GLP-1 Gold Rush: What You Need to Know About Novo, Lilly, and the Next Big Players
Are you missing out on the GLP-1 boom? Get the inside scoop on weight loss drugs that have taken the investing world by storm. Today I cover the companies with GLP-1 weight loss drugs in development.
Chances are you’ve heard of GLP-1 weight loss drugs such as Wegovy, Ozempic and Zepbound. If you were an early investor in the makers of these popular drugs, Eli Lilly and Novo Nordisk, you would have seen the share prices climb over 400% just in the past 5 years.
Today you’ll learn:
An overview of Novo Nordisk and Eli Lilly’s market dominating treatments, along with pipeline of future innovations.
A complete timeline when other competitors are set to enter the GLP-1 weight loss drug market.
Smaller GLP-1 companies that will be acquisitions targets.
Backdrop
Two firms are leading the obesity treatment market for GLP-1 drugs. Novo Nordisk and Eli Lilly. According to Pitchbook they are expected to retain about 67% of a projected $200 billion GLP-1 market by 20311
Each company offers a product approved for diabetes treatment, along with a version that is approved for obesity/weight loss. This report will not distinguish between the two treatments unless it’s absolutely necessary - largely because the drug makers can likely receive FDA approval for both use cases.
Also technically not all drugs are GLP-1s, but instead other types of therapies. In fact, most future candidates are technically not GLP-1s. For the purpose of this report we’ll not distinguish between the different types of treatments, except when necessary.
The focus on the quality of weight loss is also growing. Natural weight loss through diet and exercise typically involves about 20% lean mass loss. GLP-1 drugs currently on the market have demonstrated as high as 40% of weight loss coming from lean mass. New targets and drug combinations are expected to help minimize lean mass loss in the future. This differential feature could help a contending product rise in popularity and usage.
Leaders
Novo Nordisk NVO 0.00%↑
For diabetes treatment Novo Nordisk offers Ozempic and Rybelsus.
Wegovy Approved initially in 2021, is one of the most prominent GLP-1 receptor treatments for obesity. Novo Nordisk's first-mover advantage in this space has generated significant revenue and profits for the company over the past year.
Like most GLP-1 drugs on the market, Wegovy is an injectable medication. Many next generation GLP-1 drugs will likely be taken orally, or require less frequent injections.
As mentioned before, Novo Nordisk’s also makes Rybelsus. Currently available in lower doses for diabetes treatment, a higher dose tablet for obesity is expected to launch in the European market in 2025.
In 2026 Novo Nordisk is expected to launch CagriSema, a Zepbound (Eli Lilly) competitor. In Phase II trials CagriSema showed weight loss that was slightly better than Zepbound at the lowest dosage. Phase III trials are currently underway.
In 2029 (potentially earlier) Novo Nordisk Amycretin, an oral treatment, could be in the market. The early-stage trial of this experimental pill showed weight loss of 13.1% after just 12 weeks. That compares to 6% weight loss from Wegovy during the same time period. This impressive result sent shares of Novo Nordisk soaring in September 2024. Based on the impressive results, it’s believed that Novo Nordisk might skip a Phase II trial of the drug and go directly to Phase III.
In August 2023 Novo Nordisk acquired Inversago Pharma for just over $1B. The company has numerous CB1 receptor based therapies, which some experts believe will be the next evolution of GLP-1 treatments.
CB1 receptor-based therapies target the cannabinoid receptor 1 (CB1), which is involved in regulating appetite, metabolism, and energy balance. Blocking or inhibiting CB1 receptors can help reduce food intake and promote weight loss, making it a potential treatment for obesity and metabolic disorders.
Early CB1 therapies were effective for weight loss but caused significant psychiatric side effects, including depression and anxiety. Current research focuses on developing peripherally selective CB1 blockers, which aim to avoid these central nervous system side effects while maintaining the metabolic benefits.
