'Golden age' of weight loss jabs coming – some are about to get a lot cheaper
A 'golden age' of weight loss drugs is on the horizon which could finally reverse the rising tide of obesity, scientists say. The leader of the first head-to-head trial comparing the two leading appetite-suppressing jabs revealed at the European Obesity Congress in Malaga, Spain, there are 150 more such drugs in the pipeline.
A host of obesity experts have called on the NHS to urgently ramp up capacity at its weight loss clinics so pills and jabs can be cheaply prescribed to much of the population as they come 'off patent'. Professor Jason Halford, of the European Association for the Study of Obesity, said: 'If the government and NHS are serious about prevention they need to reconsider their position on the speed of the rollout of these drugs, as this evidence comes to light.
"In ten years time the landscape is going to be completely different. There will be lots more obesity drugs available, they should be in more usable forms and they should be a lot more affordable.'
Dr Louis Aronne, director at Weill Cornell Medicine, New York, US, led a trial showing the Mounjaro jab saw users lose 50% more weight than Wegovy, and that newer versions would keep getting better. He said: 'I think we're going to see more medications. The other day I saw a list of 150 medications, many GLP-1s, but also other mechanisms. I call it the golden age of obesity treatment.'
'They will be less expensive, and hopefully the oral small molecules which are cheaper to manufacture and distribute. I think health systems should be ready to roll them out at scale.'
Obesity rates have been rising globally for the last 30 years and more than a billion people are now considered obese. This has contributed to a rising tide of chronic illness, particularly in the West, where we live longer with diseases such as cancer, heart disease, dementia and diabetes placing a huge burden on healthcare systems.
Pharmaceutical companies are pumping tens of billions of pounds into a new generation of appetite-suppressing medicines which could finally help reverse the rise in obesity. Weight loss pills are expected to take over from injections making them more readily available.
Prof Halford added: 'The Holy Grail would be the small molecule, something that works as a hormone would do. But we could take orally like a regular tablet and that's where I think we will be going in probably the next 10 years. In a decade from now we'll have some of the medications off license so they'll be much cheaper. The more treatment we have, the more competition we have, the lower the prices. At the moment the NHS rollout does not take into account the number of medications potentially available in the next 10 years.'
Novo Nordisk manufactures market leading jabs Wegovy and Ozempic, for type 2 diabetes which are both due to come 'off patent' in the coming years so generic versions will be sold for a few pence rather than hundreds of pounds. It also has a pill form of the drugs going through clinical trials.
Another study presented at the conference showed Wegovy halved the risk of dying from stroke or heart attack in people with obesity and cardiovascular disease. The Select trial also found Wegovy protected against heart disease even before people had lost any weight, possibly by reducing inflammation.
Author Professor Donna Ryan, presenting the findings from manufacturer Novo Nordisk, said they "should change public policy everywhere". She added: "I think what our study today does is it further emphasises there is no need to wait. There's always inertia in medicine. We're slow moving. What this analysis says is that this treatment works early - so why wait?'
Currently around half a million Brits are taking the weekly jabs, mainly by paying for private prescriptions, despite over four million being eligible for them on the NHS.
NHS England responded justifying its gradual rollout of jabs such as Mounjaro, which will only see 220,000 people being prescribed it in the next three years due to the cost and resources needed to provide accompanying weight management support from a specialist.
Dr Claire Fuller, NHS England's medical director for primary care, said: 'Weight loss drugs are a powerful part of our arsenal to tackle obesity and support people to lose weight and reduce their risk of other illnesses like diabetes, heart attacks and stroke. From next month, some eligible patients will be able to access the weight loss drug Mounjaro for the first time. The drug has already been approved for use for some adults in specialist weight management services, and 220,000 people will be eligible to benefit over the first three years.
'This phased roll out will ensure those with the greatest clinical need can access the treatment as a priority, at the same time as the NHS develops new and innovative services through which other weight loss treatments can also be delivered in the future. Local NHS organisations will be providing further information on how patients can access services in due course.'
The powerful drugs must be prescribed alongside specialist support to help people transform their diet and activity levels. Without substantial lifestyle changes users will pile the weight back on if they ever come off the jabs. Some people have to stop taking them due to side effects, such as vomiting.
Novo Nordisk patented its blockbuster GLP-1 drug semaglutide in both its branded forms Ozempic and Wegovy. Its 'core' patient expires in 2026 but the pharmaceutical company has 220 'secondary' patients in 28 countries which could extend its market exclusivity to 2033. After then the price of drugs based on its semaglutide molecule will plummet and the availability of generic versions of the drugs will explode.
Other first-generation weight loss jabs such as liraglutide, sold under the brand names Saxenda for obesity and Victoza for diabetes, and dulaglutide, brand name Trulicity, are set to see their patents expire soon paving the way for generic alternatives.
Dr Sonya Babu-Narayan, director at the British Heart Foundation, said: 'A generation ago, effective drugs for obesity would have been a pipe dream. Yet here we are with the potential to make a massive dent in the number of lives cut too short by cardiovascular disease and other conditions such as dementia and cancer. It is imperative that the health service embraces this opportunity and ensures those in need of these lifesaving treatments can access them.'
Big pharma is competing to find new drugs including one drug dubbed the 'Godzilla' of appetite-suppressing injectables which saw trial participants lose up to 24% of their body weight in less than a year. The weekly jab called retatrutide helps the body burn more fat as well as making users feel more full so they eat less. This twin approach has helped it outperform Wegovy, Ozempic and Mounjaro which only suppress appetite.
As well as GLP-1 and GIP hormones, retatrutide targets a third hormone known as glucagon which triggers the body to burn more fat when we move. The trial results showed it helped people with obesity shed 60 pounds on average in just 48 weeks. Women lost even more shedding 28.5% of their body weight compared to 21.2% in the male half of the trial.
But experts insist these drug breakthroughs should not stop political leaders from ignoring the root causes of obesity, namely that society is now set up so we usually have cheap, unhealthy food at our finger tips and it is difficult or expensive to make the healthy choice.
Katharine Jenner, director of the Obesity Health Alliance, said: 'It's no surprise that major pharmaceutical companies are investing heavily in obesity treatment. They recognise the scale of the opportunity. That opportunity exists largely because we've failed to tackle the root causes of obesity.'
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