Is Success in Diabetes Possible Without Obesity Care?

My, how things have changed. Barely more than a decade ago, the dominant drugs for type 2 diabetes caused weight gain. Most big pharma companies were cutting obesity research. Eli Lilly and Sanofi were riding high in diabetes care and turning up their noses at obesity. But now the tables have turned. Sanofi’s diabetes business has withered and we’re beginning to wonder. Will success in diabetes be possible without obesity care?

This week, news from Eli Lilly and Novo Nordisk offers some pretty strong clues.

Trulicity Falling Short

A year ago, Lilly was gaining ground against Novo Nordisk with its new GLP-1 agonist, dulaglutide. The brand name is Trulicity. Although it doesn’t have an extremely impressive effect on weight, the once-weekly dosing is appealing. Novo Nordisk’s liraglutide requires daily injections.

But now, with a weekly GLP-1 drug from Novo Nordisk, semaglutide, the situation has flipped. Sales results announced this week for dulaglutide fell short of expectations. Lilly’s stock dropped by eight percent.

In contrast, sales results for Ozempic – Novo Nordisk’s brand of semaglutide – were well above expectations.

What’s Obesity Got to Do with It?

No doubt, semaglutide is a good drug for type 2 diabetes. In a head-to-head comparison with Trulicity, it delivered better control of A1C. However, the the buzz about semaglutide has a lot to do with impressive efficacy for obesity. In fact, patients in that head-to-head study lost about twice as much weight if they received semaglutide.

So when Novo Nordisk launched semaglutide for diabetes last year, the uptake was strong. And now Lilly is feeling considerable pressure. We suspect that all that buzz about the potential value of semaglutide for obesity is playing a big role.

Time will tell about semaglutide for obesity. The pivotal studies are still under way. It will take a few more years before the drug gains FDA approval for obesity treatment at a higher dose for full efficacy. Experts are hoping for the best, but developing a new drug is never free from surprises.

Success in Diabetes without Obesity?

Right now, it’s not clear that Lilly thinks they have to pay attention to obesity. Last year, the company announced results for a new dual agonist drug it’s developing for diabetes. But the big news was impressive effects on obesity. Even so, Lilly has not yet made up its mind to pursue an obesity indication.

If Lilly continues to ignore obesity, we suspect it may provide a case study for how you cannot succeed in diabetes without a commitment to obesity care. And that would be a shame.

Click here for more on the competition between Trulicity and Ozempic.

Eli Lilly and Company Headquarters, illustration from Eli Lilly via Wikipedia

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May 4, 2019