CT-388

Downtown Holly Springs , North Carolina, iStock, zimmytws Infrastructure and location have helped make Holly Springs a future hub for obesity drug production, with Amgen and Roche planning to manufacture GLP-1 therapies there to compete in the growing market. A North Carolina town with around 50,000 residents has emerged as a vital launchpad for two planned attacks on the obesity market. Amgen and Roche are pouring more than $3.5 billion into Holly Springs to make medicines that could challenge Eli Lilly and Novo Nordisk for the market. The quick-fire investments are built on a 20-year campaign to create an attractive environment for drugmakers. Novartis put Holly Springs on the biopharma map when it unveiled plans to build a vaccine manufacturing plant in the town in 2006. Holly Springs’ support for the facility, which is now run by CSL Seqirus, led to the town being overextended financially and facing significant gaps in meeting Novartis’ demands for cleared land, a new road, water and sewer service and a fire truck. Yet the project set the stage for a series of industry commitments, including a recent obesity-focused investment surge. Amgen broke ground on a $550 million drug substance production plant in the town in 2022. The biotech committed a further $1 billion in late 2024 as the magnitude of the opportunity open to its obesity drug candidate MariTide became clear. Roche’s Genentech was even quicker to double down on Holly Springs, committing $700 million in May 2025 and adding another $1.3 billion to its plan in January 2026. Roche’s plant will manufacture obesity drug candidates, including its dual GLP-1/GIP receptor agonist CT-388. Amgen is running seven Phase 3 trials of MariTide with primary completion dates in 2027 and 2028. The biotech opened its first Holly Springs plant last year and expects to grow headcount across the site to 725 by 2032 as the second facility comes online and scales up. Roche reported Phase 2 data on CT-388 in January, positioning the company to start two Phase 3 trials in the first quarter of this year. The Swiss drugmaker expects its Holly Springs facility to be operational in 2029. Manufacturing To Compete in Obesity, Late Entrants Invest Early in Manufacturing Small and large drugmakers alike have made big, proactive moves to secure the production capacity that will be vital to serving the weight loss market. September 23, 2025 · 5 min read · Nick Paul Taylor Read more Michael Haley, executive director of Wake County Economic Development, explained how decisions officials in Holly Springs made years ago put the town in the running when Amgen and Roche began looking for sites to support their obesity ambitions. “They started planning to be a life science manufacturing hub 15, 20 years ago. They focused on very traditional economic development structures,” Haley told BioSpace . Those included a business park, greenfield sites, a graywater system and water and wastewater infrastructure. Accessing Talent Such infrastructure investments helped Holly Springs to capitalize on other advantages it offers. It’s located around 20 miles from Raleigh, North Carolina, which site selection specialist Global Location Strategies (GLS) ranked as the best place in the U.S. to build a biologics production plant. GLS CEO Didi Caldwell told BioSpace that the Raleigh-Cary metro area, which includes Holly Springs, topped the rankings because of the strength of its biopharma manufacturing workforce and strong pipeline of talent from universities in the area. The Durham–Chapel Hill metro area, which is next to Raleigh-Cary, ranked third on GLS’ list. “Durham-Chapel Hill is number one for biologic specialization,” Caldwell said. “They have this deep, deep heritage of biotech, pharma and regulated manufacturing, so they have an exceptional concentration of bioprocessing and quality assurance roles.” The availability of seasoned professionals and new trainees, plus the ability to attract people from other parts of the country and world, is critical because access to talent is a problem nationally. Caldwell said there are 60,000 vacancies in the pharma industry, adding that “you can build more plants, but if you cannot staff them you’re not going to be able to operate them.” Managing Growth Pressures Demand for talent in Holly Springs is increasing, with Amgen creating 370 jobs and Roche planning to employ more than 500 people at its site. Haley expressed confidence that the region can fill the new roles, pointing to the tens of thousands of people who annually graduate from local universities and community colleges or relocate to the region. “Fifteen years ago, we had 35,000 life science employees and people would ask, ‘Can we maintain our talent advantage?’ Now we have over 75,000 people,” Haley said. “We met the challenges through the years and we feel very confident . . . that we can continue to meet the needs of our existing companies.” As well as nurturing the talent to staff the sites, the region needs to ensure infrastructure including water and energy supply can cope with the rising demand. Holly Springs invested ahead of the local surge in obesity drug manufacturing, but meeting the needs of a growing manufacturing footprint and population, which increased 10% from 2020 to 2024 in the Raleigh metro area, is an ongoing challenge. Amid a data center boom, manufacturing facilities are part of a broader set of sites clamoring for water and energy. A company has applied to build a 300-megawatt data center about 10 miles from Holly Springs, sparking pushback from residents concerned about energy and water consumption. Similar situations are playing out across North Carolina as companies apply to build data centers. Haley said there is “pressure on infrastructure, just because of the sheer growth that we’re seeing” and the complexity of projects has changed dramatically in the past 5 to 10 years, with facilities requiring more capacity for water, wastewater and power. Officials have responded to the changes. “It’s hard to play catch-up when you’re dealing with infrastructure. You’re always a little behind the eight ball,” Haley said. “For us, the solution is to have as much foresight as possible so that our utility providers are calculating potential demand, putting that into their own models and acting accordingly when they’re developing the infrastructure that they need.”

