The Obesity Society Reports on Qnexa, Contrave and Lorcaserin

Information Uncover was represented at last month’s TOS (The Obesity Society) annual meeting in Washington, D.C. And one of the most exciting bits of news coming out of the meeting was the prediction that three obesity drugs, we’ve talked about on this blog, will likely be on the market within two years. These drugs are Qnexa, Contrave and Lorcaserin.

Qnexa is manufactured by Mountain View, California based Vivus. Contrave is manufactured by La Jolla, CA based Orexigen. And Lorcaserin is manufactured by San Diego, California based Arena.

Qnexa is a combination of two drugs: Phentermine and Topiramate. Phentermine was used in the obesity drug combination Fen-phen, an obesity drug combining Fenfluramine and Phentermine. Fen-phen was taken off the market in the 90s because the drug caused severe side effects -- including serious cardiovascular issues.

However, Phentermine was the safer of the two drugs in the Fen-phen combination. Phentermine is often prescribed today for short term weight loss. Furthermore, while Phentermine is combined with Topiramate in Qnexa, the serious side effects associated with Fen-phen have not been observed in Qnexa. In addition, Qnexa surpasses the FDA obesity drug guidelines.

Orexigen’s Contrave is also the combination of two drugs. These drugs are Naltrexone and Bupropion. Naltrexone is FDA approved for the treatment of alcohol dependence. And Bupropion is FDA approved for the treatment of depression. Contrave appears to have no serious side effects, and the drug satisfies FDA obesity drug guidelines.

Finally, Lorcaserin, produced by Arena, does not produce the weight loss percentages achieved by Qnexa and Contrave. However, Lorcaserin appears to be well tolerated, while satisfying the FDA obesity drug guidelines.

With the weight loss industry in need of a safe and effective weight loss drug, weight loss service and product providers are closely monitoring Qnexa, Contrave, and Lorcaserin. We believe that if these three drugs do come on the market within two years, their presence will give a needed boost to the weight loss industry. And a number of speakers at The Obesity Society's annual meeting seemed to agree with this opinion.

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Tags: environmental scanning, obesity drugs, strategic management, Vivus, Orexigen, Arena

Learning How to Treat Obesity from a UK NHS Program

In our October 14, 2009 blog post, we discussed the Chronic Care Model as a tool to treat obesity. The model was developed by the MacColl Institute for Healthcare Innovation. Since obesity is viewed as a chronic illness, the model might be used to fight obesity. In the model, the obese patient plays the central role in the model. Now, a UK program is confirming the importance of the role the patient must play in obesity treatment.

The UK program is about one year old. The program is an “NHS [National Health Service] nurses led service” program. As the description indicates, nurses lead the program. The program emphasizes patient education as a way for the patient to establish a strategy for losing weight. Indeed, in the UK program, as in the Chronic Care Model, an educated patient with assistance from trained professionals can lead to weight loss.

As we mentioned before, the Chronic Care Model consists of six elements. These elements are: community resources and policies, the provider’s health care organization, case management, delivery system design, decision support, and self-management. And the self-management aspect of the Chronic Care Model is the most important element of the model.

It was pointed out in our Chronic Care Model blog post that some of the most important functions of the model are best carried out by trained non-physicians. And again, the UK program’s nurse leadership supports the belief that non-physician professionals can play a significant role in the treatment of a chronic illness such as obesity.

It appears that much is being learned about non-surgical, non-drug approaches to treating obesity. If research can continue to help improve these weight loss approaches, more obesity patients will be able to successfully deal with obesity on a long term basis. Of course, bariatric or weight loss centers should follow research in this area, and make use of applicable research results.

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Tags: lifestyle modification, environmental scanning, strategic management, NHS, Chronic Care Model

Using the Chronic Care Model to Treat Obesity

Obesity may be viewed as a chronic illness. Therefore, tools used to successfully treat chronic illnesses can be used to treat obesity. An effective tool for treating chronic illness is called the Chronic Care Model. The Chronic Care Model was developed by the MacColl Institute for Healthcare Innovation. The institute is based in Seattle, Washington. The institute developed the model to treat those illnesses that require an ongoing relationship between the ambulatory patient and the health care provider.

The model was developed more than a decade ago. In designing the model, the developers researched literature to uncover methods that could be used to improve the treatment of chronic illnesses. Over time, the model evolved to contain six key elements. These elements are: community resources and policies, the provider’s health care organization, case management, delivery system design, decision support, and self-management.

The first of the six elements is community resources and policies. This means that the health care provider should make use of existing community resources. Further, the provider should work to institutionalize policies that improve care. In making use of community resources, for example, a bariatric center could partner with a gym in the community to provide exercise to patients.

