Innovative diabetes drug portfolio, local partnerships help Boehringer Ingelheim take big strides in India

German drugmaker Boehringer Ingelheim (BI), which has cornered about 50 percent  market share for its new class of oral anti-diabetic drugs, SGLT2 (sodium glucose co-transporter-2), is now planning to expand its hold through co-marketing tie-ups with local partners Lupin and Cipla.

In India, BI distributes its SGLT2 drug Jardiance (Empagliflozin) both directly as well as through co-marketing tie-ups. The drug is sold as a monotherapy, as well as in fixed-dose combinations with metformin and another oral antidiabetic DPP4 inhibitor drug, Linagliptin.

While its partnership with Lupin dates back to 2016, in June it formed a co-marketing partnership with another large Indian drug company, Cipla.

Lupin and Cipla promote and distribute the same molecule under different brand names. BI supplies the drug and the brand names are owned by it.

Other drugs in BI’s portfolio

Apart from diabetes drugs, the company is also exploring more partnerships to expand the market share of other drugs in its portfolio to treat stroke, heart failure and lung cancer.

In India, BI sells about 8-9 products, which include cardiovascular drug Pradaxa, anti-stroke Actilyse, Giotrif (local brand name Xovoltib) to treat lung cancer, and Ofev (local brand name Cyendiv) for a lung disease called idiopathic pulmonary fibrosis (IPF).

“The primary reason is that India being such a large market, it is not easy to reach every possible doctor or physician on your own. After a certain point the efficiency of your field force starts coming down if you don’t have enough products to carry to the doctors,” Tyagi said.

“That is the model, which many other companies are following,” he added.

Tyagi says that along with commercial partnerships, BI is also exploring possible partnerships with digital therapeutic companies and device companies.

“The focus is on how we can do something to benefit the patient,” Tyagi said, adding that while diabetes is big for the company, it is also focussing on stroke and cancer.

“We are the only company globally to have a treatment for ischaemic stroke. That’s a key area for us. Stroke is one of the top killers in the country,” he explained.

BI markets a biologic drug called Actilyse, which belongs to a group of medicines called thrombolytic agents. Actilyse works by dissolving clots in the blood vessels.

Tyagi said there are products for new indications such as heart failure and psoriasis in the global pipeline, which the company plans to bring to India.

Diabetes focus

But diabetes, and more narrowly SGLT2 inhibitors or gliflozins, and DPP4 inhibitor Linagliptin, contribute the lion’s share of BI’s revenues in India.

The company doesn’t disclose India-specific sales but diabetes drugs contribute about 70 percent of the turnover.

“We are the market leaders in the SGLT2 class, and we are well ahead of our nearest competitors,” said Sharad Tyagi, Managing Director of Boehringer Ingelheim India in an interview with Moneycontrol.

Tyagi says BI has around 50 percent market share for its SGLT2 class drugs, and the company is now the fifth-largest company in the oral antidiabetic drugs category, with a market share of 5.5 percent.

BI is one of the fastest growing pharmaceutical companies in India, growing nearly 20 percent over two consecutive years to July.

Why SGLT2?

SGLT2 inhibitors, the new class of oral anti-diabetic drugs, are gaining traction with doctors treating type-2 diabetes patients, especially with higher cardiovascular risk and kidney-failure risks, two side diseases associated with diabetes.

Analysts say that companies such as BI are aggressively pursuing SGLT2 as they are protected by patents for at least the next four years, which means they are protected from generic competition and will have better margins.

However there is stiff competition in the SGLT2 class. There are three other versions of SGLT2 sold in India. They are: British drug maker Astrazeneca’s Dapagliflozin (Farxiga); US-based Johnson & Johnson’s Canagliflozin (Invokana); and homegrown Glenmark’s Remogliflozin Etabonate (Remo).

But Tyagi says having more players for SGLT2 benefits the market. “The market share may be static, but the absolute presence is growing. You are selling so much more. The class is expanding,” Tyagi said.

BI’s other oral anti-diabetes drug Linagliptin, which is a DPP4 inhibitor, is sold under the brand name Trajenta and is protected by patent till 2023.

DPP4 inhibitor class drugs have lost some sheen commercially. The loss of patent exclusivity by Novartis’ Vildagliptin, the top-selling DPP4 inhibitor, has opened the door for cheap rip-offs.

Diabetes: Taking a heavy toll in India

India has emerged as the diabetes capital of the world, with type-2 diabetes cases rising at a fast clip, as people are leading more sedentary lifestyles and consuming diets high in sugar.

According to the International Diabetes Federation, India is home to 77 million adults aged between 20 and 79 years with diabetes, ranking second (behind China) and poised to reach 134.2 million patients by 2045.

The Indian diabetes market is valued at Rs 14,545 crore and is growing at 10.35 percent, as pert an IMS MAT May 2020 report, with the oral anti-diabetic market being valued at Rs 10,735.4 crore and growing at 11.34 percent. The SGLT segment has close to 10 percent share of the total oral anti-diabetic market.