None With the obesity market projected to exceed $130 billion by 2034, many major pharmaceutical players are rapidly advancing pipelines to capitalize on what is arguably the most dynamic space in the industry. To identify the companies positioned to outperform, FENIX has created the Obesity Power Rankings of the Top 10 players. For context, >20 companies were assessed across more than 15 weighted criteria, including pipeline depth, clinical differentiation, and commercial infrastructure, to derive a composite score out of five. If you’re interested in a deeper look at the full assessment framework, please contact the FENIX team. Below, FENIX outlines the rationale for all rankings and highlights key headwinds and tailwinds that shape each company’s position:   Lilly (4.9/5): Lilly remains the undisputed market leader in obesity, as evidenced by its tirzepatide franchise becoming the world’s top-selling drug in 2025, surpassing Merck’s Keytruda to generate >$36 billion in annual revenue. While Lilly possesses a robust late-stage pipeline which is anticipated to help defend its leadership position, near-term momentum is expected to center on the orforglipron launch in Q2 2026. Considering Novo’s Wegovy Pill appears to hold a marginal edge in terms of efficacy, Lilly’s commercial team may need, for once, to come from behind. Novo Nordisk (4.8/5): Having effectively pioneered the modern obesity market with semaglutide, Novo entered 2026 confronting a convergence of executional challenges and a visible decline in innovation, factors that culminated in the company issuing its first negative annual sales outlook since semaglutide’s ascent. Novo now relies on strong launches of injectable 7.2mg Wegovy, Wegovy Pill, and CagriSema to stabilize its US market share and rebuild investor confidence. While these launches may alleviate near-term pressures, it remains uncertain whether Novo has truly identified a long-term successor to semaglutide. Pfizer (4.1/5): Following its $10 billion Metsera acquisition and licensing agreement with YaoPharma in 2025, Pfizer has significantly vaulted up the competitive rankings. While the company previously faced multiple setbacks in obesity (e.g., danuglipron and lotiglipron discontinuations), Pfizer finally appears to have assembled a differentiated pipeline that can fully leverage its established commercial and manufacturing infrastructure. Roche (4.0/5): Despite its historically limited presence in the cardiometabolic space, Roche has publicly emphasized its ambition to become a Top 3 player in the obesity market. Following the recent encouraging topline CT‑388 Phase 2 results, attention now turns to the upcoming Phase 2 petrelintide readout in H1 2026, a pivotal catalyst that will likely shape the trajectory of its partnership with Zealand and, ultimately, Roche’s broader obesity aspirations.  AstraZeneca (3.6/5): A compelling case can be made that AZ has the pipeline depth to emerge as a dark horse contender for the third-place position in the power rankings. The company quietly advanced a broad mid-stage pipeline throughout 2025; and with multiple Phase 2 readouts expected in 2026, it's licensing agreement with CSPC Pharmaceuticals, which added a monthly dual agonist to its arsenal, further strengthens it as a serious contender.  Amgen (3.3/5): Amgen is effectively placing a concentrated bet that MariTide’s extended dosing will be its key differentiator in the future obesity market. While quarterly maintenance dosing is differentiated, it remains to be seen whether the company can overcome the Phase 2 tolerability issues that unsettled investors at ADA 2025. Boehringer Ingelheim (3.0/5): With data from the Phase 3 survodutide program anticipated to begin reading out in H1 2026, BI is set to become the first challenger to the current Lilly+Novo duopoly. Even with positive Phase 3 survodutide data, BI likely needs to expand its pipeline beyond its Phase 2 triple agonist to become a long-term competitive player in the space. Regeneron (2.9/5): While it was previously believed Regeneron was taking a tangential approach in the obesity market, looking to develop lean mass-sparing assets, its in-licensing deal for olatorepatide in June 2025 revealed the company’s broader obesity ambitions. However, similar to both BI and Amgen, it is believed Regeneron also needs to further diversify its portfolio to be considered a future leader in obesity. Zealand Pharma (2.4/5): Zealand, guided by CEO Adam Steenburg’s ambition to end what he describes as the “Weight Loss Olympics,” is making a strategic bet that amylin will become the next foundational anti-obesity class. Following Zealand’s partnership with Roche for petrelintide, the upcoming Phase 2 ZUPREME-1 readout will offer the first meaningful look into whether petrelintide lives up to the TPP promise. Kailera Therapeutics (2.2/5): Having licensed China-based Hengrui’s GLP-1/GIP dual agonist (ribupatide), which has already demonstrated strong late-stage weight loss efficacy in a Chinese population, Kailera initiated its own Phase 3 program evaluating higher doses (>6 mg) over longer treatment durations. It will be interesting to see if Kailera follows the traditional path of partnering with Big Pharma or if it goes alone with a new US commercial model (i.e., solely direct-to-patient).