Pricing Deals and ObesityWeek Announcements
Week Of November 1 – November 7, 2025
Highlights of this week were GLP-1 drug pricing deals and company news/results timed for ObesityWeek, a major conference. Trump announced deals with Novo Nordisk and Eli Lilly to offer favorable pricing of their GLP-1 medicines for Medicare, Medicaid, and people paying out-of-pocket. Importantly, this covers oral GLP-1s that are still in trials. Novo and Lilly get a 3-year reprieve from tariffs and expedited FDA review of their drugs in the pipeline. We will see how this plays out, but lower prices, combined with an expansion of covered conditions and more convenient oral options, mean we’re likely to see these drugs a lot more in the coming years.
There are a number of announcements and press releases below. But science-wise, I just want to highlight the amylin analogs. Amylin is a pancreatic beta cell hormone that acts in glucose control and appetite suppression via mechanisms distinct from those of GLP-1 or GIP, the incretin hormones. Amylin analogs are therefore of interest for use either alone or in combination with GLP-1 medicines. Examples discussed during ObesityWeek include CagriSema -- a combination of the amylin analog cagrilinitide and the GLP-1 RA semaglutide -- and eloralintide (see the Press Releases and the Mechanism Explained sections). This is not a new class of drugs, with the first FDA approval for an amylin analog in 2005, but creativity in the GLP-1 space has led to renewed interest.
🔥 THIS WEEK’S KEY DEVELOPMENTS
CagriSema Phase 3 data shows reduced blood pressure and inflammation.
In a post hoc analysis of the phase 3 REDEFINE 1 trial, investigational CagriSema reduced systolic blood pressure by 10.9 mmHg over 68 weeks, with 40% of patients on blood pressure medication able to reduce or stop their treatment. The analysis also showed a 68.9% reduction in the inflammatory marker hsCRP and a lower proportion of patients at intermediate-to-high risk of developing atherosclerotic cardiovascular disease (ASCVD) within 10 years.
Press | Trials: NCT05567796 | Mechanism: GLP-1 receptor agonist + amylin analog
Novo Nordisk seeks approval for higher 7.2 mg Wegovy dose.
Novo Nordisk presented a sub-analysis of the STEP UP phase 3b trial showing that 19.5% of participants on an investigational 7.2 mg dose of semaglutide and 13.2% on the 2.4 mg dose (Wegovy®) achieved a BMI under 27 and a waist-to-height ratio of less than 0.53, compared to 0% for placebo. Patients who achieved these targets also reached healthy levels for two or more cardiovascular risk factors, including blood pressure, cholesterol, and blood sugar. The company noted that the higher 7.2 mg dose is currently under regulatory review with the EMA.
Press | Trials: NCT05646706 | Mechanism: GLP-1 agonist
New data shows oral semaglutide 25 mg improves cardiometabolic health.
At ObesityWeek® 2025, Novo Nordisk presented four new analyses for investigational oral semaglutide 25 mg from the OASIS 4 phase 3 trial. A post hoc analysis showed the drug improved glycemic parameters and cardiovascular risk factors, with 71.1% of participants with pre-diabetes achieving normal blood glucose at week 64 versus 33.3% for placebo. Another analysis detailed an indirect trial comparison which demonstrated comparable efficacy between the oral 25 mg dose and the injectable semaglutide 2.4 mg formulation.
