Lilly, Novo and Pfizer look to new weight-loss drugs

It only took a few months for drugmakers to introduce the GLP-1 pill and make huge changes in how patients pay for weight-loss drugs.

However, they are already outlining their vision for the future of obesity drugs.

At the American Diabetes Association’s scientific sessions in New Orleans last week, drugmakers, doctors and investors floated the idea of ​​new doses and pills, drugs that can be taken less frequently, and new treatments that go beyond GLP-1s and that could come with fewer side effects. Attendees discussed where all of these new treatments might fit in, especially with Eli Lilly currently dominating the dosage market and wowing attendees with data from its experimental triple-acting drug retaretide that produced the greatest amount of weight loss to date.

Nocturnal and competitive Novo Nordisk The new GLP-1 tablets introduced by each of them were introduced earlier this year. Both companies have made it clear that oral options are bringing more people into the weight-loss drug market, with Novo noting that prescriptions for its Wegovy pill reached more than 3 million just five months after its launch.

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

Structural treatments and AstraZeneca They each shared mid-stage data from their GLP-1 pills. If these oral drugs pass Phase 3 trials, they will likely come to market around 2029, three years after Lilly, which introduced its small-molecule pill Fundaio earlier this year (the Wijovi pill is an oral peptide).

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

“Who ultimately wins the competition? Patients, that’s what it’s really about,” Stevens said, adding that being the second small molecule drug would be important. “We are doing our best to get into second place behind orforglipron, and now Foundayo.”

Pfizer also It unveiled mid-stage data from the snapshot it acquired through its $10 billion acquisition of Metsera. The drug has shown it can be administered monthly, which Pfizer believes would be more convenient than current weekly dosing. Another drug maker, Amgenis testing a different medication that could be given monthly or perhaps even every three months.

Susan Sweeney, executive vice president of obesity and related conditions at Amgen, said the company sees an advantage in people not needing to get a weekly shot and instead considering treatment four times a year.

“For someone who has been obese for a long time, not remembering their illness can be a huge advantage,” she said.

Some companies are looking beyond GLP-1 and other hot targets like GIP and glucagon to emerging areas like amylin, another hormone produced in the pancreas that helps people feel full. One company is New Zealand Pharmawhich provided mid-stage data for a drug called pitrilintide that is being developed with it Rosh.

The experimental dose helped people lose approximately 11% of their body weight, less than currently available Wegovy and Zepbound injections. But Zealand noted that fewer people who took the drug vomited than those who took the placebo.

“I really believe that when these amylins [drugs] “We can have this, what I described as an iPhone moment, because patients are very aware of the experience they’ve had with GLP-1s, and once you launch a new modality that gives you a better experience, people will line up to access this new weight-loss drug rather than staying on the more complex drugs,” New Zealand CEO Adam Steensberg said.

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

At this year’s ADA conference, Lilly also presented phase 3 results of the triple agonist retatrutide. This medication activates GLP-1, GIP, and glucagon receptors, resulting in significant weight loss.

At the highest dose, people lost an average of 28% of body weight when they took retaretide and continued taking it as prescribed in the trial. Lilly CEO Dave Ricks sees the drug as a way to help people with a BMI over 40, or the highest classification of obesity, achieve a healthy weight, which isn’t possible if they have an average response to Lilly’s current Zepbound dose.

“We’ve shown what’s possible, and it’s meaningful: nearly half of people lose more than 30% of their body weight,” Rex 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 figure out whether the market will remain a duopoly between Lilly and Novo or whether potential new entrants will become significant players. The new arrivals indicate that about 2.5 billion people in the world are considered overweight, and 890 million are obese, according to World Health Organization statistics.

“The big question is not volume, but pricing,” Goldman Sachs analyst Asad Haider said. “Where does this end?”

Lilly and Novo have been reducing the price of their weight-loss shots over the past year, competing against each other and cornering pharmacies that sell less expensive knockoffs of their drugs. Both Lilly and Novo are also trying to improve health insurance coverage of GLP-1 weight loss drugs.

Within a few weeks, millions of seniors receiving Medicare will be able to obtain medications for $50 a month out of pocket.

Mike Doostdar, CEO of Novo Nordisk, believes so in the coming years Obesity will look like mental health once looked, with people describing it as a single condition.

“Today, there’s depression, bipolar disorder, schizophrenia, many different issues with very different and distinct medications and supports for patients. We look at obesity that way,” he said.

With so many drugs in the pipeline, the future of obesity treatment, and who uses which treatment, may look very different. At least that’s what drug makers hope to gain a bigger share of the market.