Novo’s $35B Spending Spree; Mounjaro Launches in Britain; the Obesity Drug-Arms Race; Hip Surgery and Semaglutide; Kids on Wegovy

AT A GLANCE

    • Reuters reports Novo Holdings, the controlling shareholder of Danish obesity drugmaker Novo Nordisk, plans to invest about $35 billion by 2030.
    • Eli Lilly launches Mounjaro in Britain this week, for eligible private and NHS patients, from Reuters.
    • Sy Mukherjee at Fast Company notes it is ‘…just the beginning for biopharma’s obesity-drug arms race.’
    • Patients on semaglutide undergoing hip replacement had lower readmission and joint infection rates, from The Journal of Arthroplasty.
    • Reuters reveals over 1,200 children aged 12 to 17 with an obesity diagnosis started taking Wegovy.

NEWS

    • Reuters reports Novo Holdings, the controlling shareholder of Danish obesity drugmaker Novo Nordisk, plans to invest about $35 billion by 2030.
      • CEO Kasim Kutay said ‘…Novo Holdings would invest about $5 billion a year in the next five years, and that could go up to $7 billion a year by 2030.’
      • In addition, the holding company seeks to tap into the growing market potential in Asia, with plans to invest in Indian private hospital chain Manipal Hospitals.
    • BioAge, a California biotech start-up just raised $170M, including from Eli Lilly and Amgen’s venture arms, from STAT.
      • The proceeds will be used to develop Azelaprag, an oral medication that mimics apelin, a peptide released in response to exercise and regulates metabolism and muscle biology.
      • A planned combination with Zepbound in mid-2024, ‘…will lead to further weight loss with less muscle deterioration…’ from BioAge CEO Kristen Fortney.
    • Eli Lilly launches Mounjaro in Britain this week, for eligible private and NHS patients, in Reuters reporting on retail chain Superdrug and Simple Online Pharmacy.
      • Superdrug sells a 4-week course of Mounjaro for $270 under its private service, while Simple said its starter dose would be priced at 189 pounds.
      • A spokesperson at Simple said it had ‘…a wait list of over 80,000 patients seeking a weight-loss treatment.’
      • Britain follows in the footsteps of Germany, Switzerland, and Poland to launch Mounjaro.

OPINION

    • Sy Mukherjee at Fast Company notes it is ‘…just the beginning for biopharma’s obesity-drug arms race.’
      • Eli Lilly raked in over $5 billion in sales in 2023, whilst Novo Nordisk landed almost four times as much at over $18 billion.
      • The potential market size for obesity and related health conditions may serve ‘…numbers in the tens of millions…’ of Americans, with over a billion worldwide.
      • Reports of an obesity drug market to reach over $100 billion in sales by the end of the decade are not wild or out of sorts.
      • Competitors want to relieve costs for the pricey treatments, resolve supply issues, and sell better drugs – superior weight loss, less frequent dosing, and possibly oral GLP-1 pills.
      • Not unsurprisingly, there are ‘…486 active studies of GLP-1 drugs and their effects on various types of patients and diseases currently listed in the federal ClinicalTrials.gov database…’ which makes me shudder at the total costs being poured into drug development, clinical trials, marketing, and distribution of these medications – anyone want to pick a number?
    • The Washington Post describes ‘…Plus-size influencers are getting paid to promote weight-loss drugs.’
      • Virgie Tovar, an activist promoting body positivity and fat acceptance received emails as part of a ‘…part of an industry-wide strategy to market injectable weight-loss medication via plus-size influencers.’
      • In response to a series of partnership offers from weight-loss companies, Tovar posed for a selfie with a sign that reads ‘I don’t want Ozempic.’
      • WeightWatchers ‘…flew a cadre of influencers to a hotel in Los Angeles for an event it called the GLP-1 House…’ in January, to help followers ‘reclaim their health.’
      • Ending weight bias is important; just as critical is working with patients who want to lead healthier and happier lives, through personalized care journeys toward resolution of their associated metabolic disease, such as diabetes, high blood pressure, sleep apnea and arthritis.

DATA

    • Orthopedic surgeons reviewed almost 10,000 patients undergoing total hip replacement; one in six of the patients were on semaglutide and they had lower readmission and joint infection rates.
      • There was a 32% lower risk of being readmitted to the hospital at 90 days, and a 44% lower rate of join infection at two years.
      • Dr. Matthew Magruder of Maimonides Medical Center in Brooklyn, New York led the study, which was published in The Journal of Arthroplasty.
      • As we continue to take note, it is not a particular effect of GLP-1 medications, but more the impact of treating obesity that drives better clinical outcomes for patients – be it from nutritional, behavioral, medication or surgical interventions.
      • Back at my last clinical role, I worked closely with orthopedic surgeons at The Rothman Institute, to co-manage patients with obesity and in need of hip or knee replacements… in select patients, I would undertake bariatric surgery prior to their orthopedic surgery, leading to superior outcomes.
    • Reuters reviews data from health technology company Komodo Health reveals over 1,200 children aged 12 to 17 with an obesity diagnosis started taking Wegovy.
      • This was in the first 10 months of 2023, compared to just 25 children prescribed the drug in 2022.
      • The data included health insurance claims from nearly 20 million children, or about 80% of the U.S. population aged 12 to 17; over 2.25 million adolescents had an obesity diagnosis listed in their insurance claims during the nearly six-year period reviewed – a drop in the ocean at best.

DR.RAJESH TWENTLY 30 HEALTH


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