In the wake of a government ban on top-selling diabetes drug, pioglitazone, the volumes are expected to shift to other classes such as first-generation drugs (combination of glimepiride and metformin) and newer class of drugs, ‘gliptins’, as well as insulins, even as domestic companies are protesting the ban and examining all options, including legal recourse.
With the shift to other treatments, companies like Sun Pharma, USV, Glenmark, Sanofi-Aventis and Lupin will benefit from the move, analysts say. The combination of glimepiride and metformin is the largest selling product in the anti-diabetic segment, valued at Rs 823 crore (MAT May 2013, AIOCD AWACS). The oral anti-diabetic market is estimated at Rs 3,550 crore, while insulins are around Rs 1,100 crore. Pioglitazone, sold by USV, Sun Pharma, Abbott Healthcare, Micro Labs and Lupin, corners around 20%, or over Rs 700 crore of the market.
The biggest beneficiary will be the combination of glimepiride and metformin drugs marketed by USV, Sun Pharma and Lupin. USV clocks nearly Rs 160 crore through this combination drug, while Sun Pharma mopped up Rs 90 crore and Lupin Rs 70 crore.
The relatively new class of diabetes drugs, gliptins, manufactured by Sun Pharma and Glenmark, will also benefit from the volume switch while Lupin will benefit from its brand presence in insulin, an analyst from Nomura said.
In terms of costs for patients prescribed glimepiride plus metformin, there will be some savings as the combination drug (Rs 4-5) is slightly lower than the combination of pioglitazone with glimepiride plus metformin (Rs 5.3).
Technically, a shift to gliptins makes sense but there are supply constraints as the product is patented, as well as expensive, with costs at three to six times those of pioglitazone combination therapy, he added.
Surprised by the government’s move to ban pioglitazone, the industry is protesting the move. Indian Pharmaceutical Alliance secretary-general DG Shah told TOI: “We are examining all options as the process has not been complied with the established norms and the decision to suspend production and marketing with immediate effect has put lakhs of diabetic patients to risk.”