Speaker 1: For the last few years, there's been this drug that
Speaker 1: everyone seems to be talking about.
Speaker 2: Oh wow, people with type two diabetes are excited about
Speaker 2: the potential of once weekly ozimpic.
Speaker 1: Ozembic was approved to treat diabetes in the US in
Speaker 1: twenty seventeen, but the effect it can have on weight
Speaker 1: loss has become what it's most known for, and you.
Speaker 2: May lose weight. In the same one year study, adults
Speaker 2: lost on average up to twelve pounds.
Speaker 3: Oh at twelve pounds.
Speaker 1: Well, it may seem like we've been talking about ozembic forever.
Speaker 1: My colleague Madison Muller, who writes for Bloomberg's Health Team,
Speaker 1: says it's only really been recently that a lot of
Speaker 1: people have been talking about this drug.
Speaker 4: It's only been within the last five years that we've
Speaker 4: really started hearing about ozembic, and especially within the last
Speaker 4: year or two years that this has really taken off
Speaker 4: in the public consciousness.
Speaker 1: And for the last six months, Madison's been writing a
Speaker 1: lot about ozempic and other drugs like it, like Munjaro
Speaker 1: and Wagovi.
Speaker 4: When I first started covering this beat the only drug
Speaker 4: that I was really hearing about or that people were
Speaker 4: talking about was ozempic and then a little bit of
Speaker 4: Wigo V conversations too, But ozembic is really the drug
Speaker 4: that started it all. I say that it's kind of
Speaker 4: like Kleenex, like it's just become the catch all for
Speaker 4: all of these weight loss drugs and sort of like
Speaker 4: the whole industry.
Speaker 1: But now, years after Ozempic was approved for use in
Speaker 1: the US, there's a new drug that could threaten its
Speaker 1: Kleenex like status, a drug that looks poised to steal
Speaker 1: its market share and become the go to drug in
Speaker 1: the space. It's called zet Bound, and it's picked up
Speaker 1: steam on TikTok where people are sharing their experiences taking it.
Speaker 3: Hey, it's Karen.
Speaker 5: Here's an update my first week on zet bound after
Speaker 5: being on wogov for over eights.
Speaker 1: Now that I picked up my first first description on
Speaker 1: stet bound, you guys know that I've been on manjarro.
Speaker 3: It is going to be called zet bound, and I
Speaker 3: do not care.
Speaker 2: You could call it dookie on a stick and I
Speaker 2: would still inject this.
Speaker 1: Today on the show, how a century long pharmaceutical rivalry
Speaker 1: gave rise to the weight loss drug craze and why
Speaker 1: investors and analysts think this latest drug, zet Bound, could
Speaker 1: lead its manufacturer to become the first ever trillion dollar
Speaker 1: drug company. I'm Sarah Holder, and this is the big
Speaker 1: take from Bloomberg News. In a lot of ways, this
Speaker 1: story is a tale of two pharmaceutical companies, Eli Lilly
Speaker 1: and Novo Nordisk. Both companies have been major innovators in
Speaker 1: the treatment of diabetes and have been competitors for the
Speaker 1: past one hundred years. But today we're going to start
Speaker 1: with Eli Lilly, not only because it's the manufacturer of Zetbound,
Speaker 1: but also because it's where one of the key breakthroughs
Speaker 1: behind these types of drugs was discovered. Madison told us
Speaker 1: she learned about it from a man named Richard D.
Speaker 3: Marky.
Speaker 4: Richard de Marky was a scientist at Lily for like
Speaker 4: twenty two years.
Speaker 1: His research looked at the body's end acrine system, which
Speaker 1: creates and releases hormones like insulin, and he and a
Speaker 1: collaborator filed a patent for something called.
Speaker 3: A GLP one receptor agonist drug.
Speaker 4: And what GLP one is, it's a gut hormone that
Speaker 4: helps control blood sugar, helps control insulin.
Speaker 3: In the body.
Speaker 4: And what it also does is it mimics the effect
Speaker 4: of eating food. So after you eat, your body releases
Speaker 4: this GLP one hormone and it signals to the brain
Speaker 4: that you can stop eating.
Speaker 3: And so that's what wigovi and ozembic are.
Speaker 1: But Demarki says when he shared this finding with his
Speaker 1: employer Eli Lilly back in the nineties, they were not interested.
Speaker 5: Lily knew nothing with this path but just expired, which
Speaker 5: was a sign of the fact that they didn't believe
Speaker 5: that obesity was a disease right, it was still a syndrome.
Speaker 5: They honestly did not believe that people would take an
Speaker 5: injection to treat a disease ease that was this benign Yes,
Speaker 5: I disagree.
Speaker 1: De Marki ended up leaving the company to continue research
Speaker 1: into diabetes and obesity, and the patent he filed expired
Speaker 1: in twenty seventeen.
Speaker 4: Demarki says that after he left Lily, the interest in
Speaker 4: obesity just sort of ceased at the company.
Speaker 1: Jeffrey Emmick, a senior vice president for product development who'd
Speaker 1: worked at Eli Lilly since the nineties, told Madison, quote,
Speaker 1: we just didn't think they were going to be that efficacious.
