Top 15 Diabetes Drugs in 2023 by 2022 Sales Statistics

Diabetes remains a critical global challenge, affecting millions of lives and commanding significant attention from the medical, life sciences and pharmaceutical sectors. Understanding the market dynamics of diabetes treatments becomes crucial for professionals across these industries. The top 15 diabetes drugs in 2023, according to 2022 sales data, reflect the current state of diabetes management and hint at the evolving needs and trends within this critical area of healthcare.

This article delves into the recent best-selling diabetes drugs, offering insights into their impact on the market, the innovations driving their success and their implications for patients, healthcare providers and industry stakeholders. By examining these top performers based on 2022 data, we gain a clearer view of the diabetes landscape and the strategic directions shaping the future of diabetes care and management.

Read on to learn more about the top 15 diabetes drugs in 2023, based on 2022 sales statistics.

1. Ozempic (Semaglutide)

Ozempic sales in 2022: $8.713 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: December 5, 2017

Indications Ozempic is FDA-approved for: Type 2 diabetes

Price of Ozempic: $1,029 for 1.5 mL subcutaneous solution (2 mg/1.5 mL (0.25 mg or 0.5 mg dose))

Why it did so well: Ozempic is a glucagon-like peptide 1 (GLP-1) receptor agonist used for the treatment of adults with type 2 diabetes as an adjunct to diet and exercise to improve glycemic control. The injection had a strong start since its approval in 2017 but its popularity skyrocketed in the last two years or so with its rising off-label use for weight loss, a trend largely driven by celebrities and social media. In 2023, Ozempic was the 13^th best-selling drug globally.

In 2022, Eli Lilly introduced Mounjaro (tirzepatide), a dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonist, as a direct competitor of Ozempic. Both drugs continue to dominate the diabetes and GLP-1 markets. Due to the exorbitant demand, shortages of Ozempic, as well as Mounjaro, began in 2022 and are expected into 2024.

 

2. Jardiance (Empagliflozin)

Jardiance sales in 2022: $8.388 billion

Company/Developer: Boehringer Ingelheim and Eli Lilly & Co.

Date of first FDA approval: August 1, 2014

Indications Jardiance is FDA-approved for: Type 2 diabetes, heart failure and chronic kidney disease

Price of Jardiance: $570.48 for a one-month supply

Why it did so well: Jardiance belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors, inhibiting the SGLT2 protein in the kidneys to lead to the excretion of excess glucose through the urine. Jardiance brought in $2.06 billion for Eli Lilly and $6.23 billion for Boehringer Ingelheim. Boehringer Ingelheim said Jardiance was the company’s “most significant growth and revenue contributor” in 2022. Lilly reported that Jardiance’s worldwide revenue for Q4 2022 was $612.3 million, an increase of 42 percent compared with Q4 2021. In the US, 2022 Q4 sales increased by a whopping 51 percent to $363.1 million, which the company said was “primarily driven by increased demand and to a lesser extent, an increased Q4 2022 royalty from Boehringer Ingelheim for exceeding certain annual thresholds.”

The increased demand has likely been driven by the expanded approval in heart failure, which was a significant one as Jardiance was the first drug to win approvals for the two major types of heart failure (reduced and preserved ejection fraction) in 2021 and 2022. Boehringer Ingelheim and Lilly can anticipate even higher demand this year as Jardiance won two more approvals in 2023, one in a pediatric (children ten years of age and older) indication for type 2 diabetes and the second in adults with chronic kidney disease.

 

3. Trulicity (Dulaglutide)

Trulicity sales in 2022: $7.439 billion

Company/Developer: Eli Lilly & Co.

Date of first FDA approval: September 18, 2014

Indications Trulicity is FDA-approved for: Type 2 diabetes, reducing the risk of major adverse cardiovascular events in adults with type 2 diabetes

Price of Trulicity: $930.88 per month

Why it did so well: In the US, Trulicity sales increased by five percent to hit $1.53 billion in Q4 2022. In its fourth-quarter 2022 financial results, Lilly said the growth was “driven by increased demand, partially offset by lower realized prices.” Outside the US, revenue was $409.8 million, a decrease of six percent, which the company said was driven by the “unfavorable impact of foreign exchange rates and to a lesser extent, lower realized prices, partially offset by increased demand.” But on a constant currency basis, non-US revenue increased eight percent.

Lilly also said it experienced periodic delays in fulfilling some Trulicity orders in the US during Q4 2022. Like Ozempic and Lilly’s newer diabetes drug Mounjaro, Trulicity is a GLP-1 receptor agonist and as such, is also currently listed on the FDA’s Drug Shortages list due to high demand for drugs in this class for both the diabetes and weight loss versions of it.

