Guosen: Focus on the commercialization progress of oral weight loss drugs by 2026, MNC updates layout in the CVRM track.

Guosen released a research report stating that attention should be given to the commercial progress of oral weight-loss drugs by 2026, and Phase 3 research data on weight loss with post-marketing molecules will be gradually released starting in 2027. ASCVD focuses on residual risk, significant progress in PCSK9 and Lp(a), and validation of inflammatory targets; renal disease is moving towards specialized segmentation; MASH is seen as a blue ocean market, with strong commercial performance of Rezdiffra making it a merger and acquisition hotspot. Guosen's main points are as follows: Obesity: Currently, the CVRM field has the highest short-term certainty/long-term ceiling, and is also the most crowded niche track. First-mover companies Eli Lilly and Novo Nordisk have completed the commercial placement of first-generation products, with sufficient supply of branded drugs. Against the background where the penetration rate of existing insurance plans is difficult to further increase, after reaching a price agreement with the Trump administration in 2025, a switch to a "price for volume" model is expected. The follow-up pipeline is difficult to further differentiate based on single weight loss data, and future competitive advantages may shift to "weight + management of comorbidities" or "weight loss + maintenance with low-dose oral/extended-release formulations". Attention should be given to the commercial progress of oral weight-loss drugs by 2026, and Phase 3 research data on weight loss with post-marketing molecules will be gradually released starting in 2027. ASCVD: Focuses on residual risk after statins PCSK9 mAb has already read out positive data from the first primary prevention Phase 3 study in 2025, with a focus on clinical and commercial progress of oral products; the number of events in the two secondary prevention Phase 3 studies of Lp(a) is fewer than previously expected, with results expected in 2026H2. Inflammation targets such as IL-6/NLRP-3 are a hot direction, with several M&A cases catalyzed in the past year. Novo Nordisk's IL-6 mAb will read out the first CVOT Phase 3 study in 2026H2, verifying whether inflammatory residual risk can support sufficient commercial space. HF/Cardiomyopathy Some disease mechanisms are unclear, lacking appropriate diagnostic indicators/biomarkers, such as HFpEF without a significant decrease in ejection fraction and nHCM without obvious LVOT obstruction, leading to high patient heterogeneity, making it difficult to choose endpoints and develop treatments. Renal: From broad-spectrum CKD indications to specialized renal disease populations In the past, multinational companies mainly covered broad-spectrum CKD populations such as diabetic kidney disease and cardiorenal metabolic risk with SGLT2i and antihypertensive drugs. Currently, the development focus has shifted to specialized renal diseases with clearer mechanisms such as IgAN, pMN, C3G, AMKD, and ADPKD. Although the number of patients with a single indication may be limited, the diagnostic criteria are relatively clear, treatment is concentrated in specialist physicians, commercial promotion has a shorter radius, most diseases lack effective DMT therapy, and therefore possess high pricing space and strong willingness to pay. MASH: Still in the early stages of commercialization in a blue ocean market, the first approved product has validated real payment and prescription demand Madrigal's Rezdiffra, as the first approved drug for the treatment of MASH stage F2-F3, achieved sales of $958 million in its first full commercial year in 2025, with sales of $311 million in 26Q1 (+127%), and over 42,300 patients were using the drug by the end of March 2026. In 2025, catalysts for two multi-B-level M&A cases were Roche's acquisition of 89bio and Novo Nordisk's acquisition of Akero. Risk warning: Risks of increased market competition, product clinical failure or lower-than-expected effectiveness, risks of commercialization not meeting expectations, risks of technological upgrades and iterations.