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Examining Drug Trend: Diabetes

Drug price is driving trend. Overall utilization for the top 10 drug classes in 2016 decreased, while prices increased. To better understand 2016 trend, we will be examining the top 10 therapeutic classes and their trend components, starting with diabetes.

Diabetes: Top PMPY for 2016
Diabetes affects nearly 9 percent of the U.S. population, and although incidence seems to be decreasing, prevalence remains steady. Of the top 10 brands, diabetes drugs accounted for 40 percent of the list. Although insulin still dominates the class in PMPY spend, Januvia, a DPP4 inhibitor, accounted for 9 percent of brand spend in diabetes. Insulin unit-cost increase was 5.3 percent in 2016 and made up 55 percent of PMPY spend in diabetes. Insulin utilization increased slightly at 0.2 percent overall, with double-digit increases in specific therapeutic classes, SGLT2 inhibits and GLP 1 agonist.

Forecast for Diabetes
In December 2016, Basaglar (insulin glargine) was approved. We anticipate this will have an impact on the diabetes market in 2017. There is potential for trend to decrease in 2017 if inflation is held or decreased due to competition. MedImpact is tracking the FDA’s anticipated decision on Merck’s follow-on to Lantus in June. If it is approved, this will increase competition in the market for diabetes drugs. This could potentially create a better environment for rebate negotiations, leading to lower cost in the category.

Utilization of DPP4 inhibitors in diabetes is far greater than other branded agents, outside of insulin, and is expected to maintain this level of utilization. Expect to see more utilization for SGLT2 inhibitors and GLP-1 agonists due to clinical data showing benefits in morbidity and mortality. These new drugs could significantly increase costs in this therapeutic class.

See our 2016 Annual Trend Report to learn more about trend drivers and forecasts for the top therapeutic classes. Make sure to check MedConnect for more in this series.

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