The next item on the list is the provider’s health care organization. Among other things, this item stipulates that the provider’s health care organization should actively support improvements in health care. And the provider’s organization should emphasize the use of quality measures in the application of health care.

Case management, the next list item, is meant to indicate that the provider should work with the patient to enhance the patient’s self-management. Self-management will be discussed below. Case management also entails follow-up to make sure the treatment is working. Case management also includes an effort to help guide the patient through the health care system.

The delivery system design is the next element on the list. It is essential, for example, that the delivery system be designed so that necessary resources be made available to the patient. In fact, implementing the delivery system so that both the provider and the patient have access to resources is important. In the system, evidence based treatment methods should be used. And many of these treatment methods ought to be delivered by non-physician members of the provider team. Because in some cases, it has been found that non-physician members can deliver certain services better than the physician.

Next, we have decision support. Evidence-based guidelines must be part of the health care provider's organization. Established education methods should be employed. And treatment guidelines and clinical information should be shared with the patient.

Last on the list is self-management. Indeed, it has been found that self-management is a necessary part of the Chronic Care Model -- more so than any other element. In self-management, the patient must be viewed as the central player in the ongoing treatment of the chronic illness. And as part of the process, the provider must be agree to relinquish some control to the patient.

Since the introduction of the Chronic Care Model, efforts have been made to determine if the model improves health outcomes and is cost effective. Although more work needs to be done to determine the cost effectiveness of the model, published reports appear to indicate that by using the Chronic Care Model, health care organizations can improve the treatment of chronic illness.

Since overweight and obesity may be viewed as a chronic illness, The Chronic Care Model is applicable in the treatment of the illness. It has been shown that for long-term success, a strong ongoing relationship between the individual attempting to lose or control weight and the organization providing the weight loss or weight management service is of utmost importance. And the Chronic Care Model emphasizes this relationship.

Indeed for obesity treatment, weight loss centers should review elements of the Chronic Care Model, and try to implement as many of the model's elements as possible, with an emphasis on self-management.

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Tags: environmental scanning, strategic management, Chronic Care Model, competitive advantage, lifestyle modification

GENova Biotherapeutics Inc. and Bridge Bioresearch Plc. to Look for Obesity-Cancer Link

We now know that obesity is highly correlated with a number of illnesses, including some cancers. Therefore, efforts that might shed more light on the relationship between cancer and obesity can be useful. New York based GENova Biotherapeutics Inc, which has a research focus on cancer, will collaborate with the UK based company Bridge Bioresearch Plc., which has a focus on obesity. The two companies will try to find links between cancer and obesity by sharing their research results.

Obesity has been found to play a role in a number of ailments. It is well accepted that these ailments include high blood pressure and high cholesterol. Moreover, the The Mayo clinic did a study and determined that obesity contributes to the need for hip replacement. And some experts indicate that there is a link between obesity and Alzheimer’s disease.

Further, researchers in the UK suggest that obesity is a bigger health risk, today, than smoking. In the UK, it is estimated that there might be as many as 19,000 British cases of cancers per year resulting from obesity. Finding links between obesity and cancer is almost as important as the link discovered between smoking and cancer, since obesity is associated with a number of cancers.

According to the National Cancer Institute (NCI), a U.S. government organization, obesity is related to a number of cancers. These include: "colon, breast (postmenopausal), endometrial, kidney, and cancer of the esophagus." According to the NCI, the link between cancer and obesity is not known. In fact, the NCI goes on to say, the link might be different for different cancers. And the NCI has ongoing studies to determine what these links are.

The collaboration between GENova Biotherapeutics Inc. and Bridge Bioresearch Plc. may add to results coming out of the NCI studies and other studies investigating the link between cancer and obesity. In fact, health care organizations that offer both weight loss treatment and cancer treatment might also add to the obesity-cancer link knowledge base.

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Tags: environmental scanning, strategic management, bariatric marketing

Weight Loss Through Lifestyle Modification Could Be Enhanced with Nutrisystem D

Lifestyle modification, as a way to lose weight, is the most popular weight-loss method. It’s the most popular method because it's usually the easiest, least expensive, and safest way to lose weight. The main components of lifestyle modification for weight-loss generally include a modified diet and an exercise program -- diet being more important than exercise. And Nutrisystem has introduced a new program, called Nutrisystem D, that greatly improves a person's weight-loss chances, according to a recent study done at the Temple University School of Medicine.

The Nutrisystem D program is directed at overweight people, who have type 2 diabetes. As part of the program, a person receives 150 pre-packaged meals. The meals are portioned controlled. And the meals are designed to cause low rises in blood sugar.

The Nutrisystem D study done at Temple was led by Dr. Gary Foster. The study participants following the Nutrisystem program lost more than twice the weight as did participants who followed a diet designed for diabetics.

