Still life of Wegovy, an injectable prescription weight loss medication that has helped people with obesity. It should be used with a weight loss and physical activity plan.
Michael Siluk | UCG | fake images
Drugmakers have been scrambling to join a two-horse race to lead the market for popular weight-loss drugs, which could be worth tens of billions in less than a decade.
Demand is only expected to grow, leaving room in the segment for lesser-known weight-loss drug hopefuls such as privately held German drugmaker Boehringer Ingelheim and smaller public companies such as Terns Pharmaceuticals, Viking therapeutics and Structural therapeutics.
The next entrants into this booming market have a key window of opportunity in the coming years: Goldman Sachs analysts expect 15 million American adults to take obesity medications by 2030.
At the JPMorgan Healthcare Conference in San Francisco last week, attendees flocked to hear Nordisk and Eli Lilly – the two dominant players in the weight loss drug space – talk about what to expect this year from their blockbuster weight loss drugs. Demand for those treatments has skyrocketed and been in short supply over the past year as they have helped patients lose significant weight over time.
Other large drug manufacturers such as Pfizer – which has a widely followed but so far unfortunate weight loss drug program – amgen, Roche and AstraZeneca They also described their strategies to enter the market.
But other companies with weight-loss drug ambitions have received less attention during the weight-loss drug industry's recent gold rush. They may soon compete with bigger actors.
These are some of the lesser-known companies looking to enter the market.
Boehringer Ingelheim
Boehringer Ingelheim develops weight loss drug with Danish biotech Zeeland Pharma company. That company has been working on treatments for obesity for almost a decade.
Their experimental drug works by targeting two gut hormones: GLP-1 to suppress appetite and glucagon to increase energy expenditure. Some popular weight loss drugs, such as Novo Nordisk's Wegovy, only target GLP-1.
Boehringer Ingelheim said in August that it was moving the drug, called survodutide, into a late-stage study, bringing it one step closer to potential Food and Drug Administration approval. A mid-stage trial found that overweight or obese patients lost up to 19% of their weight after 46 weeks of treatment with the drug.
That weight loss could be closer to 20% to 25% in a phase three trial, Zealand Pharma said ahead of the JPMorgan Healthcare Conference last week. It's unclear when that product might get approval.
Terns Pharmaceuticals
Smaller drug makers are developing their own weight loss drugs. They could eventually enter the market through a purchase or partnership with large pharmaceutical companies.
Those companies include Terns Pharmaceuticals, which is much earlier in the development process than Boehringer Ingelheim.
The company is conducting an early-stage trial examining its oral weight-loss drug, which works by targeting GLP-1, in patients who are overweight or obese. Oral medications will likely be easier for patients to take and companies to manufacture compared to existing weight-loss injections.
Terns Pharmaceuticals expects to publish initial 28-day data from that trial in the second half of 2024, the company's head of research and development, Erin Quirk, said during the call.
Quirk acknowledged that it may be difficult for Terns to differentiate its pill from other weight-loss medications. But he added that “even if it's not the best…analysts predict this could be a $100 billion market. If you get a 1% slice of that, it's going to be a $1 billion drug, right?” ?
Small biotech companies take action
Other small drugmakers trying to enter the space include Viking Therapeutics, which is developing drugs targeting GLP-1 and another hormone called GIP. Those are the same hormones targeted by diabetes and weight loss medications from Eli Lilly, Zepbound, and Mounjaro.
Viking Therapeutics expects to release mid-stage trial data on its weight-loss shot in the first half of the year. An early-stage study of that drug showed it caused weight loss of up to 7.8% after 28 days.
The company also plans to release phase one trial data on an oral version of its weight-loss drug during the first quarter of the year.
Structure Therapeutics is similarly developing an obesity pill, which failed to meet Wall Street's expectations for weight loss in a mid-stage trial last month.
The oral drug helped obese patients lose about 5% of their weight compared to patients who received a placebo after eight weeks. Before that data was released, Jefferies analyst Roger Song had said he expected a 6% to 7% weight loss compared to a placebo.
Structure said he expects full 12-week results in patients with obesity in the second quarter of this year. The company plans to launch a larger mid-stage study in the second half of 2024 and a late-stage trial in 2026.
Potential players in the future
Some big drugmakers signaled that they could eventually enter the weight-loss drug market.
That includes the French company. sanafi, whose own drug GLP-1 failed in a mid-stage trial nearly half a decade ago. In the coming years, the company could study potential “next-generation” weight-loss drugs that could have advantages over existing treatments, such as less side effects, executives told an industry news publication Endpoint News at the JPMorgan Healthcare conference.
“There is a lot of determination in companies, including ours, to say: the first wave will be this and what will be the second wave.” said Sanofi CEO Paul Hudson.
Meanwhile, BayerStefan Oelrich, head of pharmaceuticals, said in an interview during the conference that the company is hesitant to enter the obesity market alone, but could partner with other companies.
