Anti-Obesity Drugs Struggle In Growing Market

Obesity is contagious--sort of--argues the author of a study published in the New England Journal of Medicine last week. The study, headed up by Harvard doc Nicholas A. Christakis, says the probability that you will become obese is directly related to whether your family, friends, and friends-of-friends are obese. Obesity, in this model, is what some people have called a "social virus," a condition affecting an individual's entire social network.Some highlights of the study:

• An individual's chance of becoming obese increases by 57 percent if he or she has an obese friend.

• Close friends have greater impact: An individual's chance of becoming obese rises by 171 percent if a close friend is obese.

• Social ties seem to spread obesity even at a distance. On the other hand, a neighbor who isn't a friend seems to have no impact.

The number of overweight or obese people in the United States is expected to top 139 million in 2010, and the global market should reach $1.5 billion in 2014. Sounds like a good incentive to market weight-loss drugs. So why the dearth of anti-obesity medications?

"Acomplia" might be a good answer. Sanofi-Aventis' weight-loss drug was set to be a blockbuster, possibly making billions in the first few years. Acomplia (rimonabant) was going to do for the obesity market what Lipitor (atorvastatin) did for the cholesterol market. But then came an unfavorable FDA advisory-committee vote in June, following which the company withdrew its NDA.

"Really, though, this is just another example of obesity: 12, therapy: 0," said Morningstar analyst Debbie Wang. She added that Acomplia's rocky path is more a sign of the market's challenges than a warning to Big Pharma.

The drugs on the market and in the pipeline just don't offer large enough results to really tap into the market. "These drugs are promising 5 to 10 percent weight loss," she said. "When you're 100 or so pounds overweight, that's just not a big enough result."

This lack of oomph follows the same pattern as anti-vice drugs. Wang said the joys of eating and smoking are not so different, and the obesity market is just following in the footsteps of the smoking-cessation market. But while there's no surgical alternative for nicotine addiction--yet--Wang said the real money in the obesity market is currently tied up in surgery.

Furthermore, those so-so weight loss results are contributing to insurers' reluctance to reimburse obesity drugs. "If someone develops a drug that works as well as surgery, I'm sure insurance companies will pony up," Wang said.

Meanwhile, Christakis' study probably won't be the kick in the gut pharma companies need. Though the mass media have tossed around the term virus, Wang said that will hardly send patients scurrying to physicians, looking for a way to protect themselves. What companies should keep an eye on, though, is the performance of GlaxoSmithKline's Alli (orlistat). "Their campaign is fascinating, we can learn a lot from it," Wang said.