Diabetes is a well-known metabolic disorder, and the number of people living with it continues to rise. Although it is a segment of opportunity for pharmaceutical manufacturers, understanding it is complex. High-income nations like the US are the biggest market for diabetes, with a whopping market share of close to 40% in value. Nevertheless, 3 out of 4 people living with diabetes are in the low- and middle-income nations.
The diabetes market can be divided into insulin and non-insulin therapy. Traditionally, Eli Lilly, Novo Nordisk, and Sanofi have dominated the insulin market, leaving little space for others. However, things are changing fast with the emergence of biosimilars.
In the non-insulin therapy group, the market is dominated by oral hypoglycemic agents. This segment is highly crowded and competitive. But it also presents lots of opportunities as many high-volume drugs are going off-patent. Growth in this segment is further fueled by changing treatment guidelines and focusing on preventing comorbidities like heart diseases or chronic kidney disease.
Diabetes market of China, India, Russia, and Worldwide
According to the International diabetes federation, about 537 million people are living with diabetes globally in 2021. These numbers are further expected to rise above 600 million by 2025. However, these figures must be interpreted carefully by the industry. It is because about half of all living with diabetes remain undiagnosed. Thus, generally, people seeking diabetes treatment are much lower.
The estimated global market for diabetes drugs in 2021 is above USD 50 billion, and it is estimated to be valued at USD 78 billion by 2026. However, such global figures might be difficult to interpret due to immense differences between the nations. The bulk of these sales come from high-income countries, with the US alone having nearly 40% of its share.
The market size in low- and middle-income economies differ significantly. In high-income nations, diabetes injectables contribute considerably to the market. Thus, in high-income countries, insulin and GLP-1 agonists (e.g., exenatide, liraglutide) form the bulk of the market (above 50%). It is also because these are high-value molecules.
On the contrary, injectables have a less prominent share in low- and middle-income countries of below 30%. Thus, middle and low economic countries have significant opportunities for oral drugs. Further, greater sales of generics characterize these markets. Therefore, the total diabetes market of India is just a little above USD 2 billion, a little below USD 2 billion for Russia and China is at around USD 4 billion in 2021.
It is despite the fact that China and India have the largest number of people living with diabetes. Nonetheless, China and India are highly prospective markets due to the growing number of people living with diabetes and economic growth. The same is true for other emerging markets.
Current trends & opportunities- hypoglycemic agents
Diabetes has been a growth driver of the pharmaceutical industry and health care products suppliers since the 1990s. However, early growth in the segment was primarily due to an increase in disease prevalence. Thus, insulin, metformin, and sulfonylureas largely dominated the market.
However, the diabetes market entered quite a unique phase post-2005 with the introduction of numerous new treatments. This trend has also influenced various guidelines. Now, this segment is growing due to the introduction of GLP-agonist, DPP4 inhibitors (gliptins), alpha-glucose inhibitors, and, more importantly, SGLT2 inhibitors (gliflozins).
Further, what is even more interesting is that many of these drugs are already off-patent or losing their patent protection soon. Thus, there is significant scope for manufacturers of generics and companies in low- and middle-income nations. Therefore, although the expiry of the patents may threaten major global drug producers, it offers an opportunity for mid-cap companies.
Even more important is to look out for the changes in the treatment guidelines. These guidelines would change considerably in the near future as new data regarding the benefits of the new ...










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