On Thursday, Lilly announced it would cut 8% of its workforce, or about 3500 positions worldwide. A report in Reuters did not cite pressure on insulin prices per se, but instead cited delays in development of a drug for rheumatoid arthritis and the failure of a trial for a highly anticipated Alzheimer's drug. In its second quarter report August 1, 2017, Sanofi announced that diabetes and cardiovascular sales were down 15% and diabetes franchise sales were down 12.2%. The diabetes sales and marketing unit took a 20% cut in December 2016. Novo Nordisk also cut about 2% of its workforce in 2016 amid payer pressure, saying it would focus on "innovative" drugs. 5. Here come the biosimilars The arrival of biosimilar or "follow-on" versions of mainstay insulins promise not only price competition but, as Sanofi has already seen, the possibility of seeing a best-seller replaced on formulary.