"Taking Sugatree is like catching two birds with one stone, as it offers both ease of administration and cost-effectiveness."

Dong-A ST's employees at the Diabetes Division of the Marketing 2 team of the ETC Business Headquarters said so in unison.

Sugatree XR Tablet is a diabetes treatment combination drug launched by Dong-A ST at the start of 2024. It combines three drugs, including evogliptin 5mg, the main ingredient of the company's self-developed DPP-4 inhibitor Suganon, dapagliflozin 10mg, and metformin 1,000mg, which are SGLT-2 inhibitors.

In other words, it puts a DPP-4 inhibitor, the most commonly prescribed oral diabetes medication, an SGL-2 inhibitor, which is also effective in heart failure and kidney disease, and metformin, the standard and starting point of diabetes medication, in one pill.

Sugatree is not the first diabetes triple combination drug. Last year, Daewon Pharmaceutical launched Dapasita-M SR Tablet (dapagliflozin + sitagliptin + metformin) and Chong Kun Dang launched Duvimet S XT Tab (lobeglitazone sulfate + sitagliptin + metformin hydrochloride).

However, Park Jong-guk, head of the Diabetes Division, Marketing 2 Team at Dong-A ST’s ETC Business Headquarters, emphasized the advantages of Sugatree, which differentiates it from competing products.

"First of all, Sugatree has a smaller pill size (compared to competing products), and it is a once-a-day formulation instead of twice-a-day," Park said. "Since most diabetes patients are elderly and take multiple medications, we are confident that Sugatree, with its relatively small pill size and fewer doses, will help them manage their disease better."

Kim Da-hye, a product manager at the same team, stressed that Sugatree is a cost-effective drug.

"Sugatree is a one-pill-a-day medication with high compliance, and it is also the most economical of the three-drug diabetes treatment complexes on the market," Kim said. "The original medications of Sugatree cost about 1,300 won ($1) per day if taken separately, and the (competing) three-drug complexes cost more than 1,000 won per day. However, Sugatree costs 950 won, making it a relatively inexpensive yet effective diabetes management medication."

Sugatree has clear advantages regarding ease of use and cost-effectiveness but also has obstacles to surmount. One example is the limitations of evogliptin, an ingredient of the DPP-4 inhibitor family. DPP-4 inhibitors are a class of drugs that are often prescribed in the first line of treatment for patients who need to take three drugs.

Patients will likely be prescribed a DPP-4 inhibitor plus an SGLT-2 inhibitor. However, this market is dominated by sitagliptin, inagliptin, and gemigliptin, and evogliptin lags behind them. For Sugatree to grow, it will need to get more patients on evogliptin or switch from their existing DPP-4 inhibitor to evogliptin, which will be easier said than done.

Dong-A ST's strategy is to overcome this by securing various clinical evidence.

"We are well aware that evogliptin's growth must support Sugatree's growth," said Lim Tae-koo, another product manager. "We plan to expand our academic activities by taking advantage of the fact that evogliptin is a homegrown new drug. First, we completed evogliptin’s PMS (post-marketing study) at the end of last year. It took more than five years because we conducted the study on a large scale, but we believe we have secured safety data. We plan to actively notify the public and promote various clinical trials related to evogliptin. Once these data are accumulated, we are confident that the Suganon family (Suganon, Sugamet (evogliptin + metformin), and Sugatree) will grow together."

The team said Sugatree’s relatively good start is also a reason to expect future growth of the Suganon family.

"Even though it's been more than a month since Sugatree was launched, it has been or will be registered with dozens of general hospitals," Park said. "This year's sales target for Suganon Family is 50 billion won. As we have a single drug (Suganon), two-drug combination (Sugarmet), and three-drug complex (Sugatree), we will strive to make this the year that Suganon Family becomes the most customized diabetes treatment in Korea."