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Here Are The Companies Working On Competitor Weight Loss Drugs

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The stellar success of blockbuster drugs like Ozempic, Wegovy, Mounjaro and Zepbound has companies eager to break into the lucrative weight loss drug market — here are the hopeful rivals preparing to challenge Eli Lilly and Novo Nordisk for dominance in the obesity drug gold rush.

Key Facts

Biotech Zealand Pharma is preparing to challenge Danish compatriot Novo on multiple fronts, including survodutide—an injectable it is jointly developing with Germany’s Boehringer Ingelheim that mimics the same GLP-1 gut hormone as Wegovy and Zepbound and another hormone called glucagon and has produced strong results in mid-stage clinical trials as both an anti-obesity drug and a treatment for fatty liver disease—and petrelintide, which mimics a different hunger regulating hormone, amylin, that CEO Adam Steensberg said could become “the backbone of therapy for weight management” after it showed promise in early clinical trials this June.

San Diego-based Viking Therapeutics marked itself as a serious competitor in the weight loss drug market in February after revealing promising data from a mid-stage trial of experimental drug VK2735, which suggested it rivaled—and outperformed—Novo and Lilly drugs when given as a weekly injection and in March the company unveiled plans to test an oral tablet version after a small stage trial revealed weight loss as high as 3.3%.

Terns Pharmaceuticals is developing an oral weight loss drug targeting the GLP-1 hormone and expects to release 28-day data on weight loss from an early stage trial in the second half of 2024.

San Francisco startup Structure Therapeutics is also working on an oral, once-daily GLP-1 drug called GSBR-1290—the drug surpassed Wall Street’s expectations in June when a mid-stage study showed average weight loss of around 6% and it plans to start another mid-stage trial towards the end of this year—that founder and CEO Raymond Stevens says has the potential to become “a best-in-class” and makes an “an ideal backbone” for creating combination therapies to treat obesity and other conditions in the future.

Maryland-based Altimmune in March touted promising mid-stage trial results for its injectable weight-loss drug pemvidutide—which is in the same class as Wegovy, Ozempic, Zepbound and Mounjaro—that stood out from the crowd by preserving lean muscle mass while still inducing weight loss, most of which came from fat, and CEO Vipin Garg told Reuters the firm is actively looking for a global partner to help with late state trials and launching the drug.

U.S. pharma giant Pfizer scrapped two experimental weight loss pills last year—a once-daily pill, lotiglipron, due to elevated liver enzymes and a twice-daily pill, danuglipron, due to strong side effects—but CEO Albert Bourla has said the company is determined to “play and win” in the obesity space and in July the company said it is pushing ahead with a once-daily danuglipron pill following “encouraging” data from an ongoing early-stage trial.

California biotech behemoth Amgen ditched plans for an experimental weight loss pill in May but is still hoping for a slice of the market with MariTide, a monthly injection that is taken less frequently than popular weekly treatments from Lilly and Novo and notably appears to help some patients maintain weight loss after they stop taking it, a key issue emerging for patients on current treatments.

What New Drugs Are Eli Lilly And Novo Nordisk Working On After Ozempic And Mounjaro?

While semaglutide and tirzepatide—respectively the generic names for the active drug in Wegovy, Ozempic, Mounjaro, and Zepbound—dominate the weight loss drug market (Mounjaro and Ozempic are only licensed for diabetes), neither Novo Nordisk nor Eli Lilly are resting on their laurels. Both are refining existing medications and developing next generation drugs to shore up their position in the future, as well as ramping up capacity to address persistent shortages amid booming demand. Novo, for example, is developing an oral version of semaglutide intended for once-daily treatment as well as new drugs like the injectable CagriSema, a combination drug that targets GLP-1 and another hormone, amylin, which regulates hunger. It is also developing amycretin in pill and injectable format, which is a single molecule targeting GLP-1 and amylin. Early data on the pill suggests amycretin could outperform Wegovy. Lilly, which secured approval for Zepbound in November, is working on a suite of new drugs including orforglipron and retatrutide, which hope to build on the weight loss in Zepbound and are both in late-stage trials.

Key Background

It is still going to be years before Novo Nordisk and Eli Lilly have serious competition for their popular weight loss treatment on pharmacy shelves. While the process varies, it can take between 10 and 20 years to usher a new drug through all three phases of clinical trials and most drugs ultimately fail during clinical testing. There is no guarantee promising results on efficacy, safety and tolerability from earlier trials will be replicated in larger late-stage trials. Even companies with candidates already in the later stages of testing are still going to require several years to gather and process the data and, should things pan out, time to work with regulators to secure approval. Launching the drug is another matter entirely and shoring up enough supplies has proven difficult even for companies the size of Lilly and Novo, who have continually failed to meet demand. Despite investing billions to ramp up production, both drugs are in short supply and both companies readily admit they are unlikely to meet demand in the near future.

Tangent

Bringing a drug to market is also a costly and logistically complex process, especially during the later stages of development and it is not uncommon for promising candidates, or even entire companies, to change hands. Pharma giants, who are increasingly replacing innovation with mergers and acquisitions, are known to scoop up promising drugs, portfolios or companies. Several have already happened in the weight loss space: Swiss heavyweight Roche inked a $2.7 billion deal for weight loss drug developer Carmot Therapeutics, whose once-weekly injection, CT-388, is in the same class as Lilly’s Mounjaro and Zepbound and British giant AstraZeneca paid up to $2 billion for an experimental pill from Chinese firm Eccogene. Often, smaller companies will also seek partnerships or acquisition deals with larger pharma firms to help with the later stages of development for promising candidates. Altimmune’s Garg said the company is looking for partners for the later stages of development but would be open to considering deals with big pharma firms if they benefited shareholders.

Big Number

$100 billion. That’s how much the weight loss drug market will be worth by 2030, according to some analysts. Some think the market is potentially worth much more—some forecasts have grown to around $150 billion by the early 2030s—and both Novo and Lilly raked in billions from their GLP-1 drugs last year (which are also used to treat diabetes). There are now more than 50 weight loss drugs in various stages of clinical development from about 40 companies, according to Bloomberg Intelligence.

What To Watch For

Analysts told Forbes Lilly and Novo are likely to continue to dominate the market for the foreseeable future. Being first to market has given them a sizable first mover advantage and their sheer size will help consolidate their positions through the deals they make with pharmacies, healthcare providers and insurers. Both are also gathering data on how their anti-obesity drugs affect issues like cardiovascular disease and kidney disease, which could be used to help market the drug, including for other conditions in patients without obesity or diabetes, and secure further buy-in from governments and insurers who may have been unwilling to fund medication for what many still view as a lifestyle problem. Analysts told Forbes such data could be pivotal in securing the two companies’ position in the market and give them a powerful advantage over competitors entering with indications for weight loss alone. Novo secured such an advantage last week when the Food and Drug Administration authorized a label expansion for Wegovy to include cardiovascular benefits. Similarly, Lilly is actively targeting sleep apnea as another condition tirzepatide can help with and if a label expansion is approved, the drug would become the first pharmaceutical treatment for the underlying causes of sleep apnea.

Further Reading

ForbesZepbound Sheds More Weight Than Wegovy, Study FindsForbesPfizer’s Once-Daily Weight Loss Pill Moves ForwardForbesDrugs Like Ozempic, Wegovy, Zepbound And Mounjaro Could Treat Other Conditions-Here’s What Scientists Are Looking At

Here’s Why Ozempic And Mounjaro Rivals Won’t Topple Drugmakers Novo Nordisk And Eli Lilly Anytime Soon (Forbes)

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