North America Diabetes Drugs Market Analysis by Mordor Intelligence
The North America diabetes drugs market stood at USD 42.08 billion in 2025 and is forecast to reach USD 54.94 billion by 2030, translating to a 5.48% CAGR during the period. A growing convergence of diabetes and obesity treatment, coupled with rapid uptake of next-generation GLP-1 receptor agonists, is providing much of the forward momentum. U.S. prescription drug spending climbed 10.2% in 2024, and GLP-1s already rank as the largest and fastest-growing therapeutic spend category.[1]American Society of Health-System Pharmacists, “U.S. Drug Spending Up 10.2% in 2024, With Weight Loss Drugs Remaining Top Driver,” ashp.orgOral anti-diabetics continue to control the majority of therapy volumes even as injectable innovation accelerates, and biosimilar insulin introductions are compressing prices in key segments. Tight Medicare negotiations, state price-cap statutes, and payer prior-authorization rules are reshaping formulary choices, yet therapeutic innovations keep total spending on an upward trajectory. Mexico’s emergence as a manufacturing hub and the expansion of online pharmacies are also altering competitive economics and patient access across the region.
Key Report Takeaways
- By drug class, oral anti-diabetics led with 68.23% revenue share in 2024; non-insulin injectables are projected to deliver the highest 7.52% CAGR to 2030.
- By diabetes type, Type 2 therapies represented 88.46% of treatment volumes in 2024, while Type 1 drugs are expected to advance at a faster 6.32% CAGR through 2030.
- By drug origin, branded products controlled 79.35% of the North America diabetes drugs market share in 2024, yet generics and biosimilars are on track for a 9.01% CAGR.
- By distribution channel, retail pharmacies held 51.23% of revenues in 2024; online pharmacies are growing the quickest at an 8.78% CAGR.
- By geography, the United States accounted for 89.45% of the North America diabetes drugs market size in 2024, whereas Mexico is set to expand at a 6.39% CAGR to 2030.
North America Diabetes Drugs Market Trends and Insights
Drivers Impact Analysis
Driver | (~) % Impact on CAGR Forecast | Geographic Relevance | Impact Timeline |
---|---|---|---|
Increasing adoption of GLP-1 agonists in obese T2DM | +1.2% | United States & Canada, spillover to Mexico | Medium term (2-4 years) |
Reimbursement expansion for dual & triple incretins | +0.8% | United States primarily, Canada selective coverage | Short term (≤ 2 years) |
Biosimilar insulin price wars accelerate uptake | +0.6% | North America-wide, strongest in US | Long term (≥ 4 years) |
CGM-linked dosing algorithms spur drug adherence | +0.4% | United States & Canada, limited Mexico penetration | Medium term (2-4 years) |
Employer obesity-diabetes bundled contracts | +0.3% | United States corporate markets | Short term (≤ 2 years) |
US–Mexico near-shoring of pen-fill finish lines | +0.2% | US-Mexico border regions | Long term (≥ 4 years) |
Source: Mordor Intelligence
Increasing adoption of GLP-1 agonists in obese T2DM
GLP-1 receptor agonists unify obesity and diabetes management, a nexus relevant to more than 88% of people with Type 2 diabetes. Tirzepatide reached roughly 12% prescription share of glucose-lowering drugs by end-2023, and its popularity among non-diabetic weight-management users underscores the therapeutic blur between metabolic indications.[2]Jaime Almandoz MD et al., “Discussing Tirzepatide’s Rise in Diabetes, Obesity Care,” ajmc.com Dual GLP-1/GIP activity delivers greater body-weight and HbA1c reductions than single-target drugs, while emerging triple-agonists such as retatrutide have posted 24% weight loss at 48 weeks, setting new clinical benchmarks. Fast-tracked FDA approvals for wider cardiometabolic indications are expanding reimbursement horizons and encouraging prescribers to adopt these therapies earlier in care pathways.
