After decades of failure, weight loss drugs are finally poised to become big pharma’s latest blockbuster category. Bloomberg Intelligence sees the US obesity drug market at $12 billion in 2028 alone. Morgan Stanley Research recently projected its global sales to be $54 billion by 2030. These new drugs offer more effective and sustained weight loss than any previous pill. It is estimated that between 2013 and 2016, only 3% of people eligible for obesity medication in the US were taking any. But those lofty sales targets can be reached only when the medical sector overcomes structural barriers to their use.
These drugs are usually injected once a week that mimic the stomach hormones that control the feeling of satiety. Data on Novo Nordisk’s Wegovi, approved in June 2021, and Eli Lilly’s Mounjaro, which is expected to be approved next year, suggest that these drugs can help people lose an average of 15-20% of their body weight. can. We only have a snippet on Amgen’s early-stage weight loss drug, AMG133, but it has generated interest from investors based on the expectation that it will be similar or potentially more than Mounjaro with a once-a-month shot. Can offer weight loss. Amgen said this week that people taking higher doses of the drug had lost an average of about 14.5% of their body weight in about three months in its Phase 1 trial.
Such results would make the new drugs 2–3 times more effective than older diet drugs, which had a range of side effects ranging from unpleasant (leaky stools) to downright dangerous (increased risk of heart attack or cancer). People are eager to try new treatments. At an obesity conference last week, experts traded stories of long waits for appointments with weight loss experts. “The demand is huge in the workforce,” says Robert Kushner, who specializes in obesity medicine at Northwestern Medicine.
Pharma companies are also struggling to meet the demand. Lilly has had trouble keeping up with Monjaro’s supply, even though it is currently only approved for diabetes. When it receives expected approval from the US Food and Drug Administration as a treatment for obesity, at least one analyst thinks it could quickly become one of the best-selling drugs in pharma history. . And although Novo Nordisk’s Wegovi has been on the market for over a year, it has been in a constant state of short supply.
Novo expects its supply shortage to ease by the end of the year, which may provide some answers to key questions. For one, the magnitude of demand may be obvious; Currently, this is compounded by people turning to diabetes treatment as an option. Once supplies stabilize, it should be easy to figure out how long people stick with weekly shots, a factor that will affect how big of a blockbuster drug they become.
But all this enthusiasm assumes that the field will address some of the fundamental challenges that may prevent widespread use of these weight-loss drugs.
a major problem? Primary care physicians are reluctant to prescribe them. Doctors are generally not trained to rule out obesity, and some still hold the archaic view that the disease is purely a lifestyle rather than a medical problem. Until that group becomes more comfortable using these treatments, “I fear all these advances will remain on the shelf,” says Kushner, who advises for Novo Nordisk and is part of Wegovy’s Phase 3 study. lead.
Affordability is also a big issue. Wegovy was launched with a monthly price of over $1,600, and insurance coverage has been spotty. A patchwork of laws guide access to weight loss drugs around the US, making them more accessible in some states than others. For example, in Massachusetts, private insurers will pay for obesity drugs, but getting Medicaid to cover them remains difficult elsewhere. In Pennsylvania, a bill that would allow the state to cover treatments for Medicaid recipients has moved closer to passage after years of spoilage. And Medicare currently completely excludes coverage of obesity drugs.
Also worth considering: The story of the long-term safety of this new generation of drugs is still being written. Past experience in the field of weight loss has shown that side effects can appear once the drugs hit the market. This concern is compounded by drugs potentially being used in situations where there is no evidence for their efficacy or safety—namely, in people who are not considered to be clinically obese, but may help lose pounds. want to do.
Elon Musk, for example, recently made headlines when he attributed his fitness to fasting and Wegovi, though it’s unclear if he would actually qualify for the treatment.
The demand in the US for these treatments is undeniable. But meeting it, and thus hitting the high end of all those elevated sales forecasts, will require structural changes to the way these drugs are prescribed and covered by insurance.
Lisa Jarvis is a Bloomberg Opinion columnist covering the biotech, health care and pharmaceutical industries.
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