8. Janumet

As part of the overall Januvia franchise, combo drug Janumet has to compete with other noninsulin diabetes therapies.

Company: Merck & Co.
2016 U.S. sales: $984 million
Drug class: DPP-4 combo drug

Janumet combines Merck’s blockbuster DPP-4 drug Januvia with metformin, the standard diabetes drug that’s many patients’ first introduction to treatment for their disease. In that, it’s like many metformin combo drugs on the market, including those in Janumet’s class—Eli Lilly’s Jentadueto, combining Tradjenta and metformin, or AstraZeneca’s Kombiglyze, an Onglyza-metformin marriage.

But Janumet is part of the overall Januvia franchise, and Januvia remains a powerhouse diabetes drug. The second-best-selling diabetes med in the U.S., Januvia brought in $2.29 billion in sales last year in the States, and almost $4 billion worldwide, despite competition in the field that continues to grow.

Like their fellow DPP-4 meds, Januvia and Janumet have to contend with other noninsulin diabetes therapies, including the newest class, SGLT2 drugs. And with one of those meds—Lilly and Boehringer Ingelheim’s Jardiance—now recognized by the FDA for its ability to cut cardiovascular risks, the interclass competition is increasingly fierce.

But that’s where a potential follow-up combination med to Janumet could be: in the SGLT2 field. Merck is working with Pfizer on an entry in that class, ertugliflozin, and a Januvia-ertugliflozin combination, too. In fact, the potential Januvia combo was one reason Merck jumped into the SGLT2 business in the first place, a Merck diabetes exec told FiercePharma last year.

Word on that new combo is expected by year’s end. The FDA accepted the two partners’ applications—for ertugliflozin, the ertugliflozin-Januvia combo and an ertugliflozin-metformin combo—in March of this year, with an agency action date set in December.

8. Janumet