Using prepackaged meals as meal replacements has already been shown to lead to weight loss. Meal replacements include shakes, entrees and bars. And along with Nutrisystem's meals, pre-packaged meals include meals made by Lean Cuisine and Healthy Choice. With pre-packaged meals, a dieter can simply pick up a meal without having to worry about the calorie or nutritional content. And this can be quite convenient. Further, a 2003 Pub Med report indicated that meal replacements can be employed safely to enable one to lose weight and maintain the weight loss.

Nonetheless, staying on a diet long term -- even on a well designed diet -- can prove to be difficult. But modifying a lifestyle to follow a specific diet, long term, can be aided with external reinforcement from weight-loss counselors. And counseling is a part of the Nutrisystem D program. Since the Nutrisystem D program appears to be a good one, bariatric centers should take note of the program. Some of the procedures employed in the Nutrisystem D program may be adaptable to bariatric center programs.

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Tags: environmental scanning, strategic management, meal replacements, Nutrisystem d, bariatric marketing, competitive advantage

Vivus Is Planning to Apply for FDA Approval for Its Obesity Drug Qnexa

A few obesity drugs in the drug pipeline are continuing to show promise. The companies, developing obesity drugs, that have recently received attention include the California based companies, Vivus, Arena and Orexigen. Vivus manufactures the drug Qnexa. Arena makes the drug lorcaserin, and Orexigen produces the drug contrave. But Vivus, with its drug Qnexa, is currently dominating the news.

Qnexa is a combination of two drugs: phentermine and topiramate. Phentermine was used in the obesity drug combination fen-phen. Fenfluramine and Phentermine were fen-phen. Fen-phen was taken off the market in the 90s, at the request of the FDA, because of severe side effects, including cardiovascular problems. But phentermine was the safer of the two drugs.

Qnexa motivates weight loss by suppressing the appetite, and by making the user feel full. So far, the main Qnexa side effects are “dry mouth, tingling, constipation, altered taste and insomnia.”
And persons participating in Qnexa drug trials experienced an approximate 15 percent weight loss. This weight loss percentage greatly exceeds FDA guidelines. Further, Qnexa has the potential to reduce some risks associated with diabetes.

The market for obesity drugs is potentially lucrative, if an obesity drug is found that is safe and effective. “JMP securities recently projected Qnexa's annual sales would hit $1.5 billion by 2015.”

Based on trials results, Vivus expects to apply for approval from the FDA to market the Qnexa by the end of this year. The company is then planning to start marketing the drug by the end of 2010. Also, the company will start looking for collaborative opportunities to sell the drug.

With the weight loss industry in need of a safe and effective weight loss drug, weight loss service and product providers should closely monitor Qnexa and if reasonable, the companies should take advantage of collaborative opportunities.

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Tags: Vivus, Arena, Orexigen, environmental scanning, strategic management, swot, bariatric marketing

An Update on the GI Dynamics Intestinal Liner

Last year we wrote that the company, GI Dynamics of Lexington, Massachusetts, presented a report on the results of tests done using an intestinal liner that duplicates some of the functions of gastric bypass surgery. We went on to say that the liner, called the EndoBarrier, reduces the amount of calories that the body absorbs from food that is eaten.

Further, we indicated that the liner is inserted endoscopically through the mouth, and placed in the small intestine, covering about two feet of the intestine. Finally, we said that test results indicated that the liner could cause weight loss and produce beneficial effects for those with type 2 diabetes.

The intestinal liner mimics some of the malabsorptive characteristics of gastric bypass surgery. Gastric bypass surgery is a combination of two weight-loss surgical procedures that reduce calorie intake. In one of the procedures, called restriction, the surgeon creates a smaller stomach using a portion of the original stomach. This smaller stomach restricts the amount of food a person eats, thus reducing calorie intake. In the other procedure, called malabsorption, the surgeon reroutes the small intestine so that food bypasses a portion of the small intestine, reducing the amount of calories (and nutrients) absorbed by the body.

Persons participating in intestinal liner tests were able to lose an average of 30 pounds and there was a decrease in the blood sugar level in study subjects. Thus, there was a lessening of symptoms associated with type 2 diabetes.

Last month, GI Dynamics reported that they have improved the therapeutic effects of the Endobarrier Intestinal Liner by combining the liner with the company's Endobarrier Flow Restrictor. This device is used to delay the stomach's emptying of food into the small intestine. This is known as gastric emptying or GE. And this device appears to enhance the effects of the Endobarrier.

If ongoing tests of the Intestinal Liner plus Flow Restrictor prove successful, the combination might be a safe and effective method for weight loss and weight maintenance. And a weight loss or bariatric center may be able to employ the device and gain a competitive advantage.

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Tags: environmental scanning, swot, strategic planning, GI Dynamics