Transverse Line

Lining Up at Amazon and LillyDirect for Obesity Medicines

Hear that rumble? Nope, it not the latest SpaceX launch. It is the roar of growing demand for obesity care in the U.S. Two pieces of news in the last week remind us of how steep the upward line of growth in obesity treatment is right now. To help it scale up their reach to people seeking obesity medicines, Amazon announced that it has started delivering obesity and diabetes medicines to patients using the LillyDirect service that began its operations early this year.

Coincidentally on Friday, Reuters reported that new U.S. prescriptions for Lilly’s Zepbound brand of tirzepatide have surpassed the number of new prescriptions for Wegovy. This news is especially jolting when we note that Zepbound hit this mark just three months after its U.S. launch in December. Wegovy (semaglutide for obesity) has been on the market for more than two years.

Meeting the Medical Need

Does this mean that Novo Nordisk has grown complacent about meeting demand for obesity medicines? Or does it signal that Lilly and Novo have tapped into a need that is far greater than anyone imagined?

Past experience with introduction of breakthrough medicines suggests that complacency might be playing a small role. When an innovator gets a big head start (as Novo did) it is easy to think, “we’ve got this.”

But the biggest factor by far is likely the stunningly vast unmet need that these two drugs are tapping into. For decades, the prevalence of obesity has been growing. The severity of obesity that people experience has been growing, too. All the while, medical professionals have had little to offer people – often, not even much empathy.

So now that there are more effective medical options – and more are on the way – a great demand is rising up for these medicines. People don’t like having obesity and even less do they like being unable to do anything about it. Now they have options they’ve never had before.

Competitive Profiles

Given the impressive effectiveness of tirzepatide, no one should be surprised that it is rapidly overcoming the headstart that semaglutide had in this therapeutic space. But we don’t for a minute think that semaglutide will lose its place. FDA approval of Wegovy to prevent heart attacks, strokes, and deaths will surely spark growing utilization for years to come.

Supply Issues

Of course, this raises the thorny problem of supply issues. Lilly seems to be aggressive in keeping the Zepbound brand of tirzepatide off the FDA drug shortage list. But the Mounjaro brand of that same drug is in shortage right now. And all forms of Wegovy are listed as being in shortage with no estimate of a date when those shortages will be resolved.

Given the overwhelming demand for these medicines, it’s unlikely that Lilly will just skate past the supply challenges that have so far bedeviled Novo Nordisk in obesity. The need is great and it will continue to grow. Anecdotally, we are hearing reports that even Zepbound can be hard to find.

Companies that do the best job of fully meeting this need will be the winners in this business. So far, the performance has been mixed for both competitors.

Click here for more on the availability of Zepbound and other obesity medicines through Amazon. For the report on Zepbound prescriptions catching up with Wegovy, click here. Finally, you can explore the dynamics of unmet need and the expanding market for obesity medicines here.

Transverse Line, painting by Wassily Kandinsky / WikiArt

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March 17, 2024