As obesity becomes a global epidemic, many pharmaceutical players are competing in a booming market, where innovation and competition are redefining the rules of the game.
The stock prices of Eli Lilly and Novo Nordisk soared following the launch of new anti-obesity treatments. In just three years, global spending on obesity has increased sevenfold to reach $24 billion in 2023. The drugs, initially developed to treat diabetes, could generate sales of up to $130 billion per year. year by 2030. The market is gigantic and many players are trying to position themselves. Eli Lilly and Novo Nordisk are currently the undisputed leaders with flagship products like Wegovy and Ozempic, but the competition is far from remaining inactive. Many other laboratories are investing massively in the research and development of new molecules against obesity but also against the many pathologies associated with it.
Will they be able to catch up with the progress of these two protagonists? Could their hegemony in the field be called into question sooner than expected?
Obesity: the scourge of 21e century
Obesity is a relatively recent public health problem, closely linked to profound transformations in our modern lifestyles (processed diet, sedentary lifestyle, stress and anxiety). It took years for public authorities to take stock and recognize the scale of this epidemic. Long associated with individual choices and a lack of will, obesity has suffered from stigma, thus delaying the search for medical solutions and limiting access to treatments. Meanwhile, pharmaceutical companies have preferred to allocate their “research and development” budgets to other diseases, considered more urgent or fatal, such as cancer, cardiovascular diseases or neurodegenerative diseases.
However, advances in molecular biology and neuroscience have provided a better understanding of the complex mechanisms that regulate appetite, satiety and energy metabolism. And this knowledge has led to the development of targeted drugs. At the same time, advances in genomics, bioinformatics and medicinal chemistry have reduced the time required for research and development, making it easier to bring new drugs to market. Artificial intelligence could further accelerate this process in the years to come. Researchers are already identifying innovative molecules and biological pathways involved in weight regulation, thus paving the way for a new generation of drugs.
On the other hand, obesity is not limited to a simple weight problem. This pathology is associated with a multitude of serious illnesses, including cardiovascular diseases, type 2 diabetes, musculoskeletal disorders, certain cancers (endometrium, breast, colon), high blood pressure, liver diseases, chronic kidney disease, etc. Faced with the explosion health costs linked to obesity, authorities have gradually relaxed regulations, which has encouraged investment in this area.
The obesity market: the new El Dorado of health?
In this context, several renowned pharmaceutical groups, such as Sanofi, Roche, AstraZeneca, and Pfizer are investing massively. Among the biotechs, we find Amgen, whose results from its drug candidate MariTide are promising. China, also facing an obesity epidemic, is seeing the emergence of numerous national players, including the company Hangzhou Jiuyuan Gene Engineering, a subsidiary of the pharmaceutical giant Huadong Medicine. The latter requested authorization at the beginning of the year to sell Ozempic’s first local rival and is trying to invalidate Novo Nordisk’s patent, which has since been involved in litigation. If Novo’s patent is invalidated, the supply of weight-loss drugs in China could increase significantly.
Competition in this area therefore promises to be fierce. Since Pfizer and Roche announced the development of anti-obesity drugs last July, the shares of the two leaders, Eli Lilly and Novo Nordisk have fallen by 9% and 24% respectively. However, new entrants will have to face several significant challenges:
- Demonstrate the effectiveness and safety of their molecules;
- Prove that the side effects are tolerable. As such, Pfizer has decided not to continue the development of danuglipron in its current form but is not abandoning this avenue. A new formulation is being considered, with an adjusted dosage, in order to reduce side effects and improve tolerance;
- Develop a marketing strategy;
- Negotiate reimbursement agreements with health authorities.
GLP-1 agonists, such as semaglutide and liraglutide, have revolutionized the treatment of obesity. However, the research does not stop there. Many other molecules are under development, targeting different metabolic pathways and thus offering new therapeutic perspectives that are potentially better tolerated, more effective and durable. Among these new molecules we find, for example, ghrelin inhibitors, intestinal microbiota modulators, and activators of brown adipose tissue thermogenesis.
The race for anti-obesity drugs is the result of a combination of historical, scientific, societal and economic factors. Awareness of the scale of the epidemic, advances in basic research and substantial economic interests have helped accelerate the development of new therapies. Innovation is the key to the success of pharmaceutical companies, whose leadership position can falter at any time. The more attractive the financial prospects, the tougher the competition will be!