 

4. Januvia (Sitagliptin)

Sales in 2022: $4.513 billion (includes sales of Janumet (sitagliptin + metformin))

Company/Developer: Merck

Date of first FDA approval: October 16, 2006

Indications Januvia is FDA-approved for: Type 2 diabetes

Price of Januvia: About $613 for a supply of 30 oral 100 mg tablets

Why it did so well: Januvia is a dipeptidyl peptidase-4 (DPP-4) inhibitor indicated to improve glycemic control in patients with type 2 diabetes in conjunction with diet and exercise. The drug has been around for just under two decades and continues to perform strongly for Merck along with sister drug Janumet (Januvia plus metformin). While sales remain strong, they have been on the decline. In 2022, Januvia was flagged for nitrosamine contamination, a potential carcinogen commonly produced as a byproduct during drug manufacturing. This led to a 15 percent drop in sales compared to the previous year.

 

5. Farxiga (Dapagliflozin)

Farxiga sales in 2022: $4.381 billion

Company/Developer: AstraZeneca

Date of first FDA approval: January 8, 2014

Indications Farxiga is FDA-approved for: Type 2 diabetes, reducing risk of heart failure, chronic kidney disease (regardless of diabetic status)

Price of Farxiga: About $623 for a supply of 30 oral 10 mg tablets

Why it did so well: Farxiga is a SGLT2 inhibitor used primarily for the treatment of type 2 diabetes. Farxiga has been commercially successful due to its efficacy, its additional cardiovascular and renal benefits and approval for multiple indications. It’s been widely marketed and is considered a leading medication in the SGLT2 inhibitor class. During the first three months of 2022, Farxiga surpassed $1 billion in quarterly sales for the first time, indicating a year-over-year revenue growth of 67 percent. This performance exceeded Wall Street’s expectations by 20 percent. According to AstraZeneca, the drug had strong demand across all of its approved indications and was further supported by recent guideline updates from cardiology societies.

 

6. Lantus (Insulin Glargine)

Lantus sales in 2022: $2.380 billion (€2.259 billion)

Company/Developer: Sanofi

Date of first FDA approval: April 20, 2000

Indications Lantus is FDA-approved for: Type 1 and 2 diabetes

Price of Lantus: $64 to $77 for a 10 mL (100 units/mL) vial and $96 for a pre-filled pen

Why it did so well: Touted by Sanofi as the most prescribed long-acting insulin, Lantus was the company’s second best-selling drug in 2022. However, Lantus experienced a significant financial fall in 2022. In its 2022 financial report, Sanofi reported that sales of the long-acting insulin dropped 27.6 percent in the fourth quarter and decreased 56.7 percent in the US, impacted by prior formulary losses as well as “erosion of the basal insulin market,” the company said in the statement.

In May 2023, as part of sweeping changes in the US to lower drug prices guided by President Joe Biden’s Inflation Reduction Act, which include capping insulin at $35, Sanofi slashed the list price of Lantus by 78 percent and instituted the $35 cap on out-of-pocket costs for individuals with commercial insurance. As a result, the cost of Lantus pre-filled pens went from $438.07 to $96 while the price of a 10 mL vial dropped from $292.07 to $64. These changes took effect January 1 this year.

 

7. NovoRapid (Insulin Aspart)

NovoRapid sales in 2022: $2.259 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: June 7, 2000

Indications NovoRapid is FDA-approved for: Type 1 and 2 diabetes

Price of NovoRapid: NovoLog FlexPen (pre-filled NovoRapid pen) injectable solution (100 units/mL) is around $157 for 15 mL

Why it did so well: Novo Nordisk joined other insulin makers, led by Eli Lilly, last year and cut the price of its insulin analog NovoRapid by 25 percent, bringing its cost down to $72.34 from $289.36. Net sales of NovoRapid remained steady in 2022 at $2.259 billion, down just slightly from $2.329 billion in 2021. Novo dominated the diabetes space in 2022 thanks to the continuing Ozempic hype.

The entry of insulin biosimilars in the market, which include Sanofi’s Trurapi (approved in Canada, EU and Australia) and Biocon Biologics’ Kirsty, have and will likely continue to have an impact on NovoRapid sales. The FDA rejected Biocon’s biosimilar in 2023 for the second time over manufacturing concerns at the company’s Malaysia facility and sent Biocon a complete response letter.

 

8. Humalog (Insulin Lispro)

Humalog 2022 sales: $2.060 billion

Company/Developer: Eli Lilly

Date of first FDA approval: June 14, 1996

Indications Humalog is FDA-approved for: Humalog is a fast-acting human insulin analog designed to enhance glycemic control in both adult and pediatric patients with diabetes mellitus types 1 and 2.

