BEST SELLING DIABETES MELLITUS DRUGS IN 2023
Ozempic - $13.8 billion
Trulicity - $7.1 billion
Farxiga - $6.0 billion
Mounjaro - $5.2 billion
Januvia - $3.4 billion
Jardiance - $2.7 billion
NovoRapid - $2.0 billion
Humalog - $1.7 billion
Victoza - $1.2 billion
Toujeo - $1.2 billion
1. OZEMPIC; Novo Nordisk
Ozempic (semaglutide) injection, available in doses of 0.5 mg, 1 mg, or 2 mg, is prescribed as an adjunct therapy to diet and exercise for improving glycemic control in adults diagnosed with type 2 diabetes mellitus. Additionally, it is indicated to mitigate the risk of major adverse cardiovascular (CV) events in adults with type 2 diabetes mellitus and established CV disease.
The efficacy of Ozempic was evaluated vs Trulicity in two clinical trials:
SUSTAIN 7: This 40-week randomized trial involved 1201 adult patients with type 2 diabetes who were already on metformin. The trial compared Ozempic 0.5 mg with Trulicity 0.75 mg, and Ozempic 1 mg with Trulicity 1.5 mg. Results showed the mean change in A1C levels from baseline at Week 40:
Trulicity 0.75 mg vs Ozempic 0.5 mg: -1.1% vs -1.4%
Trulicity 1.5 mg vs Ozempic 1.0 mg: -1.3% vs -1.6%
SUSTAIN FORTE: This 40-week randomized trial included 961 adult patients with type 2 diabetes who were taking metformin with or without a sulfonylurea. The trial compared the efficacy of Ozempic 1 mg with Ozempic 2 mg.
The mean change in A1C levels from baseline at Week 40 was:
Ozempic 1 mg vs Ozempic 2 mg: -1.9% vs -2.1%
2. TRULICITY; Lilly
Trulicity (dulaglutide) is intended for individuals aged 10 and above diagnosed with type 2 diabetes, utilized in conjunction with dietary adjustments and physical activity to enhance blood sugar regulation. Additionally, Trulicity is prescribed for adults with type 2 diabetes to mitigate the likelihood of significant cardiovascular occurrences.
Clinical investigations revealed that the average reduction in A1C levels from the initial measurement at the primary endpoint ranged from 0.7% to 1.6% for the 0.75 mg dosage and from 0.8% to 1.6% for the 1.5 mg dosage. In one clinical trial, the average A1C reduction from baseline was noted as 1.5% for the 1.5 mg dosage (active comparator), 1.6% for the 3.0 mg dosage, and 1.8% for the 4.5 mg dosage.
3. FARXIGA (dapagliflozin); AstraZeneca
FARXIGA is prescribed as a supplement to dietary adjustments and physical activity to enhance glycemic regulation in adults diagnosed with type 2 diabetes mellitus. Dapagliflozin, the active ingredient in FARXIGA, acts as an inhibitor of SGLT2. Through this inhibition, dapagliflozin impedes the reabsorption of glucose filtered by the kidneys, thereby facilitating the excretion of glucose through urine.
In terms of A1C reduction, clinical data indicates the following mean changes from baseline (%):
FARXIGA 10 mg in conjunction with metformin XR: -2.0%
FARXIGA 10 mg in combination with insulin: -0.9%
FARXIGA 10 mg combined with exenatide XR 2 mg and metformin: -1.8%
4. MOUNJARO (tirzepatide); Lilly
Mounjaro is an injectable prescription medicine that is used along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes mellitus.
Effectiveness: Mounjaro 15 mg demonstrated an average reduction of up to -2.3% in HbA1c levels compared to -1.9% with Ozempic 1 mg.
Mounjaro represents the pioneering entry in a novel class of medications tailored for type 2 diabetes management. It comprises a singular peptide that activates both GIP and GLP-1 receptors within the body. Engineered from the native human GIP, Mounjaro's amino acid sequence is carefully crafted to enable dual binding to the GLP-1 receptor, facilitating its once-weekly dosing regimen.
While Mounjaro exhibits lower activity on the GLP-1 receptor compared to the native GLP-1 hormone, its activity on the GIP receptor mirrors that of the native GIP hormone. In individuals grappling with type 2 diabetes, Mounjaro orchestrates improved glycemic control through various mechanisms. It enhances both initial and subsequent insulin secretion while concurrently diminishing glucagon levels.
Moreover, Mounjaro augments insulin sensitivity and curtails food intake, along with slowing gastric emptying. Notably, the delay in gastric emptying is most pronounced after the initial dose, gradually diminishing over time.
5. JANUVIA (sitagliptin); Merck
Januvia functions as a dipeptidyl peptidase-4 (DPP-4) inhibitor, prescribed as an adjunct to dietary adjustments and physical activity to ameliorate glycemic regulation in adults diagnosed with type 2 diabetes mellitus.
In conjunction with dietary modifications and physical exertion, JANUVIA operates by augmenting the body's inherent capability to reduce blood sugar levels.
In instances of elevated blood sugar levels, Januvia intervenes to facilitate their reduction.
Conversely, when blood sugar levels decline, Januvia's activity diminishes.
Januvia adapts its efficacy based on the body's needs, intensifying its action when necessary and reducing it when not.
6. JARDIANCE (empagliflozin); Boehringer Ingelheim and Lilly
Jardiance is prescribed as an additional treatment to dietary adjustments and physical activity to enhance glycemic management in adults and children aged 10 years and above diagnosed with type 2 diabetes mellitus.
Empagliflozin, the active ingredient in Jardiance, operates by inhibiting SGLT2. This action reduces the reabsorption of glucose filtered by the kidneys, subsequently lowering the renal threshold for glucose. Consequently, this results in increased excretion of glucose through urine.
7. NOVO RAPID (insulin aspart); Novo Nordisk
Novo Rapid, manufactured by Novo Nordisk, contains insulin aspart and is a rapid-acting insulin analog used to manage blood sugar levels in individuals with diabetes. It is designed to help control postprandial glucose spikes by acting quickly after injection.
8. HUMALOG (insulin lispro); Lilly
Humalog, produced by Lilly, contains insulin lispro and is another rapid-acting insulin analog. It is designed to mimic the body's natural insulin response, helping to manage blood sugar levels effectively, particularly after meals.
9. VICTOZA (liraglutide); Lilly
Victoza, developed by Lilly, contains liraglutide and belongs to the class of GLP-1 receptor agonists. It is prescribed to individuals with type 2 diabetes to improve glycemic control and reduce the risk of cardiovascular events. Victoza works by stimulating insulin secretion and inhibiting glucagon release, helping to lower blood sugar levels.
10. TOUJEO (insulin glargine); Sanofi
Toujeo, manufactured by Sanofi, contains insulin glargine and is a long-acting insulin analog. It provides a steady and prolonged release of insulin, helping to maintain blood sugar levels throughout the day and night. Toujeo is used to manage both type 1 and type 2 diabetes.