lessthanhalf
GLP-1 Specialist

I am a bit surprised that semaglutide is still fairly popular. Given it is not cheaper, is both less effective at weight loss and has more side effects than tirzepatide, it is really hard to think of a good reason for starting anyone on it in preference to tirz. It has more accumulated evidence for benefits outside of weight loss - for cardiovascular and kidney risks etc, but all the research on tirz so far strongly suggests it is a class effect and is very likely to be the same. Obviously if someone is already on it and it is working for obesity or diabetes switching makes little sense, but retaining old patients is not going to help their share price much.
Unfortunately for novo, lily just picked better drugs to develop or was luckier. Cagri was pretty disappointing for weight loss on its own, and combined with sema is nearly as good as tirz but with more side effects, and both oral ozempic and orfoglipron are also less effective and have more side effects than tirz. Cagri looks good as an add on to reta or tirz at low doses but given the different ownership , not likely to even get studies. Oral ozempic never got promoted much and was not released everywhere, it definitely is not available in Aus, maybe due to initial production limitations so they focused on the injectable version? Orfoglipron could end up popular if people want to avoid injections, I wonder if ozempic being around for so long and being talked about so much has reduced peoples' aversion to injectable drugs a bit?
Unless novo can get their triple agonist out before reta which seems very unlikely then it is just going to get worse for them once reta is available, putting sema at the third ranked choice at best. In the longer term sema is going to end up as the cheaper less preferable option to stay in the market at all, especially once more and more drugs start being approved. In the grey market I cannot think of any reason to use sema, except maybe as a low dose add on to higher doses of reta or tirz.
Unfortunately for novo, lily just picked better drugs to develop or was luckier. Cagri was pretty disappointing for weight loss on its own, and combined with sema is nearly as good as tirz but with more side effects, and both oral ozempic and orfoglipron are also less effective and have more side effects than tirz. Cagri looks good as an add on to reta or tirz at low doses but given the different ownership , not likely to even get studies. Oral ozempic never got promoted much and was not released everywhere, it definitely is not available in Aus, maybe due to initial production limitations so they focused on the injectable version? Orfoglipron could end up popular if people want to avoid injections, I wonder if ozempic being around for so long and being talked about so much has reduced peoples' aversion to injectable drugs a bit?
Unless novo can get their triple agonist out before reta which seems very unlikely then it is just going to get worse for them once reta is available, putting sema at the third ranked choice at best. In the longer term sema is going to end up as the cheaper less preferable option to stay in the market at all, especially once more and more drugs start being approved. In the grey market I cannot think of any reason to use sema, except maybe as a low dose add on to higher doses of reta or tirz.


