From Davids to Goliaths: the GLP-1R gold rush

 Drugs targeting the glucagon-like peptide-1 receptor (GLP-1R) demonstrated remarkable success in 2023, with approved products generating sales of $37.2 billion. Currently, there are 323 active GLP-1Rs in the pipeline, with several estimated to deliver significant returns upon launch. While mega-cap companies dominate the GLP-1R market and are expected to maintain their stronghold in 2030, three smaller biotechs - Viking Therapeutics, Altimmune, and Structure Therapeutics - are emerging as potential disrupters in this drug category, giving hope to innovative newcomers.

The popularity of GLP-1R drugs has exploded in recent years. Key drugs in this category include Novo Nordisk’s Ozempic (semaglutide) and Wegovy (semaglutide), and Eli Lilly’s Trulicity (dulaglutide) and Zepbound (tirzepatide). Due to their ability to effectively treat metabolic-related disorders such as obesity and type 2 diabetes, the 11 approved GLP-1Rs generated sales of $37.2 billion in 2023 with Novo Nordisk and Eli Lilly dominating the space, accounting for 99% of sales in 2023.

The success of these pharma giants has sparked significant interest in this sector. There are now more than 300 GLP-1Rs in an active stage of development, striving for their first approval. The market outlook for these products is equally promising, as GlobalData estimates that a number of these pipeline GLP-1Rs will ultimately launch in 2030, subsequently generating sales of $48.5 billion.

Novo Nordisk and Eli Lilly are expected to continue their dominance of the GLP-1R space up to 2032. However, several smaller companies are also developing GLP-1Rs and positioning themselves to enter this market, disrupt the landscape and generate their fair share of returns (Figure 1). The emergence of these newcomers is set to reduce the GLP-1R monopolisation by Eli Lilly and Novo Nordisk, with the pharma giants forecast to only capture 78% ($37.6 billion) of 2030 sales.

Based on their market capitalisation, Viking Therapeutics ($5.2 billion), Structure Therapeutics ($1.8 billion) and Altimmune ($642 million) are small- to mid-cap companies that are significantly dwarfed by Eli Lilly and Novo Nordisk. All three US-based companies have no approved products to date. However, by 2030, GlobalData forecasts them to be ranked among the top 10 companies by GLP-1R sales.

Viking Therapeutics is expected to lead this group with its dual GLP-1R/gastric inhibitory polypeptide receptor agonist, VK-2735, which is in Phase II for obesity with an oral route of administration. Estimated to launch in 2028, this drug is forecast to deliver $2 billion in 2030, earning Viking a spot in the list of top 10 companies by GLP-1R sales, after the industry heavyweights: Novo Nordisk, Eli Lilly and Amgen. The fact that VK-2735 may be the first oral GLP-1R to gain approval in obesity presents further commercial opportunities for Viking.

Altimmune’s pemvidutide is in Phase II for obesity and metabolic dysfunction-associated steatohepatitis. With an expected launch in 2027, pemvidutide is forecast to generate sales of $1.21 billion in 2030. Finally, Structure Therapeutics’ GSBR-1290 is in Phase II for obesity and type 2 diabetes. Similarly to VK-2735, GSBR-1290 is also being developed as an oral formulation. This drug is expected to launch in 2028 and ultimately generate sales of $1.2 billion in 2030.

The domination of the GLP-1R landscape by large, mega-cap companies such as Novo Nordisk and Eli Lilly is expected to continue until 2030. However, the entry of emerging biotechs into this space highlights the dynamic potential of the sector as Viking Therapeutics, Altimmune and Structure Therapeutics aim to disrupt this landscape. If the forecasts materialise, these three emerging companies will be catapulted onto the global stage, generating huge returns for shareholders. These estimations further highlight the lucrative potential offered by GLP-1Rs for both industry giants and innovative smaller players poised to make their mark on the global stage.

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