Inaugural BMO Obesity Summit Focuses on Therapeutics and Combating a Growing Epidemic
Inaugural BMO Obesity Summit Focuses on Therapeutics and Combating a Growing Epidemic
BioPharma Analyst
Evan is a Managing Director and Senior Research Analyst at BMO Capital Markets covering Biotechnology (Large and SMid Cap) and US Major Pharmaceuticals. His respons…
Evan is a Managing Director and Senior Research Analyst at BMO Capital Markets covering Biotechnology (Large and SMid Cap) and US Major Pharmaceuticals. His respons…
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The evolving obesity therapeutic landscape and its potential to help people live longer and healthier lives have captured the public’s attention, but the rapidly developing market for these treatments is far more complex than many investors appreciate.
To better understand the advancements in anti-obesity medicine and how treatment and care are adapting to this new opportunity, BMO Capital Markets hosted providers, key opinion leaders, patients, pharmacy benefit managers and biopharma executives at the inaugural BMO Obesity Summit. The goal of this first-of-its-kind event was to bring together the many constituents in this space, including representatives from Amgen, Structure Therapeutics, WeightWatchers, Intellihealth, Corbus Pharmaceuticals, Altimmune, Terns Pharmaceuticals, Scholar Rock, Prime Therapeutics, Novo Nordisk and Lilly.
Below are five key takeaways from the summit:
1. Obesity is a complex, treatable disease central to many chronic illnesses
In 1994, researchers discovered leptin, a fat hormone critical to a patient’s ability to regulate their body weight, representing a turning point in treating obesity. Put simply, the hormone impairs the brain’s ability to respond appropriately to weight gain. This is important because research shows that cutting out foods doesn’t solve the obesity problem. Rather, chronic inflammation causes irreversible damage that raises a person’s weight set-point – a body’s predetermined weight range. This research provided a framework for treating obesity as a medical condition rather than a lifestyle issue.
Recognizing obesity as a treatable disease was a significant development because it offered a pathway to deal with the growing epidemic. Currently, nearly 40% of Americans are living with obesity, which is tied to more than 200 other chronic illnesses and diseases. Early studies have shown that weight loss of 2% to 5% can deliver measurable benefits for patient health, although losing 15% or more substantially increases those benefits. Select trials have found that some obesity medications have reduced death from any cause and significantly slowed the progress of heart failure and kidney failure. Similarly, blood sugar and type 2 diabetes have been reduced by 73%.
Other potential health benefits have been reported as well, including for chronic kidney disease, obstructive sleep apnea and osteoarthritis, although more research needs to be done.
2. There is room for many players
While investors are primarily focused on a pair of high-profile obesity medications, there is room for more players who are differentiated by format, dosing and the comorbidities treated. As some panelists explained, the market needs to understand that obesity medications can work in different ways, similar to how medical advances around cardiovascular outcomes and treatments do. To put that in perspective, there are more than 100 antihypertensive drugs in the market, but only seven for obesity – two of which are combinations of older medications.
Given the prevalence of the disease, there is a considerable need to find scalable solutions, which will create opportunities for additional players, including those using treatments like GLP-1 – the class of popular diabetes medications that have spurred the recent obesity drug conversation – and behavioral-only programs. Some solutions may use both approaches simultaneously, with several panelists noting that behavioral treatments are still relevant when patients are on GLP-1 medications.
As well, solutions must be consumer-centric, be part of a broader approach and address key health challenges. At the same time, they must manage body composition throughout the weight loss journey, as muscle preservation and the quality of weight loss are critical considerations for obesity patients. Behavioral programs are trying to fill this gap by boosting protein for patients on GLP-1. As the market matures, we’ll see greater patient segmentation and differentiation.
3. The future will be combos – and moderation
Like many diseases, obesity will be a lifelong battle for many, requiring regular use of the available medications and treatments. Finding the appropriate dosage for patients remains a key focus. In some cases, patients are responding by eating too little, which requires a plan to reduce the dosage and slow the rate of weight loss while changing other behaviors, such as diet, supplements and exercise. Taking medications every week, for instance, may not always be necessary.
As much as the new medications might be seen as a game-changer for the treatment of obesity, no one solution on its own will end the epidemic. The future will be a mix of therapies and personal lifestyle choices. Some combinations could include drugs that prevent muscle mass loss, such as myostatin inhibitors and selective androgen receptor modulators, while also reducing appetite.
4. Insurers must evolve to help patients gain better access to treatments
While health insurers are adapting to these new medications, coverage remains limited. Costs are high for all new medications, but especially for those in high demand and tight supply, and manufacturing and capacity for these drugs are expected to remain a key constraint for two years. However, insurers will have to consider the impact these medications could have on coverage costs longer term, especially as more data around other positive health outcomes comes to light. Today, some patients report waiting up to eight months to get an appointment with an obesity specialist. In time, coverage will likely be determined by genetic analysis or comorbidities.
Insurers must also prepare for an influx of claims, as patient enthusiasm for new treatments is likely underestimated. The current stigma around obesity is one of the few barriers remaining when it comes to access and having a broader understanding of the potential for these therapies. Those on Medicare will also have a challenge with coverage – and it doesn’t appear as though that will soon change. Still, in the interim, the impact on providers may be minimal as patients have shown a willingness to pay out-of-pocket.
5. Weight bias, stigma and discrimination remain a challenge
Despite the promising health benefits of these drugs, there is a stigma around obesity medications, with many thinking patients are taking the easy way out. To get past this view, patients and providers must see obesity as the disease it is rather than as a vanity project. Now that the door is open for pharmaceutical firms to enter this sought-after market, it’s created a bit of a Wild West scenario, said some of the panelists. Against this backdrop, it’s even more important for providers to take a science-based approach when prescribing these medications. Consumers and providers need more awareness of the different treatment options.
Even with these new tools, for many patients, obesity will be an issue for the rest of their lives. The current medications and behavioral therapies will help manage the disease, not cure it. More research needs to be conducted to identify any potential long-term side effects from these meds, especially as patients may need to take the medication forever.
BMO Obesity Summit
PART 1
Understanding Obesity as a Chronic Disease
Evan David Seigerman April 10, 2024
To better understand the advancements in anti-obesity medicine and how treatment and care are adapting to this new opportunity, BMO Capital…