Price of Humalog: The list price for a 5-pack of 3 mL Humalog U-100 KwikPens (totaling 15 mL or 1,500 units) is $159.12, and the list price for a Humalog U-100 10 mL (1,000 units) vial is $66.40.

Why it did so well: According to the Q3 2023 financial report by Eli Lilly, the US revenue for Humalog was $194.2 million, reflecting a 12 percent decrease compared to Q3 2022. Conversely, revenue outside the US saw a slight increase, reaching $201.2 million, up by one percent.

Humalog, or insulin lispro, initiates its effects within 15 minutes of subcutaneous administration, with peak levels observed between 30 to 90 minutes post-administration. Recognized as a “bolus insulin,” Humalog achieves high insulin levels rapidly, mirroring the release of endogenous insulin from the pancreas following meals, and maintains its action for approximately five hours.

 

9. Trajenta (Linagliptin/Metformin)

Trajenta 2022 sales: $1.846 billion

Company/Developer: Boehringer Ingelheim and Eli Lilly

Date of first FDA approval: May 2, 2021

Indications Trajenta is FDA-approved for: Trajenta serves as a DPP-4 inhibitor, prescribed as a supplementary measure alongside diet and exercise to enhance glycemic control in adults diagnosed with type 2 diabetes mellitus. Through its mechanism of action, linagliptin elevates the levels of active incretin hormones, thereby promoting the release of insulin in response to glucose levels and concurrently reducing circulating glucagon levels.

Price of Trajenta: The annual cost of Trajenta (5 mg) is estimated to be $931.

Why it did so well: The sales of the blockbuster type 2 diabetes drug Trajenta have maintained a stable trend since 2019, following Boehringer’s acquisition of full rights from Lilly. In 2022, the drug generated €1.7 billion ($1.8 billion), reflecting a notable 10 percent increase. In a clinical program, linagliptin demonstrated a significant reduction in HbA1c from baseline compared to placebo at 24 weeks. Fasting plasma glucose showed marked improvement with linagliptin compared to placebo.

 

10. Victoza (Liraglutide)

Victoza 2022 sales: $1.796 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: January 25, 2010

Indications Victoza is FDA-approved for: Victoza is a GLP-1 receptor agonist prescribed to enhance glycemic control in individuals aged 10 years and older diagnosed with type 2 diabetes. Additionally, it is indicated to lower the risk of heart attack, stroke and cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.

Price of Victoza: The wholesale acquisition cost (WAC) or list price of Victoza is around $543.51 for a 2-pen package (0.6 & 1.2 mg doses), or $815.27 for a 3-pen package (1.8 mg dose).

Why it did so well: Victoza, a prominent GLP-1 agonist from Novo Nordisk, secured substantial sales, amounting to $1.796 billion in 2022, although experiencing an 18 percent decline. The sales figures for the first half of 2023 were also lower compared to the corresponding period in the previous year, showing a decrease of 23 percent to DKK 4.65 billion ($657 million). In a clinical trial involving over 3,900 patients across 40 countries, liraglutide demonstrated improved glycemic control as monotherapy by reducing HbA1c values compared with placebo or active comparators.

 

11. Janumet (Metformin/Sitagliptin)

Janumet 2022 sales: $1.700 billion

Company/Developer: Merck

Date of first FDA approval: March 30, 2007

Indications Janumet is FDA-approved for: Janumet is a combination of the oral antihyperglycemic drugs sitagliptin and metformin. It is prescribed as an adjunct to diet and exercise to enhance glycemic control in adult patients diagnosed with type 2 diabetes mellitus.

Price of Janumet: The price for Janumet oral tablets (1000 mg-50 mg) is approximately $613 for a 60-tablet supply.

Why it did so well: Merck recorded $1.7 billion in revenue from its type 2 diabetes drug Janumet in 2022. In addition, Janumet XR (extended-release tablets) is designed to address three fundamental challenges of diabetes: insufficient insulin production by pancreatic beta cells, resistance to insulin’s effects and excessive glucose generation by the liver.

 

12. Rybelsus (Semaglutide)

Rybelsus 2022 sales: $1.647 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: September 20, 2019

Indications Rybelsus is FDA-approved for: Rybelsus is a GLP-1 receptor agonist prescribed as an adjunct to diet and exercise to enhance glycemic control in adults diagnosed with type 2 diabetes mellitus.

