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According to the forecast of Datamonitor Healthcare, the weight loss market in the United States will grow from the current 5.3 billion US dollars to 1.2 billion US dollars over the next decade. However, if a more effective treatment plan emerges, the market may experience dramatic growth. It is understood that less than 1% of obese patients are currently receiving drug treatment. If this proportion rises to 5% in 2026, the market size will reach 11.2 billion U.S. dollars.

Figure 1 Weight loss market forecast for different treatment ratios (1%, 5%, 10%) (millions of US dollars)

Source: Datamonitor Healthcare

The main weight loss drug outlook forecast

The main drugs for the current weight-loss market are Eisai Belviq (chloraserin), Orexigen and Takeda’s Contrave (naltrexone/bupropion), Vivus’s Qsymia (phentermine/topiramate), and Novo Nordisk Saxenda ( Liraglutide) and Roche Xenical (orlistat). The sales trends of these drugs over the next ten years are shown in the figure below:

Figure 2 Trends in sales of drugs in the US weight-loss market for the next ten years (2016-2026)

Source: Datamonitor Healthcare

Forecasts show that the growth of the weight-loss drug market in the next decade will be attributed mainly to Novo Nordisk’s Saxenda. A LEADER study of liraglutide showed that in patients with type 2 diabetes, the drug reduced the risk of adverse cardiovascular events by 13%, which is a major complication of obesity.

Based on this data, 42% of the doctors surveyed stated that they will increase the use of Saxenda. This will greatly promote the market share of Saxenda in class 2 and 3 obese patients at high risk of cardiovascular events. By 2026, the drug sales will increase from the current 261 million US dollars to 778 million US dollars.

However, the higher price of Saxenda determines that its dominant position in the weight loss market will depend mainly on sales rather than sales. Saxenda’s treatment costs up to $1,000 per month, and Roche Xenical (orlistat) came in second with $558 per month for treatment. Vivus’s Qsymia (phenbutylamine/topiramate) will remain the largest prescription drug in the weight loss market.

Xenical (orlistat) and Belviq (chloraserin) are less effective than Qysmia (phentermine/topiramate), Saxenda (liraglutide), and Contrave (naltrexone/bupropion), Future market share and sales will decline. Datamonitor predicts that by 2026 Orlistat sales revenue will drop from $116 million in 2016 to $78 million. Chlorocyanin will fall from 41 million U.S. dollars in 2016 to 18 million.

The future market for Qysmia (phenbutylamine/topiramate) and Contrave (naltrexone/bupropion) will increase, which will offset the impact of the drop in sales of orlistat and clindamycin on the overall weight loss market.

Contrave (naltrexone / bupropion) due to the withdrawal of partner Takeda, the market outlook will be affected. After all, Orexigen’s small size and limited resources have made Contrave’s marketing possible challenges. However, as doctors increase awareness of weight-loss drugs and the economic cost of obesity, doctors are increasingly inclined to use drug interventions to treat obesity, and sales of the drug will rise in the future.

Takeda Abandon Contrave (Naltrexone / Bupropion) Brings New Growth Opportunities to Vivus Qysmia (Petylamine / Topiramate), Qysmia Currently Has Largest Market Share (Sales) in Diet Drug Market and Will Continue to Be in the Future Is the most commonly used prescription diet pills. Its excellent clinical data makes this drug take the lead in its competitors.

Research of weight-loss drugs

As doctors become more accustomed to using drugs to treat obesity, more drug candidates will enter the market in the future. There are currently 16 weight-loss drugs currently in phase II clinical studies. Among them, tesofensine is the fastest developed, and Medix plans to start the phase III clinical of the drug by the end of 2016.

Kevin Shannon, an analyst with Datamonitor Healthcare, believes that the Johnson Seng SGLT2 inhibitor Cangrefinone and Novo Nordisk long-acting GLP-1 hypoglycemic agent somatostatin are the most promising candidates.

The SGTL2 inhibitor Enplgliflozin developed in cooperation with BI and Eli Lilly has been shown in clinical studies to reduce the risk of cardiovascular events in patients with type 2 diabetes. As the same mechanism of action drugs, canagliflozin may have the same effect. Shannon believes that cardiovascular benefit may be a common feature of this class of drugs, but it needs to be confirmed after Cangreline’s CVOT clinical outcome (2017) is announced.

Somarulin also showed cardiovascular benefits in patients with type 2 diabetes in a study called SUSTAIN 6. Novo Nordisk is currently developing an oral dosage form of the drug, and Shannon believes that the market is promising.

In addition, the combination of SGLT-2 inhibitors and GLP-1 agonists has shown an exciting weight loss effect in some clinical studies or will be a new option for future obesity treatment.

A study of AstraZeneca, DURATION-8, showed that the SGLT inhibitor dapagliflozin and the GLP-1 agonist exenatide were used in combination with metformin monotherapy in patients with poorly controlled type 2 diabetes Compared with individual drug treatment, it can effectively improve the patient’s blood glucose index, and at the same time can significantly reduce the weight of the patient.

Sanofia’s Tesofingen and 7TM Pharmaceutical’s Onipidine are central nervous system drugs. Shannon believes that the prospects for these drugs are worrying. Some weight-loss drugs that act on the central nervous system, such as Rimonabant and Sibutramine Both fenfluramine and phentermine have been withdrawn from the market.

Summary

In 2014, the cost of obesity in the United States is estimated to be US$300 billion, and the proportion of obese people in the total population is 36%. By 2030, this proportion will reach about 50%, and the resulting costs will also soar.

At present, only about 1% of obese patients receive drug treatment. The market has huge room for growth, especially when more effective therapeutic drugs are on the market. The development of potent drugs that act directly on obesity, rather than the “bandaging” effect of other metabolic studies, is a challenge for drug researchers.

Novo Nordisk, a company specializing in diabetes, recently announced that it will enter other metabolic diseases to expand its market share. This will also be the future route for other large pharmaceutical companies that are focused on the diabetes market.

Increasing competition, difficult drug bids, and significant improvements in effective treatments for existing type 2 diabetes will prompt more companies to turn to other therapeutic areas. The weight-loss market will provide these companies with a warm “safe haven” and bring the market growth for the next decade.

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