The leading (and only) CB1 candidate on our radar is INV-202, an oral tablet for weight loss. Phase I trials showed promising results and currently Phase II trials are underway. Inversago Pharma indicates that Phase II trials should conclude in the second half of 2025. The drug is not expected to reach market until 2029.
Outside of Eli Lilly (discussed below) no other competitor will come to market with a FDA cleared product until 2026 at the earliest. I will discuss compounded formulations not approved by the FDA later in the article.
Eli Lilly LLY 0.00%↑
On the market currently for Eli Lilly is Mounjaro for diabetes.
For weight loss Eli Lilly offers Zepbound which received FDA approval in 2023.
Eli Lilly’s next generation GLP-1 drug will likely be Orforglipron. This version is known as a GLP-1 small molecule - which industry experts believes is far easier to manufacture in large doses than current GLP-1 on the market and in the pipeline.
Industry experts believe Orforglipron could be approved by 2026 ahead of other competition. Data from the clinical trials indicate that Orforglipron could potentially work better than Zepbound. It’s also an oral medication, which is more desirable for patients and (usually) easier to manufacture.
Moving away from GLP-1s, Eli Lilly’s leading candidate is Retatrutide (LY3437943). During a Phase II trial, the study found weight loss of 5% or more was 100% for doses above 8mg. If the drug can overcome some concerns about adverse risks it should come to market in 2027.
In 2023 Eli Lilly completed the acquisition of Versanis Bio. Versanis' leading asset, bimagrumab, is currently undergoing a Phase 2b study, both as a standalone treatment and in combination with semaglutide, for adults with overweight or obesity.
It’s believed that the combination of bimagrumab and semaglutide could preserve some of the lean muscle mass that is commonly lost with current treatments. 2027 is the anticipated launch date.
Contenders
Boehringer Ingelheim
Privately held Boehringer Ingelheim could be one of the first companies other than the two leading incumbents to bring a weight loss drug to market.
Despite being family owned since 1885, Boehringer Ingelheim is a premier pharmaceutical company. The company reported over $25B in revenue in a 2023 annual report released to the public.
Boehringer Ingelheim is developing BI 456906 which is licensed from Zealand Pharma (more on them below). This is a novel dual agonist targeting both the glucagon receptor and GLP-1 receptor, for the treatment of individuals with overweight or obesity, as well as for those living with Nonalcoholic Steatohepatitis (NASH).
During a Phase II trial, up to 40% of individuals who reached the two highest doses of survodutide (BI 456906) achieved a weight loss of 20% or more.
The drug is currently in a Phase III trial and is expected to hit the market in 2026.
Experts believe that BI 456906 won’t be much more effective than current versions of Wegovy and Zepbound, let alone the future candidates the two leaders are working on. That will likely mean Boehringer Ingelheim won’t have much pricing power and in general should mean prices continue to trend lower on all GLP-1 weight loss treatments.
Zealand Pharma
Zealand Pharma is a publicly traded company on the Copenhagen stock exchange.
As mentioned above, the company licensed its BI 456906 candidate to Boehringer Ingelheim, expected to reach market in 2026. This is a weekly injection product currently in Phase III trials.
Zealand Pharma has two additional weight loss drug candidates that are in Phase II trials.
The first is a Petrelintide which is believed to provide comparable weight loss to GLP-1 drugs on the market, but with less side effects and less muscle loss. The Phase II and Phase IIb trials involve ramping up the dosage to see if these claims are verifiable. This drug would not be on the market until 2029 at the earliest.
Next is a Dapiglutide which provides weight loss similar to GLP-1 drugs on the market and also addresses “leaky gut” side effects that can results in cardiovascular disease, liver disease, and neuro-inflammation. Currently in Phase I trials with no exact timetable for release.
On the preclinical trial side Zealand Pharma has ZP6590 which has yet to move forward in the pipeline.
Amgen AMGN 0.00%↑
One of the world’s largest pharmaceutical companies with a broad portfolio of revenue generating drugs.
Amgen is advancing its obesity therapy, MariTide, into a comprehensive late-stage development program to evaluate its potential in addressing other weight-related conditions, including heart, kidney, and liver diseases.
