More on GLP-1 Medications – Asrar Qureshi’s Blog Post #1138

More on GLP-1 Medications – Asrar Qureshi’s Blog Post #1138

Dear Colleagues! This is Asrar Qureshi’s Blog Post #1138 for Pharma Veterans. Pharma Veterans Blogs are published by Asrar Qureshi on its dedicated site https://pharmaveterans.com. Please email to pharmaveterans2017@gmail.com  for publishing your contributions here.

Credit: Andres Ayrton

Credit: Artem Podrez

Preamble

I had earlier discussed GLP-1 in my blogpost #1111 of May 26, in relation to the changes in medical aesthetics demand created by these medications. In this blogpost, I talk about these therapies with reference to their economic and public health implications. Some details in this post are taken from Mckinsey article. Link at the end.

Beginning in the 2000s, doctors primarily prescribed GLP-1s to help treat type 2 diabetes. But in late 2023, GLP-1s began making headlines for their success in helping people lose weight. Ozempic, Wegovy, and other brands started to become household names and sales rapidly accelerated. As of February 2025, there are 11 GLP-1s on the market with indications for diabetes and weight loss, and more than 40 others in the pipeline.

The wave of GLP‑1 medications—such as Ozempic, Wegovy, and Mounjaro—is reshaping how we think about metabolic health. Originally designed to treat type 2 diabetes, these therapies are now at the center of a broader health revolution, promising weight management, cardiovascular protection, and even mental health benefits. But with enormous promise come complex questions around access, affordability, long‑term safety, and ethical prescribing.

GLP-1 (Glucagon Like Peptide-1) Class of Drugs

GLP‑1receptor agonists mimic a hormone released in the gut after meals and help regulate insulin and appetite. They promote:

Glucose‑dependent insulin release from pancreatic β‑cells

Reduced appetite and delayed gastric emptying

Enhanced satiety, leading to lower caloric intake and sustained weight loss

Beyond Diabetes and Obesity: The Deep Health Benefits

While type 2 diabetes and weight loss remain core indications, GLP‑1 benefits extend across multiple health dimensions.

Cardiovascular protection: Clinical studies show reductions in heart attacks, strokes, and mortality among users with diabetes or obesity.

Renal and liver health: Patients with chronic kidney disease (CKD) saw reduced risk of kidney failure or death. In fatty liver disease and nonalcoholic steatohepatitis, GLP‑1s improved liver inflammation and fibrosis.

Brain and mental health: Emerging research links GLP‑1 use with lower dementia rates and potential neuroprotection—especially in older adults. Early signals also suggest mood and psychiatric benefits.

These multidimensional benefits challenge old paradigms, turning obesity and metabolic syndrome into treatable conditions rather than inevitabilities.

Evolution of GLP‑1 Therapies: Easier, Better, More Inclusive

The first GLP‑1 drug (exenatide) was launched in 2005 with cumbersome dosing. Since then, big leaps have transformed both efficacy and accessibility.

Liraglutide (2010) enabled daily injection without mixing hassles.

Long‑acting pens (Bydureon, 2014) reduced dosing frequency.

Semaglutide (Ozempic, 2017) offered once‑weekly dosing with high efficacy.

Oral semaglutide (Rybelsus, 2019) eliminated injections altogether.

Wegovy (2021) brought higher‑dose semaglutide for chronic obesity indication.

Tirzepatide (Mounjaro, 2022) combines GLP‑1 and GIP receptor targeting for superior outcomes.

Next‑generation oral agents like orforglipron promise similar benefits at lower cost and broader scalability.

The Market Size For GLP-1s

Nearly one in three adults in the United States, or about 100 million people—and 900 million people worldwide—meet the clinical criteria for obesity. Obesity increases the risk of many other diseases, from type 2 diabetes and depression to cancers and dementia. Because many people who meet the criteria for obesity would like to lose weight, there is a high demand for these drugs.

In 2024, quarterly sales of three GLP-1 drugs grew to more than $4 billion. McKinsey estimates that treatment of metabolic and endocrine-related diseases (via GLP-1 drugs) will have greater revenue growth than any other therapeutic area through 2028. The population of patients meeting clinical eligibility criteria for GLP-1s is one of the largest of any new drug class in the past 20 to 30 years. McKinsey also estimates that up to 5 percent of the US population could be prescribed a GLP-1 by 2030, for a variety of diseases including cardiovascular, inflammatory, and neurogenerative.

