Novo Nordisk and Eli Lilly reign over the anti-obesity drug market, and don’t expect this duopoly to end soon, analysts say. But other corporations — each big and small — are hoping to grab a bit of this lucrative market. In a research note, Piper Sandler analyst Yasmeen Rahimi said the firm is tracking greater than 150 studies with 78 agents in development. Some are expected to provide market-moving updates before the yr draws to an in depth. “As you span five or 10 years out, I do think there can be more corporations within the space,” said Cantor Fitzgerald analyst Louise Chen, who covers Pfizer, one rival vying for a bit of the motion. Meanwhile, Novo and Lilly are studying latest formulations that include other gut hormones beyond GLP-1, hoping to boost efficacy. In addition they want to switch up delivery systems so patients could trade a weekly injection for a every day pill. All this goes on amid robust demand for Novo’s semaglutide, which is sold as Ozempic for type 2 diabetes and as Wegovy for weight reduction, and Lilly’s tirzepatide, which hopes to receive regulatory approval for weight reduction this yr. (It’s marketed as Mounjaro for type 2 diabetes already.) Addressing unmet needs So as for a corporation to compete, it’ll have to address among the unmet needs of the present products, according to Chen. An oral formulation would fit this criteria because it does two things, she explained. “It eases the manufacturing constraints since it’s easier to make, and it also lowers the worth basically. Orals are cheaper than injectables,” she said. Price has been an enormous issue for GLP-1 drugs. It will possibly cost as much as $1,350 a month and doctors say patients will need to be on these medications long-term because once they stop, the load is probably going to come back unless they are able to make significant lifestyle changes. Kyle Rasbach, a senior research analyst and portfolio manager at Eventide, said it’ll be “a difficult value proposition” for a latest GLP-1 drug to compete with Novo or Lilly. “We have seen over and over the problem that small biotech has competing with incremental innovations against very large, well-established pharmaceutical corporations that occur to be leaders within the therapeutic areas,” he said. Rasbach said the actual opportunity may very well be to develop products that are orthogonal or additive to GLP-1s. For example, Rasbach cited emerging science that’s aimed toward reducing the lack of lean muscle mass that happens when patients shed some pounds on GLP-1 drugs. Still, with a market estimated to be price greater than $100 billion a yr by 2030 , corporations will try because even a slice of it’ll be large enough to move the needle even for a big pharma company like Pfizer. “Take a have a look at Lilly, how much that stock has moved, and it just kind of defies gravity, the best way that each time there’s an obesity headline, they go a bit higher,” Chen said, noting the identical has been true for Novo Nordisk. Here are five corporations working on this area that might share updates by yr’s end. Altimmune Altimmune shares ended the week up greater than 6% after the corporate received fast-track status for pemvidutide, a GLP-1 receptor agonist, to treat a chronic liver condition often called NASH, or nonalcoholic steatohepatitis. However the stock continues to be down nearly 86% in 2023, putting its market value at a mere $121.7 million. “We consider stock has been under the radar as investors are awaiting this imminent data,” said Piper’s Rahimi, referring to data expected, possibly over the subsequent few weeks, from its Momentum clinical trial for obesity. This data will show how much weight patients lost after taking the drug for 48 weeks, how well patients tolerated it, any antagonistic effects and other details. Rahimi said the NASH news “puts pemvidutide back on the map as a key agent for obesity.” She expects positive news from the Momentum trial would likely mean the corporate could “attract strategic interest at a low valuation.” Pfizer Pfizer is scheduled to report its third-quarter earnings on Tuesday, and some have speculated that the corporate could provide an update on its progress with a phase 2b trial of danuglipron in obesity. The drug is being tested as a pill patients take twice a day somewhat than a once-a-week shot. Expectations for the drug are modest, according to Cantor’s Chen. She anticipates that any positive developments for efficacy, tolerability and dosing can be well-received. “My sense is that from a risk-reward perspective, it’s going to be positive because mainly people think it is not going to work,” Chen said. She explained that previous data from patients with type 2 diabetes who took the drug didn’t show impressive levels of weight reduction. Nevertheless, this trial uses different dosing to treat patients with obesity who shouldn’t have diabetes and it’ll likely be more competitive with other anti-obesity medications. PFE YTD mountain Pfizer shares have fallen about 40% for the reason that start of the yr. Chen expects