Roche Partners with Zealand Pharma on Weight-Loss Drug, Challenging GLP-1 Dominance

In the weight-loss drug field, the rise of GLP-1 drugs has been like a big bang. Over the past few years, the rapid adoption of this class of drugs has sparked ongoing competition for more weight-loss solutions, with major pharmaceutical companies seeking competitive advantages to challenge leaders Eli Lilly and Novo Nordisk.

Research and development strategies for weight-loss drugs have quickly diverged. Some companies are developing oral GLP-1 drugs to offer a more convenient option than injections; others are betting on entirely new molecules. Large pharmaceutical companies are now also intensifying their efforts.

Last week, Roche announced a deal with Danish biotechnology company Zealand Pharma. Zealand Pharma currently has four weight-loss peptide drugs in development, including a differentiated glucagon/GLP-1 receptor dual agonist developed in collaboration with Boehringer Ingelheim, targeting obesity and MASH.

Under the agreement, Roche will pay $1.65 billion, including a $1.4 billion upfront payment and a $250 million anniversary payment, to obtain the license for petrelintide, a once-weekly amylin analogue. Zealand Pharma began enrolling subjects in its phase 2b study of petrelintide late last year, and the drug has the potential to achieve weight loss comparable to or better than GLP-1, without the same gastrointestinal side effects. Including development and sales milestones, the deal could total up to $5.3 billion, making it the largest weight-loss drug deal to date, the two companies said.

"This is a strong validation that petrelintide has best-in-class potential," said Zealand CEO Adam Steensburg. "If you want to lead in this field, you don't choose a second-best option."

This year, results from several highly anticipated weight-loss drug trials will be released, potentially sparking competition among several large pharmaceutical companies. And Zealand is not Roche's only major move. In 2023, Roche acquired Carmot Therapeutics for $2.7 billion, gaining three early- and mid-stage weight-loss drug candidates.

The deal with Zealand will also advance the development of a new combination candidate that pairs petrelintide with Roche's CT-338, a GLP-1/GIP receptor dual agonist.

"It was clear that Roche was the one that had thought most deeply about how to lead in this area, and the partner we believed could best help petrelintide reach its full potential."

— Adam Steensburg, CEO of Zealand Pharma

Here, Steensburg discusses in depth the collaboration with Roche and why the weight-loss market is ripe for GLP-1 alternatives.

This interview has been edited for length and style.

PHARMAVOICE: How do you assess the current weight-loss drug landscape? How do smaller companies fit into it?

ADAM STEENSBURG:We are in the very early stages of addressing the biggest health crisis of our time—the obesity pandemic. Arguably, we haven't even taken baby steps to solve the global health problems associated with obesity, leaving enormous room for innovation, setting new standards of care, and disrupting the market in the future. But it must be with differentiated molecules. I think there is very little room for things that are too similar to existing products.

Looking at many other players, I think what they have are 'me-too' products. Yes, you might have a good product, but it might be too late. If you don't have differentiation, who will invest in all the manufacturing capacity and commercial rollout?

How did the collaboration with Roche come about? What were the key drivers of the deal?

Last year, we initiated a collaboration process, discussing with numerous pharmaceutical companies the opportunity to lead a new category and become a GLP-1 alternative... which, at least so far, has shown significantly fewer side effects such as nausea and vomiting. Our amylin analogue doesn't really affect people's appetite; it's more about making people feel full faster. So, we think this could be a more enjoyable weight-loss experience.

We reached out to several companies, sharing our vision of why pursuing a GLP-1 alternative is attractive... We saw very strong interest. It was clear that Roche was the one that had thought most deeply about how to lead in this area, and the partner we believed could best help petrelintide reach its full potential.

They have already built a substantial portfolio and convinced us that they want to lead in this area and know what it takes, including investments in manufacturing.

Finally, there must be a strong cultural fit with the partner, because we will only engage in collaboration if we can achieve true co-development, co-commercialization, and profit sharing. That means we have to work together for the long term to bring the product to market.

Is petrelintide's marketing message 'a more enjoyable way to lose weight'?

That's a clinical observation. GLP-1 and amylin are both endogenous peptides; amylin is released by the pancreas and stimulates leptin sensitivity. Many obese individuals are actually resistant to leptin, which is the satiety hormone that signals the brain to stop eating. Amylin is a more natural satiety signal that helps obese individuals with leptin resistance restore leptin sensitivity, leading them to stop eating earlier. This is also what people describe after trying amylin analogues—they don't lose that anticipatory seeking of food.

Why partner with a large pharmaceutical company again at this stage?

Given the scale of the obesity pandemic and the scope of this program, including how many patients we will ultimately need to cover to solve the problem, we have always known that we need a partner that not only helps us run the phase 3 program and has global commercial reach, but also makes all the necessary manufacturing investments to have sufficient capacity.

Why create a combination product with CT-388? If the amylin analogue works well on its own, why test a combination?

Petrelintide can achieve median weight loss of 15% to 20%. But there is a group of patients who need a higher degree of weight loss than most morbidly obese patients, such as those who are currently candidates for bariatric surgery. There, we see the combination as an excellent opportunity. Additionally, there are obese patients with diabetes, who make up about 20% of the obese population. For them, the combination could also be an excellent opportunity because GLP-1 is more effective at blood sugar control.