Price of Rybelsus: Without insurance coverage, the typical out-of-pocket cost for a 30-day supply of 7 mg Rybelsus tablets is $1,270, which is approximately $42 per tablet. This means that the annual cost for a year’s supply of Rybelsus could exceed $15,000.

Why it did so well: Rybelsus stands out as one of Novo Nordisk’s major current launches, generating sales of approximately $1.65 billion in 2022. The efficacy and safety of Rybelsus in reducing blood sugar in patients with type 2 diabetes were investigated in various clinical trials. In placebo-controlled studies, Rybelsus as a monotherapy exhibited a significant reduction in blood sugar (hemoglobin A1c) compared to the placebo, as assessed through HbA1c tests measuring average blood sugar levels over time. After 26 weeks, 69 percent of those on a daily 7 mg dose and 77 percent of those on a daily 14 mg dose of Rybelsus achieved an HbA1c lower than seven percent, in contrast to 31 percent of patients on placebo.

 

13. Tresiba (Insulin Degludec)

Tresiba 2022 sales: $1.363 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: September 25, 2015

Indications Tresiba is FDA-approved for: Tresiba is a long-acting insulin designed to enhance blood sugar control in adults diagnosed with type 1 or type 2 diabetes.

Price of Tresiba: The list prices are set at $118.63 for the U-100 10 mL vial, $177.95 for the U-100 FlexTouch 5×3 mL and $213.54 for the U-200 FlexTouch 3×3 mL.

Why it did so well: Tresiba is currently launched in more than 70 markets. Tresiba, a once-daily, long-acting basal insulin, is prescribed for standalone use or in conjunction with oral antidiabetic medications or bolus insulin. Offering an extended duration of action beyond 42 hours, Tresiba was found, based on the provided data, to enhance glycemic control with A1C reductions comparable to those of FDA-approved comparators, establishing its noninferiority.

 

14. Toujeo (Insulin Glargine)

Toujeo 2022 sales: $1.225 billion

Company/Developer: Sanofi

Date of first FDA approval: February 25, 2015

Indications Toujeo is FDA-approved for: Toujeo is a long-acting human insulin analog prescribed to enhance glycemic control in adults and pediatric patients aged six years and older with diabetes mellitus.

Price of Toujeo: The average cost for Toujeo Solostar is approximately $573.57 for a pack of three pens, each containing 1.5 mL of 300 units/mL.

Why it did so well: In the first half of 2023, sales of Toujeo reached $611 million, indicating a 7.2 percent rise, driven by growth in the Rest of the World region and Europe, according to Sanofi’s financial report. The approval of Toujeo was grounded in the FDA’s assessment of results from a clinical trial comprising a series of international Phase III studies. These studies involved over 3,500 adults representing diverse diabetes populations, including both type 1 and type 2 diabetes. All studies within the program successfully achieved their primary endpoints by demonstrating comparable blood sugar control with Toujeo in comparison to Lantus (less concentrated than Toujeo pen).

 

15. NovoMix (Biphasic Insulin Aspart)

NovoMix 2022 sales: $1.118 billion

Company/Developer: Novo Nordisk

Date of first FDA approval: June 2000

Indications NovoMix is FDA-approved for: Type 1 and 2 diabetes. NovoMix encompasses a series of premixed insulin treatments for individuals with diabetes who require insulin to regulate their blood glucose levels. These medications feature insulin aspart (100 units/mL) as the active ingredient, paired with protamine to extend its duration of action. NovoMix is also known as Novolog Mix. The NovoMix line is offered in several different formulations based on their insulin aspart to protamine ratio:

• NovoMix 30 (Novolog Mix 70/30), consisting of 30 percent insulin aspart and 70 percent insulin aspart protamine
• NovoMix 50, comprising 50 percent insulin aspart and 50 percent insulin aspart protamine
• NovoMix 70, with a composition of 70 percent insulin aspart and 30 percent insulin aspart protamine

Price of NovoMix: Beginning at $156.61 for 30-70 units/mL for NovoLog Mix 70/30 FlexPen

Why it did so well: Novo Nordisk has reigned as the leading insulin maker in the domestic US and global markets for several years. Despite the patent for NovoMix having expired in 2014, the premixed insulin analog continues to do well for Novo. However, the effects of growing generic competition are already being seen as sales of NovoMix dropped from $1.37 billion in 2021 to $1.118 billion in 2022. Another significant change in the insulin landscape is the voluntary price cuts and the newly introduced $35 price caps that all of three major insulin makers (Eli Lilly, Novo Nordisk and Sanofi) signed off on. However, these cuts are expected to affect the bottom line of pharmacy benefit managers (PBM) as they receive significant rebates from drug makers, more so than the companies themselves.