a weight reduction of about 15% ought to be adequate to persuade patients to switch from injectable GLP-1 medications, which may lead to a weight reduction of as much as 20% or more, within the case of Eli Lilly’s Mounjaro. Analysts even have called out that Pfizer continues to be working to develop the drug with a time release mechanism, which might shift it to a once-a-day dosage, which consumers favor. That will be viewed by investors as a positive for the stock. Goldman Sachs analyst Chris Shibutani said his base case expectation calls for danuglipron to show a weight reduction of 12% to 15%. If it hits that concentrate on, he said he would add potential sales of the GLP-1 drug to his model, and says it could add about $4 a share of additional net present value. “In a bull case scenario during which the efficacy profile is comparable or superior to tirzepatide, we expect peak sales may very well be closer to PFE’s $10bn guidance,” he wrote in a research note. “While we consider expectations are currently low for danuglipron, and we don’t provide value for the asset in our model, in a bear case scenario we will see PFE trading lower based on sentiment.” Structure Therapeutics Structure Therapeutics shares have gained greater than 88% over the past three months, peaking Thursday at $70.70, as hopes have risen for achievement with its oral GLP-1 receptor agonist, GSBR-1290. In September, Structure said GSBR-1290 showed significant weight reduction on the 60 milligram and 90 milligram levels in a 28-day study. Following that report, Leerink Partners analyst David Risinger bumped up his price goal to $97, which suggests there continues to be loads of room for upside ahead. GPCR 3M mountain Structure shares over the past three months. Risinger rates the stock an outperform, citing each the potential for this drug’s success in addition to the strength of the corporate’s management. “We note that global peak annual utilization of oral GLP-1s could easily exceed 15M people, assuming compelling industrial profiles,” Risinger wrote in a research note on Sept. 29. JMP analyst Jonathan Wolleben initiated coverage of Structure at a market outperform in mid-October. “Despite a crowded field, we expect an efficient, once-daily oral GLP-1R agonist can be a compelling option for patients,” Wolleben said. “We recently surveyed 33 physicians who write > 1,500 monthly Wegovy prescriptions who said that a once-daily oral option could be preferred over a weekly subcutaneous injection.” He noted that Structure gained greater than $500 million in market cap after its last report. He believes the info expected within the second half of November and in the primary half of next yr could move the stock even higher. “We expect GSBR-1290 could surpass management’s goal and orforglipron’s high water mark,” he said. Orforglipron is an oral drug Eli Lilly is developing. Immediately, it seems to have the perfect profile for weight reduction in a pill-form, but that might change as latest drugs are studied. Terns Pharmaceuticals The worth of this clinical stage biopharmaceutical company has been cut in half to date this yr, but Mizuho Securities analysts Graig Suvannavejh has a buy rating on the stock. The corporate is about to start a phase 1 trial for TERN-601, an experimental oral GLP-1, for obesity, with top-line data expected in 2024. It has several other compounds within the pipeline, but Suvannavejh expects the load loss drug to receive increased attention. According to FactSet 78% of analysts rate the stock a buy, with a median price goal of $16.63 At a recent investor conference, management said its money balance of $286 million as of the last quarter provides it with runway into 2026. Viking Therapeutics Viking Therapeutics shares are down lower than 2% for the reason that start of the yr, however the stock fell greater than 4% on Friday after the corporate announced earlier within the week a slight delay within the timing of information from VK2375, an oral dual agonist for obesity. Like Mounjaro, it combines two hormones: glucagon-like petide 1 (GLP-1) and gastric inhibitory polypeptide (GIP). Data on VK2375 can be released in the primary quarter of 2024 because it took barely longer than expected to enroll patients in its trial. Leerink Partners analyst Thomas Smith said investors are anticipating weight reduction of three% to 4% on the 28-week mark, with a clean safety record and solid tolerability. “This range would even be competitive with LLY’s orforglipron (*5*) weight reduction at day 28,” Smith said. He noted that the stakes have been raised by data from Structure Therapeutics, which showed about 4.9% weight reduction inside that timeframe. Viking ended the quarter with $376 million in money. Laidlaw & Co. analyst Yale Jen said that ought to last it into 2026. Jen said the obesity data won’t be the one catalyst for the stock in the primary half of 2024, as data is predicted from its other drug programs as well. He reiterated his buy rating with a $35 price goal, which is almost 280% above where it closed Friday.