May 20, 2024

GLP-1 Agonists: A New Era in Treating Obesity and Type 2 Diabetes

The World Health Organization (WHO) has sounded the alarm on the global obesity crisis, labelling it an “epidemic” that’s spiraling out of control. By 2030, it’s estimated that over 1 billion people will be living with obesity. The connection between obesity and type 2 diabetes is undeniable, with obesity increasing the risk of developing type 2 diabetes by a staggering 80 times. In the US alone, diabetes affected 10.7% of adults in 2021, a 1.3% increase from the previous decade.

As the race to find the ultimate solution for type 2 diabetes intensifies, GIP (glucose-dependent insulinotropic polypeptide) and GLP-1 (glucagon-like peptide-1) agonists have burst onto the scene as revolutionary treatments that are reshaping the type 2 diabetes and obesity landscape. Brands like Ozempic®, Mounjaro®, and Wegovy® have generated considerable buzz, offering patients newfound hope for improved glycemic control and weight loss.

Pharmaceutical giants Eli Lilly and Novo Nordisk have emerged as frontrunners in the development of these innovative therapies. According to research by JP Morgan, by 2030, 9% of the US population could be using a GLP-1 agonist, and the total GLP-1 market could skyrocket to over $100 billion. The surge in cases of these diseases, coupled with the advent of new treatments, has fueled the explosive growth of the GLP-1 market, attracting the attention of numerous stakeholders. 

What are the new drugs for GLP-1? 

The advancement of GIP and GLP-1 agonists for tackling type 2 diabetes and obesity has gained significant attention among pharmaceutical companies. Eli Lilly and Novo Nordisk have established distinct brands catering to these health concerns, with the market for type 2 diabetes currently holding a larger share, as shown below. 

2023 Total sales for the primary GLP-1 agonists of Eli Lilly and Novo Nordisk. 

Novo Nordisk has developed a variety of GLP-1 agonists using semaglutide as the active ingredient. With the FDA’s approval of Ozempic® for treating type 2 diabetes in 2017, it quickly became a market leader in the GLP-1 agonist category, boasting sales of over $14 billion in 2023. This same medication has been repackaged and marketed as Wegovy® for obesity management. Furthermore, Novo Nordisk expanded its portfolio by introducing Rybelsus® in 2019, which became the first approved oral GLP-1 agonist for treating type 2 diabetes.

In a similar vein, Eli Lilly has created a series of GLP-1 agonists using tirzepatide as the active ingredient. Setting itself apart from semaglutide, tirzepatide employs a dual-action approach, functioning as both a GIP and GLP-1 agonist. Building on their earlier success with Trulicity® (dulaglutide), Eli Lilly introduced Mounjaro® in 2022 as their latest type 2 diabetes management drug. Research suggests that the dual-action response of tirzepatide may lead to improved glycemic control and more significant weight loss. This innovation in the field of obesity management continued with the approval of Zepbound® in late 2023.

The future of GLP-1 agonists remains promising, as Pfizer is currently in the late stages of developing an oral GLP-1 agonist. Concurrently, Amgen is exploring a unique approach with their GLP-1 agonist, which will specifically inhibit GIP receptors.

What is the GLP-1 market forecast? 

With the growing prevalence of obesity, numerous pharmaceutical companies are turning their attention to the GLP-1 market, recognizing the vast potential it holds. The World Obesity Federation estimates that by 2035, roughly one in four individuals will be obese, while another one in four will be overweight. These staggering figures will significantly impact healthcare comorbidities, with the global economic burden projected to exceed $4 trillion annually.

The scale of this expenditure is akin to the financial impact of the Covid-19 pandemic in 2020, highlighting the immense market opportunity for pharmaceutical companies. According to a study by JP Morgan, it is anticipated that 9% of the US population will be using GLP-1 agonists by 2030, propelling the GLP-1 market to exceed $100 billion.

What could be contributing to the GLP-1 shortage? 

The issue of obesity has gained significant attention due to the effectiveness of GLP-1 antagonists in addressing this widespread problem. High-profile figures, such as Elon Musk and Oprah Winfrey, have openly praised weight-loss medications, specifically GLP-1 agonists, which has led to a surge in their popularity, particularly in the United States, for weight management purposes.

However, the limited availability of Wegovy®, a prescription weight-loss drug, has prompted doctors to prescribe Ozempic® off-label for weight loss. This practice has created challenges in obtaining medication for type 2 diabetes patients worldwide. In response to this growing demand, Novo Nordisk announced in late 2023 that they would be increasing their investment in Wegovy® production by 80% in 2024, amounting to a substantial $6.5 billion. 

As stakeholders aim to capitalize on the potential $100 billion market, this investment is expected to grow, further highlighting the impact of GLP-1 antagonists on the weight management industry and the importance of ensuring their accessibility to those in need. 

Navigating Supply Challenges and Ensuring Accessibility of GLP-1 Agonists 

The rise of obesity and its link to type 2 diabetes has catalyzed a significant shift in the pharmaceutical landscape, with the emergence of GIP and GLP-1 agonists offering a promising solution. However, the burgeoning demand for these medications, particularly for weight management, has led to challenges in supply and accessibility, exemplified by the shortage of Wegovy®. As the industry strives to meet the needs of a growing population affected by obesity and type 2 diabetes, ongoing investment and innovation will be crucial in ensuring the availability and affordability of these life-changing therapies for all who require them.