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Waistlines and GLP-1s—Expanding in Unison
By: Tommy Sternberg and Daria Fomina, William Blair Investment Management
The total addressable market (TAM) for GLP-1 medications like Ozempic and Wegovy could reach $500 billion. Here are opportunities and risks for investors.
This is an excerpt from NCPERS Summer 2024 issue of PERSist.The total addressable market (TAM) for GLP-1 medications like Ozempic and Wegovy could reach $500 billion. Here are opportunities and risks for investors.
It seems like everyone is talking about Ozempic, but this popular weight loss drug is only one of many glucagon-like peptide-1 (GLP-1) medications establishing themselves as the cornerstone in the management of obesity. What are the opportunities and risks for investors?
To frame the potential total addressable market (TAM) for GLP-1 medications, we can start with the 800 million people who are estimated to be overweight or obese worldwide.
If even a quarter of these individuals receive treatment at an estimated cost of $2,500 each, the TAM could reach $500 billion. Our internal models anticipate the market for obesity treatments alone (excluding diabetes treatments) to be around $180 billion by 2032. To put that number in perspective, the oncology sector, the largest single category within the prescription drug market, is forecast to be a $200 billion category.
Looking for Market Leaders
Only two companies, Eli Lilly and Novo Nordisk, have sizable GLP-1s available today, and we expect them to dominate the market over the intermediate term.1
Both benefit from significant scale advantages, which are evident not only in their substantial investments in developing next-generation medicines but also in their production capabilities as well as sales and marketing efforts.
It could take years for competitors to make inroads given the time it takes to bring new drugs to market, and in our opinion, competitors will have to differentiate on other factors, such as convenience or tolerability.
Changing Market Dynamics
Speaking of convenience, current GLP-1 medications for weight loss take the form of injectables, but oral versions are on the horizon, and the price will likely be lower. We expect this to further expand the market. The chart below illustrates our anticipated market split.
Companies beyond drug manufacturers might ride this tailwind. Certainly, companies involved with the production of injectable components and assembly of the devices stand to benefit, as do drug distributors (such as wholesalers and pharmacy benefit managers).
And then there are complementary therapeutics. Because GLP-1s stop working when not taken, weight loss maintenance is another category of interest. So is muscle preservation, since part of any weight loss entails loss of muscle mass.
Of course, where there are winners, there are losers. For example, manufacturers of robotic equipment used in bariatric surgeries have seen a slowdown in demand as patients postpone bariatric surgeries while they try GLP-1 medications. We could also see a slowing demand for the obstructive sleep apnea market, which includes continuous positive airway pressure (CPAP) devices; joint replacements; and continuous glucose monitors and insulins pumps.
The Ripple Effects on Consumer Markets
GLP-1 agonists are also impacting various consumer industries. Studies indicate that GLP-1 users consume 20% to 30% less energy, and the impact is particularly pronounced in junk food and other high-calorie foods. They also have the potential to make a profound impact on broader lifestyle choices, such as alcohol and tobacco consumption. These preference changes affect entire households, as studies indicate that GLP-1 users affect their household food procurement.
There are some dramatic left-tail-risk scenarios—for example, if all people with above-average body mass index take GLP-1 medications and stick to the prescribed regimen for a prolonged period, this could drive a decline in food consumption of more than 10%. However, we think the more likely scenario is a one- to two-percentage-point volume reduction over the course of a decade or more.
Different product types could also fare differently in this changing landscape. Early studies indicate growth (or slower decline) in volume for protein-forward products like some dairy products that appear to be less affected. In contrast, carbonated drinks and snacks might see severe cuts in consumption.
As companies navigate these shifts, understanding the broader economic and sector-specific dynamics is critical for investors. Active management certainly plays a role.
This article is excerpted from our blog, which you can read in full here.
Endnotes
1 Elli Lilly and Novo Nordisk do not only produce GLP-1s and thus the companies' profits and losses are not solely correlated to these medications. Past performance is not indicative of future results, and it should not be assumed that any investment in the securities referenced was or will be profitable. References to specific securities and their issuers are for illustrative purposes only. William Blair may or may not own any securities of the issuers referenced and, if such securities are owned, no representation is being made that such securities will continue to be held. The securities referenced do not represent all of the securities purchased, sold, or recommended for advisory clients.
Bios: Tommy Sternberg, CFA, partner, global equity research analyst, covers large-cap healthcare companies. Before joining William Blair, Tommy spent two years as an equity analyst in Oak Brook Bank's investment management and trust department. Tommy received a B.S. in economics from Duke University and an M.B.A. from the University of Chicago's Booth School of Business. Daria Fomina, global equity research analyst, covers large-cap consumer companies. Before joining William Blair, Daria was head of the Pan-European leisure research team at Goldman Sachs Global Investment Research in London. Daria received a bachelor's degree in economics (with honors) and a master's degree in financial markets from the Higher School of Economics.
Disclosures: This content is for informational and educational purposes only and not intended as investment advice or a recommendation to buy or sell any security. Investment advice and recommendations can be provided only after careful consideration of an investor's objectives, guidelines, and restrictions.
Information and opinions expressed are those of the authors and may not reflect the opinions of other investment teams within William Blair Investment Management, LLC, or affiliates. Factual information has been taken from sources we believe to be reliable, but its accuracy, completeness or interpretation cannot be guaranteed. Information is current as of the date appearing in this material only and subject to change without notice. Statements concerning financial market trends are based on current market conditions, which will fluctuate. This material may include estimates, outlooks, projections, and other forward-looking statements. Due to a variety of factors, actual events may differ significantly from those presented.
References to specific companies are for illustrative purposes only and should not be construed as investment advice or a recommendation to buy or sell any security. Past performance is not indicative of future returns.
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