Weight loss drugs exploded into the general public eye this 12 months, and 2024 will convey extra change to the evolving market. 

The medication skyrocketed in reputation in 2023 as they helped sufferers shed vital weight, regardless of hefty price tags, combined insurance coverage and a handful of unpleasant side effects. 

Demand for the medication is unlikely to decelerate in 2024, particularly as remedies regularly grow to be extra accessible. A lot of Wall Road believes the burden loss drug market will solely develop, with some analysts projecting that it will likely be worth $100 billion by the top of the last decade. Goldman Sachs analysts anticipate 15 million U.S. adults to be on weight problems medicines by 2030.

However subsequent 12 months, traders will likely be watching how the dominant gamers available in the market, Novo Nordisk and Eli Lilly, navigate supply issues plaguing their remedies. Sufferers have been struggling to get their arms on Novo Nordisk’s weight reduction injection Wegovy, its diabetes therapy Ozempic, and Eli Lilly’s diabetes injection Mounjaro.

Analysts anticipate supply constraints to enhance however notice that the broader situation will take years to resolve. 

Exterior of provide headwinds and the shortage of broader insurance coverage protection for weight reduction medication, Novo Nordisk and Eli Lilly have a giant 12 months forward of them. 

Novo Nordisk might win approvals for expanded use of Wegovy within the U.S. and Europe. Eli Lilly’s newly authorized weight reduction drug, Zepbound, might garner greater than a billion {dollars} in gross sales in its first 12 months available on the market.

Each corporations are additionally anticipated to launch new knowledge that would present different potential well being advantages of their medication past weight reduction and diabetes administration, which can improve insurance coverage protection down the road. 

Subsequent 12 months might imply much more to the opposite corporations hoping to hitch what’s thus far been a two-horse race to make weight reduction remedies.

New drug knowledge from Pfizer and Amgen, and the potential for extra buyouts or collaborations between bigger corporations and smaller makers of weight problems medication, might alter the market’s aggressive panorama within the coming months.

The supply problems plaguing Wegovy, Ozempic and Mounjaro are seemingly “the largest factor” traders will watch subsequent 12 months, Guggenheim analyst Seamus Fernandez advised CNBC. 

Some analysts stated provide constraints will seemingly persist for years, however anticipate them to ease in 2024 as Novo Nordisk and Eli Lilly work to develop manufacturing capability for his or her medication. 

Novo Nordisk throughout its third-quarter earnings name in November stated it’s “taking a look at considerably scaling our provide” of Wegovy within the U.S. in 2024. TD Cowen analyst Michael Nedelcovych advised CNBC that the corporate in the course of the name appeared to recommend that such a change would not seem like a giant soar in provide however relatively regular enhancements over time.

Provide might improve extra considerably years from now: Novo Nordisk in November stated it will make investments $6 billion to develop its manufacturing amenities in Denmark, noting it can end development from the top of 2025 via 2029. The corporate additionally stated it will spend around $2.3 billion to develop one other manufacturing website in France. 

In the meantime, Eli Lilly stated throughout its third-quarter earnings name in November that offer of Mounjaro has improved in the U.S. even because it stays constrained across the globe.

Executives additionally stated that Eli Lilly is on observe to attain its objective of doubling manufacturing capability for medication corresponding to Mounjaro, partially via investments in new manufacturing websites in North Carolina and Indiana.

However Eli Lilly CEO David Ricks stated on the decision that the corporate is “aggressively planning” additional manufacturing buildup for Mounjaro and different medication. He added that “it is an issue we work on day by day. So we’re under no circumstances proud of the capability.”

Wall Road is smitten by Zepbound partially as a result of it could trigger extra weight reduction than Wegovy. Research immediately evaluating the 2, together with an ongoing trial from Eli Lilly, would want to verify that.

Outcomes from that trial might come out subsequent 12 months after preliminary knowledge from separate studies inspecting Zepbound as a possible therapy for different well being circumstances, together with heart failure.

Blended insurance coverage protection will seemingly weigh on gross sales of Zepbound and different weight reduction medication in 2024, however Eli Lilly has already secured some protection for the drug. 

Wegovy made historical past this 12 months when it slashed the risk of great coronary heart issues by 20% in folks with weight problems and coronary heart illness in a late-stage trial. In 2024, the drug might shake up the pharmaceutical trade once more if U.S. and European regulators determine to approve it for that function. 

These potential approvals, which might make Wegovy the primary GLP-1 drug to have an expanded use for coronary heart well being, are a “foregone conclusion” for Novo Nordisk, Cantor Fitzgerald’s Louise Chen advised CNBC.  

An FDA approval might doubtlessly improve the uptake of Wegovy, encouraging extra weight problems specialists, main care suppliers and cardiologists to prescribe it to eligible sufferers, stated Dr. Eduardo Grunvald, medical director for UC San Diego’s Heart for Superior Weight Administration.

An approval can also put extra stress on U.S. insurers to finally cowl Wegovy and comparable weight reduction remedies, opening the door for broader use.

