Pharmaceutical companies compete to become the king of weight loss drugs

Semaglutide was originally a drug to treat diabetes, but as celebrities such as Musk and social media touted it as a "miracle drug for weight loss," many people flocked to it, and pharmaceutical companies saw huge potential. market. After all, compared with the diabetes market, which is becoming saturated with drugs, the weight loss market is undoubtedly a bigger piece of cake. Research and development patents, weight loss effects and even dosage all determine whether a product can be a big seller.

Whose effect is better?

Can I lose weight even if I lie down without dieting or exercising? Musk has proved the efficacy of this "weight loss miracle drug" with his own practice. Currently, the most popular related drugs on the market are Wegovy and its "sister product" Ozempic (Novotel) produced by the Danish pharmaceutical company Novo Nordisk. The main ingredients of both are semaglutide.

According to the results of a global phase III clinical trial published in the New England Journal of Medicine, 1,961 people from 16 countries lost an average of 15.3 kilograms of weight after using semaglutide; about three-quarters of the people lost weight. More than 10%, 1/3 of people lost more than 20% weight.

However, a new study suggests that US pharmaceutical company Eli Lilly may have achieved a bigger breakthrough in the field of weight loss drugs. According to the research paper, after taking the highest dose of the drug for 48 weeks, volunteers lost an average of 24.2% of their weight, or about 53 pounds. A mid-stage trial funded by Eli Lilly showed that a quarter of patients who received the highest dose lost an average of more than 30% in weight.

Ania Jastreboff, lead author of the study and director of the Yale Obesity Research Center, said he had never seen such an effect in an experiment lasting about a year. After the news was announced, Eli Lilly's stock price rose 1.32% in after-hours trading on Monday.

It is understood that Mounjaro, currently developed by Eli Lilly, is a diabetes drug that is also used for weight loss. The main ingredient of this drug is retarglutide, which mimics a hormone called glucagon and aims to stimulate patients' energy expenditure without increasing their appetite.

Huang Song, who is engaged in the research and development of artificial intelligence-assisted drugs, told a Beijing Business Daily reporter that if we only look at the Phase II clinical trial results announced by Eli Lilly, retarglutide is indeed the best effect seen so far, surpassing theirs. The previous generation product Tilpotide, which reached Phase III, also surpassed the already marketed semaglutide injection and oral products.

However, Huang Song reminded that this result should not be interpreted one-sidedly. First of all, the results of Phase II clinical trials are not the same as those of Phase III. The sample size of the trials is relatively small. At the same time, it is still unknown whether Phase III can pass and be finally approved by the FDA. Secondly, the participants in these trials are all obese. There is no reliable data report on whether people with a very high BMI index have the same weight loss effect as healthy and obese people. In addition, whether a weight-loss drug product can sell well requires a comprehensive consideration of factors such as approved indications, dosage, medication method, side effects, price, etc.

Lose weight while still making money

Whether it's semaglutide or retarglutide, these drugs mimic intestinal hormones to suppress appetite and slow gastric emptying and are injected once a week. Lin Yang, who is engaged in the medical beauty industry, had just received an injection of semaglutide in early June. She told a Beijing Business Daily reporter, “After the injection, I almost lost my appetite and didn’t want to eat anything. I felt full after just one bite. It’s fatal”.

With the "weight loss" effect, the sales of semaglutide series products are booming, which has completely ignited the market demand for weight loss drugs, and even caused a global supply shortage. According to reports, shortages and out-of-stocks have occurred in China, the United States, Australia, Europe and other countries and regions. According to public reports, the prescription drug semaglutide is currently in tight supply in many hospitals in Beijing.

Another reason for Simei’s popularity is the price. According to public information, although the actual use of Semaglutide is in mg, its specification is in ml, and 1ml of injection contains 1.34 mg of Semaglutide. On December 3, 2021, Simeiglutide was included in the "National Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug Catalog (2021)". The price of a 1.5ml bottle of Semaglutide is 478.8 yuan, and a 3ml bottle of Simeiglutide is 478.8 yuan. The price of meglutide is 813.96 yuan.

