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Irish Times
15 hours ago
- Business
- Irish Times
Should the maker of Ozempic be funding children's playgrounds in Ireland?
Last Monday Taoiseach Micheál Martin posted on social media about his delight at attending the unveiling of a primary school's new playground equipment that is 'part of Novo Nordisk Ireland's ongoing Play at Primary School Initiative'. The initiative by the manufacturer of Ozempic and Wegovy involved providing nine Deis schools with equipment, with plans to expand to more schools during 2025. On the face of it, new playground equipment seems a commendable and worthwhile initiative. But the question has to be asked: what's in it for Novo Nordisk, which has a track record in sophisticated public relations campaigning? Fundamentally, there are potential ethical considerations with any company or industry paying for children's playground equipment. But Novo Nordisk deserves additional scrutiny given its marketing practices. READ MORE In 2023, the Danish drug manufacturer was suspended by its own industry body in the UK for two years over its sponsorship of weight management courses for health professionals. This is the most severe punishment that the Association of the British Pharmaceutical Industry has issued and was only the eighth occasion in the past 40 years the ABPI board has issued such a significant sanction. It led to the Royal College of Physicians and the Royal College of General Practitioners ending their partnerships with Novo Nordisk. The suspension occurred because Novo Nordisk paid for a 'large scale Saxenda [a weight-loss drug] promotional campaign […] which was disguised' and included 'heavily biased' information. The ruling outlined 'serious concerns about Novo Nordisk's culture' and raised further concerns about Novo Nordisk at the global level. In March 2025, the ABPI voted to readmit Novo Nordisk as a full member on the basis that it 'now had the systems and culture in place' to resume self-regulation. But Novo Nordisk was since found to be in breach of UK marketing regulations on several more occasions . In Ireland, issues have also emerged. Through a freedom of information request, I obtained an inspection report by the medicines watchdog, the HPRA, of Novo Nordisk's advertising-related activities for the period January 2021 to May 2023. My findings that the pharma company broke rules around the advertising and marketing of its medication to healthcare workers over three years were reported in The Irish Times on Friday. The HPRA found 'a significant number of non-compliances' with Novo Nordisk's advertising and 'educational' activities. [ Maker of Ozempic and Wegovy broke advertising rules, regulator finds Opens in new window ] They outlined that the 'level of control and governance that was in place for educational activities, promotional and non-promotional meetings with healthcare professionals, advisory boards and medicinal product advertising were deficient'. Issues outlined included presentations to healthcare professionals that were 'unbalanced' in nature. It also found the omission of important and legally required drug information relating to adverse reactions, precautions and contraindications in materials intended for use with patients and in a promotion to healthcare professionals. A teaching guide intended for use with patients included advertising for a prescription-only product, which is not legally permitted. The HPRA also observed compliances with requirements. In response to the HPRA review, Novo Nordisk outlined a range of procedural changes. This includes extensive reviews of slides presented by third parties for work affiliated to Novo Nordisk; the removal of materials in breach of regulations; updates to internal guidance; and the introduction of relevant training processes. A spokeswoman told The Irish Times that the company 'addressed the findings to ensure compliance with industry regulation and this was completed to the HPRA's satisfaction immediately following the inspection' and that its focus 'remains on meeting the needs of patients, healthcare professionals and partners'. Between 2016 and 2023, Novo Nordisk has reported making payments valued at over €6.6 million to healthcare organisations, a patient organisation and healthcare professionals, based on my analysis of Novo Nordisk's disclosures on – the pharmaceutical industry's record of direct or indirect financial support or 'transfers of value' to healthcare professionals – and the disclosures of patient organisation payments Novo Nordisk makes on its website. It's not clear whether this is the full picture: research I was involved with has highlighted significant shortcomings with the Irish payment declaration system. In the UK, Novo Nordisk has been found to be underreporting payments to the value of almost £8 million (€9.5 million) to 150 doctors, patients, journalists and healthcare organisations. One might ask why €6.6 million in payments to individuals and organisations in our health system would be problematic? The pharmaceutical industry describes these payments as being for education, research and healthcare. But payments such as these have well-recorded effects on prescribing practices, and are linked to recipient organisations favouring the positions of the funder. Novo Nordisk has made payments to help set up patient organisations, to pay senior decision makers in the Irish health system consultancy fees, and to help fund clinical guidelines on obesity in Ireland. Guidelines and patient organisations are important endeavours, but there are valid concerns about industry funding, as international evidence shows that it can influence important organisations and initiatives. When it comes to Novo Nordisk paying senior health system decision makers as consultants, significant scrutiny is necessary given the influence they have over our health