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Anesa Mulabecirovic Sahnoun

Anesa Mulabecirovic Sahnoun is portfolio manager for the equity funds DNB Health Care and DNB Bioteknologi.


Obesity is considered a lifestyle disease. Because more people have access to high-energy foods and we are more sedentary, obesity and obesity have tripled since 1975, according to the World Health Organization (WHO). The consequences of obesity include cardiovascular disease. The interest in obesity research has increased in the last 20 years and more than 50,000 scientific articles have been published in this field. There are many companies, large and small, conducting research on anti-obesity drugs. Just a few days ago, Novo Nordisk acquired a smaller Canadian company working in the field of obesity research.

Obesity already costs 2.8 percent of global GDP

Experts agree that the obesity market offers enormous growth potential. Current estimates project a market volume of over 100 billion US dollars by 2030. The annual cost caused by obesity is estimated at 2.8 percent or NOK 14,000 billion of global GDP. When Novo Nordisk, best known for its diabetes drugs, published some results of a study on its obesity drug Wegovy, its share price shot up 18 percent. Now the question is whether the Select study has set the bar so high for other market players' obesity products that it could be difficult to catch up with market leaders Novo Nordisk and Eli Lilly.

The results of the Select study show that 20 percent of patients who received Wegovy had a reduction in cardiovascular disease, suggesting that treating obesity prevents both disease and potential consequences that result in costs for society. The Select study results suggest that public health insurers may be more willing to cover treatment. If the public sector covers treatment, the market will be even larger than if it is privately funded. Over the next two years, both Eli Lilly and Novo Nordisk are likely to sell all that is possible in terms of production, as demand is high and the companies cannot produce enough to supply the entire market. This demand could also have a positive impact on suppliers in the value chain of both companies.

60,000 patients in phase 3 trials

The drugs are first-generation medications that are now being studied further. Novo Nordisk has launched its drug in the U.S., Denmark, Norway and Germany. Wegovy and Mounjaro, the Novo Nordisk and Eli Lilly drugs, will be key growth drivers in this decade.

These drugs act like digestive hormones, called incretins, that the body normally produces when it eats. Incretins work by signaling the pancreas to release the hormone insulin after eating and instructing the liver to produce less sugar. Incretins also make food move more slowly through the digestive tract and suppress hunger signals in the brain. Weight loss of about 15 and 20 percent, respectively, has been achieved with the above drugs.

Over the next six years, we expect to see the results of additional studies that will also look at potential other benefits of this group of drugs when it comes to treating obesity and diabetes, such as whether they can also work for other conditions such as sleep apnea, chronic kidney disease, cardiovascular disease, fatty liver and vision loss.

Second and third generation

The development continues and more and more sophisticated compounds are being developed, while at the same time first-generation products are coming onto the market. Given so many manufacturers - Amgen, Novartis, Pfizer and Boehringer Ingelheim are also conducting research in this area - and with so much money being invested in research and development, the question is whether profitability could decline in the long term. In the long run, pricing power is likely to erode, which is both acceptable and necessary in the long-term as volumes increase and more competing drugs enter the market. It is also possible within an extended period of time that the drugs will be available as pills, which could also help to reduce treatment costs compared to the current weekly injections.

Currently, production is insufficient to meet demand. Obesity treatment may also have implications for other stakeholders. For example, obesity is an important risk factor for the development of sleep apnea, with one in seven obese patients suffering from sleep apnea. Reducing obesity may therefore have implications for manufacturers of sleep apnea treatment devices.

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