The battle for diabetes and weight-loss drugs: Eli Lilly vs. Novo Nordisk — who will reign?
AI-translated from the Chinese original · editorially reviewed
Republished with permission from Pharmascan
In 2022, Eli Lilly posted standout results with its diabetes and weight-loss drug Mounjaro (tirzepatide), and this year its market capitalization surpassed Johnson & Johnson to take the industry crown. The drug's remarkable weight-loss results in clinical trials position it to become one of the leading treatments for diabetes and obesity. Meanwhile, Novo Nordisk's weight-loss drug Wegovy (semaglutide) has also delivered strong sales, and falling insulin prices represent a turning point for GLP-1 drug developers.
High hopes for Mounjaro's weight-loss indication
2022 was a banner year for Eli Lilly. On the strength of outstanding results for its diabetes and weight-loss drug Mounjaro (tirzepatide) in the SURMOUNT-1 Phase 3 trial, Lilly's share price surged in June, and with a market capitalization above US$420 billion it officially overtook Johnson & Johnson, the industry's long-time leader.
In the SURMOUNT-1 Phase 3 trial, researchers found that once-weekly Mounjaro 15 mg reduced body weight by as much as 22.5%, about 23.6 kg, versus a 2.4% improvement, about 2.4 kg, in the placebo group. The study enrolled patients with a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related comorbidity (hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease).
According to GlobalData, Mounjaro has a shot at becoming the current leader in treating diabetes and obesity. The astonishing weight loss observed in the trial could make Mounjaro an alternative to bariatric surgery. With efficacy rivaling surgery, many physicians were already treating obese patients off-label in 2022, before Mounjaro had secured a weight-loss indication — at the time it was approved only for type 2 diabetes.
Commanding the weight-loss drug market: bright prospects for Lilly and Novo Nordisk
In its 2022 full-year results, Lilly reported roughly US$500 million in Mounjaro sales in the U.S. and EU type 2 diabetes markets. Yet in the first quarter of this year alone, Mounjaro delivered US$568 million. Lilly says that beyond diabetes it is pursuing formal approval for a weight-loss indication and plans to use a priority review voucher to speed things up. If the FDA grants approval before year-end, the number of obese patients benefiting will keep growing — which is why analysts see sales potentially reaching US$3 billion this year and US$15.7 billion by 2030.
Meanwhile, GlobalData also forecasts Novo Nordisk's full-year 2023 sales to grow to US$12.5 billion, reaching an impressive US$17 billion by 2029 at a 9% compound annual growth rate, driven by strong growth in its weight-loss drugs Wegovy (high-dose semaglutide) and Saxenda (high-dose liraglutide). Novo Nordisk also recently announced that the oral version of Wegovy significantly helped overweight and obese participants lose weight in the OASIS 1 trial, with results the company says are comparable to its injectable Wegovy.
Insulin prices slashed — can weight-loss drugs fill the gap?
Last year the U.S. Congress passed the Inflation Reduction Act, capping Medicare beneficiaries' out-of-pocket insulin costs at US$35 per month. After Lilly announced a voluntary 70% price cut on its insulin pens in March this year, Novo Nordisk and Sanofi followed suit with cuts of up to 75%. Novo Nordisk has also launched multiple initiatives to lower the cost of insulin for people with diabetes, including selling insulin at Walmart for US$25 a vial, offering insulin at commercial-insurance-aligned prices of US$25–35, and a 30-day insulin product bundle for US$99.
Meanwhile, GlobalData also forecasts Novo Nordisk's full-year 2023 sales to grow to US$12.5 billion, reaching an impressive US$17 billion by 2029 at a 9% compound annual growth rate, driven by strong growth in its weight-loss drugs Wegovy (high-dose semaglutide) and Saxenda (high-dose liraglutide). Novo Nordisk also recently announced that the oral version of Wegovy significantly helped overweight and obese participants lose weight in the OASIS 1 trial, with results the company says are comparable to its injectable Wegovy.
Stable supply will be the deciding factor
Wegovy is the second product in Novo Nordisk's lineup, after Saxenda (liraglutide) in 2014, to add an adult weight-management indication on top of an existing type 2 diabetes indication. But faced with unexpectedly high demand and supply chain problems, Novo Nordisk has had to restrict Wegovy's supply. Although the company recently said it would bring a second contract manufacturer into Wegovy production, it has also paused related advertising to temper soaring demand. If Mounjaro secures its weight-loss indication this year with a stable supply, it will become Novo Nordisk's most formidable competitor.
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