An estimated 25 million Americans will be on GLP-1 treatment by 2030, a spike up from the 10 million patients in 2025. That number represents a huge ongoing opportunity for Vani Manja, senior vice president and global head of Boehringer Ingelheim’s newly formed obesity and liver health unit.
“We are talking about a large unmet need in terms of patients not able to either be on or stay on these medications,” Manja said.
The global obesity market is projected to reach 1.5 billion adults by 2035, according to an IQVIA forecast. But GLP-1 penetration remains low globally, with an analysis by J.P. Morgan finding that just roughly 7% of diabetes patients and 2% of obese patients are taking them.
Even with the recent approval of two oral GLP-1 drugs, there’s still plenty of room for new players in the hot market as far as Boehringer Ingelheim is concerned.
“We are eager to be present in this space because we see the unmet need. [The] science is advancing, including ours,” Manja said. “As exciting as the GLP-1 based therapies are, this is likely the first successful chapter for innovation in the obesity space.”
Despite not having any approved therapies yet, Boehringer is going all-in on its obesity pipeline with the launch of the new business unit and tapping Manja to lead it.
“The company has carved out this therapeutic area for our pipeline in the future,” Manja said.
A unique approach
Heading up the new unit isn’t Manja’s first foray into uncharted territory. After finishing her undergrad in chemistry, Manja joined the Indian armed forces just as they “started taking women as commissioned officers,” she said.
“I did not want to miss the opportunity for such a new experience,” she said.
Although Manja called her six years in the military, including her time as a commissioned officer, “a life experience, not a career,” she considered it formative in shaping her personal values and leadership philosophy, especially around listening and building teams.
Now, she’s advancing the company’s pipeline while culturally reframing obesity as a complex disease driven by more than a lack of self-discipline. Much of that effort has involved talking to patients and advocates about the stigma, anxiety, pain and other challenges they’ve experienced.
“Fortunately, we are moving toward a space where we’re recognizing this to be what it is: A biological disease that is complex, that is chronic, that is relapsing and that is so much more than just willpower,” she said. “That is also about the environment and genetics, about neurology.”
Obesity’s link to other diseases
Boehringer’s strategy focuses on the interconnectedness of obesity and other diseases, including renal and metabolic complications like MASH, chronic kidney disease, type 2 diabetes and cardiovascular diseases.
“We've recognized it over the last decade or so,” Manja said. That’s reflected in its marketed products like the blockbuster Jardiance, which is approved to treat type 2 diabetes, heart failure, and chronic kidney disease, as well as its current pipeline.
The star of Boehringer’s obesity and liver pipeline is survodutide, a dual glucagon/GLP-1 receptor agonist, which is in phase 3 trials for both obesity and MASH.
“In addition, we have a triple agonist in the pipeline, which has the potential to be first in class from a mechanism perspective, and has the potential to bring both superior efficacy and possibly much better tolerability than current options,” Manja said, referring to its triple-agonist peptide that recently advanced into mid-stage development.
They’re also exploring the possibility of developing oral options for their medications.
The obesity market is crowded and is poised to become more competitive as a host of Big Pharma players such as Merck & Co, Roche and Pfizer move their candidates through the clinic. But Boehringer’s advantage could lie within the drugs it’s developing alongside its status as a privately owned company, Manja said.
“We are not focused on the quarterly conversations with the stock market, [and are] able to leverage our ability to be long-term focused and not be swayed by any quarterly milestones to move the needle further,” she said.
