Amgen, newer rivals could threaten Novo Nordisk and Eli Lilly’s weight loss drug dominance 

Novo
Nordisk
and


Eli
Lilly
have
long
dominated
the
rapidly
growing

weight
loss
drug
market,
but
their
duopoly
is
closer
than
ever
to
facing
a
threat
from
a
new
rival. 

Amgen
is
among
the
leaders
of
a
pack
of
drugmakers
racing
to
join
the
market
with
their
own
weight
loss
treatments. As
the
company

proceeds
with
the
trials
needed
to
bring
its
experimental
obesity
injection
to
the
market
in
the
coming
years,
it
could
see

a
few
advantages.

Amgen’s
drug,
MariTide,
is
taken
less
frequently
than
Novo
Nordisk’s
Wegovy
and
Eli
Lilly’s
Zepbound,
and
may
cause
longer-lasting
weight
loss
than
the
market
leaders’
injections.
Amgen,
one
of
the
nation’s
biggest
pharmaceutical
companies,
can
also
produce
drugs
at
scale
–
a
huge
edge
over
smaller
biotech
companies
that
lack
a
large
manufacturing
footprint. 

“There
are
a
number
of
others
trying
to
break
into
[the
market]
both
small
and
large,
but
when
I
step
back,
I
do
think
that
Amgen
has
a
real
shot
at
being
disruptive
and
challenging
Eli
Lilly
and
Novo,”
William
Blair
&
Company
analyst
Matt
Phipps
told
CNBC. 

Amgen
has
seen
its

shares
pop
12%
since
CEO
Bob
Bradway
on
Thursday
said
he
was “very
encouraged”
by
an
ongoing
mid-stage
study
on
MariTide.
But
it
isn’t
the
only
company
with
a
chance
to
upend
the
market.

Other
companies
—
like


Viking
Therapeutics,


Altimmune,


Structure
Therapeutics,


AstraZeneca
and
partners
Boehringer
Ingelheim
and

Zealand
Pharma
—
are
among
those
that
are
making
progress
on
their
own
treatments.
Novo
Nordisk
and
Eli
Lilly
are
also
working
on

new
weight
loss
drugs.

“I
don’t
know
if
I’m
ready
to
pick
another
clear
winner
yet
based
on
the
data
we
have,”
Phipps
said.

The
competition
for
a
slice
of
the
weight
loss
market
has
only
grown
more
fierce
in
recent
months.
Still,
despite
intermittent
supply
shortages
and
limited
insurance
coverage,
demand
for
Wegovy
and
Zepbound
isn’t
expected
to
slow
down
anytime
soon.
That
leaves
room
for
new
entrants
in
a
segment
expected
to
grow
to

$100
billion
by
the
end
of
the
decade.

While
Amgen
is
in
a
strong
position,
it
will
take
years
for
MariTide
to
reach
patients.
The
company
has
not
provided
an
estimated
launch
date
for
its
obesity
injection.
In
a
research
note
published
Thursday,
JPMorgan
analyst
Chris
Schott
estimated
it
will
hit
the
market
in
2028. 

Amgen
is
testing
out
a
once-a-month
or
even
less
frequent
basis
for
its
drug,
which
would
be
more
convenient
than
the
weekly
medicines
on
the
market.
Several
drugmakers
are
developing
weekly
injections
or
daily
pills,
but
some
haven’t
ruled
out
testing
less
frequent
dosing
for
their
drugs. 

MariTide
showed

sustained
weight
loss
after
a
single
injection
or
multiple
shots
during
a
phase
one
trial,
which
allowed
for
less
frequent
doses
of
the
drug,
according
to
the
study
authors.
They
added
that
the
company’s
drug
can
also
stick
around
in
the
body
for
much
longer
than
current
therapies.

Phipps
said
he’s
confident
that
patients
can
take
MariTide
even
less
frequently,
such
as
once
a
quarter,
to
maintain
the
weight
loss
they
saw
after
starting
the
drug.
That
could
make
it
easier
for
Amgen
to
manufacture
enough
supply
–
and
avoid
an
issue
that
has
been
plaguing
Novo
Nordisk
and
Eli
Lilly.

Amgen
is
already
starting
to
expand
manufacturing
capacity
for
MariTide,
executives
said
during
an
earnings
call
on
May
2.

Less
frequent
doses
of
MariTide
may
also
cause
fewer
side
effects
than
other
weight
loss
treatments,
Phipps
noted.
Many
patients
stop
taking
existing
drugs
due
to
nausea
and
vomiting.

