[비즈한국] Obesity is no longer just a matter of personal willpower. It is a 'structural disaster' that incurs 15 trillion won in socioeconomic losses annually. Bizhankook has set out to find the fundamental solution to the massive obesity bill our society faces. We look into the collapsed dietary environment for children and adolescents, and examine the sharp policy dilemmas surrounding the reimbursement of obesity drugs and the introduction of a sugar tax. Furthermore, we shed light on the innovation scene of K-Bio, which goes beyond the limits of panaceas to shift the landscape of a 100 trillion won global market.
GLP-1 (glucagon-like peptide) class treatments from global big pharma, such as Novo Nordisk's Wegovy and Eli Lilly's Mounjaro (global brand name Zepbound), have gained worldwide popularity and changed the paradigm of obesity treatment. Last year, Zepbound recorded $13.5424 billion (18.3 trillion won) in sales, and Wegovy recorded $13.4 billion (19.4 trillion won), ranking 10th and 8th in global pharmaceutical sales, respectively. In the first quarter of this year, both treatments continued their double-digit growth compared to the same period last year, reshaping the pharmaceutical market.
Because of this, an atmosphere has formed where it is taken for granted that pharmaceutical and biotech companies should develop obesity treatments. Everyone is competing to secure pipelines to challenge the dominance of Wegovy and Mounjaro.
The frenzy for Wegovy and Mounjaro is intense in Korea as well. Last year, domestic sales of Wegovy surpassed 472.5 billion won, and Mounjaro, launched in September, also recorded 215.5 billion won in sales in just four months. However, the domestic prices of these two products are several times higher than abroad. This is why there is a growing voice that, like other drugs, it is urgent to secure pharmaceutical sovereignty for obesity treatments.
"30,000 won in the US, 700,000 won in Korea?" Swayed by Global Big Pharma
The price difference for Wegovy and Mounjaro between domestic and overseas markets is quite significant. As a result, there is persistent suspicion that global big pharma companies, which control the supply chain, are selling obesity treatments uniquely at high prices in the Korean market alone.
It is understood that the administration costs for Wegovy and Mounjaro abroad are much lower than in Korea. In Japan, applying health insurance reduces the patient's burden to about 30% of the list price. This means high-dose Wegovy and Mounjaro can be prescribed for around 100,000 won per month. In China, drug prices have recently been significantly lowered through e-commerce platforms, allowing low-dose Wegovy to be prescribed in the 40,000 won range and high-dose in the 200,000 won range. Mounjaro prices are also formed around 100,000 won per month.
The U.S., the world's largest pharmaceutical market, is no exception. In the U.S., if enrolled in private insurance, patients can purchase Wegovy for $25 (34,000 won) per month through manufacturer support programs. Even without insurance, programs exist where it can be prescribed in the 300,000 to 500,000 won range. In the U.K., those covered by public health (NHS) can receive it almost free of charge, and even when purchased out-of-pocket, it is in the 200,000 won range.
Conversely, domestic prescription costs range from 300,000 to 700,000 won per pen (one month/4 doses), depending on the dosage. When Mounjaro was first launched in Korea, Novo Nordisk, feeling a sense of urgency, lowered the domestic supply price of low-dose Wegovy to the low 200,000 won range and promoted it as 'the lowest global level.' However, the price perceived by consumers remains high.
Since obesity treatments in Korea are 100% non-reimbursable under health insurance, hospitals add margins and medical fees even if pharmaceutical companies lower the supply price. Ultimately, even if the supply price is in the 200,000 won range, the actual amount paid by the patient at the pharmacy far exceeds 300,000 to 500,000 won. For this reason, some patients resort to the trick of having medicine prescribed and brought in directly from abroad.
An official from Eli Lilly Korea, the domestic supplier of Mounjaro, explained, "When calculating the price of the treatment, we consider the value of the drug, each country's regulations, market conditions including competing drugs, and income levels. Since obesity treatments are not covered by health insurance in Korea, it is relatively more expensive compared to other countries, but we are not selling it at a high price only to Korean consumers."
The problem is not just the price. With global demand exploding, there are also persistent concerns about domestic supply disruptions. Novo Nordisk and Eli Lilly are expanding their drug indications beyond obesity to dementia, sleep apnea, and metabolic dysfunction-associated steatohepatitis (MASH). Even as both companies continue to expand production facilities, it is uncertain whether supply will be able to keep up with future demand for obesity treatments.
