2023-11-23 11:05:00
Kim Kardashian would have lost 8 kilos in three weeks last year to fit into Marilyn Monroe’s sheath dress thanks to an appetite suppressant developed by Novo Nordisk? True or false, the rumor spread on social networks delights the Danish pharmaceutical giant, which has been engaged in a battle around the obesity market for less than three years. The only one with its American rival Lilly to have developed miracle remedies promoting weight loss, it is eyeing France with appetite. Ready to win first place, the laboratory will announce this Thursday, November 23, in the presence of Emmanuel Macron, a colossal investment of 2.1 billion euros on its Chartres site (Eure-et-Loir), notably for produce its blockbuster drug, Wegovy. The key to this expansion, which will double the current surface area of the site, is the creation of 500 jobs, according to the Elysée.
Enough to tickle its competitor in Indianapolis, which committed a month earlier to spending 160 million euros on its Alsatian site in Fegersheim, to manufacture Mounjaro, the other star remedy for overweight people, from 2026.
Heavy artillery
If the laboratories are bringing out the heavy artillery in France, it is because they have understood the growth potential on this side of the Atlantic. While obesity affects 40% of Americans, France is not spared. This galloping scourge now affects 17% of adults there, or 8.5 million people. However, very few patients are treated today. Enough to fuel the wildest forecasts on the sales of weight-loss drugs which offer an alternative to bariatric surgery. This procedure reduces the volume of the stomach and prevents you from eating more than you should.
According to Morgan Stanleythe jackpot will exceed 77 billion dollars worldwide in 2030, compared to 2.4 billion in 2022. Jörg Ohleyer, partner at Kea & Partners is also categorical: “The market of tomorrow is obesity, not oncology or immunology”.
The origin of this new business lies in an astonishing discovery: resulting from research on the saliva of a venomous lizard living in the deserts of the southern United States, the Gila monster, a new generation of antidiabetics was revealed. very effective in melting fat. By mimicking the action of the intestinal hormone GLP-1, these medications control blood sugar levels and, in turn, reduce appetite by sending a message of satiety to the brain.
Magic recipe for new antidiabetics
Since the discovery of these amazing appetite suppressant effects, the Big Pharma is investing heavily to develop the magic recipe of these antidiabetic drugs in the treatment of obesity. First on the starting line, Novo Nordisk is now banking on Wegovy, the smaller, more dosed brother of the antidiabetic Ozempic, which it launched in the United States in 2021, then in Europe in 2022. Its success has been dazzling: on the first nine months of the year, sales exploded by 492%, to $3.1 billion! In turn, her competitor Lilly draws the Mounjaro. This remedy is now authorized for the treatment of obesity across the Atlantic and will be in Europe in the coming weeks. No wonder: in clinical trials, it caused obese patients to lose up to 22.5% of their body mass. Even better than Wegovy (15%)!
Treated with Ozempic for type 2 diabetes, Jean-Pierre saw the miracle work. “Thanks to my weekly injections, I lost 8 kilos in one year”, tells the sixty-year-old Parisian executive who no longer believed he would one day be able to get rid of these stubborn kilos cluttering his figure. Other laboratories are working on similar products, such as Amgen, Pfizer and AstraZeneca. But they are still light years away from the Danish-American duopoly which won, at the end of October, the prestigious Galien USA Prize, awarded to the best scientific advances. The story goes that the jury would not have succeeded in deciding between the two champions as their breakthrough in obesity was revolutionary.
Reimbursement, “the nerve of the war”
Beyond success, however, there remains a major question for laboratories: how to make all these investments profitable? “The crux of the matter is whether these treatments will be reimbursed,” admits Myriam Rosilio, medical director of diabetes and obesity at Lilly France. Because, for the moment, the national health authorities, in the United States as in France, are reluctant to commit to the coverage by Social Security of products sold at prohibitive prices. Across the Atlantic, the Wegovy costs $1,349 per month and the Mounjaro costs $1,060. Even private insurers refuse to open Pandora’s box, which would cost them a fortune.
A major challenge, knowing that these medications must be taken for life to avoid regaining the weight lost. In France, Health Insurance has already been able to measure the extent of the bill. According to information from ChallengesWegovy, which benefited from early access in France, treated 2,694 patients from May 2022 to April 2023, for an amount of 5 million euros.
