Entering 2024, major multinational pharmaceutical companies (MNCs) have successively released their financial reports for the previous year, and the dust has settled on the global "drug king" competition. Humira, who has been the global sales champion for ten consecutive years, has fallen behind and been replaced by Pembrolizumab Injection, a PD-1 inhibitor under Merck's brand name Keytruda/Koreda. It successfully won the global "drug king" position in 2023 for $25.011 billion.
However, Novo Nordisk's Smegglutide is coming aggressively, and the question mark is raised about how long the crown won by K-medicine can be worn.
This can be seen from the sales growth rate of both. As a phenomenon level product that became popular globally in 2023, Smegglutide (including Ozempic/Rybelsus/Wegovy) grossed $21.157 billion in sales that year, which is approximately $4 billion lower than K Pharmaceuticals' $25.011 billion. However, in terms of sales growth rate, in 2023, the sales of K-drug only increased by 19% year-on-year, while the sales of Smegglutide grew rapidly. According to Novo Nordisk's 2023 financial report, the sales of Smegglutide's injectable hypoglycemic drug Ozempic reached 13.889 billion US dollars, a year-on-year increase of 60%; The sales revenue of Rybelsus, an oral hypoglycemic drug, was 2.72 billion US dollars, a year-on-year increase of 66%; The injection weight loss drug Wegovy has grown rapidly, with sales of 4.548 billion US dollars, a year-on-year increase of 407%.
The entry of Lilly's GLP-1 product, Tirzepatide, also poses a threat to its global position as the best-selling drug. According to Lilly's annual report, in 2023, the global market saw a sales revenue of 5.163 billion US dollars for the lipid-lowering version of Mounjaro. At this time, it is less than two years before the approval of tirposide.
Pharmaceutical industry expert Song Wen (pseudonym) told Time Finance that K-medicine is also in an upward trend, and it is not clear who will be the "medicine king" in the global market in 2024. But it can be foreseen that Novo Nordisk and Lilly have already taken over the GLP-1 track, competing for the dominant position on the track.
K medicine wins the championship, Simei sits two times and looks at one
In the past decade, Xiumeile's position as the global "king of medicine" has been unshakable.
As Abbott's flagship product, Xiumeile is the world's first approved human monoclonal antibody against tumor necrosis factor. It can specifically bind to TNF and eliminate its biological function by blocking the interaction between TNF and TNF receptors on the surface of p55 and p75 cells. In December 2002, its first indication was approved by the US Food and Drug Administration (FDA) for the treatment of moderate to severe rheumatoid arthritis; It was approved for market by the European Medicines Agency (EMA) in September 2003 and was launched in China in February 2010.
Up to now, Xiumeile can be used to treat various diseases such as rheumatoid arthritis, ankylosing spondylitis, psoriasis, and juvenile idiopathic arthritis, and has been launched in nearly 100 countries or regions worldwide. Since its launch, Xiumeile's global sales have been steadily increasing, becoming the best-selling single drug in the world in 2012, and maintaining its position as the "king of medicine" for the following 10 years.
However, due to patent expiration and competition for biologically similar drugs, Xiumeile's revenue has turned around, with a year-on-year decline of 32.2% in 2023, and a revenue of 14.404 billion US dollars. This number is 21.237 billion US dollars in 2022.
The myth of Xiu Meile is even more difficult to continue, and the position of "Medicine King" that has been held for ten years is ultimately snatched by K Medicine from Mercado.
K-drug was approved by the US FDA for marketing in September 2014 for the treatment of advanced malignant melanoma patients. As of now, K drug has been approved for nearly 40 indications globally, with sales steadily increasing. In 2022, in the eighth year after being approved for listing, K Pharmaceuticals' annual sales exceeded the $20 billion mark, reaching $20.937 billion, only $300 million less than Xiumeile. In 2023, K Pharmaceuticals completely defeated Xiumeile with a sales revenue of 25 billion yuan, becoming the new generation of global "medicine king".
However, looking at the global drug sales rankings, it is not yet certain whether K Medicine can replicate the legend of Xiumeile's long-term dominance in the charts. In recent years, the GLP-1 track has quietly heated up, becoming a new term in the pharmaceutical industry. Especially Novo Nordisk's flagship single product, Smegglutide, has been ranked Top2 on the global drug sales list only 6 years after being approved, just a fraction of the "drug king".
Since its birth in 2017, Smeglutide has been approved in many countries around the world in various dosage forms. On January 26 this year, Smeglutide (trade name: Novosi) was also approved in China for the treatment of adult type 2 diabetes. The 2023 financial report shows that sales of Smegglutide, including three indications: Ozempic (injectable hypoglycemic drugs), Rybelsus (oral hypoglycemic drugs), and Wegovy (injectable weight loss drugs), have reached $21.157 billion. Among them, the weight loss version of Wegovy has seen rapid growth, with sales of 4.548 billion US dollars, a year-on-year increase of 407%, far exceeding the growth rate of K-drug.
