GLP-1: Lilly, Novo, Pfizer focus on new weight loss drug

Just months after introducing GLP-1 pills, drug companies are responding to major changes in how patients pay for weight loss drugs.

Still, they have already outlined their vision for the future of obesity drugs.

At the American Diabetes Association’s scientific session in New Orleans last week, drug companies pitched ideas to doctors and investors, including new injectable drugs and pills, drugs that need to be taken less often, and new treatments beyond GLP-1 with fewer side effects. Participants discussed where all these new treatments fit in, especially since Eli Lilly currently dominates the injectable drug market and impressed attendees with data for its experimental triple-acting drug letaltortide, which has led to unprecedented weight loss.

Lily and rival novo nordisk The companies displayed new GLP-1 tablets introduced earlier this year. Both companies claim that oral options are bringing more people into the weight-loss drug market, with Novo touting that prescriptions for its Wigovy tablets have reached more than 3 million people in just five months since its launch.

Behind the two market leaders, there is a wave of new entrants looking to tap into this huge market in the coming years.

structural therapy and AstraZeneca Each shared mid-term data from their respective GLP-1 tablets. If these oral drugs are successful in Phase 3 trials, they will likely be on the market around 2029, three years later than Lilly, which introduced the small molecule tablet Foundayo earlier this year (Wegovy tablets are oral peptides).

Structure Therapeutics CEO Ray Stevens thinks there’s still plenty of room in the market by then.

“At the end of the day, who wins in this race? The patient. That’s really what it’s all about,” Stevens said, adding that becoming the second small molecule drug will be important. “We are working hard to get second place behind Olforgripron (now Foundayo).”

pfizer also announced interim data from the shots it acquired through its $10 billion acquisition of Metzer. The drug has shown the potential to be administered monthly, which Pfizer believes would be more convenient than the current weekly dosing. Another pharmaceutical company amgenis testing other drugs that can be administered monthly or, in some cases, quarterly.

Susan Sweeney, Amgen’s executive vice president of obesity and related diseases, said the company sees an advantage in people not needing weekly injections and considering treatment only four times a year.

“For people who have lived with obesity for many years, not remembering their illness can be a huge advantage,” she says.

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. A certain company is Zealand Pharmapresented mid-stage data for an investigational drug called petrelintide. Roche.

This experimental injection helped people lose about 11% of their body weight. This is a lower dose than currently available injectables Wegovy and Zepbound. But Zealand touted that people who took the drug had less vomiting than those in the placebo group.

“I truly believe that when these amylin[drugs]come out, we’re going to have what I describe as an iPhone moment, because patients are very familiar with the experience we had with GLP-1. And if you launch a new treatment that provides a better experience, people will line up to get that new weight loss drug rather than continue taking a more cumbersome drug,” said Adam Steensberg, CEO of Zealand.

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

At this year’s ADA, Lilly also announced Phase 3 results for its triple agonist letaltortide. The drug activates GLP-1, GIP, and glucagon receptors, resulting in dramatic weight loss.

At the highest dose, people taking letaltortide and continuing to take it as prescribed in the study lost an average of 28% of their body weight. Lilly CEO Dave Ricks sees the drug as a way to help people with a BMI over 40, the highest end of the obesity spectrum, achieve a healthy weight, which is not possible for people who have an average response to Zepbound, which Lilly currently injects.

“We showed what’s possible, and that’s significant. Almost half of the people lose more than 30 percent of their body weight,” Ricks said. “So if you start at a higher level, you can really get to a healthier state. I think that’s everyone’s goal.”

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

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

Lilly and Novo have lowered the prices of their weight-loss drugs over the past year to compete with each other and with compounding pharmacies that sell cheaper knockoffs of their drugs. Both Lilly and Novo are also seeking to improve health insurance coverage of GLP-1 drugs for weight loss.

Within weeks, millions of seniors on Medicare will be able to access medications for a $50 monthly co-pay.

Mike Douster, CEO of Novo Nordisk, believes that in the next few years, obesity will become like mental health, where people used to classify it as a disease.

“Today, it’s depression, bipolar disorder, schizophrenia, so many different problems that require very different medications and support for the patient. We look at obesity that way,” he said.

With so many drugs in development, the future of obesity treatment and who uses which treatments may vary widely. At least that’s what drug companies hope as they seek to capture a larger share of the market.