As we are inevitably at the mercy of the production schedules and pricing policies of global big pharma, the importance of securing K-obesity treatment pharmaceutical sovereignty through domestic new drugs is growing.
Hanmi Pharmaceutical128940 'Leader', Celltrion068270 'Quadruple Agonist'... K-Bio Shaking the Market with Formulation Innovation
Domestic pharmaceutical and biotech companies are also moving quickly to seize opportunities for a turnaround in the global obesity treatment market. Since the global obesity treatment market is expected to exceed 100 trillion won by 2030, it has become an unmissable future growth engine.
Currently, Hanmi Pharmaceutical is considered the most likely company to produce the first 'K-Obesity Treatment'. In December of last year, Hanmi Pharmaceutical applied for product approval from the Ministry of Food and Drug Safety for 'Hanmi Efpeglenatide Auto-injector', developed as an obesity treatment customized for Koreans, and commercialization is expected as early as the second half of this year. Since it will be produced entirely at the Pyeongtaek Bio Plant, expectations for the localization of obesity treatments are high.
In addition, Hanmi Pharmaceutical holds various pipelines such as the triple agonist (GLP/GIP/GCG) 'HM15275', currently in phase 2 clinical trials in the U.S., and a new drug for muscle growth 'HM17321' in the phase 1 clinical trial stage in the U.S. Furthermore, they are preparing to change the obesity market paradigm by building a smart patient care solution that integrates digital therapeutics with Hanmi Efpeglenatide Auto-injector to manage medication, diet, and exercise.
Latecomers have thrown their hats in the ring with differentiation strategies, such as developing new formulations that move away from existing injections or dramatically extending the drug's duration.
Ildong Pharmaceutical aims to enter U.S. Phase 2 clinical trials for its oral (pill) obesity treatment 'ID110521156' within the second quarter of this year. Ildong Pharmaceutical explains that this drug showed an average weight loss effect of 9.9% after 4 weeks of administration in previous clinical trials, which is superior to the weight loss effect of the oral obesity treatment from Eli Lilly recently approved by the U.S. FDA.
Daewoong Pharmaceutical is challenging the development of a microneedle patch-type obesity treatment that maximizes patient accessibility. In this method, a coin-sized patch is applied to the skin once a week, and the drug is slowly absorbed through microscopic needles. It is currently in the Phase 1 clinical trial stage.
There is also fierce competition in platform technology to extend the injection interval from one week to more than a month. Peptron, which owns the long-acting drug delivery technology 'SmartDepot', is conducting global Phase 1 clinical trials for 'PT403' with Wegovy ingredients and 'PT404' with Mounjaro ingredients, which are effective for more than one month. In particular, having signed a Material Transfer Agreement (MTA) platform technology evaluation contract with Eli Lilly and currently in the joint research and validation stage, they are raising expectations for a main technology export contract in the future.
Yuhan Corporation has joined hands with Inventage Lab to embark on a two-track joint development project to improve both Wegovy (IVL3021) and Mounjaro (IVL3024) ingredients into one-month long-acting injections. The goal for both pipelines is to apply for an Investigational New Drug (IND) application within the year.
Celltrion has gone a step further and begun development of 'CT-G32', a quadruple-acting obesity treatment that even global big pharma companies have not yet commercialized. They are determined to introduce a first-in-class innovative new drug that not only maximizes appetite suppression and weight loss effects but also improves muscle loss side effects, a fatal drawback of existing drugs. They plan to finish animal efficacy evaluations within the year and enter global Phase 1 clinical trials in the first half of next year. Celltrion Chairman Seo Jung-jin expressed strong confidence, stating, "The non-response rate of the triple-acting obesity treatment currently being developed by Eli Lilly is expected to be under 10%, but our company's quadruple-acting agent will lower the non-response rate where the drug does not work to under 5%.”
Korea is already bearing over 15 trillion won in annual socioeconomic costs due to obesity. In this situation, the monopoly and high-price policies of global big pharma are the biggest obstacles to expanding the reimbursement of treatments. The only solution is to secure the capability to self-supply obesity treatments as well. Attention is focused on which of the domestic pharmaceutical and biotech companies that have taken on the challenge will become the 'game changer'.