The anti-obesity drug market currently appears to be forming a duopoly dominated by two giants, Eli Lilly (LLY) and Novo Nordisk (NVO). Together, they hold nearly the entire U.S. market share for branded obesity and diabetes treatments. However, this market structure may well be creating an opening for new entrants to disrupt the established leaders.
Viking Therapeutics (VKTX) is attempting to become that challenger. Its lead candidate, VK2735, already has strong early-stage data and is available in both a weekly injectable form and a daily oral tablet. With a market capitalization of only $3.5 billion, the company’s stock is small enough that even capturing a modest share of the market could generate outsized returns for shareholders.
VK2735 is a dual agonist of the GLP-1 and GIP receptors, employing the same dual-target strategy as Eli Lilly’s tirzepatide. In a Phase 2 clinical trial, participants receiving weekly injections of VK2735 experienced weight loss of up to 14.7% over 13 weeks; in another Phase 2 trial, patients taking the tablet form achieved a maximum weight loss of 12.2% over the same period. In both trials, the gastrointestinal side effects reported by patients were overwhelmingly mild or moderate. Notably, in the injection trial, the rate of weight loss showed no sign of slowing by the end of the study period, leaving open the possibility that patients could achieve further weight reduction with extended treatment duration.
While Viking may be able to compete on efficacy with the best currently marketed products from Eli Lilly and Novo Nordisk, it could face greater challenges when measured against the late-stage pipeline candidates that these two established companies are advancing.
Eli Lilly’s investigational drug retatrutide is a triple agonist that adds a glucagon target to the GLP-1/GIP combination. Its Phase 3 clinical trial data showed that patients lost 28.3% of their body weight over 80 weeks of treatment, with 45% of participants achieving weight loss of at least 30%. Similarly, Novo Nordisk’s investigational drug CagriSema demonstrated in clinical trial data that patients lost approximately 22.7% of their body weight after 68 weeks of treatment, and the company has submitted an approval application to the U.S. Food and Drug Administration (FDA).
Viking’s candidate remains competitive against these two pipeline projects, given that its study durations are considerably shorter.
If later-stage trials of VK2735 confirm the published data, Viking Therapeutics could pose a threat to the revenue and profits of Novo Nordisk and Eli Lilly.
The Phase 3 trial for the injectable form of VK2735 only completed patient enrollment earlier this year, and with a study duration of more than one year, key data will not be released until 2027. The Phase 3 trial for the oral tablet form is expected to launch around the end of this year. If both trials replicate the early results, it would mean that the likelihood of Viking Therapeutics establishing a firm foothold in the weight-loss drug space moves from “modest” to “fairly substantial.” Conversely, if the data show that VK2735 actually outperforms what Eli Lilly and Novo Nordisk’s next-generation investigational weight-loss candidates can achieve, the entire landscape would shift, and the probability of it becoming a more formidable competitor would rise significantly.
