Eli Lilly's Tirzepatide Priced Below Novo Nordisk's Semaglutide, Setting Stage for Direct Competition

Compiled by Linan

Eli Lilly's recently approved diabetes drug Mounjaro (tirzepatide) has been priced at approximately $974 per month (for 4 pens), which is lower than Novo Nordisk's weight-loss drug Wegovy (semaglutide, a GLP-1 receptor agonist, 2.4mg weekly subcutaneous injection), priced at $1,349 per month.

Regarding Eli Lilly's pricing, Wells Fargo analyst Mohit Bansal stated that it "could open the door for off-label use," as Mounjaro demonstrated superiority over Wegovy in late-stage trials. Sales of Tirzepatide are expected to exceed $1 billion next year and reach $17.5 billion by the end of 2030.

Data shows that Tirzepatide is a first-in-class drug that can simultaneously activate GLP-1 and GIP receptors, which helps improve blood sugar control. On May 13, 2022, the drug was officially approved by the U.S. FDA for market launch. It is administered once weekly in combination with diet and exercise to improve glycemic control in adults with type 2 diabetes. Tirzepatide also represents the first new type of diabetes medication in nearly a decade.

This approval was based on the positive results of the Phase III SURPASS program, a large-scale Phase III project consisting of 10 clinical trials, with plans to enroll more than 13,000 patients with type 2 diabetes. Among these, five trials are global registration studies, including active comparator studies against semaglutide 1 mg, insulin glargine, and degludec insulin. These studies evaluated the efficacy of Mounjaro (5mg, 10mg, and 15mg) when used alone or in combination with commonly prescribed diabetes medications, such as metformin, SGLT2 inhibitors, sulfonylureas, and insulin glargine. In the SURPASS program, the 5mg dose of Mounjaro reduced A1C levels by an average of 1.8%-2.1%, while the 10mg and 15mg doses reduced A1C levels by an average of 1.7%-2.4%.

Glucagon-like peptide-1 (GLP-1) can be considered a "multifunctional" hormone. GLP-1 is a kind of "incretin" naturally secreted by the mucosa of the human gastrointestinal tract. It can bind to receptors on islet cells and stimulate insulin secretion, thereby reducing blood glucose levels. The advantage of GLP-1 receptor agonist hypoglycemic drugs is that the incidence of hypoglycemia is significantly lower than that of insulin. Additionally, they can reduce food intake and delay gastric emptying, which helps control body weight and protect islet β-cell function.

In recent years, the GLP-1 receptor target has become a mainstream direction in the development of weight-loss drugs. In June 2021, Novo Nordisk's semaglutide received approval from the U.S. FDA for market release under the brand name Wegovy, intended for long-term weight control in patients with overweight or obesity. Wegovy is the first and only once-weekly GLP-1 receptor agonist approved for weight management in obese patients.

The approval was based on the results of the STEP 3a phase clinical trial program, which involved more than 4,500 obese or overweight adult patients. In clinical trials conducted on subjects without type 2 diabetes, obese patients receiving Wegovy treatment experienced an average weight loss of 17-18% over 68 weeks. Throughout the program, Wegovy was safe and well-tolerated, with the most common adverse reactions being gastrointestinal responses.

Wegovy Approved as Weight-Loss Therapy, Gains Competitive Edge. Although the first indication for Eli Lilly's Tirzepatide is diabetes, the drug also has potential applications for weight loss, where it will challenge Wegovy.

On April 28, 2022, Eli Lilly and Company announced key data from the 72-week placebo-controlled SURMOUNT-1 study of the potential blockbuster new drug Tirzepatide (a subcutaneous weekly injection), a GLP-1/GIP dual receptor agonist.

Data showed that at week 72, the weight loss effects in patients treated with tirzepatide (5mg, 10mg, 15mg) were significantly superior to those in the placebo control group, with an average weight loss of up to 22.5% (24kg). Moreover, 63% of patients in the 15mg high-dose group achieved a weight loss of more than 20%.

Eli Lilly CEO Dave Ricks has previously stated that Eli Lilly is considering following Novo Nordisk's approach by splitting the tirzepatide brand into diabetes and obesity segments and marketing them separately. Undoubtedly, Eli Lilly and Novo Nordisk are set for a head-to-head competition.

Tirzepatide is also expected to become another ace in the diabetes market for Eli Lilly, following Dulaglutide. EvaluatePharma has also predicted that the drug's sales will reach $4.9 billion by 2026.

In China, pharmaceutical companies such as Renhui Bio, Huadong Medicine, Wanbang Biochemical, Hengrui Medicine, and Hansoh Pharma are also competing in the GLP-1 receptor agonist product pipeline. According to the MIR DATABANK database, there are currently eight GLP-1 receptor agonists on the market in China, of which only two are domestically produced: Hansoh's PEG loxenatide and Renhui's beinaglutide. In terms of 2020 sales, two drugs—Novo Nordisk's liraglutide injection and Eli Lilly and Company's dulaglutide injection—accounted for over 90% of the domestic market share.

Reference Article:

1. "Top 10 Most Anticipated New Drug Launches in 2022" Yidu Medicine, 2022-02-08

2. "Top 10 Global Hotspot Drug Market Landscape in 2021" PharmaCube, 2022-04-25

3. "Latest! Eli Lilly's New Diabetes Drug Priced Lower Than Semaglutide, Aiming to Capture the Weight Loss Market" Medical Universe, 2022-05-22

4, "Blockbuster GLP-1 New Drug Tirzepatide Price Released!" Pharma Financing, 2022-05-22