Type 2 diabetes is a major concern for a growing segment of population all across the United States and Europe and it is also spreading in the emerging countries. But as a recent Frost & Sullivan report pointed out the demand for innovative therapies and drugs is about to be fulfilled very soon

Roberto Carminati

According to sources, 90 to 95% of the 26 million American citizens struggling with diabetes are indeed suffering from the so-called Type 2 diabetes, once dubbed non-insulin dependent diabetes. Unlike Type 1 diabetes this form of the disease affects people whose body is able to produce insulin but either their pancreas does not make enough insulin or their body is not able to use the insulin well enough. Figures are also rocketing outside the United States, since a recent Frost & Sullivan report considered, quoting the International Diabetes Federation, that Europe itself has had to cope with 55 thousand new cases in 2012 alone and that an escalation is expected in the next 15 years, when according to forecasts 64 million new cases could be diagnosed. Also dubbed as the silent killer, being its symptoms often easy to miss, Type 2 diabetes is also largely influenced by lifestyles, with lack of exercise, age, weight, smoke and alcohol, together with nutritional habits, being some of the most common risk factors for individuals worldwide. In its research called Global Type 2 diabetes therapeutics market Frost & Sullivan focused on Europe but also covered other markets worldwide, and pointed out the European scenario generated revenues for nearly 10 billion euro in 2009. The figure is nonetheless about to climb up to 15.46 billion euro in 2017, with a Compounded annual growth rate (or Cagr) of 3.8 percentage points. «Overall», Frost & Sullivan reported, «the growth rate of the insulin segment was estimated to be about 52% of the total European Type 2 diabetes therapeutics market in 2012, exceeding that of the non-insulin segment». But the global research and analysis giant also recalled the numerous challenges that both therapy and science are set to face when it comes to non-insulin dependent diabetes: «Due to the chronic nature of the disease and the numerous co-morbidities that make patients particularly sensitive to long-term drug safety», F&S’ analysts considered, «the clinical and regulatory hurdles are considerable. However, the immense size of the potential market has stimulated a vast and growing pipeline of prospected new therapies», they added, «which are now aimed at addressing the unmet needs of a tighter glucose control, improved safety profiles, and a greater convenience to patients».

A global phenomenon

Other sources such as Bcc Research embraced different landscapes and macro-regional markets, considering that the global value of diabetes therapeutics and diagnostics «is expected to climb from 110 billion dollars in 2011 to nearly 157 billion by 2017», with a Compounded annual growth rate «expected to increase by 4.7% in North America, by 5.7% in Europe, and finally by 6.6% in Asia».

From his point of view, healthcare senior research analyst at Frost & Sullivan’s Aiswariya Chidambaram focused on technology instead: «The insulin segment of this market», Chidambaram stated, «is boosted by the improvements seen with modern insulins, including improved pharmacokinetic profiles and reduced risk of hypoglycaemia», which is to be considered «the main drawback to insulin therapy. Several insulin analogues now in development», Chidambaram added, «have the potential to offer better overall outcomes, resulting from their liver-targeted action». European governments and health agencies are developing and adopting different strategies to tackle the silent killer and are thus heavily investing in research and innovation. For instance, Frost & Sullivan believes that for the United Kingdom the biggest challenge «is the reform of the commissioning structures, combined with €40.61 billion efficiency savings, which results in reductions in specialist treatment». But the company has also highlighted that an effective diabetes-plan is now mandatory in Germany as well, where nonetheless the market’s growth is about to depend «on testing volumes, which are in turn expected to drive growth for diabetes diagnostics and therapeutics». Analysts are anyway confident that in the same country «quite a few new product launches are expected in the next two years, and that this will lead «to a further market expansion». France itself is coping with Type 2 diabetes and diabetes in general by developing a broad national framework of strategies against chronic diseases and in favor of an improved nutrition. Under the Eiffel tower diabetes patients can rely on «a full reimbursement of all treatments and all supplies».

The Finnish lesson

In its Global Type 2 diabetes therapeutics market report Frost & Sullivan then turned to the Southern European countries such as Spain and Italy by taking into account the pros and cons of their action against the disease: «The Italian Drugs Agency», analysts recalled, «has introduced new, potentially innovative drugs with monitoring projects that seek to define the future role of new medicine in clinical practice. Focus on integrated diabetes management and care is likely to bring multiple diabetes services under one roof. But the key issues faced by the diabetes associations in Italy include long waiting lists, lack of specialized personnel and adequate medical equipment». Spain is instead «a region where the prevalence of gestational diabetes was as high as 8.8% in 2011. However», Frost & Sullivan considered, «the country has started to introduce telemedicine at hospitals for diabetes care, which is likely to provide faster and improved access to diabetes care». Diabetes is crucial for the healthcare system in the Northern European countries too, the company noted: «The ministry of Health of the Netherlands is tackling key challenges such as prevention care, understanding the impact of a bundled payment approach on healthcare and multi-morbidity». While in Norway, according to the National Diabetes Association that was quoted by F&S, «the greatest challenges over the next two years will include the roll out and financing of the National strategy for diabetes as well as the establishment of diabetes registers with a 100% coverage». Patient-focused therapies and care, together with education and research, appeared to be some of the most critical issues in Sweden, whilst Finland is «the first country in the world to have introduced a comprehensive diabetes» plan that includes «annual and biennial check-ups provided to patients». «All in all, research advances in novel pathways, such as the neuroendocrine system, will produce next-generation anti-diabetic drugs with improved efficacy and safety profiles», Aiswariya Chidambaram stated, «creating opportunities for successful market penetration with enhanced and more effective formulations. The recent discovery of how metformin works, in addition to accumulating evidence of off-target beneficial effects including cardio-protection, will lead to an improvement in drug tolerability and the discovery of novel therapies based on the glucagon-targeted mechanism. These efforts», he then concluded, «are about to generate affordable, highly effective therapies with enhanced long-term safety and efficacy and better clinical outcomes».