The Banker's Table

Suddenly Bullish on Anti-Obesity Medicines?

It’s been a long haul. But suddenly, we’re seeing a lot of optimism about anti-obesity medicines. Skeptics are yielding to stubborn facts about the impact of obesity on health. They are also yielding to good clinical data about the benefits of sound obesity care. So, too, are they seeing that newer generations of anti-obesity medicines can produce meaningfully better results for the people affected. Yes, at long last, we’re finally seeing skeptics becoming bullish on anti-obesity medicines.

Semaglutide Tops Liraglutide in JAMA

One signal for optimism appeared in JAMA yesterday. Domenica Rubino and colleagues published an RCT of semaglutide versus liraglutide for obesity. Liraglutide, under the brand name of Saxenda, is already a billion-dollar product for Novo Nordisk. Even in market conditions where so-called health plans put every barrier they can in the way of people who need this drug.

But in this rigorous head-to-head study, semaglutide produced results that were easily twice as good and the results with liraglutide. On average after 68 weeks, people taking once-weekly semaglutide lost 15.8 percent of their body weight. In the daily liraglutide arm, they lost 6.4 percent.

At this point it is plain that semaglutide (sold as Wegovy) will be a blockbuster if and when Novo Nordisk gets its ducks in a row to supply enough of it to meet the needs of people who are ready to seek obesity care.

After Balking, Lilly Is Now “Bullish”

So that brings us to the epiphany of Eli Lilly and Company. Just three years ago, the company had outstanding initial results for its investigational drug, tirzepatide, on obesity endpoints. But Lilly was uncertain about developing it for obesity. After hesitating for months, the company decided to move forward with it in 2019. It was clearly outside Lilly’s comfort zone.

Now, finally, the company is all in. CEO Dave Ricks explained yesterday how bullish he is on anti-obesity medicines:

“Of course, long-term, we’re pretty bullish on the opportunity to unlock the potential of really aggressive weight management to reduce many, many causes of suffering. Heart failure, major cardiovascular events, NASH, sleep apnea, and others. This under-the-surface risk in Western health systems is thought to drive one in three healthcare dollars today.”

He made these carefully considered remarks at the annual JP Morgan Healthcare Conference.

A Growing Contingent

Finally, a report by Melanie Senior from In Vivo offers a clear picture of the broad interest in research and development to advance the options for anti-obesity medicines. She names a dozen potential products from eight different companies under development. In his comments to the JP Morgan conference yesterday, Ricks explained why competition in this realm is a big plus:

“Having the two competitors talk about, do studies in, and broaden access for obesity-related treatment as a real medical problem will be good for everybody.”

We could hardly agree more. More options can mean a better life for people living with obesity.

Click here for the new study in JAMA, here for Senior’s report for In Vivo, and here for Ricks’ discussion at the JP Morgan conference. You’ll find his words about tirzepatide and obesity just before the 18-minute mark in this 40-minute session.

The Banker’s Table, painting by William Harnett / Wikimedia Commons

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January 12, 2022

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