Moving from Hype to Realities in the Obesity Market
Novo Nordisk and Lilly reported on their business results this week for the final quarter of 2024. These reports brought clarity on a number of points, but to us, one thing stands out. We are moving from euphoria and hype about limitless possibilities in obesity to the realities of market competition and incremental progress.
Sales for both semaglutide (Wegovy from Novo) and tirzepatide (Zepbound from Lilly) for obesity ended the year with strong sales and prescription trends. Novo reports that last month’s prescriptions for Wegovy were double what they were a year ago. Zepbound sales just for the fourth quarter of 2024 were $1.9 billion.
Is Tirzepatide Slipping Ahead of Semaglutide?
One detail that caught our eye in the review of results was a slide Novo presented to financial analysts, summarizing U.S. trends in obesity prescribing patterns. We noted that in both new and total prescriptions for obesity, it seems tirzepatide might be slipping ahead of semaglutide.
Not for a minute do we mean to suggest that this will be the whole story for 2025. Novo has an advantage with an indication to prevent strokes, heart attacks, and deaths. That may keep the competition very close for all of 2025 as Novo pulls out of its shortage situation. The company told investors they expect a declaration soon from FDA that the shortage is over.
New Indications and More Competition
Both Novo and Lilly will be working on expanding the market with new indications and new entries into the market. Most notable in the news for new indications is that both companies have submissions at FDA for heart failure with preserved ejection fraction (HFpEF). That might suggest that approvals for both companies could come later in 2025. This will be big news.
Another focus seems to be on oral medications to follow semaglutide and tirzepatide. Novo has high hopes for amycretin and is talking with FDA about going straight to phase 3 studies after success in a phase 1b/2a trial. Lilly is hoping for an FDA submission for orforglipron in 2025 after readouts of pivotal studies earlier in the year.
It will be a busy year of intense competition. The pressure to claim leadership before other competitors arrive will be intense. Hype and euphoria will be giving way to the realities of competition and incremental progress in the obesity market.
Click here for the Novo Nordisk report on the 2024 fourth quarter and here for the story from Lilly. For perspective on outlook for this market, click here.
Self-Portrait, analytical realism by Pavel Filonov / WikiArt
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February 7, 2025