Reimbursement expansion for dual & triple incretins
Payers are recalibrating formularies to recognize the cardiovascular and renal benefits of dual and triple incretins. Medicare’s price negotiations apply greater pressure on legacy oral agents, while newer GLP-1s gain Tier-preferred coverage, thus lowering out-of-pocket costs for seniors.[3]Medicare Rights Center, “Administration Provides More Data on First 10 Drugs Subject to Price Negotiation,” medicarerights.orgCommercial insurers now classify obesity as a medical condition, unlocking pharmacotherapy budgets previously reserved for diabetes. Employer health plans are bundling obesity and diabetes care contracts tied to outcome metrics, reinforcing utilization growth.
Biosimilar insulin price wars accelerate uptake
Since the USD 35 insulin copay cap took effect, biosimilar manufacturers have accelerated market entries and discounting strategies, spurring wider patient adoption and forcing innovators to adjust list prices. Teva’s capacity expansions under federal purchasing agreements illustrate the corporate commitment to compete on volume. Intensifying price competition is broadening insulin access and enlarging overall therapy volumes.
CGM-linked dosing algorithms spur drug adherence
Integrating semaglutide with real-time continuous glucose monitoring (CGM) has produced an additional 0.55 percentage-point HbA1c reduction versus drug therapy alone. Newer CGM algorithms, though occasionally understating hypoglycemia risk, improve titration accuracy and bolster adherence. Over-the-counter CGM devices now receiving FDA clearance promise to widen technology adoption and reinforce medication persistence.
Restraints Impact Analysis
Restraint | (~) % Impact on CAGR Forecast | Geographic Relevance | Impact Timeline |
---|---|---|---|
Payer prior-authorization throttles GLP-1 volumes | −0.9% | United States primarily, limited Canada impact | Short term (≤ 2 years) |
API tariff risk from China supply concentration | −0.5% | North America-wide | Medium term (2-4 years) |
Litigation over pancreatitis & thyroid C-cell tumors | −0.3% | United States jurisdiction | Long term (≥ 4 years) |
Rising state drug price-cap legislation | −0.4% | United States state-level variations | Medium term (2-4 years) |
Source: Mordor Intelligence
Payer prior-authorization throttles GLP-1 volumes
US payers continue to impose multi-step therapy rules that delay or deny GLP-1 initiation despite favorable clinical profiles, leading to patient drop-out and slower overall market penetration. Medicare Advantage plans remain especially cautious in approving weight-management uses, preserving utilization caps that curb early growth.
API tariff risk from China supply concentration
Roughly two-thirds of global active pharmaceutical ingredient output for diabetes therapies still originates in China. Any re-imposition of punitive tariffs could elevate input costs and disrupt downstream supply, pressuring North America diabetes drugs market margins until alternative sourcing scales.
Segment Analysis
By Drug Class: Oral dominance defies injectable innovation
Oral agents secured 68.23% of the North America diabetes drugs market in 2024 and are projected to expand at 7.52% CAGR through 2030, sustaining leadership despite injectable breakthroughs. SGLT-2 inhibitors such as canagliflozin continue to gain based on cardio-renal outcome data and Health Canada labeling updates.[4]Health Canada, “Summary Basis of Decision for Invokana,” hpfb-dgpsa.c
Non-insulin injectables are climbing rapidly on the back of GLP-1, dual GIP/GLP-1, and emerging triple-agonist classes. Triple-mechanism drugs are positioned as premium therapies offering weight, cardiovascular, and renal benefits, thereby lifting value per prescription within the North America diabetes drugs market. Alpha-glucosidase inhibitors retain a niche among geriatric cohorts, and combination pills that merge multiple mechanisms aim to simplify dosing and boost adherence.
Note: Segment shares of all individual segments available upon report purchase
By Diabetes Type: Type 1 innovation accelerates growth
Therapies for Type 2 diabetes continue to dominate revenue, yet Type 1 options are showing the strongest incremental gains. Integration of weekly semaglutide with automated insulin delivery lifted time-in-range metrics from 69.4% to 74.2%, a meaningful clinical advance. The resulting enthusiasm is expanding the North America diabetes drugs market size for Type 1 adjuncts. Gene-therapy programs aimed at beta-cell regeneration are still pre-commercial but underscore the pipeline depth.
