Novo Nordisk rolls out long-awaited Tresiba, aiming for blockbuster U.S. market share

Novo Nordisk ($NVO) finally launched its next-gen diabetes treatment Tresiba in the U.S., approved by the FDA last September. The Danish drugmaker has high hopes for sales, but the long-acting insulin faces new competitors that could get in the way of those ambitions.

Novo Nordisk CEO Lars Rebien Sørensen

Tresiba will go up against Sanofi's ($SNY) market standby Lantus and its newly approved follow-up Toujeo. Plus, as of December, it will face lower-priced competition from Eli Lilly ($LLY) and Boehringer Ingelheim, in the form of their Lantus biosimilar Basaglar.

Still, Novo sees advantages to Tresiba, and it's fielding a large, experienced salesforce to get those advantages across. CEO Lars Rebien Sørensen has said that payer contracts will be key to Tresiba's market share battle with Toujeo. Sanofi is pushing hard to move patients onto the longer-acting Toujeo before Lilly and BI's biosim hits the market.

A follow-up to Novo's steady performer Levemir, Tresiba lasts 42 hours and has a "flat and steady profile" that allows patients to dose at any time of day. The company is still negotiating with most payers, but it has struck a deal with CVS Health ($CVS) for its lowest copay tier for branded meds. Several Humana ($HUM) plans offered the same arrangement.

To woo patients, the company will offer a copay discount card to keep out-of-pocket costs low for uninsured patients. The program will allow copays as low as $15 per month for up to two years.

For Novo, Tresiba's launch is an opportunity to finally make inroads in a market where it's historically fallen short. The company's current basal insulin, Levemir, has only managed to snag about 25% of the U.S. market, R&D chief Mads Krogsgaard Thomsen told a Danish newspaper last fall. That makes Tresiba and its NovoLog combo Ryzodeg--plus, it hopes, follow-up combo drug Xultophy--"super important" to the company's goal of grabbing at least half of that market.

Xultophy, for its part, was submitted to the FDA last September, and Novo hopes for an approval later this year. The company expects big things from the product, which combines Tresiba with Novo's GLP-1 drug Victoza; in fact, Thomsen says the combo product has some of the strongest late-stage data he's ever seen--"if not the strongest," he said.

Thomsen said he sees the combo bringing in at least as much as Tresiba alone. Key to that success will be selling Tresiba, he says. Novo wants doctors to see the now-launched drug as "the preferred basal insulin, like Victoza is the preferred GLP-1," Thomsen said, because if that's the case, doctors will see the combination med and think, '[I]t must be good.' "

- see the release from Novo

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Editor's note: This story was updated with details about the basal insulin market and comments from Novo officials. A mischaracterization of the active ingredients in Ryzodeg was also corrected.