Arriving on the battlefield: Eli Lilly's Zepbound challenges Novo Nordisk

Licensed reprint: Pharma Statistics Insights

The obesity market has been captured by Novo Nordisk, but Eli Lilly's army is about to make landfall. Eli Lilly's GIP/GLP-1 drug tirzepatide was approved by the FDA to treat obesity on November 8.

The doubles match begins

Eli Lilly named its new product Zepbound, but in fact its active ingredient is the same tirzepatide as its star type 2 diabetes product Mounjaro. Mounjaro was already approved for type 2 diabetes in May 2022, and used off-label to treat obesity. After this approval, Eli Lilly will be able to go head-to-head with Novo Nordisk with two major products.

Approved indications

Zepbound is approved for adults with a BMI ≥30, or a BMI ≥27 with co-existing high blood pressure, type 2 diabetes, sleep apnea, or other cardiovascular disease.

Zepbound's approval came from two phase 3 trials, which together enrolled 2,539 patients with an average weight of 231 pounds. Patients in the high-dose group (15 mg) lost an average of 48 pounds at 72 weeks, and the low-dose group (5 mg) lost an average of 34 pounds. In addition, one in three patients in the high-dose group shed more than 58 pounds. The trials incorporated diet control and exercise, so the placebo group lost about 7 pounds.

The price is a killer too

Eli Lilly's Zepbound is expected to cost US$1,059.87 per month, roughly 20% off the competing product—quite competitive. Eli Lilly also offers an assistance program with discounts of up to 50% off.

About 50 million patients in the United States use obesity drugs. Eli Lilly says, "This is only half of the obese population, which is one of the reasons for our pricing; we want more patients to be able to get the drug."

Last week Novo Nordisk announced that Ozempic brought in US$3.4 billion in the third quarter, and Wegovy US$1.4 billion. At the same time, Eli Lilly also reported that Mounjaro racked up US$1.4 billion in sales in its fifth quarter on the market, a strong sign of the rivalry.

Demand for these products is so high that both companies face supply shortages. Last week Eli Lilly said Mounjaro's sales could have been even higher, but "intermittent delays" prevented orders from being filled on time.

This year Eli Lilly invested more than US$2 billion in manufacturing plants near sites in North Carolina and Indiana, which will substantially increase the company's production capacity.

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