The advent of powerful new drugs in the case of obesity has gone on to reshape the pharma sector, thereby transforming Eli Lilly as well as Novo Nordisk into the industry’s most valuable companies as well as giving others a lot of distance that needs to be caught.
Apparently, the analysts go on to predict that the so-called GLP-1 drugs, such as the ones from Lilly and Novo, are going to become some of the most profitable products ever sold. Their advantages appear to go beyond weight loss as well as blood sugar control, thereby raising every possibility that they may also go on to change how obesity gets treated.
2024 should help answer whether any other companies can go on to break Lilly and Novo’s leadership. A similar dynamic is being played in oncology as well, where drugmakers happen to be competing against Merck and Bristol Myers Squibb’s recent dominance.
Let us have a look at five of the most significant questions facing pharma in 2024:
What is the state of obesity?
Nordisk as well as Lilly have had a big head start when it comes to creating drugs based around the gut hormone GLP-1 in cases of diabetes and later in weight loss. Ozempic, which happens to be Novo’s weekly GLP-1 in cases of blood sugar control, made use of off-label in obesity and has gone on to become a preferred culture shorthand in cases of weight loss treatment. Lilly, on the other hand, happens to be have an answer to Novo with its just-approved Zepbound, which targets yet another hormone receptor named GIP.
With the GLP-1 drug market anticipated to touch as high as $90 billion in a year, other companies are keen on competing and, in a way, surpassing the two leaders.
The chief among them happens to be the drugs’ under-the-skin injection method of delivery. Novo happens to have a GLP-1 diabetes pill, which has gone on to show that it can deliver weight loss in non-diabetic patients who happen to be obese. Lilly has gone on to speed up the development of a drug named orforglipron, and Pfizer has got two rival pills developed.
One more way to overcome the incumbents can very well be by reducing the side effects, such as nausea and vomiting, that are substantial. Within the SELECT trial that happened to show Wegovy can go on to protect heart health, 17% of participants halted taking it due to adverse events, which were two times as many as the dropout rate within the control group.
The third approach when it comes to beating the on-market GLP-1s could go on to involve preserving lean body mass, such as muscle. Patients in Wegovy’s clinical trials lost healthy lean body mass along with fat. A drug that goes on to help people retain muscle tissue can also improve their metabolic health and, hence, prevent complications such as diabetes.
Outperforming in terms of cardiovascular advantages would be the surest but, at the same time, most time-consuming as well as expensive strategy. While GLP-1 drugs have gone on to create a shift in how obesity gets treated, insurers happen to be still focused on whether the treatment can prevent from hospitalization or other heart complications. Wegovy has gone on to set the benchmark by decreasing the relative risk in terms of heart attacks, strokes, as well as death by 20%. Lilly may as well have the data later in 2024.
Cancer immunotherapy has been dominated by giants. Who wins oncology’s coming era?
Keytruda from Merck and Opdivo from Bristol-Myers have gone on to dominate the cancer treatment conversation for almost a decade. Both are on the verge of reaching their patent-protected monopolies by 2028 in the U.S., thereby pushing themselves to explore commonly used paths of extending market exclusivity, such as combination treatments as well as formulation changes.
However, the drugmakers are also working hard so as to find out what comes next.
The stream of dealmaking concerning antibody-drug conjugates in 2023, underscored by Pfizer’s $43 billion Seagen acquisition, happens to be a sure sign that big pharma sees these targeted therapies as prominent new opportunities. Radiopharmaceuticals that go on to deliver radiation right to tumor cells also happen to be drawing major investment.
It is well to be noted that, after years of disappointment, cancer vaccines have finally started making inroads too. The mRNA technology that has been put forth by Moderna, BioNTech, as well as others can be used to create customized treatments that stimulate immune responses in the tumor cells of patients. Key data from Phase 3 trials concerning Moderna’s Merck-partnered vaccine in cases of melanoma and lung cancer can very well come in the next 2 years.
How is the pharma industry going to challenge the IRA pan out?
The Inflation Reduction Act happens to be the biggest overhang when it comes to drugmakers this year, potentially thwarting revenue for specific top-selling drugs beginning in 2026 and also dampening investor spirit when it comes to funding pharmaceutical research and development. This is true even when the companies’ drugs are not one of the first 10 that are selected for price negotiation under the Medicare program.
Apparently, that list is going to get broad with time, and almost 20 new drugs every year are going to get added to the negotiation list starting in 2029. Almost six drugmakers have therefore gone on to sue the US government to block the law from taking its course.
Will the new Alzheimer’s drugs find a market?
Aduhelm, which happens to be the Alzheimer’s drug that was approved in mid-2021, was all set to be a blockbuster. As the first novel Alzheimer’s treatment in decades, it was in a flash viewed to become a significant tool when it comes to slowing the disease.
This, however, never happened. Apprehensions over whether the medication actually aided patients, in addition to the controversy over the price set by its developer, Biogen, have slowed it down from taking center stage. It is well to be noted that prominent treatment centers have already declined to adopt it, whereas Medicare, which covers almost all of those with Alzheimer’s across the U.S., has refused to provide any coverage. Due to all this, Biogen has since withdrawn Aduhelm.
However, expectations happen to be higher for Leqembi, which is a similar but more effective drug.
Leqembi can as well be joined by the rival drug from Lilly named donanemab soon.
But at the end of the day, there are still prominent challenges. Treatment goes on to involve a special kind of amyloid testing, and the drugs happen to be having notable safety risks that require tracking. Biogen has gone on to suggest demand could hence outstrip the neurologists availability to prescribe treatment.
Which companies will get the manufacturing right for complex drugs?
The pharma sector is very good when it comes to mass-producing chemical pills. In the last four decades, it has also mastered churning out protein drugs, which happen to be the most widely used products today.
New kinds of therapies are breaking the production molds and the genetics revolution has got the drugs that can very well silence genes and other treatments that can deliver them. Cells, and not proteins or chemical compounds, are more commonly the unit of medicine when it comes to certain cancers as well as inherited conditions.
Drugmakers are also getting skilled when it comes to tying antibodies to radioactive isotopes or even chemical toxins, both of which are useful when it comes to attacking tumors in a targeted form that can go on to spare healthy tissue. Others are adjusting the structure of antibodies and also adapting them so as to bind to multiple proteins all at once.
