The GLP-1 Game of Thrones

Good morning, Armchair Army,

Welcome to today's edition of The Armchair Analyst, a 5-minute daily update on the ASX life-sciences sector.

The GLP-1 market is the most hotly contested prize in big pharma right now.

But to understand who will win…

I need to understand the players at the table.

That's why I spent 10 hours over the long weekend listening to the earnings calls from the six biggest companies in the GLP-1 space.

Eli Lilly, Novo, Regeneron, AstraZeneca, Roche and Pfizer.

Ha nerdddd!

Eli Lilly was flexing this quarter.

US$10 billion upgrade on full-year revenue guidance this year, because their weight-loss treatments Mounjaro and Zepbound are selling like crazy.

(More than US$16 billion in revenue this quarter)

But the rest of big pharma isn't going to cede this market…

It’s a battle.

… and I wanted to see what everyone ELSE was doing to win.

Cue the Game of Thrones music.

GLP-1s are the biggest healthcare market in decades.

I spent the entire year picking over the ASX to find the best stock leveraged to the US$80 billion GLP-1 space.

I landed on one…

Resonance Health (ASX: RHT), a company for 20 years, sold a product that measured liver iron through MRI.

It wasn’t until GLP-1s took off that Big Pharma wanted to measure a bunch of things about GLP-1s.

Suddenly, the technology Resonance had built for 20 years as a diagnostics product became an industry benchmark for clinical trial endpoints. 

Sales took off.

$3.8M… $4.4M… $8.6M… $11.1M… $15.8M…

… and guidance set for this year at $17M - $22M.

The company has three trial sites in WA (running more than 20 active trials), and it just hired a new executive to expand to six new sites on Australia's East Coast.

Spending on GLP-1 trials is accelerating…

… and Resonance is right in the middle of it.

Today I go through what EACH of the Big Pharma companies is doing.

Who is winning… and where they are looking to differentiate.

As long as the game keeps playing… 

Resonance will keep winning.

Because in my eyes, this $40 million market cap company (that’s profitable and cash flow positive) is the BEST way to play the GLP-1 thematic on the ASX.

But first…

Neuren Pharmaceuticals (ASX: NEU) upgrades 2026 income guidance from trofinetide to US$91 to US$93 million (up from US$53 to $56 million). (NEU) 

🪑 Looks like a monster upgrade, but diving into the numbers: that upgrade includes a US$35 million milestone payment for European market entry. 

Still… if you include the US$35 million, it is still an upgrade nonetheless (from $88-$89 to $91-$93 million).

Anagenics (ASX: AN1) sells its haircare technology to YSB for A$2.5 million upfront plus milestones (up to $6 million). (AN1)  

🪑 Angenics has gone from a shell to a shell with cash.

Rhythm Biosciences (ASX: RHY) ColoSTAT® is orderable across 95% of GP practices in Australia. (RHY)

🪑 Good update, but I want to see the revenues now.

Usona files a new drug application with the FDA for psilocybin for depression. (Psychedelic Alpha)

🪑 The next day, Compass Pathways came out and said that they were “two weeks away” from filing (BioSpace)

The race to be the first psychedelic to market in the US is ON.

REPORT: Investigating the beanie designed to read your thoughts. (Neurofounders)

🪑 Yeh, science!

Ever watch that show “The Biggest Loser”?

A classic.

Contestants go on a ten-week weight-loss journey, and you see some MASSIVE transformations.

(It was trashy Australian reality TV at its best)

But years later, researchers found that just because you lost the weight… didn't mean you kept it off.

That's the EXACT SAME question that big pharma is grappling with right now.

This is the segment that Novo has defined as the “arena” for weight loss management:

Notice that topline weight loss is just 32% of what customers care about.

… it’s all of the other things.

Quality. Speed. Tolerability. Convenience. Comorbidities. Affordability.

Weight loss is a big market.

But the “best” weight loss - the ones that hit on ALL of these factors.

So…

Today, I'll look at the SIX big pharma companies competing in the modern-day "Biggest Loser" competition.

But this time, with the prize money set at US$80 billion a year.

Let’s meet our competitors.

“You come at the king, you best not miss”

Lilly was flexing this quarter.

Mounjaro and Zepbound did more than US$16 billion in revenue

The full-year revenue guide was upgraded by US$10 billion to US$91–92 billion.

In a head-to-head study, Lilly’s Retatrutide more than doubled headline weight loss compared with semaglutide (the drug in Ozempic).

… and it’s not even on the market yet.

Eli also has…

The CEO, Dave Ricks, said:

"Given the depth of our incretin pipeline, we expect our leadership position in cardiometabolic health and broad pipeline of next-generation obesity medicines to have an impact on global health for decades to come."

Decades to come…

That’s the legacy that Lilly is building.

… and it’s using all of this extra capital to cement its pipeline with assets like psychedelics, sleep, immunology, CAR-T… and even vaccines.

This year so far…

14 acquisitions.

17 licensing agreements.

US$18 billion in deals.

So a STATEMENT QUARTER from the frontrunner.

Reta is now the "benchmark" for topline weight loss.

… which means every other company has to either BEAT it or compete elsewhere.

(tolerability, muscle retention, overall cardiovascular health, etc.)

“Was driver's seat for a longgg time. Now Lilly has the wheel.”

While Novo had the first-mover advantage, drug prices are falling, and they've largely squandered their lead.

The flagship is the Wegovy pill… 

(which launches in Australia next month)

But the differentiated pipeline doesn’t have that “blockbuster”... yet.

The strategy?

Defend semaglutide from every angle:

The corporate strategy is to play defence in diabetes and weight loss… and then play offence in liver and cardiovascular disease:

Again, lots of trials across key areas… just need that momentum.

