Roche invests billions in anti-obesity drugs: what changes for cross-border workers

Context

TL;DR

• Roche announces positive results for Petrelintide, an anti-obesity drug.
• The drug shows 10.7% average weight loss with mild side effects.
• Roche aims to focus on personalized and targeted therapies.
• The global anti-obesity drug market is expected to grow to $100-200 billion by 2030.

Key facts

• Company: Roche
• Drug: Petrelintide
• Collaboration: Zealand Pharma
• Weight Loss: 10.7%
• Market Size: $100-200 billion
• Year: 2030
• BMI Threshold: 30
• Obesity Definition: Chronic disease with excessive fat accumulation

Roche focuses on next-generation drugs

In early March 2026, pharmaceutical giant Roche announced preliminary positive results for Petrelintide, an anti-obesity drug developed in collaboration with Danish biotech company Zealand Pharma. Phase 2 trials involved patients receiving a weekly injection for 42 weeks. The results showed an average weight loss of 10.7%, with mild side effects. However, the data failed to meet investor expectations: Zealand Pharma’s shares plummeted by 35%, while Roche lost around 3% the day after the announcement.

According to Manu Chakravarthy, Roche’s Global Head of Cardiovascular, Renal and Metabolic Development, the goal is not solely about weight loss. 'We’re not just looking at the number on the scale. What truly matters is the person’s overall health,' he stated. 'Not everyone will need the same thing at the same time in their obesity journey, which can span 20, 40, or even 60 years, especially when considering associated comorbidities.'

📊 A second wave of targeted therapies

Roche missed the first wave of GLP-1-based drugs’ success (such as Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound), which deliver weight loss between 15% and 20%, with peaks exceeding 25% in some studies. Now, the company is investing billions in a new generation of therapies, focusing on more personalized and targeted drugs. Petrelintide is just one of Roche’s strategies: the company has struck deals with several biotech firms to expand its portfolio in an increasingly competitive market.

The global anti-obesity drug market is expanding rapidly. According to IQVIA, tirzepatide (Zepbound/Mounjaro) sales surpassed $36.5 billion in 2025, becoming the world’s best-selling drug. Market estimates project growth from $66 billion in 2025 to $100–200 billion by 2030. However, current penetration of these drugs remains below 10% of the global obese population, particularly in the United States.

⚠️ Obesity as a global health issue

The World Health Organization (WHO) defines obesity as a chronic disease characterized by excessive fat accumulation with significant health risks. Measurement is based on Body Mass Index (BMI), calculated as weight (kg) divided by height squared (m²). A BMI above 25 indicates overweight, while a value of 30 or higher is classified as obesity. Thresholds may vary depending on ethnic groups.

GLP-1-based drugs are generally approved for adults with a BMI of 30 or higher, or a BMI of 27 or higher in the presence of related conditions such as hypertension, type 2 diabetes, or high cholesterol. According to a study published in The Lancet, by 2050 nearly 60% of people over 25 will be overweight or obese, up from 29% in 1990. The sharpest increase is occurring in sub-Saharan Africa.

Global obesity-related costs could reach $3,000 billion (2,380 billion francs) annually by 2030, according to the World Obesity Federation, exceeding $18,000 billion by 2060. This represents a massive commercial opportunity for pharmaceutical companies, but also a challenge for national healthcare systems.

Implications for Ticino and cross-border workers

For cross-border workers commuting between Ticino and Lombardy, the arrival of new anti-obesity therapies could have both healthcare and insurance implications. Currently, GLP-1 medications are not reimbursed by Swiss health insurance funds for obesity without other underlying conditions, but the situation may evolve with the introduction of more targeted and cost-effective therapies.

According to estimates, the adoption rate of these drugs remains low even in countries with greater access, such as the United States. However, the availability of alternatives like Petrelintide could accelerate uptake, particularly in cross-border contexts where patients have access to both the Swiss and Italian healthcare systems.

