Demand for semaglutide, a popular weight-loss treatment, has surged in recent months, and it will likely soon face stiff competition as a new "King Kong" treatment — as well as several other drugs in the weight-loss market pipeline — gain ground.

Is there a new 'King Kong' of weight-loss drugs?

Semaglutide, a drug that  mimics  a hormone called glucagon-like peptide-1 (GLP-1) to target areas of the brain that regulate appetite and food intake, has grown in popularity in recent months as an effective weight-loss treatment.

The drug, which is made by  Novo Nordisk, is available in two forms: Ozempic, a diabetes treatment, and Wegovy, a higher dose of the drug approved for weight loss. In a clinical trial of Wegovy, patients lost an  average  of 15% of their body weight over 68 weeks, leading many experts to call it a "game-changer" for obesity treatments.

Although semaglutide has so far garnered the most interest as a weight-loss drug, there may be a new "King Kong" drug that provides even greater weight-loss benefits, the Wall Street Journal reports.

Last June, Eli Lilly  reported promising results for an experimental obesity drug called tirzepatide. In a clinical trial of the drug, patients lost up to 20% of their body weight. So far, FDA  has only approved tirzepatide to treat diabetes under the name Mounjaro, but Lilly said it expects to complete its application for the drug to be used to treat obesity by the end of April, which could lead to an approval later this year or in early 2024.

According to Keith Tapper, a biotech analyst at  BMO Capital Markets, people on tirzepatide typically lose weight more quickly and have an overall "better experience" than those taking Wegovy. It is also slightly cheaper at around $980 for the highest dose compared to $1,350 a dose for Wegovy.

Aside from its weight-loss benefits, Lilly is also studying tirzepatide's potential use to treat liver disease, as well as whether the weight loss it induces could have positive downstream impacts on other areas of health.

"To me, tirzepatide in my career may be the most important drug Lilly's been a part of," said Lilly CEO David Rick. "It is one of the rare ones that has a chance to move the life expectancy of the population."

The race to develop better, more effective weight-loss drugs

"For all its hype, semaglutide is the stepping stone and not the final destination of a new class of obesity drugs," The Atlantic writes. Currently, several other companies, including  Pfizer, Amgen, Structure Therapeutics, and Viking Therapeutics, are also working to develop their own weight-loss drugs in hopes of joining the lucrative market.

Many companies are developing drugs that target different receptors in hopes of boosting weight loss. For example, Lilly is testing another drug that targets three receptors, GLP-1, GIP, and glucagon, to see if that increases weight loss even more. Separately, Amgen said it is working on a drug that works by "putting the brakes" on the GIP receptor and "putting the gas" on GLP-1.

Some companies are also hoping to make these weight-loss drugs easier to take. Currently, both semaglutide and tirzepatide are taken as injections, which is less convenient than pills for most people. According to Pfizer CEO Albert Bourla, an oral weight-loss drug would "[unlock] the market," which he estimated could be worth as much as $90 billion in the future.

Although Pfizer currently does not have any weight-loss drugs in its portfolio, it is developing a twice-daily GLP-1 agonist pill. Lilly is also working on an oral version of Mounjaro, and Structure Therapeutics is developing a similar oral drug.

According to Tapper, he expects these drugs to become available by 2026, and by that time the market is likely to be so diverse that it will "support a broad range of options" to meet patients' differing needs.

Shauna Levy, a professor who specializes in bariatric surgery at Tulane University School of Medicine, said she expects to see a "huge explosion" of next-gen obesity drugs over the next five years. As more drugs enter the market, prices could also decrease, making them more affordable for a broader population.

By 2026, oral forms of weight-loss drugs could cost around $500 a month, and by 2030, they could decrease to around $350 a month. However, that cost is still prohibitive for most patients, especially since weight-loss drugs are generally not covered by insurance.

Overall, "[u]nless obesity drugs receive the same kind of coverage [as other medications], no level of improvement will lead them to deliver on what Ozempic is promising us now," The Atlantic   writes. (Tayag, The Atlantic, 4/4; Loftus, Wall Street Journal, 4/3)