Exploring The 2025 Obesity Drug Pipeline

A Snippet From The 2025 Payer’s Guide to GLP-1 Drugs

In recent years, GLP-1 drugs have become increasingly popular for their effectiveness in managing obesity. As demand rises for using GLP-1 drugs to manage obesity, the pharmaceutical pipeline has also grown to match. Learn more about the obesity drug pipeline below.

The blog below is a snippet from our recently published guide: The 2025 Payer’s Guide to GLP-1 Drugs. For access to the full guide, click here or download in the sidebar.

The Obesity Drug Pipeline

Currently, the obesity GLP-1s market is very competitive between Wegovy and Zepbound. Novo Nordisk’s Wegovy continues to lead the market in sales, but analysts predict Eli Lilly’s Zepbound will dominate the market soon, in part due to results of a head-to-head clinical trial that Eli Lilly released in December 2024. The study found that patients taking Zepbound lost an average of 20.2% of their starting weight after 72 weeks, while patients taking Wegovy lost 13.7%, leading Eli Lilly to promote Zepbound as 47% more effective than Wegovy when used for weight loss. Zepbound’s new indication for sleep apnea may also contribute to increased uptake of the drug.

Given the strong interest in and uptake of these newer obesity drugs, there continues to be tremendous effort and work in developing, evaluating, and bringing new drugs to the market. The obesity drug pipeline is focused on developing additional medications to promote significant and sustainable weight loss by continuing to target gut hormones (studying double and even triple agonists) and aiming to produce drugs with fewer side effects and in more favorable dosage forms (e.g., oral options and lower frequency injectables). There are many drugs in clinical trials that are expected to be reviewed and approved over the next few years and beyond. Novo Nordisk and Eli Lilly are leading the near-term obesity drug pipeline, with pursuit of both additional expanded indications for Wegovy and Zepbound and approval of new drug candidates in the pipeline.

Novo Nordisk’s next obesity drug candidate, CagriSema, combines semaglutide (a GLP-1 agonist) with cagrilintide (an amylin analogue) in a once-weekly subcutaneous injection. In December 2024, Novo Nordisk released results of their Phase III trial, which demonstrated 22.7% weight loss at 68 weeks, falling short of their predicted 25% weight loss but similar to the average weight loss seen with Eli Lilly’s Zepbound. Additionally, at the end of the 68-week trial, 57% of patients were on the highest CagriSema dose compared to 83% of patients on cagrilintide alone and 70% of patients on semaglutide alone, indicating patients may have struggled to tolerate the drugs in combination. Following these non-superior results, Novo is pursuing a new clinical trial to further evaluate CagriSema’s potential for treatment of obesity.

Obesity Pipeline Highlights

The obesity drug pipeline is pursuing new therapies that combine different gut hormones, offer an improved dosage form (e.g., oral formulation), or offer less frequent dosing (once monthly as opposed to once weekly) while maintaining a primary focus on enhancing weight loss outcomes. The success of bringing a new drug to market may hinge on having some type of advantage over existing therapies. The table below highlights key points regarding drugs in the obesity pipeline.

The studies will continue, and the pipeline is robust, all with the potential of even greater benefits for patients who take these drugs. However, unchanged are the financial challenges for payers to provide access to these drugs for many patients who could potentially benefit from them. Hope remains, as the drugs will become more affordable in future years as market competition grows with more expanded indication approvals and new drugs entering the market.

For access to the full guide (The 2025 Payer’s Guide to GLP-1 Drugs), click here or download in the sidebar.