Drug comparison: what the market offers

Roche’s next steps

Roche has already launched additional clinical studies to evaluate the efficacy of Petrelintide and other pipeline drugs. The goal is to stand out in a market dominated by Eli Lilly and Novo Nordisk by focusing on personalized solutions that go beyond simple weight loss. However, the road ahead is still long: science is still working to fully understand the mechanisms of obesity and its comorbidities.

For those living and working between Ticino and Lombardy, the situation remains in flux. Keeping an eye on updates about these drugs could be useful for assessing potential therapeutic or insurance opportunities in the medium term.

Operational details

Why Roche Missed the First Wave of GLP-1 Drugs

In 2010, Roche was among the first companies to study GLP-1 drugs, but abandoned the project after a series of late-stage failures, just before Novo Nordisk and Eli Lilly's success boom. "We missed the first wave," Chakravarthy admitted. Now, with the introduction of Petrelintide and other targeted therapies, the company is trying to catch up in a market that is worth tens of billions and is growing at a rapid pace.

Roche's strategy is based on three pillars: personalization, reduction of side effects and a holistic approach to patient health. While drugs such as Wegovy and Zepbound focus on weight loss, Roche focuses on solutions that also improve metabolic, cardiovascular and renal parameters. This approach could attract patients with obesity and comorbidities, a target often overlooked by current therapies.

Risks for cross-border commuters: costs and accessibility

For cross-border commuters who live in Ticino but work in Lombardy, access to these drugs could be complicated by two main factors: costs and insurance coverage. Currently, anti-obesity drugs are not reimbursed by Swiss health insurance companies except in the presence of related diseases (diabetes, hypertension, etc.). However, this could change with the introduction of more targeted therapies.

According to IQVIA estimates, the global market for anti-obesity drugs could grow to $200 billion by 2030. This increase in demand could lead to increased pressure on healthcare systems and insurance companies, which could also affect health insurance premiums in Ticino. Cross-border commuters, who already face high costs for cross-border healthcare, may see increased out-of-pocket expenses or have to consider specific insurance solutions.

What changes for those who already take GLP-1 drugs

Currently, popular drugs such as Wegovy and Zepbound are approved for chronic weight management in patients with BMI ≥30 or ≥27 with comorbidities. However, not everyone responds in the same way to these therapies. According to clinical studies, about 30-50% of patients do not achieve significant weight loss, and many abandon treatment due to side effects such as nausea, constipation or gastrointestinal upset.

Petrelintide, with its average weight loss of 10.7%, could represent an alternative for those who do not respond to classic GLP-1. However, the available data are still limited and it is unclear whether the drug will gain regulatory approval in the coming years. For cross-border commuters already taking therapies such as Zepbound, transitioning to a new drug could involve additional costs and bureaucratic procedures, especially if insurance coverage is not extended.

Future scenarios: what could happen in the next 2-3 years

Scenario 1: Petrelintide Rapid Approval If the results of the phase 3 studies are positive, Petrelintide could gain approval by 2027-2028. This would pave the way for a new treatment option for patients in Ticino and Lombardy, with possible repercussions on costs and accessibility. However, given the fierce competition, Roche will need to demonstrate a significant advantage over Wegovy and Zepbound.

Scenario 2: Introduction of generic drugs By 2028-2030, generic semaglutide and tirzepatide drugs could hit the market, reducing costs and increasing accessibility. This could prompt Swiss health insurers to review their reimbursement policies, including obesity as a disease to be treated. For cross-border commuters, this would mean greater access to financially viable therapies.

Scenario 3: Regulatory changes in Ticino and Lombardy The Canton of Ticino could introduce new guidelines for the management of obesity, aligning with European standards. At the same time, Lombardy could extend public health coverage for these drugs, at least in selected cases. This would require greater cooperation between the two health systems, especially for cross-border commuters who turn to both Swiss and Italian facilities.

