A new obesity treatment paradigm is finally possible

GLP-1s for obesity offer hope to millions, but collaboration and commercial model innovation will be key.



Decades of effort to control obesity have failed, leading to cascading health problems for hundreds of millions and an ever-growing burden of care associated with the health risks obesity poses.

 

Although drugs approved for weight management such as Zepbound and Wegovy offer our best hope to halt obesity, reversing its rise requires addressing all drivers of obesity through a combination of coaching, technology, lifestyle changes, smart policy and—yes—drugs.

Retiring the outdated formula for obesity treatment



Healthcare providers and payers must recognize obesity as a chronic disease



While doctors may recognize obesity as a disease in the abstract, too many continue to treat it as a product of bad behavior. Reversing its course will demand individualized treatment solutions that leverage every tool at our disposal.



Drug manufacturers must look to build a mass market commercial model for obesity drugs



Today, only a small percentage of the approximately 130 million adults in the U.S. eligible for obesity drugs can access them—to say nothing of those outside the U.S. It's not the only path, but pharma must consider dramatically lowering prices for these drugs, boosting capacity through supply chain and manufacturing innovation and partnering with others to offer holistic obesity solutions.



Payers must accept that covering GLP-1s is both the right and smart thing to do



Payers can’t cover weight-loss drugs for every eligible patient at current prices without exploding their budgets. Pharma must convince payers that enabling patients to maintain a healthy weight will save money and lives in the long term.



Societies must address all obesity drivers—not just the easy or obvious ones



As long as food subsidies underwrite a steady supply of unhealthy food and historical inequities drive disparities in access to quality healthcare, obesity as a public health crisis will persist. Reversing its rise will require prinicpled leadership to enact policies that influence both the individual and environmental drivers of obesity.



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Frequently asked questions about obesity treatment today



Why must pharma prioritize “weight management” over “weight loss” to solve obesity?

Not every patient struggling with their weight should be prescribed a GLP-1, and not everyone with obesity needs to be on the most potent weight-loss drug. Pharma, payers and health systems must collaborate to develop guidelines and lines of therapy based on clinical evidence, population health goals and financial constraints. These guidelines and lines of therapy must consider “drug plus” solutions that integrate beyond-the-pill weight-management innovations across the patient journey.


What is the risk to pharma if it maintains the status quo with GLP-1s for obesity?

It’s impossible to predict how governments and others will respond, but these are some potential risks to pharma if the status quo holds: Employers and governments will define access narrowly, meaning fewer patients will benefit and the crisis will worsen. One of the companies working on oral, small-molecule GLP-1s will decide to pursue the mass market and push out higher-priced competitors. U.S. and European regulators could warm to the idea of drugs manufactured in China, where a handful of GLP-1s are under development. Countries could take things into their own hands by invalidating patents or developing their own homegrown molecules. Eventually, semaglutide and terzepatide will lose exclusivity, prices will fall and supply will come online. Unfortunately, by this time, it may already be too late to solve the obesity public health crisis.

If even one of these hypotheticals comes to pass, the pharmaceutical industry will lose its chance to participate in the full scope of the obesity opportunity, leading to serious reputational harm by failing to solve the signature public health crisis of our day.


What strategies should pharma pursue to boost supply of GLP-1s for obesity?

Obesity affects more than a billion people globally. GLP-1 manufacturers should start opening up supply by forecasting demand based on the true size of the opportunity, not today’s access- and affordability-restricted one. Pharma also should push for public-private coinvestment in the supply chain, consider licensing technology to contract manufacturers and commit to rapidly digitalizing its supply chain for these drugs to better predict (and correct for) challenges and vulnerabilities.


After Wegovy and Zepbound, what weight-loss drugs are currently in development?

There are more than 70 drugs for obesity treatment currently in development, including at least eight in phase 3 trials. These drugs use a variety of mechanisms of action and cover a range of routes of administration, including injectables, orals and linguals. Manufacturers include established market leaders, such as Eli Lilly and Novo Nordisk, as well as Chinese pharmaceutical companies and emerging biotechs.