Diabetes - A 'Sweet' Burden Turns Bitterly Heavy
BMI View: The high prevalence and poor management of diabetes in Mexico present sizable opportunities for multinational pharmaceutical companies. Apart from urging Mexicans to change their lifestyles, local authorities have allocated significant resources to address this issue. However, COFEPRIS' efficient response to the high disease burden may introduce unexpected competition for companies already established in the market.
Diabetes has long been Mexico's number-one health problem, as a result of increasingly unhealthy lifestyles and rising obesity levels. A study released recently by the United Nations Food and Agricultural Organization has put this issue in the spotlight again. The report stated that Mexico has overtaken the US and become the most obese country in the Americas. Despite some smaller nations with high obesity rates, such as the Micronesian island of Nauru, where 95% of the population is overweight, Mexico is one of the fattest countries in the world with 33% obesity rate. Prominent waistlines, which may have been enviable proof of prosperity, have become a serious health risk in Mexico. According to estimation from International Diabetes Federation (IDF), over 10mn Mexicans or 9% of population suffer from diabetes. Mexico had the sixth most cases of diabetes in the world and its diabetes prevalence ranked the top in 2012.
|Highest Diabetes Prevalence In The World|
|Top Ten Countries In Terms Of Number of People with Diabetes (mn) (LHS) & Diabetes Prevalence (%) (RHS)|
According to BMI's Burden of Disease Database (BoDD), disability-adjusted life years (DALYs) lost to diabetes ranks the highest among communicable and non-communicable diseases in the country, Mexico's DALYS lost to diabetes totalled over 30% of the total diabetes DALYs in Latin America. In addition, DALYS lost to the disease among Mexicans between 30 and 60 years old increased by over 40%, indicating a poor disease control in Mexico. Diabetes is the country's most common cause of mortality in adults, and the number one cause of hospital discharge in the Mexican Institute of Social Security (IMSS).
|Diabetes Not Under Control|
|DALYs Lost To Diabetes In Mexico|
A survey carried out by Mexico's Instituto Nacional de Salud Publica reported that although the treatment coverage for type 2 diabetes is high (94%), only 5% of patients diagnosed with the disease are fall under the 'maintaining the condition well' category - in terms of A1c haemoglobin measurement (which should be below seven). The study showed that of the majority of patients being treated with anti-diabetic medication: 85% are receiving anti-diabetic agents, 7% are on insulin only and 3% are on combination of both, while and 6% are treated with no medication. Most patients are treated under a public healthcare institution, such as IMSS and Secretaria de Salud (SSA).
|Low Insulin Use|
|Medical Treatments For Diabetes In Mexican Population|
|Mainly Treated By Public Healthcare Service|
|Healthcare Providers That Treat Type 2 Diabetes|
Revenue Generating Opportunities For Diabetes Therapeutics Providers
We believe that high disease prevalence and poor disease control indicates a need for the significant improvement of medicine access and quality in Mexico - creating significant revenue earning opportunities for the producers of diabetes therapeutics. Although Mexico offered some mixed results for multinationals during the past few quarters, diabetes treatments have generated double digital growth: sales of Sanofi's lantus (insulin) were particularly strong in 2012 (+25.8%). Sanofi's outperformance in Mexico is unsurprising, given its significant presence in the country. However, we believe there will be increasing competition in Mexican diabetes drug market. In order to address the high disease burden in Mexico, during 2012 alone, the Federal Commission for the Protection against Sanitary Risk (COFEPRIS) approved Bristol Myers Squibb's Kombiglyze xr (saxagliptin and metformin hcl extended-release) for type 2 diabetes treatment and Novo Nordisk's Ryzodeg (insulin) and Tresiba (insulin).Early in 2013, COFEPRIS also approved Sanofi's Lyxumia (lixisenatide) for type 2 diabetes treatment.