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The Future of Obesity Medications


Investors are excited about the new class of obesity medications, shifting their focus from injectables to pills that might follow in the next few years. Eli Lilly and Novo Nordisk lead the field, with Pfizer and Structure Therapeutics also looking to play a role.

While the injectable Mounjaro has already made Eli Lilly the most valuable pharmaceutical company in the world, oral successors to Mounjaro and its peers could have the biggest long-term impact. Pills might offer much of the efficacy of the new injectables with none of the unpleasant needles and at a lower price.

The weight-loss-pill field has become clearer as companies have presented fresh data at a major medical conference. Long-term obesity data on GLP-1s, the new class of drugs, is lacking. However, patients will likely need to be on them long term to maintain their benefit. Daily injections are unpleasant and costly, leading insurers to prefer cheaper options.

Oral maintenance could open up the obesity market, mute payor pricing concerns, and may not dilute margins. Cheaper and easier to take, pills could greatly expand the potential market for obesity medications. They could also be easier to make than injectables, easing supply crunches.

Novo’s High-Dose Semaglutide: The New Hope for Obesity Treatment?

Novo, a leading pharmaceutical company, has been at the forefront of developing GLP-1s and has a new drug in the works that may revolutionize obesity treatment. The high-dose semaglutide pill, an adapted oral formulation of semaglutide used in Novo’s injectables Ozempic and Wegovy, has shown promising results in clinical trials as a weight-loss treatment.

In a recent study, patients on the high-dose pill achieved weight loss of 15.1% after 68 weeks, compared with 2.4% with placebo. This success has fueled hopes that the once-daily high-dose weight-loss pill could receive FDA approval as early as 2024.

However, the drug’s launch may be delayed due to “portfolio prioritizations and manufacturing capacity.” Novo has reported difficulty meeting demand for Wegovy, which uses the same ingredients as the high-dose weight-loss pill, and launching the new drug may divert limited resources from the production of Wegovy.

Despite these challenges, investors are closely watching Novo’s progress. If the high-dose semaglutide pill receives FDA approval, Novo could capture a significant share of the market for obesity treatment, cementing its position as a leading pharmaceutical company in GLP-1 development.

Advances in the GLP-1 Space: Weight-Loss Pills on the Horizon

As the battle for the next big thing in the GLP-1 space heats up, major players such as Lilly and Pfizer are making strides in the development of weight-loss pills. Lilly’s contender, Orforglipron, has recently made headlines with promising results in a Phase 2 trial. Obese or overweight patients taking the highest dose lost a staggering 14.7% of their weight after 36 weeks compared to just 2% for the placebo group. According to Goldman Sachs analyst Chris Shibutani, this is similar to the success of Novo’s Semaglutide within the same timeframe.

Orforglipron holds several potential advantages over its competitors, such as Novo’s high-dose Semaglutide. For one, it is taken once daily as a pill and can be consumed with food. The efficacy of the drug still faces further testing in ongoing Phase 3 trials, with the longest study projected to conclude in mid-2025. If approved by the FDA, the earliest potential release date for Orforglipron may be as late as 2026.

Meanwhile, Pfizer has selected its candidate for the obesity and diabetes market: Danuglipron, a twice-daily pill. Though there was some concern over the requirement for two doses per day compared to Lilly’s once-daily pill, Danuglipron has made considerable headway with its selection over another early-stage obesity pill that Pfizer subsequently discontinued due to potential safety issues.

With continued development and testing, weight-loss pills within the GLP-1 space hold vast potential to address an issue that affects millions of people worldwide. The ongoing competition between Lilly and Pfizer and other pharmaceutical companies ensures promising results for this life-changing breakthrough remain on the horizon. Pfizer’s recent announcement that it was dropping its experimental GLP-1 diabetes drug, danuglipron, sent shockwaves through the pharmaceutical industry. Citi Research analyst Daniel Baum predicts that the drug will fail to capture a significant market share. However, Goldman’s Shibutani has been less pessimistic, stating that the selloff was overdone and that Pfizer is investing heavily in the development of a once-daily version of danuglipron. Despite the implications of the discontinuation of Pfizer’s lotiglipron program, Shibutani notes that safety concerns have not arisen in danuglipron trials so far. Phase 3 trials of the drug are expected to commence in 2024, with a potential launch date in 2027.

Elsewhere, Structure’s GSBR-1290, another oral GLP-1 in early-stage trials, looks set for a Phase 2b trial next year. If successful, it could launch as early as 2029. Shares in Structure rose by 18.4% on Monday following Pfizer’s news, but fell by 6.5% the following day.

Terns Pharmaceuticals is developing an oral GLP-1 called T-601, and shares have plummeted by 31% since Pfizer’s announcement. While some of this selloff might be attributed to another Tern program targeting NASH, concerns about potential liver issues have been raised due to T-601’s structural similarity to danuglipron. Nonetheless, Mizuho analyst Graig Suvannavejh has dismissed concerns and has predicted the drug’s launch timeline to be unclear.

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