The obesity injection treatment Zepbound from Eli Lilly in the U.S. and the obesity injection treatment Wigovy from Novo Nordisk in Denmark. /Courtesy of Reuters

Danish pharmaceutical company Novo Nordisk, which developed the obesity drug Wegovy, has been dominating the global obesity drug market for three years, but U.S. company Eli Lilly is expected to reclaim the top spot by the end of this year.

Market research firm GlobalData noted on the 2nd that Eli Lilly's obesity drug Zeb Bound will quickly surpass Novo Nordisk's Wegovy and dominate the obesity market this year.

An analysis indicated that research results showing Zeb Bound's weight-loss effect is 47% greater than Wegovy's, which began early last month, influenced changes in the market landscape.

Wegovy is an obesity treatment approved by the U.S. Food and Drug Administration (FDA) in June 2021 and currently holds about 74% of the global obesity treatment market. Zeb Bound (ingredient name tirzepatide) is a latecomer that received approval in November 2023. In South Korea, it is expected to be released under the product name 'Mount Jaro' in May.

Graphic=Jeong Seo-hee

◇”Zeb Bound will surpass Wegovy's market share this year”

According to Reuters, new prescriptions for Zeb Bound in the U.S. surpassed Wegovy for the first time in early March last year. Experts estimated that by August of last year, Zeb Bound had captured 40% of the U.S. obesity drug market, closely following Wegovy.

However, it was not enough to exceed Wegovy's sales. In the third quarter of last year, Wegovy recorded sales of $1.7 billion (2.5 trillion won), while Zeb Bound had $1.26 billion (1.854 trillion won). Due to Wegovy's popularity, Novo Nordisk ranked first in global biopharmaceutical sales in 2023. According to global market research firm IQVIA, Novo's annual sales in 2023 reached $68 billion (99.8 trillion won).

Nevertheless, experts predicted that Wegovy's dominance would be broken this year. In December of last year, Eli Lilly directly compared the weight-loss efficacy of Zeb Bound and Wegovy, finding that participants taking Zeb Bound lost an average of 20.2% after 72 weeks, while those taking Wegovy lost 13.7% in the same period.

Costanza Alciati, a GlobalData researcher, said, "Wegovy's influence in the obesity drug market has been tremendous, but innovations through Zeb Bound continue." He added that it would be more cost-effective than Wegovy through negotiations with health authorities and that Zeb Bound is expected to soon seize the lead in the obesity market.

There are analyses suggesting that Zeb Bound's recent FDA approval for mild to moderate obstructive sleep apnea (OSA) will also play a role.

Eli Lilly is currently conducting clinical trials to expand the treatment targets for Zeb Bound to include heart failure, prediabetes, and metabolic-associated fatty liver disease (MAFLD). Novo is verifying the efficacy of treatments for chronic kidney disease, Alzheimer's disease, and MAFLD.

Both Wegovy and Zeb Bound were originally developed as diabetes treatments, and their weight-loss side effects led to their repurposing as obesity treatments. Both are glucagon-like peptide (GLP)-1 class obesity treatments that facilitate insulin secretion while slowing digestion in the stomach, promoting a feeling of fullness and suppressing appetite for weight loss.

However, there is one key difference. The ingredient tirzepatide in Zeb Bound targets both GLP-1 and gastric inhibitory peptide (GIP). GIP is known to break down fat cells and reduce nausea, making its weight-loss effect highly regarded.

◇”Preventing control by Zeb Bound and Wegovy”… Next-generation obesity drug development continues

As the two corporations engage in fierce competition for market share in obesity drugs, several late entrants are accelerating their development.

Graphic=Son Min-kyun

Amgen, which is developing Marinotide, an obesity drug candidate that can be administered once a month, recently drew industry attention by announcing clinical phase 2 results. In the phase 2 trial involving 592 adults who were obese or overweight in November last year, an average weight loss of 14.5% was observed. Like Zeb Bound, Marinotide targets both GLP-1 and GIP at the same time.

There are also efforts to develop oral obesity treatments, instead of injectables, to enhance patient convenience. Chinese company Hansoh Pharmaceutical is conducting clinical phase 3 trials on its oral obesity treatment candidate 'HRS-9531'. Pfizer resumed the development of its oral GLP-1 obesity treatment candidate 'Danuclifron' in July of last year. According to GlobalData, there are currently 63 oral obesity treatments in development.

Domestic corporations such as HK Inno.N, Dong-A ST, Ildong Pharmaceutical, D&D Pharmatech, and Hanmi Pharm are also entering the development of next-generation obesity treatment agents.

HK Inno.N is developing the GLP-1 class obesity drug candidate 'IN-B00009', introduced from Chinese biotech company Saiwind last May. Recently, it submitted a clinical phase 3 trial application to the Ministry of Food and Drug Safety. IN-B00009 is a once-weekly injectable treatment currently undergoing phase 3 trials in China for type 2 diabetes and obesity. Clinical phase 2 results conducted in China and Australia confirmed its efficacy in lowering blood sugar and weight along with safety.

MetaVia, a subsidiary of Dong-A ST, is conducting global clinical phase 1 trials for the GLP-1/GCG dual-action agent 'DA-1726' and is expected to announce results in the first quarter of this year. Hanmi Pharmaceutical is developing 'HM15275', a next-generation obesity treatment triple-action agent expected to achieve over 25% weight loss while minimizing muscle loss. It is currently undergoing clinical phase 1 trials in the U.S., aiming to enter phase 2 next year.