The diabetes drug market became more crowded recently with FDA marketing approval of Toujeo, a long-acting basal insulin from Sanofi. Toujeo will compete with Lantus, an already-established long-acting basal insulin that has generated billions of dollars in revenue for Sanofi.
In pharma lingo, Toujeo is a me-too drug, hardly the first in its class. This is nothing new. As new drug classes enter the market, it’s not uncommon for competitors to develop treatments that are similar to first-in-class agents. Consequently, to convince clinicians to switch patients from an established agent to another in the same class requires a compelling reason, such as better efficacy or an improved safety profile, even a different delivery system, such as oral versus injection, or less-frequent dosing. But that doesn’t appear to be the case with Toujeo. The results of open-label, randomized, active-control, parallel studies of up to 26 weeks duration with 6 months’ safety extension show that glycated hemoglobin (HbA1c) and fasting plasma glucose levels were similar for Toujeo and Lantus. In other words, Toujeo was noninferior.
In the face of noninferiority, companies are forced to compete over price rather than product profile. Market experts contend that Sanofi likely will have to offer discounts to encourage sales of Toujeo, which may lead to a pricing war among the key players in the diabetes market.
Sanofi plans to roll out Toujeo in April, and market analysts will be watching to see what happens from a pricing and prescribing standpoint. We hope prescribers will consider the evidence for this product carefully to balance cost, quality, and outcomes. What is the value in prescribing a more expensive product that delivers similar patient outcomes?