The Good News, Bad News for Belviq: Bad News First…

Arena Pharmaceuticals (NASDAQ: ARNA  ) and its lead product, weight loss drug Belviq, have had a difficult run since Belviq's launch in June. On its recent conference call, Arena's marketing partner Eisai (NASDAQOTH: ESALY  ) reported anemic third-quarter Belviq sales of only $4.8 million. Arena realized less-than-stellar net Belviq revenue of only $2 million. Not surprisingly, Arena's earnings for the third quarter failed to impress as prescription sales continue on a somewhat mediocre trajectory in this early phase of its sales launch.

These numbers are surprisingly low given the growing number of patients struggling with obesity and a general lack of strong weight loss drug options. Some Arena supporters have estimated potential peak Belviq sales in the billions and had set generously high expectations for physician interest and adoption of the new therapy prior to Belviq's launch.

Unfortunately, this sunny outlook has yet to materialize in reality. While I believe Belviq will ultimately succeed in finding a place in the weight loss niche, investors may need to consider a few barriers that will undoubtedly continue to delay Belviq sales growth at least into the short and medium term.

Harder than it sounds
While millions of people struggle with weight loss on a daily basis, the truth is that physicians simply do not look to prescribe medications right away when addressing a patient's weight. Diet and exercise still remain the workhorses of weight loss therapy.

This a bit of no-brainer as lifestyle changes produce the best results without risk of harmful side effects or the burden of drug monitoring and copays. Many patients with serious obesity issues are already taking medication, and having one fewer to worry about is often enough to give relatively easy lifestyle changes a go first. In comparison, clinical weight loss guidelines warn health care professionals to only exercise drug therapy in "carefully selected" patients.

This may seem like a small thing. The benefits of living healthier are well recognized, and drug companies exploring the weight loss space including Arena, VIVUS (NASDAQ: VVUS  ) , and Orexigen (NASDAQ: OREX  ) have never implied that their products should replace healthy behaviors. However, what they may not have considered is just how entrenched these non-pharmacologic therapies are in the forefront of most physician's minds about addressing weight loss.

In many cases, drug intervention is an option used only for patients who have earnestly tried and failed to lose weight the old-fashioned way repeatedly. Sometimes this means that a patient will start a medically supervised weight loss program that kicks off with months of lifestyle and behavioral changes followed by an assessment of their motivation and technique and then another trial run of lifestyle and behavioral tweaks.

For some protocols, like the guidelines published by the Texas State Health Services, this could mean that a patient would undergo years of new diet and exercise regimens before being placed on medication. Even well-tread drugs like phentermine are essentially the third or fourth line option and this unfortunately places novel weight loss products even further down the list of options for the time being. 

Bottom line: Getting physicians to start using Belviq is harder than it sounds despite a surplus of obese patients.

Weight loss takes time
I think it's too early to say if investors should reconsider the sky-high expectations of the Belviq pre-launch estimations, but it's probably a safe bet that some time will need to pass before Arena can break the ice and start getting more commonly recognized as an option.

Physicians will most likely continue to trial Belviq with their most insistent or dangerously obese patients first before expanding their prescriptive patterns to include Belviq as an earlier option. There are some very interesting developments (some clear winners, others not so clear) that could help push Belviq into the blockbuster category that I'll discuss in a later article.

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Read/Post Comments (17) | Recommend This Article (7)

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On November 21, 2013, at 3:40 PM, keahou wrote:

    Perhaps reading the patient reviews may be enlightening at: http://www.drugs.com/comments/lorcaserin/belviq.html

  • Report this Comment On November 21, 2013, at 3:55 PM, biogemfinder wrote:

    No post from RSDribble? That's incredible! I am sure he will be back with some explanation of why Belviq will eb an epic failure and how he has been right all along and how Drs will never prescribe Belviq because "it does not work". But EISAI who paid 100s of millions at the beginning in 2010, and now 60M more for WW marketing rights must be incompetent and does not care about money on arena, right? Unlike the fools who continuously bash arena and belviq who donl;t have to out where their money is vs eisai who has ponied up 100s of millions already in cash and is willing to pay excess of billion in one time adjustments, I will follow the lead of eisai with my investment dollars and stay long until this whole thing unfolds..its just been 5 months give it 12 months at least....

  • Report this Comment On November 21, 2013, at 3:56 PM, keahou wrote:

    Here is a review of Qsymis, the competition. Notice the ratings for Qsymis comes in at 6.5 while Belviq is much higher at 9.3:

    http://www.drugs.com/comments/phentermine-topiramate/qsymia....