Mediator trauma
In addition to the difficulties linked to costs, there is the distrust of patients and doctors towards these new developments. Olivier Soula, general director of the biotech Adocia, recalls that “the effects of obesity, notably diabetes, high blood pressure and cardiovascular problems, are so expensive – 10.6 billion euros per year in France – that the place of these drugs is obvious”, the past abuses of certain appetite suppressants require caution. Anorectics, amphetamines and other products from Sanofi, Abbott and Roche withdrawn from the market due to serious side effects are there to remind us of this. Some caused depressive disorders and suicidal thoughts in patients.
Without forgetting the trauma of Mediator in 2010. The antidiabetic, also misused as an appetite suppressant, is suspected of having caused hundreds of deaths, and the case is still in the hands of the courts. “It’s true that we don’t have much perspective on new drugs and we can wonder what the consequences will be twenty years from now, if they are generalized to millions of patients,” recognizes this executive from a pharmaceutical group wishing to remain anonymous.
Last month, a Canadian study warned of a series of side effects ranging from digestive disorders to pancreatitis, a sudden inflammation of the pancreas. The European Medicines Agency, meanwhile, launched an investigation into the more serious risks of suicidal thoughts and self-harm in July, which was due to conclude in November. The industry therefore expects health authorities to impose strict limits on these treatments. “They will certainly be reserved for the most serious cases, such as those with cardiac obesity,” anticipates Isabelle Gaillard, cardiometabolism medical director at Amgen France.
The Eldorado turns into the Wild West in the United States
In the meantime, far from reassuring the most cautious observers in France, the obesity business is turning into the wild west in the United States. Since the launch of Wegovy, Americans have been flocking to this treatment to refine their silhouette, at least those who can afford it. A frenzy encouraged by celebrities who boast on Instagram or TikTok of having regained their figure thanks to these injections. Or by the rumors that panic social networks. In a tweet that went around the world last year, American billionaire Elon Musk transformed himself into a shock ambassador for the Danish laboratory. Questioned on the social network X (formerly Twitter) regarding the secret of his remarkable weight loss, the charismatic boss of Tesla and Space answered in two words : ” the young “… “and Wegovy”.
Problem is, the race for weight loss among the rich and famous has caused a shortage of Wegovy, which affects the entire family of antidiabetics to which it belongs: Ozempic and Saxenda from the Danish manufacturer, or Trulicity from Lilly. Manufacturers can no longer keep up. “These production failures only increase the number of misuses and inappropriate prescriptions of diabetes medications, which are sold to patients simply wanting to lose weight,” is alarmed in France by cardiologist Jean-François Thébaut, vice-president of the French Federation of Diabetics.
“All the ingredients of a bubble”
To make matters worse, these products are easily purchased online across the Atlantic, notably on Amazon Pharmacy. On the K Health, PlushCare or Push Health sites, you sometimes just need to answer a simple questionnaire to obtain a prescription. While others lure the market with complete weight loss programs at knockdown prices. For $188 per month, Nextmed promises its members treatment from Wegovy, from prescription to follow-up consultations. “Like all markets with stratospheric prospects, obesity attracts its share of profiteers, even crooks”, deplores Anne-Sophie Joly, founder of the National Collective of Obese Associations, resigned to seeing illegal parallel sales networks and counterfeits flourish.
However, this is not enough to dampen investor enthusiasm. So boosted, Novo Nordisk’s market capitalization exceeded Denmark’s GDP this summer! Lilly’s stock, for its part, has almost doubled in one year, now standing at $600. “The markets are overreacting. The miracle cure does not exist if it is not part of a global prevention policy. believes Jörg Ohleyer, who is wary of too many promises. “We can already see all the ingredients of a bubble ready to burst,” alerts the consultant.
Alzheimer’s and Parkinson’s, the next blow?
But Novo Nordisk, like Lilly, is already preparing the next move. Thus, the Danish laboratory is determined to exploit the Ozempic and Wegovy vein to the end. He launched studies on the applications of semaglutide – the molecule common to his two “blockbusters” – in neurodegenerative diseases, which are still poorly treated. From there to offering appetite suppressants to cure Alzheimer’s or Parkinson’s diseases? A new jackpot in sight for the Big Pharma.
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