The Bill & Melinda Gates Foundation has moved to open a low-cost anti-obesity drug market focused on low-income countries. The aim is to develop and distribute alternative anti-obesity drugs with lower production costs so patients in developing countries can receive treatment. The move is seen as an attempt to resolve structural inequality in which only wealthy countries benefit because current anti-obesity drugs are expensive. Low-cost anti-obesity drugs are also expected to create new opportunities for next-generation anti-obesity drug development by Korean pharmaceutical companies, which emphasize price competitiveness and ease of use.
According to Reuters on the 12th (local time), the Bill & Melinda Gates Foundation is working with the Pan American Health Organization (PAHO) to supply highly effective anti-obesity drugs for weight loss to low-income countries.
The current anti-obesity drug market is dominated by Denmark's Novo Nordisk with "Wegovy (ingredient name semaglutide)," a glucagon-like peptide (GLP)-1 class drug, and the United States' Eli Lilly with "mounjaro (tirzepatide)." These treatments, which mimic the GLP-1 hormone, were developed as diabetes drugs by promoting the secretion of insulin that regulates blood sugar, but evolved into anti-obesity drugs after their weight-loss effects were confirmed.
Board Chair Gates told Reuters, "The foundation has long produced medicines proven effective in high-income countries 'super cheap' and distributed them worldwide," adding, "Obesity is now a chronic disease that the world must tackle together."
The Gates Foundation is supplying an India-made generic (copy drug) of "YesutoGo," an HIV pre-exposure prophylaxis developed by U.S.-based Gilead, to low-income countries at about $40 per year (57,000 won). The idea is to develop similarly low-cost generics for anti-obesity drugs and supply them to developing countries with many patients.
About 70% of the roughly 1 billion people with obesity worldwide live in middle- and low-income countries, but these countries lack the health budgets to address obesity, diabetes and cardiovascular disease. Wegovy and mounjaro are expensive medicines that can cost hundreds of dollars per month. The World Health Organization (WHO) projects that the economic loss from overweight and obesity will reach $3 trillion (4,285 trillion won) by 2030. Even with medicines available, the cycle continues in which medical costs rise because the drugs go unused.
The Gates Foundation operates a "public-health low-cost supply model." It supplies already validated drugs like Wegovy and mounjaro in generic or simplified formulations. Starting next year, patents for semaglutide, the active ingredient in Wegovy, will expire in some countries, including China and India, and low-cost generics are expected to proliferate. Local pharmaceutical companies have already begun developing generics, and corporations with contract development and manufacturing organization (CDMO) capabilities are also expected to benefit.
If a low-cost anti-obesity drug market is created, later entrants with price competitiveness, safety and ease of use could also seize new market opportunities. Global pharmaceutical market research firm IQVIA said in a report on the 8th that "if ease of administration is improved, such as with oral tablets or long-acting injectables, it could be an alternative for anti-obesity drug infrastructure in middle- and low-income countries."
Korean pharmaceutical companies are also accelerating development of next-generation anti-obesity drugs using a variety of platforms. D&D Pharmatech, Ildong Pharmaceutical and Hanmi Pharmaceutical are developing oral anti-obesity drugs, while Daewoong Pharmaceutical, Daewon Pharmaceutical and Dong-A ST are developing anti-obesity treatments that deliver drugs via patches with microneedles.
Development is also active for long-acting formulations that extend weekly anti-obesity injections to once a month. Hanmi Pharmaceutical has developed the long-acting GLP-1 anti-obesity injection "efpeglenatide" with its own technology and is conducting a phase 3 clinical trial, while G2GBIO is developing an anti-obesity injection whose effect lasts about three months.