There are differences between different platforms in terms of actual purchases. Taking a certain e-commerce platform as an example, the price of 1.5ml is around 575 yuan to 680 yuan. Based on an average usage cycle of three to six months, the maximum cost will not exceed 3,000 yuan.

Under the huge gap, its exclusive manufacturer Novo Nordisk has harvested a "magic tool to attract money". Taking the first quarter of this year as an example, Wegovy’s revenue was 4.563 billion Danish kroner (approximately US$675 million), a year-on-year increase of 225%. In other words, Novo Nordisk makes an average of US$7.5 million per day through it.

In terms of the secondary market, the total market value of Novo Nordisk's product simeglutide has doubled to US$350 billion since its launch, and Eli Lilly's latest total market value has exceeded US$400 billion, surpassing Merck, Roche, and Pfizer. and other pharmaceutical giants.

Pfizer CEO Albert Bourla has also said that weight-loss drugs could eventually bring the company $10 billion in annual revenue. But in reality, Pfizer's research and development was not smooth. Pfizer said on June 26 that it would stop developing its obesity and diabetes drug Lotiglipron, which is still in clinical trials, due to elevated transaminases in patients taking the drug in mid-stage clinical studies.

Lotiglipron is a drug developed by Pfizer for obesity and diabetes that patients only need to take once a day. Pfizer said it will focus on another oral weight loss drug, Danuglipron, which is undergoing Phase II clinical trials. Affected by this news, Pfizer's stock price fell 5.59% during the session on Monday and closed down 3.68%.

side effects that cannot be ignored

Obviously, weight loss pills have become the new favorite of major pharmaceutical companies. According to the National Institutes of Health, more than 2/5 of U.S. adults are obese, and about 1/10 adults are severely obese.

But the side effects cannot be ignored. According to Lin, she would have drowsiness and want to drink water after the injection. Deng Zhidong, general manager of Hainan Boao Medical Technology Co., Ltd., said that currently, most of the weight loss drugs on the market are side effects of weight loss rather than direct weight loss drugs, so the effects are often unsatisfactory.

Unlike people who try their best to find medicine, Manman (pseudonym) once took an injection according to the doctor's advice because her BMI was too high. The initial dose was 0.25mg, but after adding 0.5mg, she suffered severe gastrointestinal reactions. "Although I lost weight quickly, I was actually dehydrated and couldn't concentrate on work at all."

Deng Zhidong said that pharmaceutical companies are investing in the field of weight loss drugs mainly because of the large market demand and technical potential of weight loss drugs, and also to increase the company's revenue sources. Supervision in the field of weight loss drugs requires strict control of the research and clinical trial results of new drugs to ensure the safety and effectiveness of the drugs.

According to Eli Lilly's drug research, patients taking the drug will experience side effects such as nausea, diarrhea, vomiting and constipation. The higher the dose, the more serious the side effects. Researchers describe it as generally "mild to moderate" in severity and say symptoms may improve if patients start on a lower dose and then move to a higher dose.

In addition, the European Medicines Agency (EMA) also poured cold water on it. In May this year, the EMA issued a drug safety risk advisory, which raised a thyroid cancer safety signal for products including the GLP-1 target for diabetes and obesity drugs.

Lu Dingliang, a partner at Jingshi Law Firm, analyzed to a Beijing Business Daily reporter that in my country, weight loss products are generally divided into drugs, health foods and foods based on their nature. For supervision of weight loss products, we must first strictly control the qualitative nature of weight loss products. In addition, some current weight loss foods even add toxic and harmful substances, such as sibutramine, phenolphthalein, etc.

In fact, on June 3, the marketing application for semaglutide injection for weight loss indications was officially accepted by the State Food and Drug Administration of my country. Previously, it was only approved for blood sugar control in patients with type 2 diabetes.