Drugmakers have been scrambling to join a two-horse race to lead the market for popular weight loss drugs, which could be worth tens of billions in less than a decade.
Demand is only expected to grow, leaving room in the segment for lesser-known weight loss drug hopefuls such as the privately held German drugmaker Boehringer Ingelheim and smaller public companies such as Terns Pharmaceuticals, Viking Therapeutics and Structure Therapeutics.
The next entrants into the booming market have a key window of opportunity in the coming years: Goldman Sachs analysts expect 15 million U.S. adults to be on obesity medications by 2030.
During the JPMorgan Healthcare Conference in San Francisco last week, attendees flocked to hear Novo Nordisk and Eli Lilly – the two dominant players in the weight loss drug space – speak about what to expect this year from their blockbuster weight loss drugs. Demand for those treatments soared, and they slipped into shortages over the last year, as they helped patients shed significant weight over time.
Other large drugmakers such as Pfizer — which has a widely followed but so far ill-fated weight loss drug program — Amgen, Roche and AstraZeneca also outlined their strategies for joining the market.
But other companies with weight loss drug ambitions have garnered less attention throughout the recent weight loss drug industry gold rush. They may soon compete with the larger players.
Here are some of the lesser-known businesses angling to enter the market.
Boehringer Ingelheim
Boehringer Ingelheim is developing a weight loss drug with Danish biotech firm Zealand Pharma. That company has been working on obesity treatments for nearly a decade.
Their experimental drug works by targeting two gut hormones: GLP-1 to suppress appetite, and glucagon to increase energy expenditure. Some popular weight loss drugs such as Novo Nordisk’s Wegovy only target GLP-1.
Boehringer Ingelheim in August said it was moving the drug, called survodutide, into a late-stage study, bringing it one step closer to potential Food and Drug Administration approval. A mid-stage trial found patients who are overweight or have obesity lost up to 19% of their weight after 46 weeks of treatment with the drug.
That weight loss could be closer to 20% to 25% in a phase three trial, Zealand Pharma said ahead of the JPMorgan Healthcare Conference last week. It’s unclear when that product could win approval.
Terns Pharmaceuticals
Smaller drugmakers are developing their own weight loss drugs. They could eventually enter the market through a buyout or partnerships with large pharmaceutical companies.
Those companies include Terns Pharmaceuticals, which is much earlier in the development process than Boehringer Ingelheim is.
The company is conducting an early-stage trial examining its oral weight loss drug, which works by targeting GLP-1, in patients who are overweight or obese. Oral drugs will likely be easier for patients to take and for companies to manufacture compared to the existing weight loss injections.
Terns Pharmaceuticals expects to release initial 28-day data from that trial in the second half of 2024, the company’s head of research and development, Erin Quirk, said during the conference.
Quirk acknowledged that it may be difficult for Terns to set its pill apart from other weight loss drugs. But she added that “even if it’s not the best…analysts are out there predicting that this could be $100 billion market. If you get a 1% piece of that, that’s a $1 billion drug, right?”
Small biotech companies make moves
Other small drugmakers trying to enter the space include Viking Therapeutics, which is developing drugs that target GLP-1 and another hormone called GIP. Those are the same hormones that Eli Lilly’s weight loss and diabetes drugs, Zepbound and Mounjaro, target.
Viking Therapeutics expects to release mid-stage trial data on its weight loss injection in the first half of the year. An early-stage study on that drug showed that it caused up to 7.8% weight loss after 28 days.
The company is also slated to release phase one trial data on an oral version of its weight loss drug during the first quarter of the year.
Structure Therapeutics is similarly developing an obesity pill, which missed Wall Street’s expectations for weight loss in a mid-stage trial last month.
The oral drug helped obese patients lose roughly 5% of their weight compared to patients who received a placebo after eight weeks. Before that data was published, Jefferies analyst Roger Song had said he was expecting 6% to 7% weight loss relative to a placebo.
Structure said it expects full 12-week results on patients with obesity in the second quarter of this year. The company plans to launch a larger mid-stage study in the second half of 2024 and a late-stage trial in 2026.
Potential players down the line
Some large drugmakers signaled that they could eventually move to enter the weight loss drug market.
That includes French company Sanofi, whose own GLP-1 drug failed a mid-stage trial almost half a decade ago. In the coming years, the company could look at potential “next-generation” weight loss drugs that could have advantages over the existing treatments, such as fewer side effects, executives told industry news publication Endpoint News at the JPMorgan Healthcare conference.
“There’s a lot of determination in companies, including ours to say, the first wave is going to be this, what’s the second wave going to be?” said Sanofi CEO Paul Hudson.
Meanwhile, Bayer‘s pharmaceuticals head Stefan Oelrich said in an interview during the conference that the company is hesitant to enter the obesity market on its own, but it may partner with other companies.