The basal insulins are the most successful insulin class, with other insulin classes demonstrating high substitution or low and declining sales. Current basal insulins offer good safety and emerging therapies are not expected to improve efficacy significantly. However, the launch of two late-stage pipeline products Degludec and DegludecPlus in 2012 - 13 will alter market dynamics.
With strong marketing and sales resources committed by Novo Nordisk, late-stage basal insulin Degludec (insulin degludec) will offer strong competition to class leader Lantus (insulin glargine; Sanofi) and largely cannibalize predecessor Levemir (insulin detemir; Novo Nordisk).
Key patents for blockbuster Lantus will expire from 2014 - 15. However, the threat of biosimilar insulin is expected to have less impact than typical small molecule generics, as physicians are expected to be reluctant to introduce potential additional variability into patients' insulin treatment regimens.
Novo Nordisk, Sanofi, and Eli Lilly are also the only companies with promising insulin products in late stage development. Alternative insulin delivery mechanisms under development, such as MannKind's Afrezza (inhaled insulin), are not expected to make it to market in the near term.