Eli Lilly under pressure: Can it solve GLP-1 supply squeeze?

Four doses of Mounjaro: 7.5mg, 10mg, 12.5mg and 15mg, will be in scarce supply through at least the end of April due to surging demand, according to the FDA’s website.

“While Lilly continues to manufacture and ship all doses of Zepbound, due to the unprecedented demand for these medicines, some patients may experience difficulty when trying to fill their prescription at their pharmacy,” a Lilly spokesperson said.

Rather than the medicine itself, the company​ is struggling to make enough of the pre-filled pens used to inject the drug – as manufacturing them requires ‘some of the most complex production systems on the planet,’ Lilly CEO David Ricks previously told Bloomberg news.

The drugmaker added that it is moving with ‘purpose and urgency to ensure our innovations are available to those who need them’.

The obesity drug market is no stranger to supply woes, with Novo Nordisk recently snapping up three manufacturing sites from Catalent to address an ongoing shortage of Wegovy, in an $11 billion deal.

In fact, Novo Nordisk CEO Lars Fruergaard Jørgensen has admitted that the gap between supply and demand for weight loss medications is significant enough to take years to fully close.

But, with trials indicating that Lilly’s Mounjaro could be even more effective than Novo Nordisk’s Wegovy– why is Lilly struggling and how can the pharma giant boost its supply chain​ to fully capitalise on demand?

Supply and demand

“I think we are all surprised by the enormous wave of obesity drugs – numbers are going crazy and classic law of a market – offering needs to keep pace with demand and it’s extremely complex in this context,” Nicolas Schmitz, senior manager and strategic market analyst at KBI Biopharma told Bio Pharma Reporter.

“It’s only the beginning for Lilly as Zepbound is overtaking Wegovy in US new prescriptions for obesity treatment, with 77,590 new scripts in the first week of March – so securing supply is essential.”

As GLP-1s have become more popular, more people have been using the drug for cosmetic weight loss – an issue Eli Lilly addressed in its recent commercial that aired during the 2024 Oscars ceremony.

The ‘Big Night’ ad warned against using GLP-1s for ‘vanity’ – depicting a contrasting scene of a celebrity red carpet event and a plainly dressed, overweight woman riding public transport.

The voiceover states: ‘Some people have been using medicine never meant for them. But that’s not the point…people whose health is affected by obesity are the reason we work on these medications. It matters who gets them.’

Vikram Shanbhag, vice president, life sciences and healthcare at SG Analytics, believes that this was an important step in dissuading misuse of these drugs, which could impact supply.

“Lilly’s recent commercial will hopefully help curb off-label usage and normalize demand,” he told Bio Pharma Reporter.

Release the vials

In response, patients have urged Lilly to drop the pens and release Mounjaro in vials for those able to self-administer the medication – which the drugmaker has done in certain countries outside the U.S.

A TikTok campaign #releasethevials started by Mounjaro-user Dave Knapp has gained significant traction, with the medical sales professional claiming that thousands of people contact him on a daily basis to ask when the medication will be available.

“There needs to be pressure to do it. They have that ripcord they could pull here to alleviate the shortages,” he said.

Commenting on the #releasethevials initiative, Shanbhag believes Lilly, ‘which always puts patients at the center​’ should do this immediately.

“Mounjaro has been available in vials in Canada since November 2023 and has been used without any major issues. This can be a good interim solution, till Lilly is able to ramp up the supply of doses on pre filled pens,” he said.

However, Schmitz believes the industry must move with caution, as ‘we need to be very careful in ensuring patients are properly educated on self-administration and most important safe’.

Notes from Novo?

While releasing the vials may provide short-term relief for both Lilly and its patients, it will not secure a consistent and robust supply chain.

Forging strategic manufacturing partnerships to ramp up supply will likely be Eli Lilly’s key focus moving forward, in order to stay ahead of its competitors in the lucrative market​.

“Lilly can inspire themselves from what Novo Nordisk is currently doing – investing. Crucially, the acquisition​ of three finish and fill sites from Novo Holdings after Novo Holdings acquired Catalent. De-risking supply chains is key, making investments and having flexible distribution strategies to prioritize deliveries to areas with the highest need,” Schmitz said.

Shanbhag agrees that companies like Lilly need to vertically integrate to ensure success, also pointing out the significance of the Novo Nordisk and Catalent deal.

“There could be further disruptions due to various geo-political issues, making vertical integration essential. Lilly should also diversity its source countries, India and Vietnam are strong options, to cope with these supply chain shocks,” he added.

The demand for Eli Lilly’s wildly popular weight loss drugs is not likely to wane. Therefore, in order to get ahead of Novo Nordisk, the company must prioritise manufacturing expansion to better navigate increases in demand.