Breaking news! This "weight loss injection" has been launched in China, and the strongest competitor to Simae has arrived

Eli Lilly China has just announced that its GLP-1 class star drug Tirzepatide injection has officially launched in China.

On July 19 last year, the star drug Tirzepatide injection for "long-term weight management" indications was approved by the National Medical Products Administration.

Under the name "weight loss injection," the "dual giants" Semaglutide and Tirzepatide have already been popular in the domestic market for many years. Finally, on May 21 last year, Tirzepatide was approved for glycemic control in China, followed by the approval of both for weight loss.

Just last month, Eli Lilly released an even more significant piece of news, announcing head-to-head data against Semaglutide.

With the official launch of Tirzepatide, the "dual giants" have finally gathered in the domestic weight loss market.

Average weight loss of 26.6%, Eli Lilly also announced head-to-head results against Semaglutide

Tirzepatide is currently the first and only approved glucose-dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist.

GLP-1 is an incretin that promotes insulin secretion in a glucose concentration-dependent manner, inhibits glucagon secretion to lower blood sugar, and delays gastric emptying, thus having a weight loss effect. Tirzepatide can bind to and activate GIP receptors and GLP-1 receptors, reducing food intake, lowering weight, and decreasing fat mass by regulating appetite.

Tirzepatide covers two indications in China:

Tirzepatide was first approved by the U.S. Food and Drug Administration (FDA) in May 2022 for improving glycemic control in adults with type 2 diabetes, and subsequently approved in the European Union, Japan, and others. In November 2023, the FDA's approval officially allowed Tirzepatide to enter the chronic weight management market.

On May 21 this year, the National Medical Products Administration approved Tirzepatide for glycemic treatment in type 2 diabetes patients based on five global Phase III studies—the SURPASS series clinical trials—and one Asia-Pacific Phase III study—the SURPASS-AP-Combo clinical trial (with 83.4% of participants being Chinese patients) [3].

In terms of weight loss, Tirzepatide achieved an average weight reduction of 21.1% over 72 weeks in Phase III clinical trials, and at 84 weeks (72+12 weeks of enhanced lifestyle intervention), the total average weight loss with Tirzepatide treatment reached an impressive 26.6% (29.2 kg) [4,5].

In May 2024, the results of the first multi-center study on the efficacy and safety of Tirzepatide for overweight and obesity in China (SURMOUNT-CN) will also be published in JAMA

Research results show: In week 52, the 10mg group and 15mg group had an average weight loss of 13.6% (12.3kg) and 17.5% (16.1kg), respectively, both better than the placebo group's 2.3% (2.1kg). The average waist circumference decreased by 11.4 cm and 14.5 cm from baseline, better than the placebo group's 2.6 cm.

In terms of safety, the most common adverse events during treatment were still gastrointestinal reactions, most of which were mild to moderate, with very few adverse events leading to treatment discontinuation (<5%). The cardiovascular metabolic indicators in the treatment group, including fasting blood glucose, insulin, very low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and diastolic blood pressure, showed significant improvement compared to the placebo group.

Under the name of "weight loss injection," Novo Nordisk's semaglutide is undoubtedly a pioneer, and any latecomers will inevitably be compared to semaglutide by the public.

On December 4, 2024, Eli Lilly announced the highly anticipated topline results of the randomized, open-label phase 3b clinical trial SURMOUNT-5. In the primary endpoint of this head-to-head study, tirzepatide achieved 1.47 times the relative weight loss compared to semaglutide, with an average weight loss ratio of 20.2%, while semaglutide was 13.7%.

Weight Loss Competition: Is Losing Less than 20% Not Enough?

On December 20, Novo Nordisk announced the results of the phase III trial of CagriSema, a fixed-dose combination of its insulin weekly formulation cagrilintide 2.4mg and semaglutide 2.4mg [7].

Compared to cagrilintide 2.4mg, semaglutide 2.4mg, and placebo (all administered once weekly), patients receiving CagriSema treatment lost 22.7% of their weight after 68 weeks, while patients receiving cagrilintide treatment lost 11.8%, those receiving semaglutide lost 16.1%, and those receiving placebo lost 2.3%.

However, the weight loss effect of CagriSema was superior to that of semaglutide and cagrilintide monotherapy, but the market's response was a stock price plunge of 18%, with many media analyzing that this data left the market "disappointed."

At the end of 2024, Viking Therapeutics and AstraZeneca will also release the latest data on their GLP-1 therapies. Viking's latest GLP-1/GIP inhibitor VK2735 showed a 28-day placebo-adjusted average weight loss of 8.2% in oral Phase I clinical trials, while subcutaneous Phase II results indicated a 14.7% average weight loss over 13 weeks compared to baseline [9].

Viking emphasized that significant weight loss effects were observed in patients receiving the subcutaneous formulation as early as the first week of the trial, with nearly 100% of patients not experiencing rebound after stopping the medication for 4 weeks.

AstraZeneca also announced the results of its investigational oral GLP-1 therapy AZD5004 during the same period, which showed a weight loss of 5.8% over 4 weeks in Phase I clinical trials conducted on obese patients with type 2 diabetes, along with improvements in blood glucose indicators.

However, the market's response to these results has been far from positive. Weight loss data, oral formulations, no plateau phase, no rebound—big pharmaceutical companies have exhausted their resources—GLP-1 has propped up the weight loss market, ultimately creating today's insatiable appetite.

A 100 Billion Market, Competition Just Beginning

Semaglutide and tirzepatide are such phenomenal drugs that have led to a leap in the field. JP Morgan predicted last year that with the dual giants of semaglutide and tirzepatide driving the market, annual sales of such drugs would exceed $100 billion by 2030. Just six months later, BMO Capital Markets raised its forecast to $150 billion [11].

With such a large population base, the Chinese market is a battleground for competitors. According to Frost & Sullivan's forecast, the market size for GLP-1 drugs in China will exceed 50 billion yuan by 2030.

Tirzepatide is priced at approximately $974 per month for treatment (4 doses) in the United States (about 7,047 yuan). Currently, four specifications are available in China: 2.5mg: 0.5ml, 5mg: 0.5ml, 7.5mg: 0.5ml, and 10mg: 0.5ml. Currently, the retail price for 0.5mL:2.5mg*4 pre-filled injection pen is 1,758 yuan/box (4-week supply), with prices varying across different e-commerce platforms, generally ranging from 1,700 to 2,500 yuan/box.

From liraglutide and dulaglutide to semaglutide and tirzepatide, the explosive growth of GLP-1 receptor agonists has undoubtedly made the "dual giants" the biggest beneficiaries at present Today, the market for GLP-1 receptor agonists in China is not just dominated by the "dual giants."

In addition to Eli Lilly and Novo Nordisk, domestic companies are also making strides in GLP-1 drugs, with HengRui Medicine, Shiyao Group, Innovent Biologics, and East China Pharmaceutical all making their moves. In May of last year, HengRui Medicine's innovative GLP-1 drug with independent intellectual property rights set a record with an overseas transaction amount of USD 6 billion for exclusive rights to develop, produce, and commercialize globally outside of Greater China.

With rivals ahead and newcomers surrounding, the launch of Tirzepatide is just the beginning: China's hundred billion "weight loss injection" market sees the "dual giants" gathering, and domestic drugs competing fiercely.

How the legend continues to unfold remains to be seen.

Author of this article: Yun Ye, Source: Dingxiangyuan, Original title: "Breaking! This 'weight loss injection' has been launched domestically, and the strongest competitor of Semaglutide has arrived."

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