A scale and fat cells
Taylor Tieden for BioSpace
In this deep dive
BioSpace
dissects the global obesity and diabetes markets along with the growing pipelines that aim to serve them.
The global obesity market is
forecasted to reach
between
$100 billion
and $160 billion in the next decade. Meanwhile, the market for type 2 diabetes, which is closely related, is
predicted
to exceed $70 billion by 2032. There is thus considerable opportunity for Novo Nordisk, Eli Lilly, Pfizer and the multitude of other biopharma companies vying for a piece of the lucrative pie.
Weight-Loss Market Estimates and Projections
Source: IQVIA, Reuters, Goldman Sachs
Taylor Tieden for BioSpace
While exceedingly successful, many suspect the current GLP-1 injection therapies for obesity will ultimately be replaced by oral GLP-1 drugs, and several companies, including Lilly, Novo and Pfizer, are racing to bring their versions to the market. In addition, the space is not limiting itself to GLP-1s but is also exploring novel mechanisms to tackle these widespread diseases.
Here,
BioSpace
examines the current obesity and diabetes markets along with the growing pipelines that aim to serve them.
Weight Loss: A Two-Horse Race
The obesity market is currently dominated by two companies: Novo Nordisk and Eli Lilly. While Novo’s obesity drug Wegovy had a two-year head start on Lilly’s Zepbound, the latter is
making up ground
. On August 7, Novo reported its
second-quarter earnings
, revealing profits of $1.7 billion for Wegovy and $4.23 billion for diabetes drug Ozempic. Despite growth rates of 53% and 30%, respectively, for the drugs, investors were not impressed because analyst forecasts were missed. Lilly, on the other hand,
beat Q2 expectations
, bringing in $1.24 billion for Zepbound and $3.1 billion for diabetes treatment Mounjaro.
But the future is much more than a two-horse race. Several companies, including
Pfizer
,
Roche
,
Viking Therapeutics
, and Rivus Pharmaceuticals, are developing obesity therapeutics. Some leverage the GLP-1 pathway, while others commit to different mechanisms, including amylin analogs and mitochondrial uncoupling. Other players in the space include Veru Pharmaceuticals, Regeneron, Altimmune, Amgen, and Amylyx.
Approval Timeline
The obesity space truly caught fire with the clinical success of Wegovy and Zepbound, but these products follow several other treatments for obesity and diabetes approved over the past two-plus decades. Here is a sampling of noteworthy products.
November 2023
Eli Lilly,
Zepbound
Generic name: Tirzepatide
Treatment: Weight management
June 2022
Vivus,
Qsymia
Generic names: Phentermine and topiramate
Treatment: Weight management in pediatric patients
May 2022
Eli Lilly,
Mounjaro
Generic name: Tirzepatide
Treatment: Type 2 diabetes
June 2021
Novo Nordisk,
Wegovy
Generic name: Semaglutide
Treatment: Obesity
December 2020
Novo Nordisk,
Saxenda
Generic name: Liraglutide
Treatment: Obesity in adolescents
September 2019
Novo Nordisk,
Rybelsus
Generic name: Semaglutide
Treatment: Type 2 diabetes (pill form)
December 2017
Novo Nordisk,
Ozempic
Generic Name: semaglutide
Treatment: Type 2 diabetes
September 2014
Takeda,
Contrave
Generic names: Naltrexone and bupropion
Treatment: Weight loss
July 2012
Vivus,
Qsymia
Generic names: Phentermine and topiramate
Treatment: Weight management in adult patients
January 2010
Novo Nordisk,
Victoza
Generic name: Liraglutide
Treatment: Type 2 diabetes
April 2005
Amylin Pharmaceuticals,
Byetta
Generic name: Exenatide
Treatment: Type 2 diabetes
The Highly Sought Weight-Loss Pill
In 2019, the FDA approved Novo’s Rybelsus as the first oral GLP-1 for type 2 diabetes. Considered by many to be the next frontier in obesity treatment,
oral medicines
are under development by a number of companies, including Novo, whose amycretin is in Phase I trials, and Lilly, which has a Phase III trial underway for orforglipron. Brazilian owned multinational company Eurofarma also has a Phase III study underway for its oral candidate sibutramine/topiramate XR.
Meanwhile, a host of companies have oral assets in earlier-stage trials.
Pfizer
recently announced that it would move forward with a modified-release formulation of its candidate danuglipron, and in December 2023, San Francisco–based Structure Therapeutics
announced positive results
from a Phase IIa trial of its weight-loss pill GSBR-1290.
Note: Not all companies with oral medicines in Phase I and II trials are included.
Taylor Tieden for BioSpace
Widely hailed as “the next big thing” in the obesity space, several companies—including Eli Lilly, Novo Nordisk and Pfizer—are developing oral GLP-1 candidates.
How long before oral GLP-1s take majority share of the market?
Source: BioSpace
LinkedIn poll
, August 2024
Taylor Tieden for BioSpace
This deep dive was originally published as a special edition of ClinicaSpace.
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