Zealand Pharma Capital Markets Day Summary Company Overview - **Company**: Zealand Pharma - **Event**: 2025 Capital Markets Day - **Date**: December 11, 2025 - **Focus**: Management of obesity and metabolic health pipeline Key Industry Insights - **Obesity Market Evolution**: The obesity market has significantly evolved, with key trends reinforcing Zealand Pharma's perspectives shared two years ago [2][12] - **Healthcare Crisis**: Over 1 billion people globally are living with obesity, creating a civilization-scale problem that requires innovative solutions beyond current GLP-1-based therapies [14][15] - **Consumer Engagement**: The consumer segment is rapidly growing, with nearly two-thirds of discussions initiated by consumers, indicating a shift towards consumer-driven treatment choices [40][41] Core Company Strategies - **Pipeline Development**: Zealand Pharma aims to maximize the value of petrelintide, an amylin analog, and invest significantly in its metabolic health pipeline, increasing research investments fivefold over the next five years [22][24] - **Partnership with Roche**: A 50/50 partnership with Roche is established to co-commercialize petrelintide, combining Zealand's biotech agility with Roche's pharmaceutical strength [18][19] - **Research Expansion**: A new research hub in Boston will complement the existing Copenhagen site, focusing on AI, machine learning, and novel chemistry approaches [22][23] Product Highlights - **Petrelintide**: Described as the "crown jewel," petrelintide is designed to help individuals feel full faster and is positioned as a foundational therapy for weight management [7][17] - **Survodutide**: A dual agonist targeting GLP-1 and glucagon receptors, showing promising phase two data for weight loss and metabolic health improvements [50][56] Clinical Insights - **Weight Maintenance Focus**: Emphasis on transitioning from weight loss to weight maintenance, addressing the need for durable therapies that help maintain weight loss [16][34] - **Real-World Data**: High discontinuation rates of current therapies highlight the need for better patient experiences and alternatives to GLP-1 therapies, which often lead to gastrointestinal side effects [44][46] Future Outlook - **2030 Ambition**: Zealand Pharma's "Metabolic Frontier" ambition includes five product launches and over ten clinical candidates by 2030, aiming to establish itself as a generational biotech company [22][24] - **Transformational Potential**: The partnership with Roche and the development of innovative therapies position Zealand Pharma to redefine obesity management and address significant unmet medical needs [18][19][22] Additional Considerations - **Cultural Commitment**: Zealand Pharma emphasizes its unique culture and commitment to agility and innovation, which are seen as critical to its success in the competitive biotech landscape [11][25] - **Healthcare System Impact**: The company recognizes the broader societal implications of obesity and the need for comprehensive solutions that address the healthcare crisis associated with it [15][12]

Core Insights - Eli Lilly is set to begin late-stage trials for its experimental amylin obesity drug, eloralintide, next month following positive mid-stage study results [1][2] Group 1: Drug Efficacy - The highest dose of eloralintide resulted in an average weight loss of 20.1% over 48 weeks for patients with obesity or who are overweight [2] - The lowest dose led to a 9.5% weight loss at 48 weeks, compared to 0.4% for the placebo group [6] - A two-step dose escalation starting at 6 mg resulted in a 19.9% weight loss, while a three-step escalation starting at 3 mg led to a 16.4% weight loss [6] Group 2: Competitive Landscape - Eli Lilly's advancements position it as a strong competitor in the amylin treatment space, which is seen as the next wave of obesity treatments [3] - Major pharmaceutical companies like Roche, AbbVie, and Novo Nordisk are investing heavily in amylin treatments, indicating a competitive market [4] - Novo Nordisk and Pfizer are engaged in a takeover battle for Metsera, which has a potential once-monthly amylin drug in its pipeline [4] Group 3: Mechanism and Side Effects - Amylin analogs mimic a hormone that suppresses appetite and reduces food intake, potentially offering advantages over existing GLP-1 treatments [5] - Common side effects of eloralintide include mild to moderate gastrointestinal symptoms and fatigue, particularly at higher doses [7] - Patients who gradually increased their doses experienced fewer side effects [7][8]