A successful broad indication in Phase III could mean that MariTide secures lucrative Medicare coverage for the drug.
MariTide is seen as promising because it involves less frequent dosage compared to current drugs which need to be injected weekly. Current versions of MariTide need to be inject just once per month, with testing planned for even less frequent dosage.
Phase II trials were promising, showing weight loss that was on par with current GLP-1 medications. With Amgen’s financial resources it’s believe that MariTide could reach market in 2027.
Altimmune ALT 0.00%↑
Very small ($500M) pharmaceutical company with nearly no revenue. These types of companies are as speculative as they get. Investors rely on positive data coming from clinical trials and ultimately hope the company is bought by a larger company … more on that later.
Altimmune has a promising candidate in the GLP-1 weight loss space. Unlike larger competitors, even a small amount of penetration would be significant revenue for a company of this size. Although Altimmune will likely be acquired once that phase is reached.
Altimmune’s pemvidutide ALT-801 is heading for a Phase III trial with a potential 2027 launch date. Trial results show weight loss data that is slightly better than Wegovy.
ALT-801 midstage Phase II data shows that after 48 weeks lean mass weight loss stood around 22%. If you recall, many GLP-1 treatments show higher amounts of lean mass weight loss (which isn’t ideal). The 22% figure would be roughly what someone who used diet and exercise to lose weight would experience.
Pfizer PFE 0.00%↑
Pfizer is one of the most widely held and well known pharmaceutical companies in the world. With an already large portfolio of revenue generating drugs, the potential for a bump in valuation due to the weight loss market is lower than other companies on this list.
Pfizer’s leading candidate is Danuglipron (PF-06882961) and was developed in house by the Pfizer team. This is an oral GLP-1 that will likely not come to market until 2028 - well after Novo Nordisk and Eli Lilly (likely) come to market with oral GLP-1 treatments.
The initial trial phase was for a 2-dose version that had high levels of participants who stopped taking the drug due to side effects. Pfizer decided not to advance to Phase III with a 2 dose version and instead is testing a 1 dose version.
Structure Therapeutics GPCR 0.00%↑
At the time of publication Structure Therapeutics had $0 in revenue and is the purest form of speculation in the pharmaceutical market. Presently the company had plenty of cash (~$900M) and burned around $120M over the past 12 months. The company is likely on the radar of every major pharmaceutical company as an acquisition target.
Like Pfizer, Structure Therapeutics is working on an oral GLP-1 that is not anticipated to come to market until 2028, potentially a year or two later than Novo Nordisk and Eli Lilly. However, due to the fact Structure Therapeutics has no revenue, any revenue generated (or hype of potential revenue) could help drive the shares higher.
Structure’s GSBR-1290 showed positive results in a 12 week Phase IIa trial. A Phase IIb trial is expected to commence in late 2024 that will last 36 weeks. Most in the industry don’t expect GSBR-1290 to be significantly better than Eli Lilly’s Orforglipron which should come to market (at least) a year prior.
Structure Therapeutics shares will trade with the hype of GLP-1 drugs, but the best outcome for shareholders is likely a buyout given where pricing for the treatments will decline significantly by the time GSBR-1290 comes to market. .
Viking Therapeutics VKTX 0.00%↑
Viking Therapeutics might be one of the most hyped pre-revenue pharmaceutical companies in this space. When I was working at Brownstone Research MKTW 0.00%↑copywriters (who often come up with the stock picks) were trying to get me to pump this stock.
With Altimmune trading below a $500M valuation and Structure Therapeutics around $2b, Viking Therapeutics has the added pressure of a near $7B valuation for a company with zero revenue.
At the time of publishing the financials look very similar to Structure Therapeutics. Roughly $1B in cash and a $120M burn rate over the past 12 months. Both companies will be racing to come to market as soon as possible given that giants Eli Lilly, Novo Nordisk and potentially Amgen will already be in the market.
