Tirzepatide

Injected weight loss drugs remain favored over newer oral treatments by a significant margin, with Eli Lilly’s Zepbound leading the pack, according to a survey of healthcare specialists by Spherix Global Insights. In the poll, which includes input from 185 specialists in the United States, 80% were highly satisfied with Zepbound, compared with 59% for Novo Nordisk’s rival injectable, Wegovy. Though it remains early in the launches of Novo’s oral version of Wegovy and Lilly’s GLP-1 pill Foundayo, 48% and 47% of those surveyed were highly satisfied with the newer products, respectively. Novo made the Wegovy pill available in the U.S. in early January of this year, while Lilly brought Foundayo to the market in early April. As for the beginnings of the companies' obesity showdown, Novo launched injected Wegovy in 2021 and Lilly followed two years later with Zepbound. In the survey, Spherix asked the respondents to indicate their level of satisfaction on a 1-10 scale with each of the four therapies. Scores of 8-10 were considered highly satisfied. Scores of 1-3 and 4-7 were categorized respectively as low satisfaction and neutral. Zepbound’s average rating from the respondents was 8.5, followed by injected Wegovy (7.5), oral Wegovy (7.4) and Foundayo (7.2). The survey included the opinions of primary care physicians (54), gastroenterologists (37), endocrinologists (33) and bariatric surgeons (28), as well as nurse practitioners and physician assistants (33). In the survey, Spherix also found that discontinuation with the treatments remains “substantial, creating opportunities for strategies for treatments that can improve resistance.” Those surveyed flagged an overall 25% discontinuation rate within 12 months of starting GLP-1 treatment among patients they see. Participants in the survey were also asked about the top three reasons their patients discontinued treatment. Overwhelmingly, the top two answers were cost/lack of insurance coverage (74%) and gastrointestinal side effects such as nausea, vomiting and diarrhea (72%). The next most common reasons for discontinuations were insufficient weight loss (38%), weight-loss plateau (24%), achievement of weight-loss goal (21%) and gastroparesis (18%). Respondents were also asked to rate each of the four treatments on 13 specific attributes using a 1-10 scale. The results produced an overall brand performance score led by Zepbound at 8.4, followed by injected Wegovy (7.6), Wegovy pill (7.0) and Foundayo (6.6). Of the 13 categories, Zepbound had the highest rating in seven, including degree of weight loss provided (8.5), gastrointestinal tolerability (6.8), speed to reach meaningful weight loss (8.1) and sustainability of weight loss (7.7). The only bottom rating for Zepbound was in its out-of-pocket cost to patients. Its 4.7 average rating was the lowest for any of the four drugs in any of the 13 categories. Injected Wegovy got the highest rating (8.0) in cardiovascular outcomes evidence and ease of access (6.1), but the lowest average rating in gastrointestinal tolerability (6.3), route of administration (6.6) and tolerability of administration (7.0). Among the four treatments, Wegovy pill scored the highest in out-of-pocket cost to patients (5.1), route of administration (8.4) and tolerability of administration (7.6). It received the lowest average score, however, for administration requirements (6.2), as it must be taken in the morning on an empty stomach, followed by another 30 minutes of fasting. Foundayo had the lowest score in eight of 13 attributes, including degree of weight loss (6.7), ease of access (5.4), speed to reach meaningful weight loss (6.4) and sustained weight loss (6.7), though again, the short time that Lilly’s pill has been on the market makes it more difficult to assess. As for the battle among the two weight loss pills, Spherix sees Novo in the lead, backing prescription data collected this year by IQVIA. “Wegovy pill is still ahead as far as usage and initiations—usage being percent of physicians who have adopted it,” Jim Hickey, Spherix's franchise head, gastroenterology, said in an interview with Fierce. Spherix also found that roughly half of the patients taking the oral GLP-1 drugs are new to the incretin weight-loss treatments, with the other half having used injectables. More than three-quarters of the participants in the survey agreed that the new oral drugs are expanding the patient population for weight-loss treatment.