Long Standing Rivalry in Diabetes Market Intensifies as Eli Lilly’s Drug Outshines Novo’s in Head to Head Trial

Eli Lilly’s Type 2 diabetes injectable drug is not only effective at reducing blood sugar and body weight, but it is also better at doing that than its competitor drug Ozempic. On March 4th, Lilly reported that tirzepatide, a GLP-1 and GIP receptor agonist beat Novo Nordisk’s diabetes drug in Phase 3 SURPASS-2 study, showing a greater reduction in blood sugar and weight.

Tirzepatide is a part of the next wave of diabetes drug research, which is targeting two pathways, GIP (glucose-dependent insulinotropic polypeptide receptor) and GLP1 (glucagon-like peptide-1 receptor) aimed at stimulating the body’s secretion of blood sugar-lowering insulin. By targeting both the hormones at once, Lilly believes it may be able to get the blood sugar down to a level that other drugs have not been able to achieve.

Head to Head Trial

The severity of diabetes is usually measured by calculating the amount of glucose bound hemoglobin (glycated hemoglobin). In the SURPASS-1 trials, tirzepatide proved better than placebo in lowering the levels of glycated hemoglobin. With a once-weekly 15 mg dose of tirzepatide, patients registering an average of 7.9% at baseline were reduced by more than 2% points to about 5.8% at 40 weeks.

In the SURPASS-2 head-to-head trial, 15mg tirzepatide dose reduced glycated hemoglobin levels by 2.5% points, from an average baseline of 8.3%, in comparison to Ozempic, which decreased the levels by 1.9% points at 40 weeks. Even the lowest dose (5mg) of Lilly’s drug was better at reducing glycated hemoglobin levels in comparison to Novo’s drug-2.09% reduction in comparison to 1.86%. Interestingly, almost half of the patients on Lilly’s high dose drug in comparison to 20% on Ozempic achieved glycated hemoglobin levels as seen in people without diabetes. Achieving normal or near-normal glucose levels is what many medications aim for.

Lilly’s drug also proved superior to Novo’s drug at reducing body weight. The highest dose of tirzepatide brought down weight by 12.4kg, whereas patients on Novo’s drug could only burn half of it.

The treatment was also accompanied by side effects, which mainly included nausea, vomiting, and diarrhea. About 5% of people on low dose and 8% on high dose discontinued the treatment due to adverse events. In comparison, fewer than 4% of people on Ozempic left the study.

Tough Fight

Lilly and Novo have been giving each other a tough fight in the diabetes space for quite some time. In 2014, Lilly set the bar high when it launched Trulicity, the first once-weekly drug in a class called GLP-1 agonists, and began competing with Novo’s daily injection Victoza for market share. But Novo came back strongly three years later when it launched Ozempic and upped the game with its oral version of the drug, Rybelsus, in 2019.

Currently, Lilly’s Trulicity is leading the market, holding 44.7% US market share compared to 27.9% for Ozempic. According to the forecasts, Trulicity will have the highest sales in 2024 as it is estimated to reach $6.6 billion compared to Novo’s $6.1 billion sales in the same year.

But Novo is expecting to accelerate the growth in the diabetes market with its newly launched drug Rybelsus, the first and only oral GLP-1 drug. This drug is of great significance to Novo as it will help overcome challenges surrounding insulin pricing in the US and the threat to branded insulin sales from the launch of insulin biosimilars. Rybelsus has generated $173 million during the first 9 months of the year 2020 and is expected to reach sales of $3.3 billion by 2024.

If Lilly’s tirzepatide gets approval, it will give a tough fight to Novo’s approved diabetes drugs, but since the latter can be consumed orally, it might get more preference from patients who detest punching themselves with a needle.

Related Article: Study Shows New Diabetes Drug Induces Remarkable Weight Loss in Obese Patients

Author

Rajaneesh K. Gopinath