MariTide
causes
some
of
those
same
side
effects,
but
Phipps
said
a
monthly
or
quarterly
injection
of
the
drug
would
lead
to
fewer
days
of
feeling
sick
compared
with
a
weekly
dose.
He
added
that
fewer
doses
could
help
patients
stick
to
the
treatment
and
maintain
weight
loss.

“Even
if
you
do
have
some
nausea
for
the
day,
just
once
a
quarter
versus
once
a
week
I
think
that’s
huge
for
getting
more
patients
to
stay
on,”
said
Phipps. 

Much
like
Wegovy
and
Zepbound,
Amgen’s
treatment
activates
a
gut
hormone
receptor
called
GLP-1
to
help
regulate
a
person’s
appetite. 

But
while
Zepbound
activates
a
second
appetite-suppressing
hormone
receptor
called
GIP,
Amgen’s
drug
blocks
it.
Wegovy
does
not
target
GIP,
which
as
a
receptor
may
also
improve
how
the
body
breaks
down
sugar
and
fat.

While
Amgen’s
progress
has
excited
Wall
Street
and
sent
its
stock
climbing,
other
companies
are
also
moving
toward
putting
a
product
on
the
market.
Here
is
where
those
other
drugs
stand.

Novo
Nordisk
and
Eli
Lilly
are
developing
new
drugs
for
weight
loss
and
diabetes
that
could
improve
on
their
current
treatments
and
enter
the
market
earlier
than
MariTide
and
other
experimental
medicines.

They
include
a
weekly
injection
from
Novo
Nordisk
for
diabetes
and
obesity
called
CagriSema.
That
drug
combines
semaglutide,
the
active
ingredient
in
Wegovy,
along
with
an
experimental
drug
called
cagrilintide. 

CagriSema
helped
diabetes
patients
who
were
overweight
or
obese

lose
15.6%
of
their
weight
after
32
weeks
in
a
mid-stage
trial. Novo
Nordisk
is
studying
CagriSema
in
six

late-stage
clinical
trials
and
could
release
data
from
a

68-week
study
in
obese
patients
later
this
year.

Meanwhile,
Eli
Lilly
is
studying
an
experimental
drug
called

retatrutide
in
a
late-stage
trial.
That
treatment
helped
patients
lose
up
to
24%
of
their
weight
after
almost
a
year
in
a
mid-stage
trial,
which
set
a
new
bar
for
weight
loss.

Retatrutide
mimics
three
different
hunger-regulating
hormones:
GLP-1,
GIP
and
glucagon.
That
combination
appears
to
be
even
more
effective
at
curbing
a
person’s
appetite.

Eli
Lilly
is
also
developing
an
oral
drug
called
orforglipron,
which
targets
GLP-1.
The
company
is
slated
to
release
late-stage
trial
data
on
the
pill
and
retatrutide
in
2025. 

Among
other
potential
entrants,
Boehringer
Ingelheim
and
Danish
biotech
firm

Zealand
Pharma
are
developing
a
weekly

weight
loss
injection.
The
experimental
drug
targets
GLP-1
to
suppress
appetite
and
glucagon
to
increase
energy
expenditure. 

Boehringer
Ingelheim
in
August
said
it
was
moving
the
drug,
called
survodutide,
into
a

late-stage
study.
A
mid-stage
trial
found
patients
who
are
overweight
or
have
obesity
lost
up
to

19%
of
their
weight
after
46
weeks
of
treatment
with
the
drug.

In
February,
the
companies
also
posted
positive
mid-stage
trial
data
on
survodutide
in
patients
with
a
severe
form
of
liver
disease.

Boehringer
Ingelheim
hopes
survodutide
will

launch
as
a
treatment
for
obesity
or
liver
disease
in
2027
or
2028,
as
long
as
trial
data
is
favorable,
according
to
a
Reuters
interview.

AstraZeneca
is
also
developing
a
daily
obesity
pill,
called
ECC5004,
under
a

partnership
it
inked
with
Chinese
biotech
company
Eccogene
in
November. 

AstraZeneca
executives
have
said
the
pill
is

rapidly
absorbed
and
doesn’t
stay
in
the
stomach
long,
which
could
reduce
side
effects
relative
to
existing
treatments.
Executives
have
also
said
that
patients
can
take
the
pill
alone
or
in
combination
with
its
other
oral
drugs,
such
as
the
diabetes
drug
Farxiga,
to
treat
obesity
and
related
health
issues.