Speaker 1: But over in Denmark, a different approach was unfolding at
Speaker 1: Novo Nordisk.
Speaker 4: At Novo he had this counterpart, Lottie Knudsen, and she
Speaker 4: is still at the company. She's still at Novo. She
Speaker 4: has a leadership role now. And back then she was
Speaker 4: a young scientist. This was in the nineties and she
Speaker 4: was also interested in GLP one drugs for obesity, and
Speaker 4: she encountered similar sort of disbelief you know, at Novo,
Speaker 4: and they questioned her work, but she had support from
Speaker 4: Lee Readership and that was sort of what mattered. She
Speaker 4: got the resources that she needed to keep going with
Speaker 4: this research.
Speaker 1: Madison says. Novo Nordisk's research paid off more than a
Speaker 1: decade later with a drug called Sexenda.
Speaker 4: That was the first GLP one drug ever to be
Speaker 4: approved by the FDA for weight loss, and that happened
Speaker 4: in twenty fourteen, and so Novo kept going. They wanted
Speaker 4: this drug was injected daily. They wanted a drug that
Speaker 4: could be injected weekly, and so they were trying to
Speaker 4: change the molecule so that it could be a weekly
Speaker 4: injection instead of a daily injection. They changed it slightly,
Speaker 4: like added a fatty acid chain or something to it
Speaker 4: and the way that they changed the molecule actually led
Speaker 4: to a lot more weight loss, so they weren't trying
Speaker 4: still to develop a more effective weight loss drug. They
Speaker 4: were trying to make a once weekly version, and they
Speaker 4: came up with ozempic. Ozempic was the result of that,
Speaker 4: and the weight loss from ozempic was just substantial, like
Speaker 4: it was way more than sax senda. It was super effective,
Speaker 4: and that sort of started this whole interest and obesity again.
Speaker 1: So Novo Nordisk was out as the front runner in
Speaker 1: the space. But remember Eli Lilly is going to become
Speaker 1: a big player here too, They just weren't there yet.
Speaker 1: While Novo Nordisk was working on ozepik, Eli Lilly was
Speaker 1: actually focused on treating a very different disease.
Speaker 4: They were at the time of like twenty fourteen to
Speaker 4: twenty seventeen, really focused on Alzheimer's. They had for decades
Speaker 4: poured billions of dollars into Alzheimer's research, so they were
Speaker 4: really hopeful about this, and all of those trials ended
Speaker 4: up being failures, like really expensive, disappointing failures.
Speaker 1: So right around twenty seventeen, Novo Nordisk is out ahead
Speaker 1: with ozempic, and Eli Lilly is on its back foot,
Speaker 1: licking its wounds from its Alzheimer's flops. When Eli Lilly
Speaker 1: brings in a new CEO, dave Rix, and right away
Speaker 1: he made weight loss drugs a priority.
Speaker 4: He sent his top scientists to go basically do a
Speaker 4: short stint in diabetes research to see what he could find,
Speaker 4: see if he could find promising research. And he did,
Speaker 4: I mean pretty much right away. He found this small
Speaker 4: study of trizeppetide, which is a GLP one drug combined
Speaker 4: with another gut hormone called GIP and there was this
Speaker 4: small study done in healthy people in Singapore just to
Speaker 4: see if the drug was safe or not. And what
Speaker 4: they saw was that people in this study lost so
Speaker 4: much weight that they had to drop out of the study.
Speaker 1: That study was a good start, but Eli Lilly still
Speaker 1: had to make up for lost time.
Speaker 4: They knew that they needed to do this as fast
Speaker 4: as they possibly could, to get a drug on the
Speaker 4: market as fast as they could, because drug development can
Speaker 4: take a really long time, like it can take six
Speaker 4: to eight years, even a decade, and they didn't really
Speaker 4: have that time.
Speaker 3: Zembic was already out there. They needed to do this quickly.
Speaker 4: And so what Dan Skavronsky, who is now the chief
Speaker 4: scientific and chief medical officer at Lily, told me was
Speaker 4: that he basically told the scientists to go forth with
Speaker 4: the innovation, do things quickly, and he kind of like
Speaker 4: freed them from the bureaucratic processes that can bog down
Speaker 4: drug development at a big company like Lily. And yeah,
Speaker 4: I mean, these scientists just went really fast. They got
Speaker 4: a drug on the market quickly, They did these trials quickly.
Speaker 4: They also went straight from a diabetes trial into a
Speaker 4: late stage obesity trial.
Speaker 3: They worked with the FDA to speed up the process
Speaker 3: a little bit too.
Speaker 4: And yeah, and then Manduro was approved for diabetes in
Speaker 4: twenty twenty two, and zet Bound was approved for weight
Speaker 4: loss last year.
Speaker 1: After the break, What set Zetbound apart and why it
Speaker 1: could make Eli Lilly the first ever trillion dollar drug company.
Speaker 3: We're back.