The Risks and Side Effects: What Clinicians Should Know

Like any powerful therapy, GLP‑1 medications carry potential downsides.

Gastrointestinal symptoms: Nausea, vomiting, diarrhea, or constipation are common during initial dose‑titration, but typically subside. Slow dose escalation and dietary advice help mitigate these effects.

Safety alerts: A boxed warning exists for medullary thyroid carcinoma (based on rodent data). Though cautious, human studies have not shown elevated risks of pancreatitis or pancreatic cancer—but vigilance remains important, especially for those with pancreatitis history.

Off‑label abuse: Rising use without clinical indications—especially for cosmetic purposes—has sparked concerns around mental health risks, eating disorders, and legal exposure for improper prescribing.

Monitoring and clinician education are essential to balance benefits and avoid misuse.

System-Wide Effects: What GLP‑1s Mean Beyond Medicine

The ripple effects go far beyond healthcare, for industries and economies.

Medical aesthetics: A surge in new or converted patients seeking cosmetic treatments after weight loss is reshaping aesthetics demand across clinics and spas. The topic was taken by me in the previous blog.

Medtech disruption: Demand for obesity-related devices (e.g., bariatric procedures, CPAP machines) may decline, while demand for injection pens and wearable monitoring tools grows.

Pharma supply chain: Growing production of injectors, packaging, and raw materials present new investment opportunities across the GLP‑1 ecosystem.

Keys to Responsible Use: Maximizing Benefit, Minimizing Harm

To safely integrate GLP‑1 therapies into practice, stakeholders need a responsible approach:

Patient Education & Holistic Management

GLP‑1s are most effective when paired with nutrition, exercise, and psychological support. Patients should be counseled on managing side effects, monitoring health, and maintaining long-term habits.

Equity and Access

To prevent exacerbating health disparities, expand public coverage and subsidy schemes, prioritize high‑need groups (e.g., T2D patients), and guard against supply shortages driven by cosmetic demand.

Ethical Prescribing

Prescribe only when medically appropriate. Off‑label use for cosmetic reasons should be accompanied by screening for eating disorders or mental health issue.

Ongoing Surveillance & Real‑World Data

Monitor long-term safety and outcomes, especially relating to rare but serious risks like thyroid tumors or pancreatitis. Real‑world data collection should guide product improvement and regulation.

Looking Ahead: The Future of GLP‑1 Therapies

The GLP‑1 landscape is evolving fast.

Broader therapeutic targets: Trials are underway for conditions like polycystic ovary syndrome (PCOS), non‑alcoholic fatty liver disease, and certain neurocognitive disorders.

Next-gen formulations: New oral drugs (e.g., orforglipron), transdermal patches, and peptide combinations aim to improve accessibility, reduce side effects, and lower costs.

Digital and integrated care: Pairing GLP‑1 use with continuous glucose monitoring (CGM), wellness coaching, and automated insulin systems may deliver more personalized and effective care.

Sum Up

GLP‑1 receptor agonists have transcended their original purpose to become a beacon in metabolic health. They address not just blood sugar or body weight, but the broader spectrum of chronic diseases plaguing global populations. But realizing their full potential requires more than prescriptions; it demands holistic care, equitable access, thoughtful policy, and vigilant oversight. When deployed responsibly, GLP‑1s offer a path to turn age‑related, lifestyle‑driven chronic illness into preventable and treatable conditions.

Concluded.

Disclaimers: Pictures in these blogs are taken from free resources at Pexels, Pixabay, Unsplash, and Google. Credit is given where available. If a copyright claim is lodged, we shall remove the picture with appropriate regrets.

For most blogs, I research from several sources which are open to public. Their links are mentioned under references. There is no intent to infringe upon anyone’s copyrights. If, any claim is lodged, it will be acknowledged and recognized duly.

Reference:

https://www.mckinsey.com/featured-insights/mckinsey-explainers/what-are-glp-1-medications?cid=omcknsl-eml-nsl--mck-ext-----&hlkid=e508d69fbd5f4bcd8772586bcec944d8&hctky=15999472&hdpid=b6fb590a-8a89-46be-aa77-63538513baa0