RPT-BREAKINGVIEWS-Obesity drug battle enters 'make it easy' stage

By Robert Cyran

NEW YORK, April 17 (Reuters Breakingviews) - The obesity battle promises to be the pharmaceutical industry’s biggest ever. To succeed, drugs will have to evolve into pill form, making them easier to manufacture and expanding the volume of people willing to take them. Eli Lilly’s LLY.N promising new tablet is nudging the market into that new world.

The results themselves don’t appear that remarkable. Patients on the highest dose of 36 milligrams daily lost nearly 8% of their weight and lowered a measure of blood sugar by a statistically significant amount over a 40-week trial. That's a long way from Lilly’s Zepbound, which is already on the market for obesity, where patients have lost up to a fifth of their weight in a trial.

Yet there are clear advantages to a pill form of these revolutionary drugs. To start, people don’t like taking shots. Some are afraid of needles and injectable drugs usually require refrigeration, a hassle for users. So providing effective tablets should both increase the number of patients willing to give the treatment a go and actually stick with it. Current offerings like Novo Nordisk's NOVOb.CO Wegovy and Zepbound have unpleasant gastrointestinal side effects, and the pain of injection doesn’t help compliance. A majority of patients stop such therapies within two years, according to a Reuters analysis last year.

For Lilly and its peers, pills could also save them money. They are simpler, and usually cheaper, to make than injectable drugs, because the molecules are smaller. The U.S. drug giant is also planning a relatively rapid rollout. The company said that, if approved, it could launch its new pill worldwide, probably in 2026, without supply constraints. In contrast, prior drugs were plagued by persistent shortages after they hit the market.

Investors are expecting great things, as they added about $100 billion to Lilly’s market value, taking it to about $800 billion on Thursday. And it trades at 11 times estimated revenue over the next year according to LSEG, or about twice as much as most pharma rivals. Yet multiple firms, including Novo and smaller startups, are racing to make their own simple-and-cheap pills. Exceeding already lofty Wall Street projections, like Goldman Sachs’ forecast of nearly $100 billion in total sales by 2030, will depend heavily on expanding users. This is one significant step in that journey.

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CONTEXT NEWS

Eli Lilly said on April 17 that an under-development oral treatment caused weight loss of nearly 8% in patients on the highest dose, and lowered blood sugar in patients with type 2 diabetes in a late-stage clinical trial. Participants were still losing weight when the trial ended. Lilly is conducting six more late-stage trials of the drug.

Lilly said the drug, orforglipron, had a safety profile consistent with similar approved glucagon-like peptide-1 (GLP-1) receptor agonist therapies. Large-selling rival treatments, however, are injectables, while orforglipron is a pill.

If approved, Lilly said it is confident it could launch the drug worldwide without supply constraints.