Pharmaceutical companies to benefit from weight loss


Article published on 19 Jun, 2023 on Globes / by Gali Weinreb

Three drugs and a host of products in the pipeline are forecast to change obesity treatment, in a market projected at upwards of $100 billion, and with Israeli players too.

After many years during which no drugs with significant effects on obesity came to market, the tide has turned. Three drugs have entered or are about to enter the market, and demand is immeasurably greater than supply. Companies are scrambling to keep up. At the same time, a black market has developed, and even people who are not defined as dangerously overweight are using medications not intended for them, with some even boasting about it publicly.

The expected change in obesity treatment is dramatic. A market potentially worth billions of dollars has been created that stretches from nutritionists, support groups, trainers, and supplements to pharmaceutical companies. This change has positive and negative aspects.

The mechanism and the cost

The anti-obesity drugs that have become popular in the past year are based on a mechanism called Glucagon-like peptide-1 (GLP-1). First developed to treat diabetes, GLP-1 is based on a hormone that is also secreted by a healthy body. The GLP-1 receptor agonist encourages insulin secretion, and therefore helps those who have developed insulin resistance to decrease blood sugar levels by enhancing the secretion of insulin.

How does this help with weight loss? We don’t know exactly, and this is another proof of the complexity of the metabolic syndrome (the medical term for a combination of diabetes, hypertension, and obesity). These drugs seem to reduce appetite and slow down the passage of food from the stomach to the intestine, thus preserving a feeling of fullness. The side effects of these drugs can be nausea, diarrhea, and vomiting. This in itself can, of course, lead to weight loss, although not all patients suffer from these side effects.

Even during the period of supply shortages , both Ozempic and Mounjaro continued to be consumed not only by diabetics.

Not all GLP1 agonists affect weight the same way. The two leading drugs are based on a version of GLP1 called semaglutide, developed by Novo Nordisk. Ozempic, an injection approved for the treatment of diabetes since 2017, has been demonstrated in clinical trials to be capable of reducing an average of 3-7% of body weight, when used over a year, which is nice, but not exciting. Wegovy, the same injection with a higher weekly dose, led to a decrease of almost 15% on average in a clinical trial published in 2021-and not just for a lucky few who achieved exceptionally good results; 50% of the patients actually achieved a 15% weight loss.

Another drug on the market is Mounjaro, or by its generic name Tirzepatide, sold by Eli Lilly. At present, it is approved for treatment of diabetes, but it has been submitted for approval for weight reduction. In trials, this drug achieved weight loss of 20% and more, in 50% of patients.

The US pharmaceutical market is complicated in terms of the real price to the customer (the end-consumer or the insurance company), but the catalog price is $1,400 per month for Wegovy and $975 for Mounjaro.

Insurers’ dilemma: Is obesity a disease?