SPCEO1 wrote: At a different job 25 years ago, I spent months reporting on a diet drug combo called fen-phen. At the time, drugmakers were eager to come up with patented drugs that could duplicate the success of fen-phen. Then one of the drugs in the combo was linked to heart disease and deaths and it all came crashing down.
For a long time, obesity drug development was out of favor as Big Pharma focused on other lucrative arenas such as cancer. Now obesity medicines are making a roaring comeback, thanks to a new class of diabetes drugs that also turn out to be surprisingly potent weight loss agents. And at the JPMorgan Healthcare Conference last week, obesity medicines were a major focus, as I reported with
my colleague Emma Court.
Companies including Eli Lilly and Pfizer are trying to match the success of Novo Nordisk, the maker of the highly effective Wegovy injection that mimics a weight-related hormone called GLP-1. Amgen was also among companies presenting at the conference with a potential obesity entrant. The companies are aiming to bring to market weight loss drugs targeting the same pathway that either melt off even more pounds, have less frequent dosing or don’t require injection.
“This is the beginning of a whole new therapeutic area,” Eli Lilly Chief Scientific Officer Daniel Skovronsky told me at the meeting. The new drugs mimic the effects of natural hormones called incretins that are secreted from the gastrointestinal tract and tell the body food has been eaten.
Lilly’s drug, called tirzepatide, helped people lose more than 20% of their weight in one big trial last year, with a second big trial slated to finish this year. Meanwhile, in an early trial, patients on the highest dose of Amgen’s AMG 133 saw an average loss of 14.5% of their weight after just 12 weeks of treatment, according to results released in December. Like Novo’s medicine, Amgen’s drug and Lilly’s tirzepatide are injectable.
Covid vaccine juggernaut Pfizer is working on two drugs that hit the GLP-1 pathway that can be given as pills. It thinks that in the obesity market, the convenience of pills may be a key competitive advantage. At a fireside chat at the meeting, Pfizer CEO Albert Bourla said he thought the overall market for the class of medicines could grow to $90 billion a year, including both the obesity and diabetes uses combined. His company might capture $10 billion of that, he said.
To achieve those big numbers, though, a lot still has to happen. Final stage trials will have to show the various potential entrants are as safe and effective, as they at least appear to be so far. Companies will have to consistently produce the medicines. Supply issues limited Novo Nordisk’s Wegovy last year, although the company says the shortage has been resolved with all doses available for order since the end of last year.
But the biggest question mark of all is whether drugmakers can convince insurance companies to cover the new medicines. Spotty coverage has been a long-standing problem for obesity drugs. In a couple years, as more trial results roll in and more of the drugs hit the market, we should get a much better sense of how how big this new class will turn out to be. —
Robert Langreth