The Newest Obesity Drug Player

VIVUS and Arena Pharmaceuticals had better check their rearview mirror because Novo Nordisk looks ready to submit a new obesity drug to the Food and Drug Administration around the end of the year.

The drug, Victoza, is new to obesity, but it's already approved to treat diabetes.

In a trial of overweight or obese people who don't have diabetes, Victoza produced an 8% decline in weight compared to a 2.6% loss for those who got placebo. The FDA also likes to see the number of people able to lose 5% of their body weight on the drug to be at least double the amount that are able to meet that threshold while taking placebo, which Novo Nordisk met as well: 64% of patients taking Victoza lost at least 5% of their body weight compared to 27% of those on placebo.

Here's how Victoza stacks up against VIVUS' Qsymia, Arena's Belviq, and Orexigen's Contrave, which is finishing up a cardiovascular safety trial and could be approved to treat obesity before Victoza.

Source: Novo Nordisk and the FDA.

Take the comparisons with a grain of salt since the trials enrolled different patients and had slightly different trial designs, but the take home point is there: Victoza looks like it can compete.

Competing on other factors
Victoza is injected once a week, while the other obesity drugs are taken orally on a daily basis. Whether that's a benefit or negative is debatable. Some people will probably prefer to not have to deal with their drug on a daily basis, but for others the needle will be a no-go.

Safety is always a concern given that obesity isn't an immediate life-threatening issue. Qsymia produces the highest weight loss, but it also has the most severe side effects. Novo Nordisk said withdrawals from the trial due to adverse events were below 10% in both treatment groups, but the company didn't go into further detail.

The decision of which drug to use may also come down to price, especially if the drugs continue to be covered by insurance at a low rate. Victoza is expected to cost about $25 per day as an obesity treatment compared to around $5 per day for Belviq and Qsymia. Of course, if Novo Nordisk can do a better job at getting insurance coverage -- and being already covered for diabetes might help -- the patients won't care because they'll only be paying the copay, not the full cost of the drug.

The real benefit
The trial tested non-diabetics, but the study highlights one of the benefits of using Victoza over other diabetes medications in obese and overweight patients. GlaxoSmithKline's Avandia and Takeda's Actos actually cause weight gain, and other diabetes drugs like the DDP-4 inhibitors don't help with weight loss.

Doctors may also be interested in using it in non-diabetics, simply because it's a diabetes medication. In the Victoza trial, 69% of the patients diagnosed with pre-diabetes at the start of the trial no longer showed signs of pre-diabetes after taking Victoza, compared to 33% for the placebo-treated group.

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