Table of Contents
Obesity Drug Markets in the US and EU
Executive Summary 10
The large and growing obesity problem 10
Current approaches to obesity management 11
Pharmaceutical options for the treatment of obesity 12
The obesity drug pipeline 13
Market forecasts 14
Chapter 1 The large and growing obesity problem 18
Summary 18
A potentially life threatening medical condition 19
Levels of obesity 19
Overweight 20
Obesity 20
Morbid obesity 20
Super obesity 21
Co-morbidities and mortality 22
Arthritis 23
Asthma 23
Cancer 24
Cardiovascular disease and hypertension 25
Dementia 26
Depression 27
Diabetes 27
Kidney disease 27
Rising prevalence of obesity 28
Trends by sub-population 31
United States 31
Europe 31
Obesity in children and adolescents 33
Heavy social and economic impact 35
Cost burden 35
Social effects 36
Societal and other effects 38
Medical overview of obesity 39
Pathogenesis of obesity 39
Physiological factors 40
Genetic factors 41
Environmental factors 42
Lifestyle factors 43
Psychological factors 44
Societal trends 46
Obesity as a component of metabolic syndrome 47
Conclusion 48
Chapter 2 Current approaches to obesity management 50
Summary 50
Background 51
Diet and exercise programs 52
Dieting 52
Types of programs 53
Patient volumes 54
Exercise 54
Types of programs 54
Patient volumes 55
OTC weight loss supplements 56
Types of products 56
Patient volumes 57
Pharmaceutical options 58
Types of medications 58
Patient volumes 59
Surgical intervention 60
Types of procedures 61
Patient volumes 63
Comparison of options 64
Safety 65
Efficacy 66
Cost 67
Insurance reimbursement 67
Unmet needs 69
Conclusion 70
Chapter 3 Pharmaceutical options for treatment of obesity 72
Summary 72
Leading prescription medications 73
Meridia 74
Xenical 77
Acomplia 80
Others 83
OTC medicines 85
Alli 86
Comparison of pharmaceutical options 89
Safety 89
Efficacy 91
Cost 92
Insurance reimbursement 93
Conclusion 95
Chapter 4 The obesity drug pipeline 98
Summary 98
Introduction 99
Pre-clinical testing 99
Phase I testing 116
Phase II testing 116
Phase III testing 117
Leading obesity drug candidates 118
Lorcaserin hydrochloride 118
Lepislim 120
Taranabant 120
Contrave 121
CP-945,598 123
Qnexa 123
Discontinued obesity drug candidates 125
Conclusion 132
Chapter 5 Market forecasts 134
Summary 134
Introduction 135
Current sales levels 135
United States 137
Europe 138
Five year forecasts 139
United States 141
Europe 143
Conclusion 145
Index 146
List of Figures
Figure 1.1: Rates of obesity and overweight in the US, 1980–2006 29
Figure 1.2: Rates of obesity and overweight in Europe, 1980–2006 30
Figure 2.3: Comparison of safety, efficacy and cost of obesity management approaches 64
Figure 3.4: Comparison of safety, efficacy and cost of pharmaceutical options for obesity management 89
Figure 4.5: Comparison of leading obesity drug candidates, 2008 119
Figure 5.6: Obesity medication sales in the US and EU, 2006 and 2007 136
Figure 5.7: Obesity medication sales by region, 2007 137
Figure 5.8: Obesity medication sales in the US and EU, 2008–2013 140
Figure 5.9: Total obesity medication sales by region, 2008–2013 141
List of Tables
Table 1.1: Proportion of cancers related to obesity 24
Table 1.2: Prevalence of adult overweight and obesity by country, 2003 32
Table 2.3: US and EU patient caseloads for leading obesity management approaches, 2007–12 (millions of persons) 52
Table 2.4: Safety risks associated with obesity management approaches 65
Table 2.5: Comparative efficacy of obesity management approaches 66
Table 3.6: Safety risks associated with leading obesity medications 90
Table 3.7: Safety risks associated with leading obesity management approaches 92
Table 3.8: US cost comparison for leading obesity medications, 2008 93
Table 4.9: Pharmaceutical pipeline for obesity medications 101
Table 4.10: Discontinuations of obesity drug programs 126
Table 5.11: US sales of obesity medications, 2006 and 2007 138
Table 5.12: European sales of obesity medications, 2006 and 2007 139
Table 5.13: US sales of obesity medications in $m, 2008–2012 142
Table 5.14: European sales of obesity medications in $m, 2008–2012 143