Eli Lilly can also be studying the cardiovascular advantages of Zepbound in a section three scientific trial in diabetes sufferers with elevated cardiovascular threat, and outcomes are anticipated in late 2024. The drugmaker is conducting a similar study in overweight sufferers with heart-health dangers, however outcomes might not come till 2027. 

In the meantime, Novo Nordisk’s different remedies might attain their very own milestones subsequent 12 months.

Novo Nordisk expects to launch knowledge within the first half of 2024 from a late-stage trial inspecting Ozempic as a therapy for kidney failure in diabetes sufferers with continual kidney illness. The corporate hinted that the trial could be successful when it halted the examine a 12 months sooner than deliberate in October based mostly on an interim evaluation.

Novo Nordisk may also launch section three scientific trial knowledge on a 25-milligram model of its once-a-day weight loss pill, which makes use of semaglutide, the identical lively ingredient as in Ozempic and Wegovy. 

That trial is essential as a result of Novo Nordisk is ready to see that knowledge earlier than submitting for approval of the oral weight reduction drug, stated Cowen’s Nedelcovych. He added that in the long run, the provision of weight-loss capsules might enhance capability for his or her injectable counterparts. 

Additionally in 2024, a study following sufferers from a earlier late-stage trial might doubtlessly generate knowledge supporting Wegovy as a therapy for stopping the event of diabetes, Nedelcovych stated.

New knowledge subsequent 12 months will likely be essential to figuring out whether or not Pfizer will get a bit of the burden loss drug area. The stakes are excessive: CEO Albert Bourla has stated the corporate hopes to capture $10 billion of that market. 

Pfizer axed a twice-daily version of the one weight problems product in its pipeline earlier this month after sufferers taking the capsule misplaced vital weight however had hassle tolerating the drug in a mid-stage study. 

Now, the corporate is pinning its hopes on a once-a-day model of the capsule, referred to as danuglipron, which it believes might trigger fewer adversarial unintended effects. Pfizer stated it expects to launch extra knowledge on that model of the drug within the first half of 2024, which can assist the corporate determine whether or not to start out a late-stage examine on the capsule. 

Nonetheless, some analysts have raised questions on whether or not the once-a-day model will likely be simpler to tolerate.

“Regardless of ongoing work, tolerability nonetheless seems to be a difficulty with the product, and it’s not clear to us why this can enhance” in a section three trial or with a once-daily model, JPMorgan analyst Chris Schott stated in a December notice.

Barclays analyst Carter Gould stated in a December notice that it’s “more and more obvious” that the corporate should look externally for an weight problems therapy, whether or not that is via an acquisition or partnership, to seize a slice of the burden loss drug market prefer it had hoped.

In the meantime, upcoming knowledge will reveal how critical Amgen’s weight reduction drug portfolio is. Within the first half of 2024, Amgen is slated to publish early stage trial data on an oral weight reduction medicine.

Within the second half of the 12 months, Amgen plans to launch mid-stage trial knowledge on an injectable drug that helped trigger as much as 14.5% weight loss after 12 weeks in an early examine.

Swiss firm Roche stated earlier this month it will buy the privately held U.S. weight problems drugmaker Carmot Therapeutics for $2.7 billion. AstraZeneca signed a licensing agreement with Chinese language biotech firm Eccogene to develop an weight problems capsule. 

Novo Nordisk and Eli Lilly have additionally snapped up smaller weight problems drug corporations this 12 months to keep up their dominance available in the market. 

In a press release to CNBC, Novo Nordisk stated it has elevated its give attention to “sourcing and elevating exterior innovation” to enrich its in-house merchandise and broaden its drug pipeline, particularly for diabetes, weight problems, heart problems and uncommon blood issues.

The corporate additionally stated it’s within the “full vary of enterprise growth actions,” from acquisitions to partnerships on early or late-stage merchandise, with regards to corporations with new organic medication, new potential therapy targets and new mechanisms of motion, or how a drug works.

Chen stated acquisitions or partnerships will be the solely means for small- to mid-cap weight reduction drugmakers to meet up with Eli Lilly and Novo Nordisk.

Some smaller corporations have indicated that they’re open to the concept: Altimmune stated Dec. 5 that it’s looking for partners to launch and develop its experimental weight problems drug pemvidutide. 

Shares of Altimmune have jumped greater than 140% since Nov. 30, when the corporate launched mid-stage trial data exhibiting that its injectable drug precipitated 15.6% weight reduction on common after 48 weeks.

Different smaller weight reduction drugmakers embrace Structure Therapeutics, whose once-daily capsule helped chubby or overweight sufferers lose as much as 10 kilos of weight on common after a month in an early-stage trial. The corporate is predicted to report mid-stage trial knowledge on its drug in diabetes sufferers this month and extra outcomes on the capsule in sufferers with weight problems early subsequent 12 months, Guggenheim’s Fernandez famous. 

Nonetheless, some greater drugmakers might wait to see bigger and later-stage knowledge from smaller corporations earlier than transferring to accumulate them. That knowledge might not come out till 2025 or later for a lot of corporations, stated Fernandez.