The obesity drug market is undergoing a profound transformation as Novo Nordisk and Eli Lilly, two pharmaceutical giants, are becoming dominant players in this hugely profitable arena.
With approximately 70 candidate treatments from a host of challengers and an array of groundbreaking innovations in the pipeline, it is evident that the battle for supremacy has just begun. Experts hail this era as the dawn of a revolution in the fight against obesity, with the introduction of novel drugs that promise unprecedented weight loss results.
Leading the charge is Wegovy, a groundbreaking medication developed by the Danish pharmaceutical powerhouse, Novo Nordisk. Wegovy received regulatory approval in 2021 and has demonstrated the potential to facilitate weight loss of up to 15%, setting the stage for a groundbreaking transformation in the obesity treatment landscape.
Eli Lilly is also poised for a significant impact with Mounjaro, a drug initially developed for diabetes. Dubbed the 'King Kong' of obesity medications, Mounjaro has exhibited impressive weight loss results of up to 22% in clinical studies, and it is expected to secure approval for obesity treatment in the United States this year.
Jan De Kerpel, Director of Life Sciences and Healthcare at the investment bank Van Lanschot Kempen, told De Tijd: "After the success of Covid-19 vaccines, obesity drugs are the next big thing in the pharmaceutical industry." In addition to cancer medication, the focus has shifted towards therapies that can address two massive societal challenges: Alzheimer's disease and obesity.
'Led to cardiovascular issues'
This new wave of obesity medications marks a turning point in a field that has been plagued by failures, malfunctioning treatments, and even harmful interventions for decades. Early attempts at tackling obesity with drugs focused on mechanisms that accelerated metabolism and targeted the brain directly. However, these approaches led to a plethora of health risks, including cardiovascular problems and severe side effects like mania and depression.
Bart Van der Schueren, President of the Belgian Association for the Study of Obesity, highlights the misguided emphasis on intervening in the brain and metabolism. "For a long time, it was assumed that obesity was a disease of the brain or adipose tissue,” he told De Tijd. “They tried to tackle obesity with medication that speeds up metabolism to burn fat. But that led to cardiovascular problems."
Recognising the complex hormonal signals that regulate hunger and satiety, experts like Chantal Mathieu, a professor of endocrinology at KU Leuven, argue that the traditional approach was flawed. Obesity is not merely a lack of willpower; it is a result of disrupted hormonal signals that control our eating behaviour. This understanding has led to the development of drugs that mimic natural intestinal hormones, signalling the brain and stomach to stop eating.
Wegovy, for example, replicates the action of the GLP-1 hormone produced in the small intestine, resulting in the pancreas producing insulin. This medication, and others like it, mimic hormones that provide a feeling of satiety to the brain, offering a safer approach to obesity treatment.
The commercial success of these new drugs is evident, with Wegovy's revenue surging by 367% to €1.6 billion in the first half of the year. Eli Lilly reported impressive results as well, with Mounjaro generating more than $1.5 billion in revenue during the same period. The potential market is vast, with approximately one billion obese individuals globally, and that number is projected to increase. This has sparked a frenzy of interest among pharmaceutical companies, both large and small.
Caution advised on safety
The race for dominance in the obesity drug market has led to the development of around 70 candidate treatments. Some aim to imitate various intestinal hormones beyond GLP-1, with the goal of providing a more comprehensive approach to weight loss.
As promising as these developments are, experts remain cautious and call for a thorough assessment of safety and potential side effects as new medications emerge. While a weight loss of 20% or more can have a positive impact on type 2 diabetes, cholesterol, and blood pressure, it is imperative to ensure that these drugs are both effective and safe.
With Novo Nordisk and Eli Lilly currently leading the obesity drug market, there is a growing concern about a potential duopoly and high prices. To address this, experts emphasise the importance of new entrants and healthy competition to meet the diverse needs of patients.
However, Novo Nordisk and Eli Lilly are actively acquiring promising newcomers to maintain their competitive edge. Their investments in innovative startups and biotech companies underscore their commitment to reshaping the future of obesity treatment. As the obesity medication market surges, it appears that Novo Nordisk and Eli Lilly are poised to claim the lion's share, positioning themselves as industry leaders in the fight against obesity.