Comparative tables: costs and coverage

| Appearance | Switzerland (Ticino) | Italy (Lombardy) | |---------|------------------|-------------------| | GLP-1 Medication Coverage | Reimbursement only with comorbidities | Limited Reimbursement (SSN) | | Wegovy Monthly Cost | ~400-500 CHF | ~200-300 EUR (if private) | | Petrelintide (estimate) | Not yet defined | Not yet defined | | Access for cross-border commuters | Depends on tax residency | It depends on the NHS |

Challenges for cross-border commuters: what to do now

Cross-border commuters who live in Ticino but work in Lombardy must monitor three key aspects in the coming months:

1. Medication updates: Follow developments in Petrelintide and other upcoming therapies and see if they are approved and reimbursed in Switzerland and Italy. 2. Costs and insurance: Discuss with your health insurer whether you can obtain partial or full reimbursement, especially in the case of related diseases. If refused, consider supplementary policies or cross-border solutions. 3. Medical advice: Contact specialized centers in Ticino (such as the EOC Endocrinology Service in Lugano or Bellinzona) for a personalized evaluation, especially if you are already on GLP-1 therapy.

The role of Ticino institutions

The Canton of Ticino, through the Department of Health and Social Affairs (DSS), could play a key role in the management of obesity in the medium term. Currently, there is no indication of any regulatory changes, but market pressure and patient demands could push for new initiatives. In particular, the DSS could:

• Promote local clinical trials to evaluate the efficacy of Petrelintide and other drugs in Ticino patients. - Work with health insurers to extend insurance coverage, at least in selected cases. - To raise awareness of the risks of obesity and the therapeutic opportunities available.

What we don't know yet

Despite progress, many uncertainties remain: - It is not yet clear whether Petrelintide will get regulatory approval and when. - The estimated costs for the drug have not been communicated, nor whether it will be available in Ticino before in other Swiss cantons. - It is not clear whether Ticino's health insurers will extend coverage to drugs such as Petrelintide, even in the absence of comorbidities.

Useful tools to maximize net To reduce the loss on the gearbox, compare the CHF-EUR exchange rate and the banks for cross-border workers.

Key points

Step 1: Assess suitability for treatment

Before considering taking anti-obesity medications, it is essential to check if you are suitable for treatment. According to the criteria of the WHO and the Swiss and Italian health authorities:

• BMI ≥ 30: Overt obesity. - BMI ≥ 27 with comorbidities: Overweight with type 2 diabetes, high blood pressure or high cholesterol. - Age: Over 18 years old (some drugs have more restrictive limits).

For cross-border commuters living in Ticino, the assessment can be carried out at: - Endocrinology Centers of the EOC (Lugano, Bellinzona, Locarno, Mendrisio). - General practitioners with expertise in nutrition and metabolism. - Specialist clinics in Lombardy (if you opt for a cross-border approach).

If you fall within the parameters, the next step is to apply for a medical prescription, which can be used to check your insurance coverage.

Step 2: Check your insurance coverage

In Ticino, health insurers do not reimburse anti-obesity drugs except in the presence of related diseases. However, some supplemental policies may offer partial coverage. Here's what to do:

1. Contact your health insurer: Ask if it covers medications such as Wegovy or Zepbound if you have comorbidities. 2. Evaluate additional policies: Some insurance companies offer specific plans for obesity or metabolic diseases. 3. Check with your employer: Some companies offer additional benefits, such as contributions to specific therapies.

If coverage is not available, the cost of these drugs can be as high as CHF 400-500 per month in Switzerland, making them unaffordable for many. In Lombardy, costs are lower (around EUR 200-300 per month if purchased privately), but availability is limited.

Step 3: Monitor Petrelintide Updates

Petrelintide is still being studied, but preliminary results are promising. To stay up to date:

• Follow official sources: Roche, Zealand Pharma and Swiss (FOPH) and Italian (AIFA) health authorities. - Subscribe to specialized newsletters: Sites such as Frontaliere Ticino or Swissinfo publish regular updates on drugs and regulations. - Consult your doctor: Specialists can provide up-to-date information on new treatments.

