Daewoong Pharmaceutical and Yuhan Corp, both boasting strong marketing power, are in head-to-head competition in the antidiabetic treatment market.

The two are the only drugmakers that sell both of the DPP-4 (dipeptidyl peptidase-4) inhibitors and next-generation SGLT-2 (sodium-glucose cotransporter-2) inhibitors.

Daewoong recently signed a joint sales agreement with AstraZeneca for the SLGT-2 inhibitor Forxiga lineups (Forxiga, Xigduo), following the licensing agreement with LG Chem to sell DPP-4 inhibitor Zemiglo products (Zemiglo, Zemimet, and Zemiro).

Yuhan distributes Boehringer Ingelheim's DDP-4 inhibitor Trajenta (Trajenta, Trajenta Duo) and SGLT-2 inhibitor Jardiance (Jardiance, Zadie Duo).

According to U-BIST prescriptions data in 2017, Yuhan’s DPP-4 inhibitor Trajenta sold 55.99 billion won ($52.6 million), and SGLT-2 inhibitor Jardiance, 12.43 billion won.

During the same period, Daewoong’s DPP-4 inhibitor Zemiglo sold 29 billion won, and SGLT-2 inhibitor Forxiga, 25.7 billion won.

Regarding revenue, Yuhan is ahead of Daewoong in DPP-4 inhibitor, and Daewoong, in SGLT-2.

Jardiance can be covered by national health insurance if metformin and linagliptin (Trajenta) combo therapy cannot control blood sugar levels enough. Forxiga is added if sitagliptin (Januvia by MSD) alone cannot control blood sugar levels appropriately.

However, Forxiga is not yet covered by insurance if it is combined with Zemiglo.

Different criteria apply to different SLGT-2 inhibitors. Thus, it is essential to know whether they can be combined with existing remedies such as metformin, sulfonylurea, and DPP-4 inhibitors.

Jardiance is the only SGLT-2 that can be combined with all of the three other agents – metformin, sulfonylurea, and insulin. How Yuhan ups sales power for Jardiance will decide whether the drug will be a threat to Forxiga.

Daewoong is not getting behind too far because Forxiga sales are already ahead of Jardiance. LG Chem is also pushing Zemiglo to be used for a combo drug.

In January, LG Chem filed a phase-1 plan to the Ministry of Food and Drug Safety for exploring drug interactions between dapagliflozin (Forxiga) and empagliflozin (Jardiance).
Positive clinical results can lead to more prescriptions of Zemiglo as well as Forxiga, creating synergy effects between the two drugs, LG Chem said.

Daewoong Pharm, which saw the need for more reimbursements while selling Suglat, is also showing commitment to boosting combos.

In the local pharmaceutical industry, Daewoong is known to have the best sales power, with more than 400 salespersons, which is twice as many as those of CJ HealthCare.

“In SGLT-2 inhibitor market, the key is whether it can be used with existing products, such as DPP-4 inhibitors. If the combo therapy gets possible, sales will naturally go up,” said a product manager at a drugmaker.

sjh@docdocdoc.co.kr

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