Eli Lilly’s new dual glucagon-like peptide-1/gastric inhibitory peptide (GLP-1/GIP) agonist, tirzepatide, is likely to gain significant market share across the GLP-1 class and the wide type 2 diabetes (T2D) market. Eli Lilly has gained significant market share across the GLP-1 and sodium-glucose transport protein-2 (SGLT-2) drug classes with Trulicity (dulaglutide) and Jardiance (empagliflozin), respectively. In head-to-head studies, the company has proven that tirzepatide has superiority over its main competitor, Novo Nordisk’s semaglutide. The dual agonist has also proven to be efficacious in tackling obesity and cardiovascular risk factors associated with T2D. As such, it is likely to maintain Eli Lilly’s long-term dominance in the GLP-1 space after the patent expiry of Trulicity in 2027. Additionally, the strong clinical data relating to obesity provides access to an entirely separate market and directly competes with Novo Nordisk’s Wegovy (semaglutide). Key opinion leaders (KOLs) interviewed by GlobalData have reported that they are keen to prescribe a therapy that can address levels of glycated hemoglobin and obesity.

In a head-to-head study between tirzepatide and semaglutide, its likely main competitor, tirzepatide’s estimated mean change from baseline in the level of glycated hemoglobin was -2.01%, -2.24% and -2.3% with 5mg, 10mg and 15mg doses, respectively, while semaglutide’s was -1.86%. The estimated differences between the 5mg, 10mg, and 15mg tirzepatide groups and the semaglutide group were −0.15 percentage points (95% confidence interval [CI], −0.28 to −0.03; P=0.02), −0.39 percentage points (95% CI, −0.51 to −0.26; P<0.001), and −0.45 percentage points (95% CI, −0.57 to −0.32; P<0.001), respectively. The results demonstrate that tirzepatide, at all doses, is non-inferior and superior to semaglutide. Additionally, the data for reductions in bodyweight demonstrate that they were greater with tirzepatide than with semaglutide (-1.9kg, -3.6kg, -5.5kg for all doses, respectively; P<0.001). Another advantage for tirzepatide in comparison to other GLP-1s was that it had only mild adverse events, which were primarily gastrointestinal.

In patients with T2D, tirzpeatide was found to be noninferior and superior to semaglutide regarding the mean changes in the glycated hemoglobin levels. Because tirzepatide demonstrated this superiority, it is likely to become a leading therapeutic in the GLP-1 space in addition to the wider T2D market. There is an increasing need for therapeutics that can address the additional comorbidities of T2D such as obesity and cardiovascular disease. The fact that tirzepatide addresses this need will likely increase its popularity with physicians. Obesity is closely associated with T2D and due to the ongoing Covid-19 pandemic, a greater spotlight has been placed on therapeutics that can address weight reduction. Thus, tirzepatide will likely achieve positive uptake as a result. GlobalData forecasts that tirzepatide will become a market leader in the GLP-1 space for both T2D and obesity and will likely overtake the market share of semaglutide toward the end of the decade.