The race to develop the first oral glucagon-like peptide-1 receptor (GLP-1R) agonist for obesity is intensifying, with four candidates currently in Phase III trials. These oral medications aim to capture a significant share of the obesity market, which is projected to exceed $126 billion in sales by 2030. The shift from injectable GLP-1R agonists to oral formulations addresses issues such as convenience, cost, and patient preference.
Market Dynamics and the Rise of Oral GLP-1R Agonists
The current obesity treatment landscape is dominated by injectable GLP-1R agonists, including Novo Nordisk's Wegovy and Saxenda, Eli Lilly's Zepbound, and Shanghai Benemae Pharmaceutical’s Yishengtai. While effective, these injectables require professional administration, posing a barrier for some patients. Oral GLP-1R agonists offer a more convenient and accessible alternative, potentially increasing patient adherence and expanding the market.
Jasper Morley, Pharma Analyst at GlobalData, noted the strategic importance of oral GLP-1R agonists, stating that Novo Nordisk and Eli Lilly are vying to expand their GLP-1R portfolios and solidify their positions as frontrunners in the obesity category. With 63 oral GLP-1R drugs in active development, the competition is fierce.
Key Phase III Candidates
Novo Nordisk is currently leading the race with two Phase III candidates. Rybelsus, already FDA-approved for cardiovascular risk factors and type 2 diabetes, is undergoing evaluation for a label expansion to include obesity. Additionally, Novo Nordisk's novel Phase III candidate, NN-9932, is expected to launch by the end of 2025 and has the highest probability of success among all drugs in this category, with a 35% likelihood of approval.
Eli Lilly's orforglipron calcium is another prominent Phase III candidate. It aims to be the first oral GLP-1R approved for obesity and the first GLP-1R to gain approval as a small molecule. With a projected launch in 2026, orforglipron calcium represents Eli Lilly's bid to expand its dominance in the GLP-1R category.
Jiangsu Hengrui Enters the Fray
China-based Jiangsu Hengrui’s HRS-9531 is the final Phase III contender and the only one not being developed by pharmaceutical giants Novo Nordisk or Eli Lilly. This highlights the increasing interest from global players in entering the competitive oral GLP-1R market. The entry of Jiangsu Hengrui could potentially disrupt the market and offer a new treatment option for patients with obesity.
The Growing Obesity Epidemic
Obesity, defined as excessive fat accumulation resulting from an imbalance between energy intake and expenditure, has reached epidemic proportions. The New England Journal of Medicine projects that half of all US adults will be obese by 2030. This alarming trend presents a lucrative opportunity for drugmakers developing innovative treatments for obesity.
The success of GLP-1R-targeting drugs underscores their viability as a treatment approach. The emergence of oral therapies is poised to reshape the obesity treatment landscape, offering greater convenience and accessibility for patients. As the race for the first oral GLP-1R approval intensifies, Novo Nordisk and Eli Lilly are positioned at the forefront, striving to capitalize on their already successful GLP-1R portfolios and solidify their dominance in the market.
