As drugmakers race to develop the next big diet pill, Eli Lilly may have a head start

Drug manufacturers are scrambling to take advantage of the next big innovation coming in the bestseller of the weight loss industry: efficient, convenient and potentially affordable obesity pills.

Rated 40% of US adults are thick, make successful pill a a great opportunity.

It’s too early to crown a winner, especially since key data from several pharmaceutical companies is due later this year. And there is still a very important issue of lowering prices for the major players.

But for now, one experimental oral drug from Eli Lilly seems to have an advantage over pills from Novo Nordisk and Pfizer – though it may not get US approval first.

All three manufacturers are developing oral versions GLP-1s, a class of drugs that mimic a hormone produced in the gut to suppress a person’s appetite. Novo Nordisk popular Wegovy and Ozempic The treatments that sparked a gold rush in the weight loss industry last year are weekly injections of GLP-1, also known as semaglutide.

Tablets are easier to make than injections, which are in the form disposable pens. This means that oral medications could help alleviate it lack of supply which plague their injectable specimens.

Pills are also usually less expensive than injections, although it is unclear whether this will be the case with obesity pills.

Wegovy’s retail price exceeds $1,300 on a monthly package, and Ozempic is about $935. Novo Nordisk has a low-dose oral version of semaglutide that has same retail price as Ozempic for a monthly pack of 30 tablets. This pill, which is marketed as Rybelsusapproved only for type 2 diabetes.

None of the three drugmakers provided an estimate of how much the new obesity pills would cost.

Novo Nordisk has one major advantage: the Danish company has already announced the results of a phase three clinical trial for its own a high-dose version of oral semaglutideaimed at weight management, and told CNBC that he expects to file for FDA approval later this year.

Eli Lilly is still in the middle of phase three clinical trials for its oral drug orforglipron, meaning it will likely come to market later.

Still, analysts are confident of orforglipron’s competitive advantage in the long run, especially after Eli Lilly introduced results of the second phase of the clinical trial last week, which showed a strong efficacy profile for the drug.

According to Eli Lilly’s Phase II results, overweight or obese patients who took 45 milligrams of orforgliprone once daily lost up to 14.7% of their body weight after 36 weeks. This compares with a 2.3 percent weight loss in people who received a placebo.

Eli Lilly’s results appear to be consistent with the weight reductions produced by the Novo Nordisk pills, but they were achieved over a shorter trial period.

In overweight or obese patients taking 50 milligrams of Novo Nordisk once daily, average weight loss 15.1% after 68 weeks, according to results from a phase three clinical trial released Sunday.

Bank of America analyst Geoff Meacham said in a research note on Sunday that the available data on Eli Lilly’s orforgliprone compares “quite favorably” to Novo Nordisk’s oral semaglutide, “cross-trial comparisons aside.”

Cantor Fitzgerald analyst Louise Chen told CNBC that orforgliprone could potentially achieve an even greater rate of weight loss over a longer trial period.

“The more you use these drugs, the more loss you’ll see until it levels off, right?” Chen said. “So I think if you’re getting close to losing weight with semaglutide in almost half the time with orforgliprone, you’re probably going to beat it.”

Chen said he hopes orforglipron will produce a similar reduction to Eli Lilly’s injectable tirzepatide, which caused weight loss about 22% after 72 weeks.

Phase III clinical trials of orforgliprone will likely study the drug over a longer period of time.

At least for now, analysts say Eli Lilly’s pill may have an edge over Pfizer’s oral GLP-1, danuglipronewhich is still in the second phase of clinical trials.

Patients with type 2 diabetes who took the 120 mg twice daily version of danugliprone lost about 10 pounds after an average of 16 weeks, according to the results of one other phase of the clinical trial.

Due to the different patient populations and the lack of long-term data on the drug, it is difficult to compare the efficacy of danugliprone with that of other oral GLP-1s.

A Pfizer spokesperson told CNBC that the company is still studying the drug in further Phase 2 clinical trials and “would like to have longer data” beyond the 16-week mark in the future.

Health experts seem to agree: “Having a pill once a day increases patient compliance a lot, so that’s definitely a big advantage. People often miss a few times a week if they have to take something twice a day,” he said. dr. John Yoonprofessor of endocrinology at UC Davis Health.

Pfizer is developing a once-daily version of danugliprone.

The company also announced on Monday that it will stop development another experimental pill, lotigliprone, which Bansal said is “a more attractive GLP-1” in Pfizer’s portfolio because it is only taken once a day. Shares of Pfizer fell 5% on Monday following the news.

But Pfizer and Eli Lilly have one key advantage over Novo Nordisk’s semaglutide: no dietary restrictions.

In accordance with FDA label for the low-dose approved version of the drug. They were instructed to wait 30 minutes before eating, drinking or taking other oral medications.

This is because Novo Nordisk’s oral semaglutide is a peptide drug that is more difficult for the gut to absorb, according to dr. Eduardo Grunwaldmedical director of the UC San Diego Center for Advanced Weight Management.

“If you take it with food or drink, it’s just not going to be absorbed as efficiently,” Grunvald told CNBC.

He said the Eli Lilly and Pfizer pills are non-peptide GLP-1s that are more easily absorbed and do not require dietary restrictions.

Cantor Fitzgerald’s Chen said market research shows these restrictions are “a big negative for patients,” making the Eli Lilly and Pfizer pills convenient alternatives.

Overall, Eli Lilly’s orforgliprone appears to be a leading contender in the diet pill field due to its strong efficacy data and convenience as a once-daily pill without dietary restrictions.

But Chen pointed out that data coming out later this year could potentially change that: “Save some room for new data coming in.”

For health professionals like Grunvald, naming a winner in the field of oral weight loss drugs is less important.

“I think these oral GLP-1s mean more tools in our toolbox, more options for different people who may respond differently to different drugs,” he said. “This is really the future of all of this.”