Speaker 1: When we left off, Eli Lelly had just brought its
Speaker 1: new drug, zet Bound, to market, but it was still
Speaker 1: years behind Novo Nordisk and ozempic. Is it a big
Speaker 1: advantage for a drug manufacturer to be first to market?
Speaker 4: So you would think so, and in some cases it is,
Speaker 4: But you know, It's unlike other industries where innovating too
Speaker 4: late is could be a death sentence for some companies.
Speaker 4: In the drug industry, what we see is that being
Speaker 4: first to the market has an advantage, but ultimately just
Speaker 4: having the best drug is what can set a pharmaceutical
Speaker 4: company apart.
Speaker 1: Madison told me, one of the key things to know
Speaker 1: about zetbound is that it works slightly differently than its
Speaker 1: main competitors.
Speaker 4: Ozepic and Wigovi are GLP one receptor agonist drug, and
Speaker 4: so what scientists are starting to realize is that by
Speaker 4: like layering and combining other hormones or other sort of
Speaker 4: molecules with GLP one, you can get even more weight loss.
Speaker 4: And so that's what zetbound is. It's a combination of
Speaker 4: GLP one and another gut hormone called GIP and what
Speaker 4: we see with that is that the weight loss can
Speaker 4: reach up to like twenty one percent, and the weight
Speaker 4: loss that you see from wagovi tops out at around
Speaker 4: fifteen percent. And Lily has another drug in the works
Speaker 4: that combines three different gut hormones and that one is
Speaker 4: up to a third of your body weight.
Speaker 3: Is what patients are losing.
Speaker 4: So it's sort of like by layering or combining different
Speaker 4: hormones together, you can get even more weight loss, which
Speaker 4: is sort of what we're seeing with zetbound.
Speaker 1: As for what this new drug means for Zepbound's parent company,
Speaker 1: Eli Lilly, Madison told us there's this new acronym that's
Speaker 1: popping up among investors.
Speaker 4: One of the analysts told me that JBL, which stands
Speaker 4: for just by Lily, is this new acronym that some
Speaker 4: investors that he's spoken to are saying there's like no
Speaker 4: limit in how high its stock will go, that it's
Speaker 4: just going to continue growing. It has a price earnings
Speaker 4: ratio of around fifty right now, which is really unheard
Speaker 4: of for a pharma company.
Speaker 1: If Eli Lily continues on the trajectory that Wall Street
Speaker 1: expects it to, how much could it be worth.
Speaker 4: If Eli Lilly continues on its current growth trajectory, there
Speaker 4: are expectations, I guess that it could become the first
Speaker 4: ever trillion dollar drug company. And there are expectations that
Speaker 4: its current valuation implies that zeb bound could bring in
Speaker 4: seventy billion dollars by twenty thirty just one drug alone.
Speaker 1: The growth of drugs like zepbound and MCGOV has meant
Speaker 1: real money for pharmaceutical companies, but their long term success
Speaker 1: will depend on how many people take them. Some people
Speaker 1: are deterred by the unpleasant side effects of these drugs,
Speaker 1: and some are turned off by the price, which can
Speaker 1: run upwards of one thousand dollars a month in the US,
Speaker 1: and a lot of private insurers don't cover them well.
Speaker 1: After doing all this reporting, what are your takeaways from
Speaker 1: the story of Lily and Novo and what will you
Speaker 1: be watching for next?
Speaker 4: Yeah, I think the story between the competition between Lily
Speaker 4: and Novo is not over yet, and it's going to
Speaker 4: continue for the next decade or even longer.
Speaker 3: And what I'm.
Speaker 4: Curious to see is sort of how other drug makers
Speaker 4: now enter this race and who's going to be next.
Speaker 4: You know, which product ultimately will win, because it might
Speaker 4: not be one of Lily or Novo's. I mean, Amjin
Speaker 4: is developing a shot that's taken once a month, and
Speaker 4: experts are really excited about that because the prospect of
Speaker 4: a drug being taken less frequently is very enticing and
Speaker 4: would likely be also attractive to patients. And so there
Speaker 4: are these other drugs that are and other companies that
Speaker 4: are sort of circling, and you know, on the cusp
Speaker 4: of they're still a little bit further behind Lillian Novo,
Speaker 4: But it will be interesting to see what's now and
Speaker 4: how this continues to play out.
Speaker 1: Thank you so much, Madison, Thank you, thanks for listening
Speaker 1: to the Big Take from Bloomberg News. I am Sarah Holder.
Speaker 1: This episode was produced by David Fox. It was edited
Speaker 1: by Caitlin Kenney and Rebecca Greenfield. It was mixed by
Speaker 1: Alex Suguiera. It was fact checked by Tiffany Choi. Our
Speaker 1: senior producers are Naomi Shaven and Jill Duddy Carly. We
Speaker 1: get editorial direction from Elizabeth Ponso. Nicole Beemsterborr is our
Speaker 1: executive producer. Sage Bauman is our head of podcasts Special
Speaker 1: Thanks to Madison Muller for her reporting. Thanks for tuning in.
Speaker 1: We'll be back tomorrow.