~1.5 years ago I was reading a Financial Times article (FT.com) on obesity drugs and their order to market when my critical (/pedantic) eye picked up a comment that wasn’t quite right “Pharma’s first movers can often prove resilient . . . Merck’s blockbuster Keytruda managed this in cancer therapy.”
Still in my first year as an independent consultant, I thought it worth sending a note to the editor in an attempt for 5 seconds of fame and was happy to see it published in the letters section a few weeks later (FT.com).
I enjoyed reading the Lex note on obesity drugs. One line jumped out: “Pharma’s first movers can often prove resilient . . . Merck’s blockbuster Keytruda managed this in cancer therapy.” Keytruda was technically the second mover, receiving approval in September 2014, when Opdivo was approved in July 2014. Opdivo actually outperformed Keytruda in product sales from 2014 to 2017, at which point Merck’s lifecycle efforts paid off, and it has since been far more successful. – Excerpt from Letter to FT
Ironically, Novo and Wegovy are facing increased pressure from followers Eli Lilly and its obesity drug Zepbound, and it seems like a case of a first-mover struggling.
Novo faced supply issues from 2022 to 2024, which were solved by many pharmacies compounding their version at lower prices. Lilly also faced shortages due to high demand, but launching in 2023, it learned from Novo’s early mistakes and was able to invest quickly to expand its Indiana production sites (WSJ). Now, Zepbound has overtaken Mounjaro for prescriptions in the US (WSJ).
Mounjaro has shown greater weight loss than Wegovy (NEJM), and based on analyst expectations (WSJ), it looks like it may continue to grow successfully. With Novo having recently let its CEO go, it is now entering a new era, and it will be interesting to see how the new CEO steers the ship. Is it possible for Novo to regain its past lead, or is Lilly’s position too strong?
In pharma, it’s always helpful to look at case studies for lessons and avoid past mistakes. We’re living through another now, and it may be years before we can look back and do a detailed analysis on this early stage of the obesity market. We can say that both companies will be learning and preparing for the second generation of obesity drugs, including oral versions that will increase convenience.