But
the
drug,
which
targets
GLP-1,
is
years
away
from
entering
the
market.
The
company
has
completed
a
phase
one
trial
in
patients
with
diabetes
and
plans
to
present
the
data
at
a
medical
conference
later
this
year,
executives
said
during
an
earnings
call
in
April.

Also
in
an
early-stage
trial
is
AstraZeneca’s
experimental
obesity
drug
AZD6234,
which
targets
another
gut
hormone
called
amylin.
The
company

hopes
it
can
combine
AZD6234
with
its
oral
GLP-1
to
help
patients
achieve
greater
weight
loss
than
with
existing
drugs,
AstraZeneca
CEO
Pascal
Soriot
said
in
November.

Meanwhile,
investors
are
eager
to
see
new
data
on
Pfizer’s
once-daily
obesity
pill
around
the
middle
of
the
year,
which
will
determine
the
company’s
fate
in
the
weight
loss
drug
market.
The
company

scrapped
the
twice-a-day
version
of
that
pill,
danuglipron,
in
December
after
patients
had
a
difficult
time
tolerating
it
in
a
trial. 

Pfizer
could
have
another
chance
to
enter
the
market
if
it
acquires
a
smaller
obesity
drugmaker.
But
for
now,
a
deal
appears
unlikely
as
the
company
works
to
rebound
from
the
decline
of
its
Covid
business
last
year.

“As
it
relates
to
bolt-on
acquisitions,
in
the
near
term
you
would
not
expect
us
to
do
much
there,”
Pfizer
Chief
Financial
Officer
David
Denton
said
during
an
earnings
call
on
May
1.

Beyond
those
major
pharmaceutical
companies,
Viking
Therapeutics,
Altimmune
and
Structure
Therapeutics
have
drawn
immense
attention
to
their
respective
weight
loss
drug
pipelines.
The
trio
has
far
fewer
resources
and
less
manufacturing
capacity
than
Amgen
or
Pfizer,
but
that
could
change
if
they
get
scooped
up
by
a
large
drugmaker. 

Viking
Therapeutics
in
March
released

initial
data
from
a
mid-stage
trial
on
its
experimental
injection,
which
targets
GLP-1
and
GIP. Those
who
received
weekly
doses
of
the
treatment
lost
up
to
13.1%
of
their
weight
compared
with
patients
who
received
a
placebo
after
13
weeks. 

Viking
will
likely
conduct
another
phase
two
trial
that
could
last
between
six
and
nine
months,
the
company’s
CEO
Brian
Lian
said
during
an
investor
call
in
March.
Viking’s
treatment
likely
won’t
reach
the
market
until
2029
or
later,
Jefferies
analyst
Akash
Tewari
wrote
in
a
note
that
same
month.

Also
in
March,
Viking
said
it
plans
to
start
a
phase
two
trial
on
an
oral
version
of
its
drug
after
it
showed

positive
results
in
a
small
study.

Structure
Therapeutics
is
also
developing
an
oral
GLP-1
for
obesity
and
diabetes.
But
it
missed
Wall
Street’s
expectations
for
weight
loss
in
a
mid-stage
trial
in
December.

The
pill
helped
obese
patients
lose

roughly
5%
of
their
weight
compared
with
those
who
received
a
placebo
after
eight
weeks.

Structure
said
it
expects
full
12-week
results
on
patients
with
obesity
in
the
second
quarter
of
this
year.
The
company
plans
to
start
a
larger
mid-stage
study
in
the
second
half
of
this
year
and
a
late-stage
trial
in
2026. 

Altimmune
is
developing
a
weekly
obesity
injection
called
pemvidutide,
which
targets
GLP-1
and
glucagon.

In
November,
Altimmune
released
mid-stage
trial
data
showing
that
its
drug
caused
15.6%
weight
loss
on
average
after
48
weeks.
The
company
also
announced
additional
data
from
that
study
in
March
showing
that
its
injection

minimized
the
loss
of
muscle
mass,
a
negative
side
effect
of
existing
weight
loss
injections. 

Altimmune
will
meet
with
the
Food
and
Drug
Administration
in
the
second
half
of
the
year
to
chart
a
path
forward
for
the
injection.

Correction:
This
article
has
been
updated
to
reflect
the
correct
spelling
of
Bob
Bradway’s
name.