Drugmakers eye oral alternatives for diabetes and weight loss injectables

Drugmakers are rushing to develop the next needle-free generation of diabetes medications to meet the growing demand for injectables used off-label for weight loss.

Dan Skovronsky, the chief scientific and medical officer of Eli Lilly and Company, told investors in a February earnings call that oral medications will likely play a large role in treating the rising number of obesity cases across the globe.

The WHO estimates that more than 1.9 billion adults are considered overweight worldwide (including 650 million who are obese). Skovronsky argued that companies need to look beyond injectable drugs—like Lilly’s Trulicity and Mounjaro, which treat Type 2 diabetes—to find pharmaceutical solutions for potential weight loss treatments.

“Just given the scope of the problem around the world, we’re going to need orals,” he said, adding that since obesity is often chronic, patients may have to manage it for life. “A lot of times, in medicine, that doesn’t happen.”

Skovronsky, who also serves as EVP of science and technology and president of Lilly Research Laboratories, pointed to the company’s oral GLP-1 (glucagon-like peptide 1 receptor agonist) as one prospective pill that could one day “match the safety, tolerability, and efficacy of injectables”—a top priority for Lilly. Its oral GLP-1, orforglipron, is in Phase 2 trials for Type 2 diabetes and obesity, and the drug is expected to enter Phase 3 in 2023.

“You could bet we’re working on oral solutions that can bring additional incretin activity to patients in a pill. Nothing ready to disclose today, but we’re working hard,” he said.

Skovronsky’s comments come as Lilly competes against Novo Nordisk—the maker of injectable drugs like Ozempic and Wegovy—for a greater share of the diabetes and weight loss treatment market. Novo Nordisk’s Rybelsus, the first (and currently only) FDA-approved oral GLP-1 for Type 2 diabetes, could see sales near $6 billion by 2028, according to Evaluate Pharma estimations.

Pfizer is also developing an oral GLP-1, which is in clinical trials.