Weight loss drug candidates multiply, spurring hopes of better outcomes,
lower costs
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[June 27, 2023]
By Deena Beasley
SAN DIEGO (Reuters) - New data on weight loss drugs that could compete
with Novo Nordisk's Wegovy are raising expectations there will soon be
more options, and possibly lower prices, in an estimated $100 billion
marketplace, doctors and pharmaceutical executives say.
Drugmakers are ratcheting up their research and aiming for new
formulations that can be taken as pills, options to deliver higher
weight loss or drugs that reduce fat while maintaining muscle.
"It has really been an explosion of innovation," said Dr. Robert Gabbay,
chief science officer at the American Diabetes Association (ADA), which
receives funding from both Novo and Eli Lilly and Co and just concluded
its annual meeting in San Diego. "If there are multiple (treatments) in
the market, that will lead to some level of competition and greater
access."
More than 40% of Americans are obese, according to the U.S. Centers for
Disease Control and Prevention, and demand is strong for treatments to
reduce body weight as well as maintain weight loss. Wegovy and Lilly's
Mounjaro, which are both weekly injections with U.S. list prices of more
than $1,000 a month, were originally developed for type 2 diabetes.
They are part of a class of drugs known as incretins designed to mimic
the action of the GLP-1 hormone, which helps regulate blood sugar, slow
the rate at which the stomach empties of food and decrease appetite.
Wegovy was approved for obesity in 2021 after studies showed that it led
to 15% weight loss over 68 weeks, while Mounjaro, which demonstrated
weight loss of more than 22% over 72 weeks, is expected to be authorized
later this year.
At the ADA conference, Novo presented data from a late-stage trial of a
high-dose oral version of Wegovy showing similar weight loss results to
the injected form when used alongside diet and physical activity,
compared with 2.4% for a placebo.
"It's all about options," said Mico Guevarra, medical director at Novo.
"What are your patient's needs and goals? Let's pick something that
works for you." Lilly said the highest dose of its experimental pill
orforglipron led to 14.7% weight loss after 36 weeks in a mid-stage
trial of people who were obese or overweight. "We are also thinking
about worldwide needs and those patients that just don't want an
injectable," said Lilly Senior Vice President Jeff Emmick.
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A selection of injector pens for the
Wegovy weight loss drug are shown in this photo illustration in
Chicago, Illinois, U.S., March 31, 2023. REUTERS/Jim Vondruska/Illustration/File
Photo
NEW MILESTONES
Lilly also presented data from a mid-stage trial of its
next-generation "triple g" injected drug retatrutide, which
activates receptors for three hormones, showing that it led to mean
weight reduction of up to 24.2% after 48 weeks. A drug that can
safely deliver 25% weight loss would represent a new milestone in
treatment, getting patients closer to the outcomes achieved by
invasive bariatric surgery. "One of the things we know about
bariatric surgery is that there's a strong relationship between that
amount of weight loss and improvement in a number of co-morbidities:
cardiovascular outcomes, sleep apnea," said Lilly's Emmick. Lilly's
Phase 3 trial program for retatrutide will include measuring the
drug's impact on things like sleep apnea and arthritis. Pfizer on
Monday said it had discontinued work on experimental once-daily
obesity pill lotiglipron, after liver safety issues were seen in
clinical studies. The company said it would continue to develop its
twice-daily weight loss drug candidate. Structure Therapeutics is
developing oral obesity drugs that it says are simpler to
manufacture than the current injectables. "The opportunity exists
for better pricing. Accessibility is really important to us,"
Structure CEO Ray Stevens said. Zealand Pharma and Boehringer
Ingelheim said their experimental obesity treatment was shown to
reduce body weight by close to 19% in a mid-stage trial when looking
at participants who had reached the intended dosage level for the
injected medication. Versanis Bio, which is partially owned by
Novartis, is working on drug called bimagrumab that is designed to
block proteins from binding to receptors believed to inhibit muscle
growth and promote fat accumulation. "We define weight loss quality
as the percentage of weight loss attributed to fat loss," said
Versanis Chief Scientific Officer Lloyd Klickstein. "With diets,
bariatric surgery, incretin drugs or other weight loss drugs,
two-thirds to three-quarters of the weight loss is fat, but
one-quarter to one-third is lean." Drugmakers anticipate that data
from upcoming trials designed to show that weight loss from GLP-1
drugs has a significant impact on cardiovascular outcomes will help
convince health insurers to loosen any reimbursement restrictions.
So far, however, there is not a lot to differentiate between GLP-1
drugs - a situation that can help insurers when it comes to seeking
price discounts in exchange for health plan coverage. That is "where
we have the opportunity to use our negotiations to drive lower costs
because we need it to be a competitive category," said Sree
Chaguturu, chief medical officer at CVS Health, which owns health
insurer Aetna.
(Reporting By Deena Beasley; Editing by Michele Gershberg and Jamie
Freed)
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