5. Humalog

Demand for Eli Lilly’s Humalog grew in the U.S. last year, but sales shrank, driven by lower realized prices.

Company: Eli Lilly
2016 U.S. sales: $1.69 billion
Drug class: Fast-acting insulin

Demand for Eli Lilly’s fast-acting insulin Humalog grew in the U.S. last year, but that didn’t stop sales from shrinking.

Sales for the Indianapolis drugmaker’s top product decreased 5% from the year before, driven by lower realized prices, Lilly said. Translation? Discounts in a drug class that’s been seriously pressured by payers. Rebates and discounts are digging into list prices, yielding less revenue on a net basis.

Things may get more difficult for the Lilly med as biosimilars move in. Sanofi, which knows a thing or two about insulin after fielding star med Lantus, is developing its biosimilar SAR342434. In May, that Humalog copy snagged a positive recommendation from the European Medicines Agency’s Committee for Medicinal Products for Human Use (CHMP). Globally, Humalog brought in $2.77 billion.

The Humalog biosim may find a U.S. audience ready and willing to prescribe it, too, according to results from a recent Barclays survey. 42% of respondents said they expected to write scripts for the medication once it arrives, versus just 10% who thought they’d prescribe Basaglar—a Lilly copy of Lantus—a year from now, analyst Geoff Meacham wrote to clients.

One potential reason? The rapid-acting insulin market is far more concentrated—namely on Humalog and Novo Nordisk’s NovoLog—than the basal insulin market, which features more competition, Meacham wrote. “Respondents may be more open to a potential new rapid-acting option as bargaining power could be limited.” 

5. Humalog