February 21, 2024


Daniel Acker | Bloomberg | Getty Images

Drugmakers are racing to capitalize on the upcoming blockbuster weight loss industry’s next big innovation: effective, convenient and potentially affordable weight loss pills.

estimate 40% of U.S. adults Obesity, which makes a successful drug a huge opportunity.

It’s too early to call a winner, especially with key data from several drug companies due later this year. Pricing remains the most important issue for major players.

but now, an experimental oral drug from Eli Lilly Seems to have advantages over pills Novo Nordisk and Pfizer — though it probably won’t win U.S. approval first.

All three manufacturers are developing oral versions of GLP-1, a class of drugs that mimic a hormone produced in the gut to suppress a person’s appetite. Novo Nordisk’s popular Wegovy and Ozempic treatments, weekly injections of GLP-1, also known as semaglutide, sparked a gold rush in the weight-loss industry last year.

Pills are easier to make than injections, which come in the form of disposable pen.This means oral medication may help relieve supply shortage trouble their injecting counterparts.

Pills are also often less expensive than injections, but it’s unclear if the same will be true for weight loss pills.

Wegovy’s list price Up to $1,300 The monthly package, Ozempic’s is about $935. Novo Nordisk has low-dose oral semaglutide, same price For example Ozempic, 30 tablets per month.This pill is marketed under the name rebelsusis only approved for type 2 diabetes.

None of the big three drugmakers has an estimate for the cost of the new weight-loss drug.

Novo Nordisk has an important advantage: The Danish company has released results from a Phase 3 trial of its high-dose oral semaglutide drug aimed at weight management, and told CNBC it expects to be available later this year. US Food and Drug Administration (FDA) application for approval. Year.

Eli Lilly’s oral drug forforglipron is still in the middle of phase 3 clinical trials, meaning it may hit the market later.

Still, analysts are confident in forforglipron’s competitive advantage in the long run, especially after Eli Lilly’s IPO Phase II Clinical Trial Results The powerful efficacy of the drug was demonstrated last week.

Powerful

Overweight or Obese Patients Taking 45 mg of forforglipron Daily Lose Weight, According to Eli Lilly’s Phase 2 Results Up to 14.7% of body weight 36 weeks later. In comparison, those who took the placebo lost 2.3 percent of their body weight.

Lilly’s results appear to be consistent with the weight loss induced by the Novo Nordisk pill, but achieved during the shorter trial period.

Overweight or obese patients who took 50 mg of the Novo Nordisk drug once a day lost an average of 15.1 percent of their body weight after 68 weeks, according to results of a phase 3 clinical trial published Sunday.

Eli Lilly’s orforglipron data compared favorably with Novo Nordisk’s oral semaglutide “aside from cross-trial comparison caveats,” Bank of America analyst Geoff Meacham said in a research note on Sunday.

Cantor Fitzgerald analyst Louise Chen told CNBC that orforglipron has the potential to achieve a greater degree of weight loss over a longer trial period.

“The more you use these drugs, the more weight you lose until you reach a plateau, right?” Chen said. “So our thinking is that if you’re very close to the weight loss effect of semaglutide when you’re using orforglipron almost half the time, you’re likely to beat it.”

Chen expressed hope that Orforglipron will achieve similar effects to Eli Lilly’s injection tezeparatide, leading to weight loss About 22% after 72 weeks.

The company’s Phase 3 clinical trial of orforglipron will study the drug over a longer period of time.

For now at least, Eli Lilly’s drug may also have an advantage over Pfizer’s oral GLP-1 danuglipron, which is still in phase 2 clinical trials, analysts said.

Type 2 diabetics taking Danuglipron 120 mg twice daily lost about 10 pounds After an average of 16 weeks, according to the results of a phase II clinical trial.

It is difficult to compare the efficacy of danuglipron with other oral GLP-1s due to the different patient populations and lack of long-term data on the drug.

A Pfizer spokesperson told CNBC that the company is still studying the drug in further phase 2 clinical trials and “will also seek longer data beyond 16 weeks in the future.”

easy to use

Wells Fargo analyst Mohit Bansal said in a research note that given Eli Lilly’s strong orforglipron data, Pfizer’s danuglipron will face competition in the oral GLP-1 space.

Doctors often prefer once-daily medications, such as orforglipron, to twice-daily medications, such as danuglipron, he added.

Health experts seem to agree: “If it’s a once-a-day pill, patient compliance goes a long way, so that’s definitely a big advantage. If people have to take their medication twice a day, they’re often missing out on a weekly basis.” several times.” said Dr John YinProfessor of Endocrinology at UC Davis Health Center.

Pfizer is developing once-daily danuglipron.

The company also said Monday it would stop developing another experimental drug, Lotiglipron, which Bansal said was a “more attractive GLP-1” in Pfizer’s portfolio because it is only taken once a day. Pfizer shares fell 5% on Monday following the news.

But Pfizer and Eli Lilly do have one key advantage over Novo Nordisk’s oral semaglutide: no dietary restrictions.

Patients need to take Novo Nordisk’s oral semaglutide in the morning on an empty stomach with no more than four ounces of plain water, according to the agency. FDA label A low-dose, approved version of this drug is used. They were instructed to wait 30 minutes before eating, drinking or taking other oral medications.

According to reports, this is because Novo Nordisk’s oral semaglutide is a peptide drug, which is more difficult for the intestinal tract to absorb. Dr Eduardo GrunwaldMedical Director of the Center for Advanced Weight Management at UC San Diego.

“If you take it with food or drink, it’s not absorbed as effectively,” Grunwald told CNBC.

The Eli Lilly and Pfizer pills are non-peptide GLP-1, which is more easily absorbed and does not require dietary restrictions, he said.

Cantor Fitzgerald’s Chen said market studies have shown that the restrictions “are a big negative for patients,” making drugs from Eli Lilly and Pfizer a convenient alternative.

Overall, Eli Lilly’s orforglipron appears to be a top contender in the weight-loss drug space due to its strong efficacy data and convenience as a once-daily pill, independent of dietary restrictions.

But Chen stressed that data due later this year could change that: “Leave some room for the new data that is coming.”

For health experts like Grunwald, picking a winner in the oral weight-loss pill space isn’t all that important.

“I think these oral GLP-1s mean we have more tools in our toolbox, more options for different people who may respond differently to different drugs,” he said. “This really is the future of it all.”