Obesity R&D: The Making of a $100 Billion Market
Obesity has emerged as a focal point for drug development in recent years, driven by its growing prevalence across many countries. The burden on global healthcare systems is stark: in Britain, for instance, the NHS is estimated to spend around £6.5 billion annually on obesity treatments and related care. More importantly, the impact on patients is severe, with obesity contributing to debilitating comorbidities such as cardiovascular disease, cancer, and psychiatric disorders.
Recent advancements in clinical trials have deepened our understanding of this complex disease, spurring a shift in the treatment landscape. As a result, the life sciences industry is increasingly exploring novel therapeutic modalities, sparking heightened competition and innovation in this dynamic sector. While the current obesity treatment market is dominated by two major players, the battle for market share is intensifying, suggesting a much more open market in the years to come. For now, those involved in obesity R&D must stay ahead of evolving trends to deliver life-saving treatments to patients.
The Changing Treatment Paradigm
To understand the dynamics affecting obesity R&D, it's important to consider the evolution of the treatment landscape.
Until relatively recently, many healthcare professionals and drug developers did not consider obesity a disease, but rather an arbitrary measure of a person’s body mass index (BMI). Treatment options centered around diet and exercise improvements, and drug developers often focused on obesity in the context of its many comorbidities. Approved drugs specifically for obesity often came with a considerable tolerability trade-off for relatively modest efficacy.
However, increased scrutiny of BMI-driven definitions of obesity has led to a shift in approach. Research has increasingly highlighted that failing to consider factors such as age, sex, ethnicity, muscle mass, and other genetic variables—each of which plays a major role in an individual’s body fat—leads to a distorted perspective.
This realization has prompted drug developers and manufacturers to start using real-world data to assess obesity in new ways. Obesity is now recognized as a disease that should be researched and treated like any other. This approach has led to the development of active ingredients that not only promote considerable weight loss, but crucially also prevent the onset of other conditions associated with obesity.
The Current Market
Among the obesity products currently on the market, Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound are by far the most prescribed. However, by 2030, the number of available obesity products could rise to 26, sold by 21 different companies.
Novo Nordisk and Eli Lilly's first-to-market advantage is significant, with $5bn in 2023 sales, tremendous investments in manufacturing and further drugs in the pipeline. However, there is ample opportunity for new entrants to make their mark as the market opportunity for obesity drugs will rise to $70bn by 2030.
One particularly promising area of innovation is in drug administration and dosing frequency. The two leading obesity drugs currently require weekly injections. However, companies exploring oral options or less frequent injections are attracting commercial interest, as these treatments are likely to be preferred by patients.
Another promising area is the potential for these drugs to treat other conditions. Research into the active ingredients used in popular weight-loss drugs has revealed potential applications beyond obesity, including in conditions such as non-alcoholic steatohepatitis (NASH), chronic kidney disease, and even Alzheimer’s disease. Companies that can demonstrate efficacy in these additional indications could see significant gains.
Looking to the $100 Billion Future
The question for drug developers and life sciences companies is how best to support the clinical development of novel approaches to obesity treatment. Currently, there are more than 300 obesity products in various stages of development. The combined impact of these drugs, particularly those in late-stage development, has led Evaluate to forecast that obesity treatments could generate more than $100 billion in sales by 2030 when factoring in additional use in type 2 diabetes and beyond.
Of course, challenges may arise along the way. Reimbursement of obesity drugs is a dynamic topic, as payers and healthcare systems conduct their own cost-benefit analyses. Current use is largely restricted to those in the US with employer health insurance or paying out-of-pocket. Sheer demand for the drugs is also straining the supply chain, which adds another hurdle for newcomers to overcome.
However, the commercial potential in this space is vast, making investment decisions more clear cut compared to other areas. Companies with promising clinical assets are likely to attract attention from larger players, provided they can demonstrate efficacy. Ultimately, this commercial interest underscores the emergence of a highly impactful market. The development of highly effective treatments that meaningfully improve patients’ ability to manage obesity is a significant advancement in addressing this disease. Now, it’s up to drug developers and manufacturers to seize this opportunity.
Topics: Bioeconomy & Society
