Diabetes drugs make up one of the biggest selling and most competitive markets in the pharma world. According to market research by Precedence, the global Type 2 diabetes market was just under $30 billion last year. And companies like Novo Nordisk and Eli Lilly are consistently among the highest TV ad spenders for their diabetes meds.
Yet, patients struggle to remember these drugs' names, and that is a problem when it comes to switching them to newer meds. That’s according to a new report out by Phreesia, based on a survey of slightly more than 4,000 patients conducted from Christmas 2021 to New Year's 2022.
The survey found that brand awareness was weak: Eli Lilly’s Trulicity had just a 29% recall among those surveyed, while Lilly and Boehringer Ingelheim’s Jardiance was at 27% and Merck’s Januvia at 24%. Those drugs topped the list and show just how poorly people remember these meds. And that's despite the big money companies plow into branded ad campaigns. For example, in July, there were five diabetes drugs among the top 10 biggest TV ad spenders, with a total of $79 million, according to iSpot.
But what patients have heard of is metformin, a blood-sugar-lowering drug developed last century and one that's long been available as an inexpensive generic med. A massive 76% of respondents had heard of this drug.
An even greater number, a whopping 87% of respondents, have tried the off-patent metformin, Phreesia found, but the survey showed a steep drop in prescription use after. Only some 16%, 17% and 19% of respondents had tried Trulicity, Jardiance and Januvia, respectively.
The competitive nature of the market and the unique way the disease is managed is contributing to this low brand awareness, Jai Seth, senior research manager at Phreesia, explained in an interview.
Many patients may start on metformin before moving onto other newer, branded drugs. But patients could also be given insulin, both short- and long-acting and with various names. Diabetics also have blood sugar level measuring strips and devices, which also come in several brands. Patients may be switched to different drugs if they have side effects or to help with the co-morbidities inherent in diabetes like chronic kidney disease, heart disease risk and obesity.
Diabetes patients are also largely left to manage their disease at home. This includes monitoring their sugar levels to ensure they aren’t too high or too low and taking their medications accordingly, all the while also trying to change their diets and often up their exercise.
With around 20 diabetes drugs on the market, it's not unreasonable that the average patient can't remember all the brands, Seth noted. Fundamentally, they won't care whether they are on say Jardiance or AstraZeneca’s Farxiga, because those names have little meaning for them, he argued. "What we found when looking through the report is that there is a lot more that patients need beyond just the need for medications itself.”
There is a bigger role pharma marketers can play in other areas, such as with education campaigns, Seth noted. “The more value they will perceive from that brand," the higher the brand recall will be.
Switching diabetes medication is a key motivator for diabetes drug makers. Doctors usually offer their patients the drug they know well and are reluctant to make changes to that prescription, given how sensitive blood sugar levels can be.
But while doctors are not always keen on switching, patients are, Phreesia found. In fact, around 71% of respondents said they are likely to try a new medication for Type 2 diabetes, and 37% are “very” or “extremely likely” to try a new drug.
Patients have a low level of satisfaction with their drugs, often because of common side effects such as nausea. Only 20% of respondents said they are completely satisfied with Januvia, the most commonly tried diabetes drug after metformin. “[These] data indicates that pharma marketers may be able to improve patient satisfaction by raising awareness about top-performing medications and persuading patients to switch,” the report found.
Mental health was also a key factor for patients, but one not often addressed. More than one-third (37%) of surveyed respondents said they worry about their diabetes often or all the time, while 42% said their condition has at least a moderate impact on their mental health.
“That data not only reveals the limited support Type 2 diabetics currently receive, it also offers an opportunity for pharma to close the gap,” the report said, to integrate well-being more into their campaigns.