Viking Therapeutics is attempting to bring VK2735 to market and is currently testing an injectable and oral version. Phase II trials of the injectable version from a weight loss perspective were slightly better than Wegovy. The side effects were about the same or potentially worse. The drug has moved to Phase III.
The oral version of VK2735 is peptide based, making it a challenge to manufacture. The company is currently testing higher dose levels to bring the performance to the level it needs to be.
The injectable version could be ready by 2028 and the oral treatment could be ready by 2029.
Roche
In December 2023 Roche acquired Carmot Therapeutics for $2.7B with escalators of potential $400M in milestone payments.
This gave the company access to CT-388 a weekly injectable similar to Zepbound. Phase Ib trials showed results that were mostly in-line with other companies we’ve covered. The company is currently testing a Phase II with Phase III (hopefully) starting in 2025. If all goes as planned, CT-388 could come to market in 2028.
The second candidate is CT-996, a once daily oral medication. The company is still in the early stages of testing, but initial results showed substantial safety concerns. The setback likely means a 2029 anticipated launch won’t happen.
AstraZeneca AZN 0.00%↑
In November 2024 AstraZeneca formed an exclusive licensing agreement with Eccogene for a once daily GLP-1 candidate. AZD5004 (before licensing agreement it was ECC5004) is heading for a Phase II trial later in 2024.
The company has two other treatment candidates still in Phase I after scraping a candidate in 2023 due to poor results.
The challenge for AstraZeneca is similar to other large pharmaceutical companies on the list in that coming to market with a solution many years after the fact will likely do little to the valuation of the stock over the long term. But given that AstraZeneca has shown interest in licensing other treatments, the company could be looking to make more deals to build up its pipeline.
Compounded Formulations
Several companies offer non-FDA approved compound formulations of semaglutide, the active drug found in Wegovy. Publicly traded online health care company Him & Hers HIMS 0.00%↑ announced a version in early 2024 that was significantly cheaper than the prescription versions. Noom, Roman and other companies have followed suit as semaglutide is not a proprietary drug.
The lift in demand for these compound formulations will likely be short lived as demand is still outpacing supply for Wegovy and Zepbound.
Insurance coverage for the non-diabetic (weight loss only) consumer would all but kill the compound “knock off” versions that have come to market. It’s believed that Novo Nordisk and Eli Lilly will continue to increase supply and lower pricing to allow for more insurance coverage.
Both leading companies realize the window for exclusivity will close in a few years and one way to keep (even more) competition from cropping up is to continue to increase supply and lower the cost.
Conclusions
The duopoly nature of Novo Nordisk and Eli Lilly will remain in tact for at least another 18-24 months. Both companies have treatments in the pipeline that will keep them in a leadership position in the GLP-1 weight loss market.
Other companies will start to emerge with FDA cleared products by 2026 at the earliest. By then, pricing of existing treatments will be lower and more insurance coverage will exist.
No company I researched has a treatment in the pipeline that I view as “game changing” or significantly better than what Novo Nordisk and Eli Lilly currently make or that is in the pipeline.
Hype can play a major role in driving the stock prices of these companies higher. Even with the backdrop of lower pricing and increased competition, Eli Lilly and Novo Nordisk should continue to draw investor interest.
On the small cap side, Altimmune and Structure Therapeutics are the most intriguing given the valuation haven’t fully priced in success. It also makes them likely candidates for acquisition.
The risk for Viking Therapeutics is likely to the downside as the share price has caught the wave of hype from stock touts and “guru’s”. The further shares climb also makes it less likely an acquisition comes, meaning Viking Therapeutics will need to compete against much more well capitalized and capable competitors.
News and clinical trial results will continue to come in for these treatment candidate and others. I’ll be updating this post as news develops. Please consider subscribing to receive future updates. I’ll also be posting similar reports for other industries including semiconductors and software.
Thanks for checking out my GLP-1 weight loss drug report, hope all is well and you’ll be hearing from me again soon.
Colin
https://pitchbook.com/news/reports/q3-2024-obesity-drugs-the-next-wave-of-glp-1-competition