Biotech execs vie for a share of obesity drug boom: ‘It’s the early innings’

Pharma giants Novo Nordisk and Eli Lilly might’ve led the way into a new era of obesity drugs, but they’re not going to own it, biotech executives say. 

“We’re really just at the beginning of what’s going to be a very long journey in a very large market,” said Nancy Thornberry, founding CEO of Kallyope, which is developing its own competing therapies. 

Thornberry, along with Structure Therapeutics CEO Raymond Stevens and Aardvark Therapeutics CEO Tien Lee, questioned the dominance of early drugs at the STAT Future Summit on Thursday. 

There’s no denying that Ozempic, Wegovy, and Mounjaro from Novo and Lilly have generated buzz and renewed interest in the world of weight loss drugs, the executives said. So far this year, federal funders have doled out over $70 million in research grants to study GLP-1-based drugs, the class of treatments that Novo and Lilly’s products are part of. But so much research also opens the door to other possible treatments — ones that might actually work better or be preferable to current options, they said. 

Aardvark, for example, is developing a small-molecule oral drug that affects hunger, which Lee distinguished from appetite. While people on GLP-1s have reductions in appetite, the participants in Aardvark’s Phase 2 studies have reported little nausea and “very significant reductions in hunger,” which Lee says is controlled by a different neural pathway than appetite.  

Oral treatments are what several companies are striving toward now. They’re widely favored by providers and patients, versus the injectable treatments, Thornberry said. But the future obesity drugs must also go beyond the basics — side effects, administration, and so on — to be competitive, the panelists said. 

Novo’s Select trial data, for example, showed Wegovy cut participants’ cardiovascular risk. Lilly is also running trials for conditions related to obesity, such as sleep apnea and nonalcoholic steatohepatitis, to see if its weight loss drug has other uses. Such added benefits could proffer drugmakers an edge, and give especially those developing new mechanisms an opportunity to knock Lilly and Novo off the top — or to be used as a complementary treatment. 

“If this was just obesity, maybe Lilly and Novo would continue being the dominant pharmaceutical companies, but we’re seeing cardiovascular, we’re seeing NASH, addiction, so many different disease effects,” Stevens said. “We’re talking about overall human health here. It’s not just one thing. So I think almost all the pharma companies will need to come into this space.”

Researchers are also trying to separate the broad label of obesity into separate classes of disease. While still “poorly understood,” progress on that front could create a market where different treatment approaches are needed for distinct manifestations of obesity, Thornberry said. 

“It’s the early innings,” Stevens said. “There’s so much more opportunity. We’re just scratching the surface.”