The successful trial of a daily weight-loss pill has been hailed as a “landmark moment” in the fight against obesity, with Ireland’s leading expert in the field describing it as a “huge step forward”.
The highly anticipated results of the trial conducted by pharmaceutical company Eli Lilly found that the pill helped people lose weight and lower blood sugar levels, positioning it alongside new wave of drugs combating obesity and diabetes.
More than 500 trial participants in the US, China, India, Japan and Mexico who took a 36mg pill of orforglipron lost an average of 7.3kg over nine months, according to results from a phase three clinical trial.
The daily pill was also shown to lower blood sugar levels, in some cases bringing them below the formal threshold for diabetes.
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“As a convenient once-daily pill, orforglipron may provide a new option and, if approved, could be readily manufactured and launched at scale for use by people around the world.” said David Ricks, Eli Lilly’s chief executive.
Prof Donal O’Shea, the HSE lead on obesity, noted that Eli Lilly “are going for the obesity licence this year and the diabetes licence next year which is amazing”.
He said this suggested the drug company was “prioritising this for obesity” and said it was “another landmark moment in the pharmaceutical industry”. All current obesity treatments - Novo Nordisk’s Ozempic, Wegocy and Saxenda, and Lilly’s Mounjaro - are delivered by weekly injection and there has been a race among the biggest pharma companies to develop an oral alternative.
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Prof O’Shea added that it was a “huge step forward when it comes to drug inequity” because the pill should be more readily accessible to lower income countries where cold storage is an issue.
He also noted that people “much prefer tablets to injections and their willingness to take a tablet is much higher than their willingness to have an injection so adherence will be much better”.
While the drug was still in its early stages of development and there is no indication as to how much it might cost in Ireland or when it might be on the market, Prof O’Shea suggested a reasonable timeline would see it being dispensed by medical practitioners here sometime in 2027.
“It will be in the company’s interest to really get moving so they can make the money back on their investment. The investment needed to get a drug to market and through clinical trials is enormous so they need to recoup that cost.”
Cost will be a factor if or when the new pill becomes available here, with the HSE reluctant to approve weight loss medication for inclusion in the Drug Payments Scheme despite the fact that Ireland has one of the highest obesity levels in Europe.
About 60 per cent of adults are classified as either overweight or obese, according to the HSE. However only one weight-loss drug – Saxenda – is included in the scheme, which caps a family’s monthly drug bill at €80. It is available only to patients with a body mass index (BMI) above 35 who are also pre-diabetic and at risk of cardiovascular disease.
Mounjaro is being assessed for inclusion while Ozempic and Wegovy are not included.
The drug can cost more than €2,000 a year, which explains the HSE’s reluctance to cover them, although the economic cost of obesity could be up €1.5 billion a year, according to HSE figures.
“These drugs usually come off patent seven years after their first licence and that’s when generics come along and prices tumble. We’re quite far away from having wide availability under the medical card scheme but it’s a matter of time,” Prof O’Shea said.
He pointed out that “actively treating obesity will prevent many other complications” and drew an analogy with hypertension treatments decades ago.
“In the 1960s people were told to manage their stress, reduce their salt and take crude treatments but we gradually understood blood pressure better, and we now have very good treatments,” Prof O’Shea said.
“In terms of obesity we’re where blood pressure treatment was in the 1970s. We’re at the beginning of sensible and meaningful treatments.” – Additional reporting: Guardian
