Novo Nordisk's Tresiba gaining ground in basal insulin market

Sales of Novo Nordisk's new basal insulin product Tresiba have started to gather momentum since its US launch in January, rising three-fold in the first half of the year.

Tresiba (insulin degludec) is a key product in Novo Nordisk's diabetes portfolio, launching in competition to Sanofi's blockbuster Lantus (insulin glargine) brand as well as recently launched biosimilar copies of the latter drug. The drug had been held back by a US FDA rejection in 2013 but finally got a green light last autumn.

Since then, Novo Nordisk has been trying to differentiate itself from the pack with new data showing lower rates of hypoglycaemia (low blood sugar) compared to Lantus, and the first-half figures suggest it is making headway.

Sales of the drug rose 161% to DKK 1.45bn ($216m) in the first six months, a sizeable increase but still well shy of the €2.86bn ($3.1bn) in Lantus sales posted by Sanofi in the same period, which was a decline of 11%.

Sanofi said recently Lantus was actually growing 9% in volume, against a 6% background growth in the basal insulin market and despite competition from Tresiba and biosimilars that have pushed down pricing.

Novo Nordisk chief executive Lars Rebien Sørensen, said downward price pressure had also been a factor, particularly in the US where "the market environment is becoming increasingly challenging and contract negotiations for 2017 have reflected an intensifying price competition".

Tresiba may also have been affected by an Institute for Clinical and Economic Review (ICER) report in March which concluded that evidence is not sufficient to demonstrate a net health benefit associated with use of insulin degludec as compared to insulin glargine.

Nevertheless, the strong sales performance for Tresiba and other new insulin products - such as combination products Ryzodeg (insulin degludec/insulin aspart) and Xultophy (insulin degludec/liraglutide) - helped Novo Nordisk post a 7% increase in sales to DKK 54.7bn.

Novo Nordisk's other major growth product in diabetes - the GLP-1 agonist Victoza (liraglutide) - had another strong showing with sales rising 14% to DKK 9.54bn, maintaining a market share of around 59% according to the Danish drugmaker.

The product benefited from the results of the LEADER trial showing it could cut the risk of cardiovascular events compared to placebo when added to standard care in high-risk type 2 diabetes patients.

Victoza was however unable to repeat that performance in a just-published study involving diabetic and non-diabetic patients with advanced heart failure, contradicting the results of an earlier study involving diabetics only.

Liraglutide is also sold as a treatment for obesity under the Saxenda brand name, and this product added DKK 619m to the pot in the first half, up from DKK 78m a year earlier. It has now been launched in seven countries and at first glance seems to be outperforming other recent anti-obesity product launches.