Physician Views: As momentum grows for the SGLT-2 inhibitor class, can AstraZeneca's Farxiga move into Invokana's slipstream?
Having fully acquired the joint venture that it previously operated with Bristol-Myers Squibb, the forthcoming US launch of Farxiga – approved by the FDA last week – will provide AstraZeneca an early opportunity to demonstrate its credentials in the diabetes market.
A less than straightforward regulatory process will see Farxiga reach the market as the second SGLT-2 inhibitor therapy, following the launch of Johnson & Johnson's Invokana last year.
First-to-market status has typically acted as a key determining factor in the subsequent commercial success of type 2 diabetes treatments, and since being launched, Invokana has delivered a stronger-than-expected performance.
As a result, the SGLT-2 inhibitor class has become rapidly established in the treatment paradigm, but it remains to be seen if Farxiga can find a suitable position in Invokana's slipstream.
While physicians have embraced the SGLT-2 class – with sizeable usage reported in metformin-refractory patients and a recent NEJM survey indicating that "second-line SGLT-2 competition versus DPP-4 inhibitors is a reality," according to analysts at Leerink Swann – it remains to be seen how Farxiga competes with Invokana.
Bearish analysts point to a lack of superiority for AstraZeneca's drug, which coupled with its slower progress to market (due to side-effect concerns) could also limit uptake. Nevertheless, with momentum growing for the SGLT-2 class, there could be an opportunity for AstraZeneca to deliver some early success for its post-JV diabetes portfolio – albeit if ex-partner Bristol-Myers Squibb remains a beneficiary via sizeable royalty payments - Spotlight On: Why AstraZeneca's Farxiga approval is a win-win for Bristol-Myers Squibb.
FirstWord has this week polled US-based endocrinologists the following questions:
A less than straightforward regulatory process will see Farxiga reach the market as the second SGLT-2 inhibitor therapy, following the launch of Johnson & Johnson's Invokana last year.
First-to-market status has typically acted as a key determining factor in the subsequent commercial success of type 2 diabetes treatments, and since being launched, Invokana has delivered a stronger-than-expected performance.
As a result, the SGLT-2 inhibitor class has become rapidly established in the treatment paradigm, but it remains to be seen if Farxiga can find a suitable position in Invokana's slipstream.
While physicians have embraced the SGLT-2 class – with sizeable usage reported in metformin-refractory patients and a recent NEJM survey indicating that "second-line SGLT-2 competition versus DPP-4 inhibitors is a reality," according to analysts at Leerink Swann – it remains to be seen how Farxiga competes with Invokana.
Bearish analysts point to a lack of superiority for AstraZeneca's drug, which coupled with its slower progress to market (due to side-effect concerns) could also limit uptake. Nevertheless, with momentum growing for the SGLT-2 class, there could be an opportunity for AstraZeneca to deliver some early success for its post-JV diabetes portfolio – albeit if ex-partner Bristol-Myers Squibb remains a beneficiary via sizeable royalty payments - Spotlight On: Why AstraZeneca's Farxiga approval is a win-win for Bristol-Myers Squibb.
FirstWord has this week polled US-based endocrinologists the following questions:
- By what percentage they anticipate usage of SGLT-2 inhibitors to increase over the next 12 months?
- Whether they would consider treating patients whom had discontinued treatment with Invokana (canagliflozin) - due to side-effect issues - with a second SGLT-2 inhibitor?
- Whether they plan to prescribe Farxiga (dapaglifozin) in preference to Invokana and the reasons for doing so?
- How significant superiority data for Invokana versus Januvia (sitagliptin) has been in driving usage of Invokana to date?
- To what extent Farxiga's labelling – non-black-box warning relating to low cases of bladder cancer – will have on anticipated usage of the drug?
