Decision Resources, a research and advisory firm for pharmaceutical and healthcare issues, forecasts the type 2 diabetes therapeutic market in China, the third largest after the U.S. and Japan, will grow 10% annually, reaching $3.5 billion in 2017. Fueling this expansion are the growing number of drug-treated patients and the increasing use of dipeptidyl peptidase-4 (DPP-IV) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists and insulin analogues.

The report, Type 2 Diabetes in China, found although further generic erosion of older oral antidiabetics is expected, recently launched DPP-IV inhibitors and GLP-1 receptor agonists will continue to enjoy market exclusivity and garner higher patient share in China during the 2012 to 2017 period.

Biosimilar versions of insulin analogues, both long- and short-acting, will have only a modest impact on China’s type 2 diabetes market during the forecast period. Most biosimilar insulins are only fractionally less expensive than the originators, which encourages physicians and patients to stay with branded insulins. Together with the launches of additional novel agents, Western-branded therapies will consistently capture more than 70% of sales in China’s type 2 diabetes therapeutic market by 2017.

The findings also reveal that Chinese physicians show strong interest in DPP-IV inhibitors and GLP-1 receptor agonists. DPP-IV inhibitors are favored because of their improvement in glycemic control without the risk of hypoglycemia. GLP-1 receptor agonists are effective in lowering HbA1c and body weight and therefore are ideal for obese type 2 diabetes patients. However, due to their high prices and lack of reimbursement, physicians who currently prescribe them do so mostly in the second- or third-line setting, after their patients fail to maintain glycemic control with less expensive options. Meanwhile, patients must be able to afford the high out-of-pocket payment.

“More than 95% of Chinese residents have access to some form of government-sponsored medical insurance, but broad access does not translate into affordable healthcare,” said Decision Resources analyst Jing Wu, M.S., M.B.A. “Select DPP-IV inhibitors and GLP-1 receptor agonists have a reasonable chance of being included on the next version of the National Reimbursement Drug List (NRDL), likely to be released in 2014. However, in order to control treatment costs, the reimbursement of these agents will be restricted to specific type 2 diabetes patient groups.”