If Petrelintide obtains approval, it could be available in Ticino by 2028-2029, but it is still too early to make certain predictions.

Step 4: Evaluate cross-border alternatives

For cross-border commuters who are unable to access treatment in Switzerland, one solution could be to turn to Italy. However, even in Lombardy access is limited:

• GLP-1 drugs: Partial reimbursement by the NHS only in severe cases (e.g., obesity with BMI >40). - Private costs: Around 200-300 EUR per month for Wegovy or Zepbound. - Specialist centres: In Milan and Monza there are clinics that follow patients with obesity, but waiting times can be long.

Before opting for a cross-border route, it is advisable to: - Check the coverage of the NHS with your general practitioner in Italy. - Contact the Ticino cantonal health service to find out if there is a collaboration with Lombardy facilities. - Consider travel and logistics costs: Frequent travel between Ticino and Lombardy could make the treatment impractical.

Step 5: Prepare for regulatory changes

The market for anti-obesity drugs is rapidly evolving, and both Switzerland and Italy could introduce new rules in the coming years. Here's what to keep an eye out for:

• Extension of insurance coverage: Some Ticino health insurance companies may start reimbursing these drugs, especially if patient pressure increases. - New cantonal guidelines: The Ticino DSS could update its recommendations, aligning with European standards. - Cross-border collaboration: Agreements could be created between Ticino and Lombardy to facilitate access to therapies and checks.

To stay up to date, it is useful to: - Follow the official communications of the Canton of Ticino and the Lombardy Region. - Participate in information events organized by patient associations or health institutions. - Regularly consult websites such as frontaliereticino.ch or those of health insurance companies.

Useful tools for cross-border commuters

To assess the economic impact of these drugs on their situation, cross-border commuters can use:

• Cost of living calculator to compare healthcare costs in Ticino and Lombardy calcolatore cost-of-living. - Health policy comparator to check the coverage of anti-obesity drugs comparatore health. - Cross-border health rights guide to understand how to access treatment in both countries guida sanità.

What to do if your health insurance company refuses reimbursement

If your health insurance refuses to cover the medication, you can:

1. File an appeal: Some health insurers allow you to challenge the decision, especially if you have medical documentation that proves the need for treatment. 2. Look for alternatives: Contact public centers that offer obesity therapies (for example, the dietetics departments of Ticino hospitals). 3. Evaluate private solutions: Some private clinics in Ticino or Lombardy offer obesity management programs with more affordable costs.

Deadlines and timelines to remember

• 2026: Results from phase 3 studies for Petrelintide (if positive, could expedite approval). - 2027-2028: Possible approval of Petrelintide in Switzerland and the EU. - 2028-2030: Arrival of generic GLP-1 drugs, with possible cost reductions.

Helpful Resources

• Roche website: www.roche.com (Petrelintide updates). - FOPH (Switzerland): www.bag.admin.ch (guidelines on anti-obesity drugs). - AIFA (Italy): www.aifa.gov.it (reimbursements and approvals). - Cross-border commuter Ticino: www.frontaliereticino.ch (guides and updates for cross-border commuters).

Conclusion: Act now to prepare for the future

The arrival of Petrelintide and other anti-obesity therapies represents an important novelty for those who live and work between Ticino and Lombardy. However, there is still a long way to go towards widespread and affordable access. Cross-border commuters should be prepared to monitor developments, assess their insurance options and, if necessary, explore cross-border solutions.

For those already on GLP-1 medication, it is essential to stay in touch with their doctor and periodically check if there are more effective or cheaper alternatives. Meanwhile, following updates on this rapidly changing market can be the difference between affordable treatment and unaffordable spending.

Scopri il calcolatore per stimare i costi sanitari transfrontalieri and assess your situation now.

Source: rsi.ch

Discover Ticino job offers updated daily: 4,000+ positions from Swiss companies hiring cross-border workers.