Note: Segment shares of all individual segments available upon report purchase
By Drug Origin: Biosimilar momentum challenges brand dominance
Branded medications still account for 79.35% of the North America diabetes drugs market share, but the trajectory favors biosimilars. The USD 35 insulin copay cap erodes traditional branding advantages, allowing follow-on manufacturers to compete primarily on availability and service. Federal contract wins and streamlined FDA interchangeability guidelines should accelerate penetration of biosimilar insulin glargine, lispro, and aspart across retail and specialty channels.
By Distribution Channel: Digital transformation accelerates
Retail pharmacies retained 51.23% share in 2024, yet online channels are scaling at 8.78% CAGR as patients gravitate to subscription refills and home delivery. PBM-owned mail facilities direct a disproportionate volume of high-cost GLP-1 scripts, partially offset by “any willing pharmacy” rules that broaden independent pharmacy participation. The rise of telehealth-linked e-pharmacies is expected to reinforce competition on convenience and copay assistance rather than on sheer geographic presence.

Note: Segment shares of all individual segments available upon report purchase
Geography Analysis
The United States generated 89.45% of North America diabetes drugs market revenues in 2024, driven by high per-capita healthcare spend and broad insurance coverage. Federal drug-price negotiations could deliver USD 98.5 billion in savings over a decade, with legacy diabetes brands among the first 10 products slated for price ceilings. State price-cap laws introduce patchwork compliance burdens but may spur regional competitive discounts.
Canada’s market is steered by provincial formularies and rigorous health-technology assessments. While dual-agonist GLP-1s are receiving incremental coverage, uptake varies by province, leaving room for branded manufacturers to demonstrate cost-effectiveness through outcomes evidence. Generic adoption remains comparatively high in Ontario and Québec, reinforcing pressure on innovators.
Mexico is the fastest-growing territory, clocking a forecast 6.39% CAGR through 2030. Expansion of COFEPRIS fast-track approvals and US–Mexico near-shoring of injectable-pen assembly lines are fortifying supply chains, lowering prices, and enhancing local availability. As manufacturing employment grows near border clusters, domestic insurance penetration is widening, further enlarging the addressable population for modern antidiabetic therapies.
Competitive Landscape
North America’s diabetes arena is moderately concentrated, characterized by a handful of multinational incumbents with broad GLP-1, SGLT-2, and insulin portfolios. Innovators are hedging against biosimilar erosion by pursuing multi-indication data in obesity, heart failure, and chronic kidney disease—strategies that extend exclusivity periods and bolster brand equity. Lilly, Novo Nordisk, and AstraZeneca have each announced eight-figure investments to scale triple-agonist production lines and companion digital-health platforms.
Biosimilar entrants such as Viatris and Teva are leveraging aggressive contracting and expanded fill-finish capacity to challenge share in basal and rapid-acting insulin segments. Simultaneously, digital-first pharmacies like Hims & Hers and Ro are partnering with manufacturers to distribute GLP-1 starter kits bundled with remote monitoring, expanding their footprint in the North America diabetes drugs market.
Strategic licensing between device companies and pharma—exemplified by continuous glucose monitoring data integrations—signals a tightening link between therapeutics and digital diagnostics. Over the medium term, companies capable of offering therapy-device bundles tied to measurable outcomes are positioned to capture premium reimbursement tiers.
North America Diabetes Drugs Industry Leaders
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Novo Nordisk
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Sanofi
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Eli Lilly
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Merck
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AstraZeneca plc
- *Disclaimer: Major Players sorted in no particular order

Recent Industry Developments
- February 2025: U.S. FDA cleared Merilog (insulin-aspart-szjj) as a biosimilar to Novolog for pediatric and adult diabetes therapy.
- December 2024: U.S. FDA approved the first generic referencing Victoza (liraglutide injection) 18 mg/3 mL.
- June 2024: AstraZeneca’s Farxiga gained FDA approval for glycemic control in pediatric T2DM patients aged 10 years and older.
- February 2024: Canada introduced Bill C-64 toward universal, single-payer coverage of selected diabetes medicines.