Core Insights - The weight loss and diabetes drug market is experiencing significant growth, driven by demand for effective treatments and new competitors entering the space [1][3] - Eli Lilly and Novo Nordisk remain the leading companies, with Eli Lilly gaining market share and accounting for nearly 60% of prescriptions in the injectable obesity and diabetes class [2][9] - The market is projected to reach approximately $100 billion by the end of the decade, with a potential 25 to 50 million U.S. patients using GLP-1s by 2030 [3][12] Market Dynamics - Eli Lilly has outperformed Novo Nordisk, increasing its market share from 53% in Q1 to 57% in Q2 of the current year, attributed to superior efficacy and safety of its drugs [9][10] - Novo Nordisk is facing challenges, including a nearly 40% drop in stock value this year and a need to cut its workforce by 11.5% to regain market footing [11][14] - The competition is intensifying, with many pharmaceutical companies investing in obesity drugs, often through partnerships with smaller developers [4][42] Access and Coverage Issues - Access to GLP-1s remains limited due to insurance coverage gaps, with many insurers not covering obesity treatments, leading to high out-of-pocket costs for patients [5][23] - Coverage for GLP-1s for obesity has slightly increased, with 36% of surveyed companies providing such coverage, up from 34% in 2024 [24] - Employers are hesitant to cover these high-cost drugs due to concerns about long-term patient adherence and potential weight regain [25][28] Future Developments - Both Eli Lilly and Novo Nordisk are working on oral formulations of GLP-1s, which could significantly change market dynamics and improve patient access [30][34] - Analysts predict that oral pills could capture around 24% of the weight loss drug market by 2030, with Eli Lilly expected to lead this segment [34][35] - The success of new oral treatments will depend on their pricing and effectiveness compared to existing injectable options [40][39] Competitive Landscape - The market is seeing a variety of new entrants and experimental drugs, with companies exploring different mechanisms for weight loss and less frequent dosing [41][42] - Novo Nordisk and Eli Lilly are also looking into new hormone-targeting treatments to expand their portfolios beyond current offerings [45][46] - The competitive landscape is evolving, with potential partnerships between smaller biotech firms and larger pharmaceutical companies to enhance drug development [51]

Core Viewpoint - Roche has entered a $5.3 billion deal with Zealand Pharma to develop a new obesity treatment, petrelintide, aiming to compete in the growing obesity drug market dominated by Novo Nordisk and Eli Lilly [1][2]. Company Developments - The Roche-Zealand partnership will involve co-development and co-commercialization of petrelintide, with Zealand receiving $1.65 billion upfront and potential milestone payments up to $5.3 billion based on trial outcomes and sales [6][7]. - Zealand Pharma's stock surged by 38% on the announcement day, while Roche's shares increased by approximately 4% [7]. Product Insights - Petrelintide is an amylin analog, a new class of weight loss treatment that may offer comparable weight reduction to GLP-1 drugs but with better tolerability and preservation of lean muscle [3][4]. - Analysts project that petrelintide could achieve a 15-20% weight loss in phase 3 trials as a monotherapy, with Zealand calling it a potential "future backbone therapy" for weight management [5][6]. Competitive Landscape - The obesity drug market is becoming increasingly competitive, with Roche's deal positioning it against established players like Novo Nordisk and Eli Lilly, who are also advancing their own obesity treatments [15][16]. - Zealand's CEO indicated that the partnership with Roche could accelerate the timeline for bringing petrelintide to market, potentially ahead of competitors [14][17]. Strategic Fit - The collaboration was driven by a strong scientific and cultural alignment between Roche and Zealand, with both companies emphasizing the importance of a true partnership in the development process [12][9]. - Roche has been actively expanding its obesity treatment portfolio, including the acquisition of Carmot Therapeutics to enhance its capabilities in this area [10][11].