Obesity drug war may be about more than marketing to the overweight

Obesity drug opportunities may lie in finding overlapping patient concerns
Obesity drug opportunities may lie in finding overlapping patient concerns

Third-quarter earnings season has shown that the obesity market is gaining traction, but news from other fronts indicates that the turf war is becoming more complex than targeting the overweight.

Among the hints:Orexigen's focus on the diabetes or pre-diabetes marketplace. The company noted in its Monday earnings call that demand through its Direct Save home delivery program for its just-approved drug Contrave has been stronger than expected, with 5,000 prescriptions funneled through this discrete access program.

The company admitted to stumbling when it comes to processing these prescriptions, but its focus on the diabetes market, which was expected once it allied with Takeda, shows the ways drug manufacturers are thinking about obesity's reach and possibly capturing multiple patient populations with minor tweaks, in a way that is distinct from add-on indications like those of AbbVie's multi-indicated Humira or Allergan's similarly indication-endowed Botox.

Novo-Nordisk is among those elbowing into the diabetes-obesity space, albeit from the diabetes side of things. In this case, the company is seeking to play up the weight-loss benefits of liraglutide, which it is approved to tout  in its Victoza ads as a medication that “may help you lose weight,” even though the diabetes shot is not indicated for weight-loss.

Current liraglutide marketing addresses concern about weight-gain that follows some diabetes medications, and although Novo wants to deploy an obesity-indicated liraglutide under the name Saxenda as opposed to Victoza, it would still be entering the weight-loss market with a history of familiarity among both diabetes patients and professionals, who are often coping with or concerned with co-morbid conditions including obesity.

Eisai may also be poised to add a new angle to the prescription weight-loss market by thinking smaller and off-center. In this case, it is about exploring the use of its weight-loss drug Belviq (lorcaserin) as a smoking-cessation aid. Phase-II results published November 3 showed “statistically significant improvement over placebo in reducing the number of patients who smoke after 12 weeks of treatment.” Among the factors that make this hypothetical stand out is the potential marketing crossover that is distinct from an expanded indication is that while the study indicated lorcaserin may help patients quit smoking, it also showed that patients tended to lose about one kilogram, or just over two pounds, compared to placebo patients who generally stayed the same weight.

Weight gain may have been a secondary consideration, but Eisai's Cheif Medical Officer Gary Palmer said  weight-gain worry scares off many smokers from becoming ex-smokers, as well as factors such as the lack of appetite-suppressing nicotine, and the fact that food tends to “start tasting better and smelling better,” when taste buds are no longer dulled by smoking. Although smokers would be short-term patients, unlike obese patient who are expected to keep filling Belviq, a smoking indication could keep dollars flowing: Pfizer's smoking-cessation drug Chantix brought in $648 million in sales last year, and $670 million the year before, despite side-effect concerns and a black-box warning from the FDA.