North America Diabetes Drugs Market Report Scope
Diabetes Drugs are used to treat diabetes mellitus by lowering the glucose level in the blood. The North America Diabetes Drugs Market is segmented into drugs (insulin drugs (basal or long-acting insulins, bolus or fast-acting insulins, traditional human insulins, and biosimilar insulins), oral anti-diabetic drugs (Biguanides, Alpha-Glucosidase inhibitors, Dopamine D2 receptor agonist, SGLT-2 inhibitors, DPP-4 inhibitors, Sulfonylureas, and Meglitinides), non-insulin injectable drugs (GLP-1 receptor agonists and Amylin Analogue), and combination drugs (insulin combinations and oral combinations)) and geography (United States, Canada, and Rest of North America). The report offers the value (in USD) and volume (in units) for the above segments.
By Drug Class | Insulins | Basal / Long-acting | |
Bolus / Fast-acting | |||
Traditional Human Insulin | |||
Biosimilar Insulin | |||
Non-Insulin Injectables | GLP-1 Receptor Agonists | ||
Dual / Triple Agonists (e.g., Tirzepatide, Retatrutide) | |||
Amylin Analogues | |||
Oral Anti-Diabetics | Biguanides | ||
SGLT-2 Inhibitors | |||
DPP-4 Inhibitors | |||
Alpha-Glucosidase Inhibitors | |||
Sulfonylureas | |||
Meglitinides | |||
Thiazolidinediones | |||
Combination Drugs | |||
By Diabetes Type | Type 1 Diabetes | ||
Type 2 Diabetes | |||
By Drug Origin | Branded | ||
Generic / Biosimilar | |||
By Distribution Channel | Hospital Pharmacies | ||
Retail Pharmacies | |||
Online Pharmacies | |||
By Geography | United States | ||
Canada | |||
Mexico |
Insulins | Basal / Long-acting |
Bolus / Fast-acting | |
Traditional Human Insulin | |
Biosimilar Insulin | |
Non-Insulin Injectables | GLP-1 Receptor Agonists |
Dual / Triple Agonists (e.g., Tirzepatide, Retatrutide) | |
Amylin Analogues | |
Oral Anti-Diabetics | Biguanides |
SGLT-2 Inhibitors | |
DPP-4 Inhibitors | |
Alpha-Glucosidase Inhibitors | |
Sulfonylureas | |
Meglitinides | |
Thiazolidinediones | |
Combination Drugs |
Type 1 Diabetes |
Type 2 Diabetes |
Branded |
Generic / Biosimilar |
Hospital Pharmacies |
Retail Pharmacies |
Online Pharmacies |
United States |
Canada |
Mexico |
Key Questions Answered in the Report
How big is the North America Diabetes Drugs Market?
The North America Diabetes Drugs Market size is expected to reach USD 37.10 billion in 2025 and grow at a CAGR of 3.58% to reach USD 44.24 billion by 2030.
1. What is the current size of the North America diabetes drugs market?
The market generated USD 42.08 billion in 2025 and is projected to climb to USD 54.94 billion by 2030 at a 5.48% CAGR.
2. Which drug class leads the market today?
Oral anti-diabetics hold 68.23% of sales, supported by familiar dosing and lower costs despite rapid growth in GLP-1 injectables
3. How fast are biosimilars growing in the region?
Generics and biosimilars are forecast to post a 9.01% CAGR through 2030 as patent expirations and Medicare price caps shift demand.
4. Why are GLP-1 receptor agonists gaining so much traction?
They deliver simultaneous glycemic, weight-loss, cardiovascular, and renal benefits, broadening eligible patient pools beyond traditional diabetes management.
5. Which country shows the fastest demand growth?
Mexico is on pace for a 6.39% CAGR, buoyed by new manufacturing plants, streamlined COFEPRIS reviews, and improving insurance coverage.
6. How will Medicare price negotiations affect market dynamics?
Price ceilings on older brands should free payer budgets for newer dual and triple incretins, accelerating transition to advanced therapies while trimming overall system costs.