar-lowering drugs reached more than a dozen, coupled with the rapid advance of four batches of volume procurement, diabetes drug prices, the market will inevitably change significantly, in China, the market profits will become more and more "thin".
same time, overseas, the popularity of new sugar-lowering drugs has been much higher than at home, these products rise at the same time, more later.
Global diabetes leaders such as Lilly, Novo Norfoe and Nord are also developing a new generation of sugar-lowering drugs, such as Novo Norfoe's oral anti-sugar drug Somaglutide, Lilly and Cinda's GLU-1-like peptide-1s and GCGR dual agonists, which are destined to become increasingly intense.
: GLP-1 products in the new health insurance catalog