- Despite the growing obesity epidemic in the U.S., the market for weight-loss drugs, such as Orexigen’s Contrave or Vivus’ Qysima, is floundering.
- Analysts had once predicted a multi-billion-dollar market for the drug class by 2020, but Orexigen’s recent struggles belie that optimism. Following anemic sales of Contrave last year, co-marketing partner Takeda Pharmaceuticals dumped U.S. rights to the drug back on Orexigen in March.
- Although Orexigen now plans to add a new salesforce to assume marketing duties in the U.S., the company now projects “zero-to-limited” growth for Contrave in 2016, FiercePharma reports.
Orexigen’s situation has become so dire it is at risk of being delisted from Nasdaq, as its stock has traded below $1.00 for 30 consecutive trading days. With Takeda gone, Orexigen also lost Takeda’s large safes force, forcing it to hire a new team, including a new SVP of market access and a VP of sales.
Orexigen estimates that Contrave will have 10% market share of the obesity market by 2018, but that seems rather optimistic given all current indicators.
First quarter sales were up slightly to $13 million from $11.5 million a year ago. But for a market once predicted to hit $3 billion in sales by 2020, Contrave looks to be in trouble.
Competitors Vivus and Arena, which makes Belviq, have also suffered, with their stocks trading near all-time lows as well. Arena has faced five straight quarters of declining sales, and Vivus’ Qsymia struggled in the first quarter. Qsymia’s net revenue from 2015 totaled only $54.6 million.
"Docs are still afraid"
So what's the problem? Barry Mennen, MD, who works general practice three days per week and on obesity-related issues for two in the Washington, DC area, explained: "I think there are several reasons that internists and family practitioners fail to deal with their patients' overweight and obesity issue. First, physicians are not trained specifically in nutrition and have never felt really comfortable in this area."
Mennen also pointed to the Fenfluramine/phentermine fallout from the late 1990's. “Physicians fear anti-obesity medications because of the fen-phen disaster. And even though the FDA, when reviewing the data in 1997, gave phentermine a complete vote of confidence while taking fenfluramine off the market, docs are still afraid of that drug,” he said.
Mennen prescribes phentermine and fluoxetine in combination and also has prescribed Qsymia and Contrave.
“But for physicians with full waiting rooms of patients with hypertension, diabetes, post-MIs, COPD, migraines, etc., it is a tough sell to get them to talk weight loss with their patients," Mennen added.