Press | Trials: NCT05564117 | Mechanism: oral GLP-1 agonist
PRESS RELEASES
• Viking’s VK2735 resolves prediabetes, metabolic syndrome in Phase 2 data. Press | Trials: NCT06068946 | NCT07104500 | Mechanism: dual GLP-1 and GIP agonist
• Lilly advances eloralintide to Phase 3 after positive obesity data. Press | Trials: NCT06603571 | NCT06230523 | Mechanism: selective amylin agonist
• Altimmune completes enrollment for pemvidutide in alcohol use disorder. Press | Trials: NCT05819853 | NCT06987513 | Mechanism: glucagon/GLP-1 dual receptor agonist
• Structure confirms aleniglipron Phase 2b data on track for year-end. Press | Trials: NCT06693843 | NCT06703021 | Mechanism: GLP-1 receptor agonist
• Altimmune data shows pemvidutide significantly reduces liver fibrosis in MASH. Press | Trials: NCT05989711 | Mechanism: glucagon/GLP-1 dual receptor agonist activity
• GSK advances MASH drug efimosfermin into Phase III trials. Press | Trials: NCT05583344 | Mechanism: fibroblast growth factor 21 (FGF21) analog
• Lilly caps Zepbound, orforglipron costs for Medicare patients. Press | Mechanism: GLP-1 receptor agonist
• Novo Nordisk reaches U.S. deal to lower Wegovy, Ozempic prices. Press | Mechanism: GLP-1s
• Novo Nordisk submits updated proposal to acquire Metsera. Press | Mechanism: incretin and non-incretin analog peptide programs
• Pfizer files antitrust lawsuit to block Novo Nordisk-Metsera deal. Press | Mechanism: GLP-1s
• Lilly to build $3B Netherlands plant for oral GLP-1 orforglipron. Press | Mechanism: oral, small molecule GLP-1 receptor agonist
🆕 NEWLY REGISTERED TRIALS (4 in last week)
LY4167586 Phase 1 study evaluating a new drug for obesity in healthy participants with overweight (Eli Lilly, n=84)
[Weight Loss/Efficacy]
Trials: NCT07225556 | Mechanism: Mechanism not disclosed
Orforglipron Phase III trial evaluating the oral GLP-1 agonist for treating Peripheral Artery Disease (Eli Lilly, n=1205).
[Safety/Tolerability]
Trials: NCT07223593 (ATTAIN-PAD) | Mechanism: GLP-1 receptor agonist
Semaglutide Phase 1 investigating its use for Alcohol Use Disorder (AUD) in patients who have undergone bariatric surgery (Yale University, n=10)
[Weight Loss/Efficacy]
Trials: NCT07223983 | Mechanism: GLP-1 receptor agonist
BMF-650 Phase 1 study evaluating the drug in healthy overweight or obese adults (Biomea Fusion Inc., n=80)
[Weight Loss/Efficacy]
Trials: NCT07223216 | Mechanism: oral GLP-1 receptor agonist
💡 TRIAL SPOTLIGHT
Educational spotlight selected by editors
Efficacy and Safety of Orforglipron in Participants With Peripheral Artery Disease (ATTAIN-PAD)
Eli Lilly is launching a Phase 3 trial to evaluate orforglipron, a GLP-1 receptor agonist, in 1205 participants with peripheral artery disease (PAD). This study will assess the efficacy and safety of the once-daily oral medication over approximately 58 weeks in a patient population that is not yet recruiting. Orforglipron works by mimicking the GLP-1 hormone to help regulate blood sugar and appetite, mechanisms that have proven effective for weight loss and diabetes management. The strategic significance of this trial lies in its potential to expand the application of the highly successful GLP-1 drug class beyond metabolic conditions into the direct treatment of vascular diseases like PAD. Given that PAD affects over 200 million people and has significant unmet medical needs, a positive outcome could offer a novel therapeutic approach for this widespread cardiovascular condition.
🔬 MECHANISM EXPLAINED
Understanding the science behind the therapeutics
Selective amylin agonist (Example drug: Eloralintide)
Selective amylin agonists represent a distinct and promising therapeutic approach for obesity and metabolic diseases, operating differently from the well-known GLP-1 pathway. Amylin is a neuroendocrine hormone co-secreted with insulin that centrally regulates appetite and satiety, slows gastric emptying, and suppresses post-meal glucagon secretion. Drugs like eloralintide mimic these natural effects, leading to reduced caloric intake and significant weight loss, as demonstrated in recent clinical trials. This mechanism matters because it provides an alternative to the dominant incretin-based therapies (like GLP-1 and GIP agonists), which primarily stimulate insulin secretion in a glucose-dependent manner. Positioned as a potential monotherapy with a different tolerability profile or as a complementary agent to GLP-1s for enhanced efficacy, the selective amylin agonist class could carve out a significant niche for patients who need alternative options or greater levels of weight management.
This newsletter compiles publicly available information from company press releases and ClinicalTrials.gov. Not investment advice.