Thanksgiving Trimmings: Obesity Market Bulging with New Drugs

Thanksgiving is right around the corner. It’s the time of the year we ring in the holiday season and bring together the melting pot of families, football, and of course, feasting on lots of turkey, stuffing, pumpkin pie and all the trimmings. Speaking of trimmings, why not talk about weight-loss drugs?

So let’s really talk turkey. It turns out that America is a nation of gobblers year-round. More than 35% of U.S. adults are obese, according to the Centers for Disease Control and Prevention. Obesity is blamed for over 300,000 deaths annually in the U.S. at a related economic cost exceeding $100 billion.

A cornucopia of new drugs.

Drug developers and regulators are keen on reshaping these measurements. Following a 13-year famine of prescription weight-loss drug approvals, two different drugs in the U.S. were approved in a one-month period in 2012: Belviq® (lorcaserin) and Qsymia® (phentermine / topiramate). And in September 2014, the Food & Drug Administration approved a third new drug, Contrave® (bupropion / naltrexone). A few days later, Novo Nordisk dished up their diabetes med, liraglutide, on a platter to an FDA drug advisory panel with puffed-up hopes of gaining their seat at the table for Saxenda®, the re-sculpted weight-loss drug brand name. The panel endorsed Saxenda 14-1 (with marketing approval in the offing).

Will these new drugs last?

Sales for newcomers Belviq and Qsymia have disappointingly sagged, robbing them of their initial plumpness. And analysts predict it’s no turkey shoot for Contrave either. No surprise: weight-loss drugs suffer from a fat history of hiccups, and have always been looked at, well, with a grain of salt. Safety concerns, physician skepticism, and lack of reimbursement being the major culprits cramping growth.

So what’s the skinny on the new drug names?

FDA has final say over all drug names. This often creates a tight squeeze for brand names that appear too fanciful or that make wild claims. The OTC diet brand name Slim-Fast, for example, would likely not pass muster with regulatory authorities today. Let’s see how the new weight-loss drug names successfully trotted around the regulatory grinder, or if any of them are ground turkey:

Contrave––Avoiding any linkage to its chemical heritage (bupropion / naltrexone), or to their trade names––Wellbutrin®, Zyban® (both bupropion), and Revia® (naltrexone)––Contrave suits the weight-loss indication. Contrave is chiseled from the word contravene (meaning “to violate the order; break”). It denotes contra (“against”) and suggests crave (“desiring something”), hinting at “stop craving.” The anti-obesity claim is supported by the “reduced appetite” effect of the cocktail drug. The 2-syllable name is straightforward, serious, and easy to say in English.

Qsymia––Qsymia replaced the originally announced name, Qnexa (reviewed elsewhere). Qnexa was queen for a day, but it was changed by manufacturer Vivus because FDA said it caused confusion with other drug names. Qsymia is all about the Q. The initial Q (followed by a consonant) is a distinctive mnemonic device. (Called a “break-away consonant” in drug naming parlance.) Vivus intends to “own” the 17th letter of the alphabet, and associate it with Qsymia. To do so, they’ve branded a patient program (“Q and Me Patient Support Program”) and named their clinical studies employing the “Q” motif (EQUIP, CONQUER, SEQUEL, and AQCLAIM). In other words, Q is their X factor. In spite of all of that, a big round “Q” followed by three syllables makes Qsymia feel like a full-figured drug name.

Belviq––BEL-VIK is a bit leaner than Qsymia––both verbally and visually. This 2-syllable name bloomed from belle (“beautiful”) and the –iq suffix. The bel- prefix is feminine with common use in Pharma naming: recently Belsomra® and Beleodaq®. The –iq suffix has a Pharma lineage too: Cometriq® and Myrbetriq® recently, and older names Actiq® (pain med), Luxiq® (derm product), and Angeliq® (for PMS). The –iq suffix lends a cosmetic feel to Belviq (think Clinique), perhaps setting up a smart, new image in prescription weight-loss meds. Can it help plug the leak of flat sales?

Saxenda–– Liraglutide is currently marketed for diabetes under the brand name Victoza®. Saxenda is the proposed name for the higher dose weight-loss product, pending FDA final approval. Saxenda brings to mind the Alzheimer’s brand name, Namenda; and then the artificial sweetener brand Splenda; and finally Saxenda sounds like ”sex enda.” Saxenda may be a turkey. But a proper name safety evaluation, if not done already, will help determine if any “look-alike/sound-alike” names interfere, or if any associations will cause potential misbranding challenges to Saxenda name approval. Stay tuned.

Will these new drugs be successful?

One might joke that we won’t know until the fat lady sings. But in this case it’s perhaps more accurate to say that we won’t know until the fat lady, with the help of exercise, diet and medications, is slimmed down, singing, and in stilettos.

What do you think? Let us know here.