Lilly, Novo, Pfizer look to new weight loss drugs

Drugmakers are just months away from launching GLP-1 pills and making major changes to the way patients pay for weight-loss drugs.

Even so, they have already begun to outline their vision for the future of obesity drugs.

At the American Diabetes Association’s Scientific Sessions in New Orleans last week, drugmakers gave doctors and investors insight into new vaccines and pills, drugs that can be taken less frequently and new treatments beyond GLP-1s that may have fewer side effects. Participants discussed where all these new treatments might fit; especially since Eli Lilly currently dominates the market for vaccines and impressed participants with data from the experimental triad drug retatrutide, which caused the most weight loss ever seen.

Lilly and rival Novo Nordisk each showcased its new GLP-1 pills that it launched earlier this year. Both companies touted oral options as bringing more people to market for weight-loss drugs, with Novo touting that prescriptions for Wegovy pills rose to over 3 million just five months after launch.

Behind the two market leaders is a wave of new entrants hoping to enter this huge market in the coming years.

Structure Therapeutics And AstraZeneca each shared mid-stage data from their respective GLP-1 pills. If these oral drugs are successful in Phase 3 trials, they will likely hit the market around 2029, three years after Lilly, which launched its small-molecule pill Foundayo earlier this year (the Wegovy pill is an oral peptide).

Ray Stevens, CEO of Structure Therapeutics, thinks there will still be plenty of room in the market by then.

“Who wins at the end of the day in competition? It’s the patients and that’s what it’s all about,” Stevens said, adding that being the second small molecule drug would be important. “We are working really hard to move into the second position behind Orforglipron (now Foundayo).”

Pfizer Moreover He announced the mid-stage data of the acquisition he achieved by purchasing Metsera for 10 billion dollars. The drug has demonstrated the potential to be given monthly, which Pfizer thinks would be more convenient than the vaccines currently administered weekly. Another drug maker amgenis testing a different drug that could be given monthly or even quarterly.

Susan Sweeney, Amgen’s vice president of obesity and related conditions, said the company sees an advantage in people not having to get weekly injections and instead considering treatment as little as four times a year.

“For someone who has been living with obesity for a long time, not having to remember their illness can be a great advantage,” he said.

Beyond other hot targets like GLP-1 and GIP and glucagon, some companies are looking at emerging areas like amylin, another hormone produced in the pancreas that helps people feel full. a company Zealand Pharmacypresented mid-stage data of the drug called petrelintide, which he co-developed with Roche.

The experimental shot helped people lose almost 11% of their body weight; this is less than the currently available Wegovy and Zepbound injections. However, Zealand suggested that people taking the drug vomited less than those in the placebo group.

“I truly believe that these agents [drugs] launch, we could have what I describe as an iPhone moment, because patients are so aware of their experience with GLP-1s, and when you launch a new method that gives you a better experience, people will line up to get access to this new weight loss drug rather than continuing with the more cumbersome drugs,” Zealand CEO Adam Steensberg said.

Like other potential market entrants, Zealand’s drug will take years to reach the market. Market leader Lilly is developing its own amylin analog called eloralintide, which is currently in Phase 3 trials.

At this year’s ADA, Lilly also presented Phase 3 results of its triple agonist retatrutide. This drug causes dramatic weight loss by activating GLP-1, GIP, and glucagon receptors.

At the highest dose, people lost an average of 28% of their body weight when they took retatrutide and continued using it as recommended in the trial. Lilly CEO Dave Ricks sees the drug as a way to help people with a body mass index over 40 or the highest obesity classification reach a healthy weight; That’s something that wouldn’t be possible if they had an average response to Lilly’s current Zepbound vaccine.

“We showed what is possible and that it makes sense: Nearly half of people lose more than 30% of their body weight,” Ricks said. “So if you start at a higher level, you can actually get to a healthier state, which I think is everybody’s goal.”

Investors are now trying to figure out whether the market will remain duopoly between Lilly and Novo or whether potential new entrants will become major players. Newcomers point out that according to the statistics of the World Health Organization, approximately 2.5 billion people in the world are considered overweight and 890 million people are considered obese.

“The real question is not volume, it’s actually pricing,” Goldman Sachs analyst Asad Haider said. “Where will this end?”

Lilly and Novo cut prices on their weight-loss drugs last year as they competed with each other and consolidated pharmacies that sold cheaper knockoff versions of their drugs. Both Lilly and Novo are also trying to improve health insurance coverage of GLP-1 drugs for weight loss.

In a few weeks, millions of seniors on Medicare will have access to medications for $50 a month.

Novo Nordisk CEO Mike Doustdar thinks about this in the coming years Obesity will become similar to mental health, where people once labeled it as a single condition.

“Today, that means support for many different problems, many different, different medications and patients, from depression to bipolar to schizophrenia. That’s how we look at obesity,” he said.

With so many drugs in the pipeline, the future of obesity treatment and who will use which treatment may look very different. At least that’s the hope of drugmakers trying to capture a larger share of the market.