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 The forthcoming guidelines from the American Diabetes Association
and the American Association of Clinical Endocrinologists follow
last Friday's decision by U.S. regulators to expand the health
benefits Lilly can claim for Jardiance to include preventing fatal
heart attacks and strokes in type 2 diabetes patients.
The decision by the Food and Drug Administration on the once-daily
pill that costs about $400 a month pushed Indianapolis-based Lilly's
shares up 3 percent.
Ashtyn Evans, analyst with the Edward Jones investment company,
expects annual Jardiance sales to approach $4 billion by the early
2020s, up from $200 million now, split with privately held German
partner Boehringer Ingelheim.
Evans predicted that doctors would now favor Jardiance for new
patients over other similar drugs called SGLT-2 inhibitors,
including Johnson & Johnson's Invokana and AstraZeneca's Farxiga,
until they complete their own heart-protection studies in the next
two years.
The American Diabetes Association is expected to issue its annual
guidelines next Thursday, association spokeswoman Michelle Kirkwood
said.
The endocrinologists' association in January will issue its updated
guidelines mentioning Jardiance's cardiovascular effect, said Dr.
Alan Garber, a professor of medicine at Baylor College of Medicine
and a past president of the group.
Some 29 million Americans have diabetes. Type 2, closely linked to
obesity, accounts for more than 90 percent of diabetes cases.
Jardiance was approved by regulators two years ago. The
heart-protective data was released later.
Metformin, a generic drug that costs about $50 a year, is expected
to remain the first treatment option for people with type 2
diabetes, but the guidelines are likely to make Jardiance a
preferred secondary option, according to doctors and analysts.
With the FDA's Dec. 2 decision and the new guidelines, the treatment
could become far more prescribed by primary care doctors, which
would enable Lilly to access many more patients, Morningstar analyst
Damien Conover said.
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Typically, Jardiance is prescribed by specialists when blood sugar
is not controlled by metformin alone.
"When you think of the overall patient population, getting it into
the primary care users, that's going to be important," Conover said.
Insurers should be willing to pay for the drug now, Baylor's Garber
said.
Insurer Anthem Inc said Jardiance is among the medium-cost drugs on
its list of covered treatments as of April, reflecting the
cardiovascular benefit. Express Scripts, the largest U.S. pharmacy
benefit manager, said the drug is on its national list of preferred
drugs.
(This version of the story corrects first paragraph to say
"guidelines that are expected to reflect" instead of "guidelines
reflecting"; and sixth paragraph to delete reference to "Jardiance
and similar medicines" as being part of the guidelines.)
(Reporting by Ransdell Pierson, Bill Berkrot and Caroline Humer;
Editing by Will Dunham)
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