Much has been written on GLP1 agonists being the nail in Resmed's coffin, and many here (myself included) think that this is premature.

I went digging for some medical evidence to see if I could shoot my thoughts down. 

TL:DR - Whilst GLP agonists reduce weight, it won't be enough to make an outsized dent to Resmed's business model.

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GLP1 agonists seem to help people lose between 4-17% weight loss - with numbers of 4-6% for people with diabetes (more likely to be in Resmed's target group).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063254/

If any weight loss intervention is destroy Resmed's business, a person needs to 1) lose enough weight and 2) sustain the weight loss.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874406/

A 10% weight reduction at 1 year (picked as it's the number/duration quoted in many GLP1 studies), results in remission of OSA for 13% of people. 

That's still 87% who don't remit. 

And whilst important, weight loss alone doesn't account for sustained improvement in OSA. See the 10 year data in the link above.

If we look at weight loss in bariatric surgery, a more drastic intervention than in the above paper, the data show that 72% manage to keep >20% weight off at 10 years.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112115/

These weight loss numbers from bariatric surgery are likely to be far more impressive in terms of magnitude and durability than for GLP1 agonists.

Weight loss by bariatric surgery cures a lot of OSA, but not all of it.

https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-018-3484-5

In fact 45% of people had OSA that did not improve at all following bariatric surgery. So it isn't purely a weight related condition.

So what is the take home message here?

GLP1 agonists will absolutely have a role in reducing obesity, and with it OSA. But they won't single handedly cure obesity or OSA and the magnitude of the clinical effect isn't going to be as big as the market seems to be anticipating. Almost certainly not enough to justify a 30% drop in value over the last 3 months.

I'll be buying more Resmed.

Disc: Held, and buying more.