u/fuckagriculture

Author claims Roche is underestimated, with petrelintide producing only ~10.7% mean weight loss but no vomiting or GI discontinuations at the maximally effective dose, and CT-388 showing 22.5% placebo-adjusted weight loss at 48 weeks. The mechanism is that the obesity market is shifting towards tolerability, convenience, maintenance, and combinations, positioning Roche for patients who cannot tolerate stronger GLP1s. The catalyst is planned combination work between petrelintide and CT-388. The main risk is that lower efficacy may limit adoption, though author frames it positively for a subset.

Author argues NVO is falling behind because CagriSema failed the primary endpoint of non-inferiority to tirzepatide in REDEFINE 4, showing its next-gen drug cannot match Lilly's current one. As the obesity market fragments across more companies and mechanisms, Novo has the largest downside exposure due to its concentration in weight loss and diabetes. The main risk is that Novo is not only a weight loss company, and Wegovy still exists.

Author claims LLY is ahead scientifically and commercially in obesity drugs, with strong financials (revenue +48% y/y, net income +25%) and a pipeline including retatrutide that produced 28.3% weight loss over 80 weeks. The causal mechanism is superior efficacy and commercial execution driving growth as the market fragments. The catalyst is retatrutide's planned FDA submission in Q1 2027. The main risk is premium valuation because the market already expects Lilly to win.