“The new arrival wants a seat at the table”

My favourite quote of the entire earnings season came from Roche:

"We at Roche have the ambition to become a top three player in obesity."

Roche is looking to differentiate in two key areas…

Tolerability and muscle mass retention.

Roche did TWO deals in the past few months. 

Hanmi, US$190 million upfront and US$2.3 billion in milestones.

Rona, US$100 million upfront and US$1 billion in milestones.

These two assets focused on muscle mass retention.

On tolerability

Petrelintide: 1.9% of patients stopped treatment because of gut side effects, compared with 1.7% on placebo.

Its flagship Enicepatide delivered up to 22.7% weight loss at 48 weeks, with "no sign of plateau".

(Roche is about to take this head-to-head against Mounjaro)

It’s a competitive race…

But this quarter, Roche put its money where its mouth is with TWO deals in a differentiated space in the weight-loss arena.

Muscle retention.

“Good. Different”

To get a sense of the Regeneron strategy, this is the quote from the Regeneron CSO George Yancopoulos:

"We don't want to just compete with just another obesity agent where we're maybe fighting that we might have 1% or 2% more weight loss."

"A weight loss agent that not only causes similar weight loss to all the other weight loss agents, but also, by a completely different mechanism of action, dramatically lowers your lipids and your cardiovascular risk."

Regeneron's obesity drug is olatorepatide, a GLP-1/GIP drug licensed from China.

It's about to enter a large global 3,000-patient phase III program.

The "different mechanism" is a cholesterol antibody.

The plan is to co-formulate the two.

One injection for weight and cholesterol.

Then there's the liver.

Where Regeneron is also using gene silencing.

An siRNA drug targeting a gene called CIDEB cut liver fat by ~70% on average in 12 weeks.

From a single dose, in 40 people.

(Early days. But Yancopoulos wasn't shy, calling it "game-changing" and "unprecedented" in the same answer.)

Regeneron isn't trying to beat Lilly on headline weight loss numbers.

It's trying to win on cholesterol and liver fat…

While using a different mechanism of action to get there.

“Combine a bunch of stuff together… see what configuration works.”

Combination.

That’s the AstraZeneca strategy.

GLP-1 PLUS a heart and kidney blockbuster.

GLP-1 PLUS an oral cholesterol drug.

Here is the quote from Sharon Barr, head of R&D…

"Only AstraZeneca has the portfolio that allows us to combine a small molecule GLP-1 receptor agonist together with an SGLT2 inhibitor."

The target is NOT the headline weight loss number.

(See a pattern emerging?)

In fact, they said that “weight management is the wrong term”.

AstraZeneca’s target is the person who doesn't look overweight, but carries "abdominal adiposity, the visceral fat."

(The deep fat wrapped around your organs. The dangerous kind.)

AstraZeneca's oral GLP-1, elecoglipron, is now in 10 phase III trials.

Its amylin drug, lenbelintide, has started three more.

But GLP-1s are just part of AstraZeneca’s overall strategy.

Oncology is still the big ticket, with revenue up 16% to US$21.9 billion in the first nine months.

“The US$10 billion buyer’s remorse”

Ever go to Abby’s Auctions, buy a piece of furniture and then regret it 9 months later?

You try to tell yourself it was a great buy… 

But the chair just sits there in your living room staring at you… pissing you off.

That’s basically Pfizer right now.

12 months ago, Pfizer bought Metsera for ~US$10 billion.

Outbidding Novo.

Now Pfizer has axed both oral tablet programs from the Metsera acquisition.

With just berobenatide left.

Berobenatide stands out as a once-a-month injection.

… not once a week.

They’ve basically given up on weight loss as a differentiator, and moved to “convenience”.

This is what Albert Bourla, CEO, said:

"The market reminds us really of the times of the VIAGRA launch."

"People are willing to pay out of pocket for products that they value, regardless of whether they are reimbursed or not."

Pfizer plans 10 active and planned phase III trials for it this year.

First approvals are targeted for 2028.

Convenience is the differentiator.

After listening to over eight hours of big pharma earnings calls, I have one conclusion.

The GLP-1 market is the most hotly contested prize in big pharma right now.

Billions in acquisitions.

Billions in trials.

But the benchmark isn’t just the headline weight loss number.

… Eli Lilly has that covered.

The battle is now over the QUALITY of the weight loss.

Roche is all in on lean mass.

Regeneron is going after muscle and liver fat.

Pfizer is leveraging convenience.

… and AstraZeneca says that "weight management" is the wrong term.

ALL of this needs a benchmark.

A referee that says… your product is better.

We’ve moved beyond the bathroom scales (or in the giant novelty ones that they used to use on the Biggest Loser competition)

Now it’s about all the other things.

Fat around the organs.

Muscle mass retention.

Iron in the liver.

This is where my latest Armchair Pick comes in: Resonance Health (ASX: RHT).

Its MRI technology measures all of these biomarker endpoints and provides them to its big pharma clients.

The GLP-1 war will NOT be fought on body weight alone.

But on all the smaller endpoints customers care about.

Novo has a great slide that shows all the different things customers care about when it comes to weight loss.

Topline weight loss… that’s only 32% of the story.

Quality. Speed. Tolerability. Comorbidities. Affordability. Convineince.

THESE are the levers that the other big pharma companies are pulling to topple the Eli Lilly dynasty.

… and Resonance will be there all of the way.

See you all tomorrow,

The Armchair Analyst.

What is an armchair pick?

An Armchair Pick is an invite-only spot I reserve for my highest-conviction investment ideas.

It's a paid arrangement, but to align myself, I only take my fee in shares - half escrowed for 6 months, half for 12.

It is general commentary only, not personal financial advice or a recommendation to buy, sell, or hold. Always see the disclosure at the top of the article and do your own research.