New research from Decision Resources Group finds that the prevalent type 2 diabetes (T2D) population in the G7 is rapidly increasing. This increase, from 71.8 million adults to 88.6 million from 2014 to 2024, is driven by rising obesity levels and an aging population across all markets. Rising levels of T2D is a major economic concern, given the high rates of morbidity and mortality, and the cost of its associated comorbidities, such as renal disease. An estimated 47 percent of the T2D population has impaired renal function.
And although the percentage of patients with impaired renal function is expected to stay relatively constant over the next several years, the prevalence will increase in line with the overall T2D population. T2D patients with renal disease, called diabetic nephropathy (DN), are currently prescribed angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). However, these treatments cannot reverse DN progression. According to primary research, DN is considered the renal disease with the greatest unmet need for new therapeutic options.
Insights from Decision Resources Group’s T2D and DN research:
- Growth of DN: In the US in 2015, nearly 7 million people have DN. According to findings from PatientBase: Diabetic Nephropathy 2015, the prevalence of DN is expected to increase by nearly 50 percent over the next 20 years. Primary research reveals that 46 percent of patients seen monthly by surveyed nephrologists have DN. This is greater than what is reported by surveyed endocrinologists (26 percent) and primary care physicians (17 percent), according to TreatmentTrends Diabetic Nephropathy 2015 report.
- Treatment utilization in DN varies depending on physician type: In treating DN, surveyed endocrinologists and primary care physicians report a significantly higher percentage of patients on ACE inhibitors compared with surveyed nephrologists. Conversely, nephrologists report higher use of ARBs. Of the DN patients on an ACE inhibitor, lisinopril (Merck’s Prinivil, AstraZeneca’s Zestril, generics) dominates with nearly 40 percent patient share, while those treated with an ARB are predominately on losartan. Despite these differences, the majority of surveyed physicians agree that disease-modifying treatment is sorely needed.
- Rapid growth is expected in the market size for both T2D and DN: In T2D, the market is expected to reach over $71 billion, while the DN market will reach peak sales in excess of $1 billion during the 2014-2024 forecast period In diabetes, the SGLT-2 inhibitors and GLP-1 receptor agonists are expected to become the highest grossing drug classes in the treatment of T2D by 2024, with sales of approximately $15 billion for each class. In DN, novel therapies such as AbbVie’s atrasentan, NephroGenex’s Pyridorin, and Bayer’s finerenone, among others, are poised to meaningfully impact treatment decisions due to their potential to modify the disease and halt its progression. AbbVie’s atrasentan is expected to reach the market first followed closely by Bayer’s finerenerone.
“The pipeline for DN has been rapidly growing,” said Decision Resources Group Analyst Caitlin Koris.
“The rising prevalence of T2D, and consequently DN, will impose increasing strain on healthcare budgets globally.”
“There are four agents in late-stage development, all with unique mechanisms of action and enrolling in Phase III clinical programs. There are several more agents in the early-stage development pipeline. While there have been noticeable failures in the past, interviewed nephrologists are excited about the first potential disease-modifying agent. Assuming regulatory approvals, surveyed physicians have indicated high patient share for these agents among their CKD-ND and dialysis patient populations.”
For more information on the findings you can visit DRG on the web.