Lilly, Novo and Pfizer look to new weight loss drugs

Drugmakers have only been months into introducing GLP-1 pills and facing huge changes in the way patients pay for weight-loss drugs.

Despite everything, they are already setting out their vision for the future of obesity drugs.

At the American Diabetes Association’s Scientific Sessions in New Orleans last week, drugmakers pitched to doctors and investors the idea of ​​new vaccines and pills, drugs that can be taken less frequently and new treatments beyond GLP-1 that could cause fewer side effects. Attendees debated where all these new treatments fit in, especially with Eli Lilly currently dominating the injection market and impressing attendees with data from its experimental triple-action drug, retatrutide, which produced the greatest weight loss ever.

Lilly and rival Novo Nordisk introduced the new GLP-1 pills that they each introduced earlier this year. Both companies have argued that oral options are attracting more people to the weight-loss drug market, with Novo saying prescriptions for its Wegovy pill have reached more than 3 million just five months after its launch.

Behind the two market leaders lies a wave of new entrants who hope to enter this massive market in the years to come.

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

Structure Therapeutics CEO Ray Stevens believes there will still be plenty of room in the market between now and then.

“Who ultimately wins with competition? The patients, and that’s really what it’s about,” Stevens said, adding that it would be important to be the second small molecule drug. “We’re really trying hard to get to that second position behind orforglipron, now Foundayo.”

Pfizer Also has revealed data midway through a shot secured through its $10 billion acquisition of Metsera. The drug has shown the potential to be administered monthly, which Pfizer said would be more convenient than current weekly injections. Another drug manufacturer, Amgenis testing a different drug that could be administered monthly or even quarterly.

Susan Sweeney, Amgen’s executive vice president for obesity and related conditions, said the company sees an advantage in the fact that people don’t need to take a weekly injection and are instead thinking about treatment as few as four times a year.

“For someone who has lived with obesity for a long time, it can be a major benefit to not remember their illness,” she said.

Some companies are looking beyond GLP-1 and other hot targets like GIP and glucagon and into emerging areas like amylin, another hormone produced in the pancreas that helps people feel full. A company is Zeeland Pharmawhich presented mid-term data on a drug called petrelintide with which it is being developed. Rock.

The experimental vaccine helped people lose nearly 11% of their body weight, less than currently available shots from Wegovy and Zepbound. But Zealand touted that fewer people taking the drug vomited than those in the placebo group.

“I sincerely believe that when these amylins [drugs] “, said Adam Steensberg, CEO of Zeeland.

As with other potential new entrants, it will be years before the New Zealand drug is available. Market leader Lilly is developing its own amylin analogue called eloralintide, which is already in phase 3 trials.

At this year’s ADA, Lilly also presented Phase 3 results of its triple agonist retatrutide. This medication activates the GLP-1, GIP, and glucagon receptors, producing dramatic weight loss.

At the highest dose, people lost an average of 28% of their body weight when they took retatrutide and continued to take it as prescribed in the trial. Lilly CEO Dave Ricks sees the drug as a way to help people with a body mass index above 40, or the highest obesity classification, achieve a healthy weight, which is not possible if they have an average response to Lilly’s current vaccine, Zepbound.

“We’ve shown what’s possible, which is significant: almost half of people lose more than 30 percent of their weight,” Ricks said. “So if you start at a higher level, you can really get to a healthier state, which is everyone’s goal, I think.”

Investors are now trying to determine whether the market will remain a duopoly between Lilly and Novo or whether potential new entrants will become significant players. The newcomers point out that about 2.5 billion people worldwide are considered overweight and 890 million are considered obese, according to World Health Organization statistics.

“The big question is not volume, it’s really price,” said Asad Haider, an analyst at Goldman Sachs. “Where does it end?”

Lilly and Novo have cut the price of their weight-loss shots over the past year as they compete with each other and compound pharmacies that sell cheaper counterfeit versions of their drugs. Lilly and Novo are also trying to improve health insurance coverage of GLP-1 weight-loss drugs.

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

Mike Doustdar, CEO of Novo Nordisk, believes that in the coming years obesity will once be like mental health, where people considered it a condition.

“Today there is depression, bipolar, schizophrenia, and many, many different problems, with very distinct and different medications, and patient support. We look at obesity that way,” he said.

With so many drugs in the pipeline, the future of obesity treatment and the question of who uses what treatment could be very different. At least that’s what drugmakers are hoping for as they try to capture a larger share of the market.