  • Report this Comment On November 21, 2013, at 4:41 PM, dalesurf318 wrote:

    The author failed to give the GOOD news mentioned in the Headline. He also failed to acknowledge a few key points:

    Obesity was recently classified as a DISEASE, opening the door to more insurance coverage and Rxs by doctors;

    The American Association of Clinical Endocrinologist now recommend treating obesity (using weight loss drugs) to prevent pre-diabetics from becoming diabetics;

    Eisai will has submitted Belviq for marketing approval in Mexico, Brazil, and Canada and should receive approvals or answers soon. Additional marketing partnership deals may be in the works for Taiwan and other highly populated nations, which could quickly boost the demand for Belviq exponentially

  • Report this Comment On November 21, 2013, at 4:42 PM, clayknolls wrote:

    Nobody knowledgeable about arna and belviq would take this article seriously. The prescription numbers have continued to increase quite strongly in recent weeks. The article just cites numbers that are now nearly two months old and tries to color them in a bad light when they really were quite reasonable for the first three months of a new launch. The article ignores a host of good news related to Arena in recent weaks, including the increased $60 million (plus) commitment from Eisai in cash to Arena, and a host of upcoming catalysts.

  • Report this Comment On November 21, 2013, at 4:47 PM, marp11 wrote:

    when i stop laughing at this drivel..i will reply;;;poor eisai ponying up to 1.56 BILLION to arna ...how dumb

  • Report this Comment On November 21, 2013, at 7:48 PM, RBRMD wrote:

    Person who wrote the article knows nothing about practicing medicine. It helps to know:

    1. Easier to cure cancer than obesity with diet and

    exercise.

    2. Doctors are not dumb. Useless protocals are ignored.

    3. Belviq works very well with no important side effects or interactions that I can see in over 300

    patients.

    4. I do agree that it has been a slow start, but a critical mass of physician awareness has just now been achieved.

    5. Diabetes, Nicotine addiction, acute treatment of depression, combinations.

    6. Statins, Viagra et.al, #3 Belviq. Big 3 of my 25 years of practice so far.

    7. You better hold on to something. This one is about to go for a ride.

  • Report this Comment On November 21, 2013, at 8:15 PM, gazoo99 wrote:

    Just another "Motley Stool" hit article on behalf of the "Wall Street" Cronies!

    Who do they think they're fooling any more?

    Just wondering????? cause they don't seem to get it.

  • Report this Comment On November 21, 2013, at 10:21 PM, tar262weir333 wrote:

    Oh God, how much longer will these meaningless MF articles continue?

  • Report this Comment On November 22, 2013, at 6:39 AM, bwyatt25 wrote:

    Please Motley Fool enough of these poorly written and researched so called investment articles. I used to have great respect for what the Fool was trying to do to help investors but this is just drivel. Who at the Fool vets these submissions, the tea lady???

    Couldn't even remember that he had written about good news in the title, so did not provide any.

    Do some damned research whoever you are or just don't bother to write.

  • Report this Comment On November 22, 2013, at 9:13 AM, billcatedit wrote:

    Does Motley really pay you for this meaningless dribble? What is your motive?

  • Report this Comment On November 22, 2013, at 11:18 AM, hlanden wrote:

    Misleading Headline.

  • Report this Comment On November 22, 2013, at 2:33 PM, keahou wrote:

    Adam says, Belviq scripts flat, Qsymia scripts down 3.9%. The trend continues but the skepticism continues re Belviq.

  • Report this Comment On November 22, 2013, at 4:30 PM, MDPhD wrote:

    Everyone here, and everyone up to now has missed the point about a selective 5HT2c agonist.

    This pathway tells you that you are getting what you desire.

    In one case, food, yes, but the pathway is not limited. This drug will be useful in smoking cessation, and other addictive behaviors.

    Investors know nothing about how these things work. I suppose that's why there are consultants.

    Who wants to hire me?

  • Report this Comment On November 22, 2013, at 7:36 PM, bamobrien wrote:

    Everyone upset about the lack of 'good news' should take a reading comprehension course before putting a number dime into the market.

    Do yourself a favor and read the whole article- this is part 1 of 2.

    Physicians will not quickly adapt to a novel central nervous system antagonist for weight loss, period. I stand by this.

    Reclassification of obesity as a disease is about as important to this conversation as reclassifying Pluto as a planetoid. I'm actually rather optimistic about Belviq but I think folks need to reign in their optimism.

    MDPhD has hit the nail on the head- there's more to 5HTc than meets the eye (both good and bad). Retail investors can hold onto whatever they want to believe but the court of public opinion has no sway over pharmacology.

  • Report this Comment On November 22, 2013, at 7:38 PM, bamobrien wrote:

    As an addendum I do appreciate that some of you registered for Fool soley to respond to this article. If you're unhappy with the thesis ask yourself: why didn't Belviq soar sky-high 6 months ago at launch?

    I'm on point.

  • Report this Comment On November 24, 2013, at 7:52 AM, TechNicole wrote:

    I wonder what Ho's agenda is? Those of us who actually do research know why ARNA did not soar 6 months ago, as well know how good Belviq is doing. I would never ever take financial advice from this Ho.

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