Ozempic, Mounjaro, Wegovy or Zepbound, these new drugs have revolutionized the management of diabetes and obesity and could even be beneficial for other diseases. A dazzling global success, coveted by laboratories around the world, with its share of abuses.
Shots to lose weight, praised by thousands of anonymous people on social networks. These treatments were originally reserved for diabetics. The effect on weight loss was discovered somewhat by chance. Mimicking an intestinal hormone, called GLP-1, these drugs slow down digestion and reduce the feeling of hunger. To treat obesity, two treatments containing these GLP-1 analogues are currently on the rise: Wegovy, which contains the same molecule as the antidiabetic Ozempic, but in a higher dose, and Zepbound, which contains the same active substance. as the antidiabetic Mounjaro.
“These products are what we call in English game changersspecifies Antoine Flahault, director of theInstitute of Global Medicine of the University of Geneva. “This is a game changer, particularly for the treatment of obesity and diabetes, but also for a number of other pathologies.”
“With physical activity and diet, we can hope, when we are really diligent and observant, to lose 5 to 10% of our weight. This is practically double that we can hope for with these products,” continues he on the show Geopolitis.
Race for the “miracle shot”
Despite frenzied production, demand for these drugs far exceeds supply. Two pharmaceutical companies currently dominate this market for GLP-1 analogues: the Danish Novo Nordisk and the American Eli Lilly are engaged in a fierce battle. For the first half of 2024 alone, Ozempic and Wegovy’s combined sales totaled nearly $11 billion. Zepbound and Mounjaro grossed nearly $7 billion.
Other laboratories are joining the race, including the giants Roche, Pfizer and AstraZeneca. The Californian company Viking therapeutics is also very advanced and aims to compete with Eli Lilly. Over the next five years, analysts predict the arrival of around fifteen new treatments. Not to mention that China and India are already emerging on the generic market. The Ozempic and Wegovy patents expire there in 2026. “Today, there are already very large Chinese groups who are in the running and who are starting to have all the know-how to produce. The day the patent will fall, we will see generics flood the market”, predicts Antoine Flahault.
Novo Nordisk and Eli Lilly continue to invest massively in research to develop new molecules and inject billions into new production lines. Novo Nordisk CEO Lars Fruergaard Jørgensen says that since the start of last year, his group has committed no less than $30 billion to increase production capacity.
Especially since these products could have potential new markets: clinical studies – sometimes still very preliminary – have indicated promising results in cardiovascular, renal, hepatic pathologies, sleep apnea or neurodegenerative diseases such as Parkinson’s or Alzheimer’s. These treatments even seem to be effective against addictions: the company Eli Lilly recently announced that it wanted to test its effectiveness in nicotine and alcohol dependence.
Obesity has more than doubled in 30 years
For treating obesity alone, the potential is considerable. In 2022, 2.5 billion adults worldwide were overweight, of which 890 million suffered from obesity. This is a major public health issue and also an economic issue. According to a study by the consulting firm McKinsey, obesity costs the world 2,000 billion dollars each year. This is the equivalent of the GDP of Italy or Brazil.
However, these new anti-obesity treatments are currently only marketed in a handful of countries, around fifteen, mainly in Europe, including Switzerland, in North America and in China since this year. Prices vary greatly: in the United States, the cost of these drugs can exceed $1,300 per month, almost nine times more than in Germany, for example.
You shouldn’t offer it just to fit into your swimsuit
Obesity is considered a chronic disease by the WHO, but these medications are not reimbursed in all countries in the world. “In Switzerland, Wegovy against obesity is reimbursed for only three years,” emphasizes Antoine Flahault, who specifies that these types of treatments will have to be prescribed “probably for a long time” to be effective in the long term.
For him, the most important thing is that everyone who needs it can benefit from this therapeutic advance. The doctor also warns of the misuse of these drugs produced in limited quantities. “We must, in fact, not offer it just to fit into our swimsuit (…) I believe that with all the stocks we have today, we could treat 10% of the obese population in the north -American.”
Like the United States and Australia, the Gulf countries have some of the highest obesity rates in the world. In Saudi Arabia, as in other countries that do not have access to anti-obesity treatment, part of the population is turning to the anti-diabetic version already available in the country. A phenomenon which worsens the shortage of treatments for diabetics.
Side effects?
Ozempic has been marketed since 2017 in the United States, Mounjaro since 2022. The perspective on the side effects of these treatments therefore still remains limited. Even more in their anti-obesity version. But Antoine Flahault notes the numerous research carried out which do not show “for the moment, very serious adverse effects.” “We do not have any major doubts or questions today about the risk profile of these products,” he adds. The most common side effects include gastrointestinal upset, including nausea, vomiting, and increased risk of developing inflammation of the pancreas.
New studies will eventually lead to reassessments of the benefit/risk ratio of these products (…) without necessarily calling into question the interest of these molecules in the treatment of diabetes and obesity.
Most recently, Danish authorities asked European authorities to re-evaluate a very rare potential side effect following two studies which found a higher risk of developing non-arteritic anterior ischemic optic neuropathy (NAION). This pathology is one of the causes of blindness in diabetics. According to Antoine Flahault, these new studies “will possibly lead to reassessments of the benefit/risk ratio of these products, sometimes to restrictions of use in certain people (…) without necessarily calling into question the interest of these molecules in the treatment of diabetes and obesity.
Health authorities in several countries are also warning users against the use of unregulated products. These drugs are so successful that counterfeits are also multiplying. L’WHO issued an alert this year against falsifications of Ozempic in circulation in Brazil, the United Kingdom and the United States. Swissmedic also warned last year against the use of fake Ozempic injectors spotted in Germany.
>> Review the subject of Focus on the Ozempic:
Mélanie Ohayon, Natalie Bougeard
