Boehringer Ingelheim Korea's recent history aligns with the growth of its SGLT-2 inhibitor Jardiance (empagliflozin).

Jardiance began as a treatment for type 2 diabetes and demonstrated benefits for cardiovascular-renal-metabolism (CRM), being the first among SGLT2 inhibitors, achieving a total management milestone.

As the Phase 3 EMPA-REG OUTCOME clinical study, announced in 2015, marks its 10th anniversary, the company is pursuing another turning point.

For the BPM corner, Daily Pharm met with PM Eun-Hee Cho of the CRM business unit (Type 2 diabetes) and PM Gyujin Lee (Chronic heart failure, chronic kidney disease) and heard about this year's strategy and initiatives for Jardiance.

Jardiance provides a diabetes-heart-kidney total management…the company challenges the market with its 'one-team' strategy

Jardiance, which received domestic approval in August 2014, has gradually expanded its indications from type 2 diabetes to chronic heart failure and chronic kidney disease.

Nine years after its domestic launch and ten years after its initial clinical presentation, Jardiance has already achieved a high market share in the diabetes treatment market. As the business unit name suggests, its main strategy focuses on total management under the concept of CRM.

PM Cho stated, "Although Jardiance has a 10-year history as a treatment for diabetes, unfortunately, the rate at which domestic diabetes patients reach the target blood glucose level (6.5%) is still insufficient," adding, "Since the expanded reimbursement for triple combination therapy in 2022, there has been an opportunity to increase patient accessibility in the diabetes area."

PM Cho said, "With the increasing number of diabetes patients experiencing co-morbidities and complications, we believe that Jardiance can play an even more critical role. We expect that expanding indications and reimbursement for chronic heart failure and chronic kidney disease will provide additional growth drivers."

As PM Cho noted, Jardiance has already established growth momentum thanks to the addition of new indications and expanded reimbursement scope.

Last October 2023, Jardiance was approved for the chronic kidney disease indication, and since February, reimbursement has been applied for chronic heart failure with spectrum ejection, further enhancing its influence.

PM Lee stated, "In the past year, guidelines in various areas have been continuously updated. Through discussions at academic conferences, including updates of the 2023 European Society of Cardiology (ESC) Guidelines for the treatment of chronic heart failure and the 2024 Kidney Disease Improving Global Outcome (KDIGO) Guidelines for treating chronic kidney disease, we have observed that Jardiance's influence is expanding."


Currently, within the business unit, each PM is responsible for different indications for Jardiance. But overall, the company sets a strategy under the concept of CRM.

Overall, rather than differentiating by indication, the company focuses on positioning Jardiance as a chief drug within a CRM total management strategy.

PM Cho said, "While PMs play a representative role for the product, since Jardiance is company's chief, various departments collaborate to set the direction," adding, "Ultimately, the approach has been organized to effectively deliver CRM benefits with a patient-centric focus, as patients are our ultimate customers."

Furthermore, PM Lee emphasized, "From the PM’s perspective, the most important task is how to clearly communicate the advantages of Jardiance and differentiate it in the market," and added, "We are approaching this from a 'one-team' perspective to provide comprehensive treatment options rather than differentiating by indication."

Jardiance faces introduction of generic drugs…"Will maintain our original drug position"

Although Jardiance has been steadily increasing its influence, there are other concerns related to the emergence of generics following the patent expirations of other SGLT‑2 inhibitors. The Jardiance patent is also expected to expire in October.

Regarding this, the company anticipates that, ahead of celebrating the 10th anniversary of Jardiance's domestic launch next year, the primary goal in the diabetes area will be to solidify its position as an original drug.

PM Cho stated, "The benefits of CRM total management have reached a relatively mature stage. Jardiance has a differentiating factor and an opportunity since it is the only original SGLT‑2 inhibitor with all major indications in the Korean market. Emphasizing these strengths is the core strategy for this year."

"Although there are concerns regarding Jardiance generics, based on past experiences, we can anticipate it to some extent," PM Cho added, "Considering that SGLT‑2 inhibitors have already been widely adopted, we expect that the market entry speed of a generic version of Jardiance will be relatively slow, but we plan to actively communicate with key stakeholders."

In addition, the business unit plans to secure growth momentum by capitalizing on indications such as chronic kidney disease, for which reimbursement has not yet been applied.

PM Lee said, "Because early diagnosis of chronic kidney disease is a major challenge, we plan to focus on activities that raise disease awareness through company-wide campaigns aimed at improving recognition of the condition," and added, "Given the ongoing optimism from the nephrology community regarding expanded reimbursement for chronic kidney disease, we are also working internally to ensure that SGLT2 inhibitors become reimbursed."

Despite the challenge posed by the emergence of generics, both PMs believe that the original drug, Jardiance, maintains a significant presence in the face of increasing market competition.

The PMs view Jardiance as still having substantial value as an 'all-around player' capable of realizing the concept of CMR.

The company plans to solidify its market-leading position and establish the momentum of a new decade ahead of the 10th anniversary of its domestic launch.

PM Cho said, "Our first objective this year is to accelerate the expansion of reimbursement for chronic kidney disease to enable more proactive engagement with healthcare providers," and added, "We aim to establish and communicate the history of the past decade through the clinical data and real-world prescribing experience accumulated with our original SGLT2 inhibitor."

PM Lee further remarked, "In addition to its role as a treatment for effective glycemic control, Jardiance became a key drug for type 2 diabetes addressing cardiac and renal complications," and added, "We will continue to work to reinforce Jardiance's role as a long-term treatment option in the domestic market."