Currently, in order to boost its momentum and sprint towards becoming the "Medicine King", Novo Nordisk is continuously increasing its production capacity. On February 5th this year, Novo Nordisk announced that it had agreed to acquire three filling factories belonging to Catalent from its major shareholder Novo Holdings for a prepayment of $11 billion.
Novo Nordisk said that this acquisition means that more patients with diabetes and obesity will receive current and future treatment. The acquisition has realized the expansion of production scale and speed, and provided future selectivity and flexibility for Novo Nordisk's existing supply network. It is expected that this acquisition will gradually improve Novo Nordisk's filling capacity from 2026. Over the past year, Novo Nordisk has announced multiple times that it will invest or build new factories in the global market to support markets in short supply.
GLP-1 duo fighting, Lilly or overtaking on bends?
The journey of pursuing the "Medicine King" with Smegglutide is not without obstacles. Competing against it are several top ten global drug sales rankings, including Abbott, Gilead, Pfizer, and others. In addition, although Lilly has not yet secured a top ten spot on the global drug sales rankings, the battle between its major product, Telposide, and Smegglutide, is intensifying.
Tilposide is another heavyweight product of the GIP/GLP-1 track, which is a receptor agonist for glucose dependent insulinotropic peptides (GIP) and glucagon like peptide-1 (GLP-1). In May 2022, the glucose reducing version of Tilpodide Mounjaro was approved by the US FDA for marketing, which is used to control and improve the blood sugar of adult patients with type 2 diabetes. Subsequently, the drug has been approved for marketing in countries and regions such as the European Union and Japan. On November 8, 2023, the weight-loss version of Zepbound with telposide was approved in the United States for the treatment of adult obese patients and overweight populations.
With the approval of the weight-loss indication for Telposide, on the one hand, the battle for the "king of weight loss drugs" has added to the suspense, and on the other hand, Smegglutide is facing the challenge of being eroded in the market, and the pressure on the road to compete for the global "king of drugs" has increased sharply.
According to financial report data, in 2023, Lilly's annual revenue reached 34.124 billion US dollars, with a growth rate of 20%. Among them, Tilposide provided the strongest growth momentum, with total sales of Tilposide hypoglycemic version Mounjaro reaching 5.163 billion US dollars, a year-on-year increase of 970%. The weight-loss version of Zepbound, which was just approved at the end of last year, contributed $176 million in revenue to Lilly in less than two months.
GlobalData, a data and analysis company, believes that the powerful clinical data of weight loss efficacy will make Tilpolotide surpass Smeaglutide and become the best-selling drug in the obesity and diabetes markets. It is estimated that the sales will reach 27 billion dollars in 2029.
After being approved in the United States, Lilly launched a convenient service in the US market to seize more market share for the weight-loss version of Zepbound with Tilposide. On January 4th, Lilly announced the launch of Digital Healthcare LillyDirect, which provides independent healthcare services, customized support, and home delivery services for groups including obese patients. Among them, Lilly will provide delivery services through third-party pharmacies.
In addition, Lilly's GLP-1 product has also undergone head to head testing with Smegglutide multiple times. Earlier, Tilpodide and Smeglutide had conducted a head to head test to evaluate the effectiveness and safety of these two weight loss drugs for adult obese or overweight non diabetes patients with weight related complications.
On February 15th, the clinical trial website clinicaltrials.gov showed that Eli Lilly had registered a randomized, multicenter, open-label phase III clinical trial called the GLP-1R/GIPR/GCGR triple target agonist Rotarutide, It is intended to evaluate the efficacy and safety of its new drug Retatrutide and Smeglutide in combination with or without sodium glucose cotransporter 2 inhibitor in type 2 diabetes adults with poor glycemic control.
It is reported that this study is expected to start on March 20th this year, and the main study will be completed on December 11th, 2026. All studies will be completed by March 30th, 2027, for a total of about 26 months, including up to 24 visits, with an estimated recruitment of 1250 patients. The primary endpoint is the change in hemoglobin A1c (HbA1c) values from baseline at week 80 (%).
Novo Nord is also unwilling to be left behind. On November 14, 2023, Novo Nordisk registered a phase III clinical trial of CagriSema and Telposide head to head control for weight loss on the clinicalrials.gov website. The trial plans to enroll 800 obese or overweight patients and is expected to be completed by August 2025.
Song Wen told Time Finance that the current pattern of the GLP-1 track is very clear, with Novo Nordisk and Lilly dominating most of the market. There is no room for "underachievers", but the competition for dominance between the two is still ongoing.