Roche Expands Obesity Pipeline with $1.65 Billion Zealand Pharma Partnership

Roche has committed to an initial payment of $1.65 billion to enhance its growing pipeline of obesity treatments. This investment, supplemented by potential milestone payments amounting to $3.6 billion, grants Roche the ability to co-develop and co-commercialize Zealand Pharma’s long-acting amylin analog, petrelintide.
Interest in amylin-based treatments has surged, particularly after key industry players, including Zealand, presented data at the EASD 2024 meeting in September. The industry’s enthusiasm has translated into high-value agreements in recent days. For instance, AbbVie recently provided an upfront payment of $350 million to secure Gubra’s phase 1 candidate. Roche’s latest agreement, finalized on Wednesday, is an even more substantial commitment, securing its position in the competitive field.
Under the terms of the agreement, Roche will provide an upfront payment of $1.4 billion upon deal closure, followed by an additional $250 million over the subsequent two years. Moreover, Zealand stands to earn up to $1.2 billion in development-related milestone payments, primarily tied to the initiation of phase 3 trials evaluating petrelintide as a monotherapy. Further sales-based milestone payments could amount to as much as $2.4 billion.
Both companies will equally share profits and losses in the U.S. and European markets. Beyond these regions, Zealand will receive royalties on net sales, with percentages reaching the high teens. The agreement also requires Zealand to allocate $350 million, offsettable against milestone payments, toward a fixed-dose combination of petrelintide and Roche’s GLP-1/GIP receptor agonist CT-388, or other next-generation petrelintide-based combinations.
Analysts at William Blair have highlighted the significance of this agreement, stating that it represents one of the most substantial financial commitments in the obesity treatment sector, including the largest upfront cash payment for a single-asset collaboration.
“With an anticipated pro forma cash balance of nearly $3 billion, this deal positions Zealand to expedite the advancement of petrelintide both as a standalone therapy and as a combination candidate for chronic weight management applications,” the analysts noted in a March 12 report.
Roche’s interest in amylin analogs has been a recurring subject of discussion among analysts, given the growing interest in this mechanism. The company formally entered the obesity treatment space in late 2023 through its acquisition of Carmot Therapeutics for $2.7 billion, gaining access to a pipeline that included CT-388. However, this move did not fully satisfy Roche’s ambitions in the field.
“We recognize the necessity of complementing our foundational therapy with additional combinations,” stated Manu Chakravarthy, M.D., Ph.D., Roche’s global head of cardiovascular, renal, and metabolism product development, during a presentation at the EASD event in September. “We are actively exploring both internal developments and external opportunities to create a highly competitive portfolio.”
Roche’s strategic priorities include amylin analogs, gut hormones, and other metabolic modulators. Meanwhile, Zealand engaged in discussions with multiple potential partners before finalizing this collaboration.
During a recent earnings call, Zealand’s CEO, Adam Steensberg, M.D., indicated that the timing of this partnership aligns well with Roche’s ability to contribute to phase 3 trial design and manufacturing investments. Under the terms of the agreement, Roche will oversee commercial manufacturing and supply. Zealand initiated a phase 2b trial of petrelintide in patients with overweight and obesity in late 2023, with enrollment progressing faster than anticipated. The company expects to conclude recruitment shortly.
The primary endpoint of the ongoing study is assessing weight change from baseline after 28 weeks, with data remaining blinded through 42 weeks. A separate team will evaluate 28-week results to facilitate discussions with regulatory authorities while ensuring the integrity of the trial. Additionally, Zealand is preparing a second phase 2b study focused on individuals with overweight or obesity who also have Type 2 diabetes.
Petrelintide remains behind Novo Nordisk’s CagriSema, which combines the amylin analog cagrilintide with the GLP-1 drug semaglutide. Novo Nordisk intends to submit CagriSema for regulatory approval in early 2026, though its phase 3 results have not met investor expectations. The company had projected weight reductions exceeding 25%, but the data did not fully align with these forecasts.
Zealand has estimated that petrelintide as a monotherapy could lead to weight reductions of 15% to 20% over a year or longer. Combining petrelintide with CT-388 may enhance this outcome further.
Following the release of CagriSema’s data, David Kendall, M.D., Zealand’s chief medical officer, reaffirmed the company’s monotherapy weight loss projections. Zealand also believes that petrelintide may offer advantages over cagrilintide in terms of maximum dosage and bioavailability.
Investor response to the announcement was positive, with Zealand’s shares on the Danish stock exchange rising by more than 40% during Wednesday’s morning trading session.