Unsurprisingly, the dramatic success of Lilly and Novo Nordisk has opened the floodgates for investment in these drugs, and there are a ton of them coming. Novo Nordisk has the most popular single agonist (semaglutide), and the most popular double agonist (GLP and GIP receptor agonists) at bet, tirzepatide, and they have a great triple agonist (GLP, GIP and glucagon agonist), retatrutide, with even better results and that is close to approval. But there are a lot of competitors with drugs that are coming, and I don't think having the first one (semaglutide) will help Lilly very much ...

Sorry, I mangled those 2 sentences.

To be clear, Novo Nordisk has the first successful drug, the single agonist (targeting the GLP-1 receptor) semaglutide, including its commercial formulations, Ozempic (and Rybelsus, for the tablet form) for diabetes, and the same drug, with a slightly different dosage (2 mg instead of 2.4 mg), is branded as Wegovy for the weight loss indication.

Lilly has the slightly more effective drug tirzepatide, a double agonist (a single molecule targeting both GLP and GIP.) It is also marketed under 2 names, Mounjaro when it is for diabetes, and the same drug (with the same dosage levels) is branded Zepbound when it is for obesity.

(This is mostly marketing: nothing prevents doctors from using these drugs interchangeably, and in popular use, we mostly hear about Ozempic and Mounjaro, whether the speaker is talking about diabetes or, more likely, obesity. The medically and scientifically preferred nomenclature is to use the generic or nonproprietary drug names, semaglutide and tirzepatide in this case.)

So Novo has the first hugely successful diabetes/anti-obesity drug, with patent exclusivity expiring in 18 months, and Lilly has the second, more effective drug, protected until 2036. Novo's loss of leadership to Lilly is an example of how the first-mover advantage only takes you so far. Lilly is well-positioned with what may turn out to be the 3rd blockbuster, the triple agonist retatrutide (targeting GLP-1, GIP and glucagon receptors), but the field is developing rapidly, and there are sure to be competitors from all the major drug firms.

dtb