system. Nothing here is intended to question the benefits of Novo Nordisk's approved medicines – if a medicine is approved for use in Ireland then the evidence shows that it meets the required standards for benefits and risk. What we should question is whether the drug maker's marketing efforts are affecting the decision making of our politicians, policymakers, prescribers and healthcare organisations. These decisions should be based on evidence only, not who has paid for our playgrounds, our conferences or our lunches. Novo Nordisk is applying to the State to reimburse its weight loss drugs for a much larger group of people. This decision has the potential to put unprecedented pressure on the State's health budget, potentially more than doubling state expenditure on medicines to €10 billion. The drugs are so expensive that US researchers have suggested it would be less expensive for the United States to just buy Novo Nordisk than to reimburse its weight loss drugs. There's a reason that the College of Psychiatrists of Ireland ended pharmaceutical industry partnerships in 2010 and the Irish College of General Practitioners last year voted to phase out pharmaceutical industry partnerships. It's because, as the College of Psychiatrists put it, the college's aims do not always align with the industry's aims and there is a need for the college to be able to provide 'independent appraisal of the value of specific drugs'. Our health and education systems struggle for funding for important initiatives. Pharmaceutical companies and other industries sometimes step into this void. But we need to ask if there are hidden costs to this funding, costs that may not be worth paying for. James Larkin is a senior postdoctoral fellow in the department of General Practice at RCSI
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Business Standard
2 days ago
- Business
- Business Standard
Why Ozempic maker Novo Nordisk is losing its lead in weight-loss drugs
In 2023, Novo Nordisk overtook Louis Vuitton Moët Hennessy (LVMH) to become Europe's most valuable company, riding the meteoric rise of its weight-loss and diabetes drugs, Wegovy and Ozempic. But soon after, the Danish firm has seen its dominance slip as rival Eli Lilly surged ahead in drug efficacy, manufacturing, and marketing. Despite controlling 62 per cent of the GLP-1 agonist market, drugs that mimic gut hormones to suppress appetite, Novo Nordisk's share prices have tumbled over 50 per cent in the past year. Internal struggles, product shortages, and clinical trial disappointments have raised doubts about the company's long-term prospects in a market expected to be worth $150 billion annually by 2035, reported The Wall Street Journal (WSJ). Earlier this month, these concerns culminated in a surprise leadership shakeup. The company's controlling foundation forced the ouster of CEO Lars Fruergaard Jørgensen, signalling a growing urgency to course-correct. How Wegovy's underestimation hurt Novo Nordisk's momentum Novo Nordisk's early misstep was a critical underestimation of demand for Wegovy, launched in 2021 as a weight-loss version of its blockbuster diabetes drug Ozempic. Based on the limited uptake of an earlier weight-loss drug, Saxenda, the company prepared for modest sales and used a cautious manufacturing model, blending internal and contract production. But five weeks post-launch, prescriptions for Wegovy exceeded what Saxenda had taken five years to achieve. Instead of scaling up rapidly, Novo responded by limiting supply, urging doctors not to start new patients and rationing lower-dose starter kits to protect supplies for existing users, according to WSJ. This decision had serious consequences. Shortages pushed consumers toward compounded, copycat versions of semaglutide sold at lower prices through US compounding pharmacies. Telehealth platforms capitalised on this gap, offering cheaper alternatives and eating into Novo Nordisk's market share. It is important to note that the firm has recently announced that it plans to bring Wegovy to Indian markets as well. How Eli Lilly capitalised on Novo Nordisk's supply and trial delays Eli Lilly, once trailing in the weight-loss space, quickly filled the supply void. It launched Mounjaro for diabetes in 2022 and followed up with Zepbound, a weight-loss version, in 2023. Zepbound's clinical data showed over 20 per cent body weight reduction, surpassing Wegovy's results. While Lilly also faced supply constraints, it managed to resolve them faster than Novo Nordisk. Today, weekly US prescriptions for Zepbound have overtaken Wegovy's, and Mounjaro is closing in on Ozempic's numbers. Lilly also moved faster on consumer engagement. It launched a direct-to-patient service offering discounted weight-loss drugs and was first to partner with telehealth firm Ro. Novo Nordisk only rolled out similar initiatives months later. Lilly's drug pipeline surges while Novo Nordisk stumbles in trials While Lilly has emerged with a promising R&D pipeline, Novo Nordisk has faced disappointing results. In December, lacklustre trial data for its experimental combination drug CagriSema triggered a 20 per cent plunge in its share value, erasing nearly $100 billion in market capitalisation. Although CagriSema is still in phase 3 trials and has demonstrated weight-loss benefits, it has failed to distinguish itself from existing therapies in head-to-head comparisons. Meanwhile, Eli Lilly's Orforglipron, a once-daily oral GLP-1 agonist, has cleared initial phase 3 trials. Analysts see this as a significant development, as small-molecule oral drugs are typically cheaper and easier to manufacture compared to injectables. Novo Nordisk hopes to bring an oral form of semaglutide (Wegovy) to market by the end of 2025, but it is already perceived as lagging in the next-generation obesity drug race. Eli Lilly, meanwhile, announced earlier this month that a head-to-head clinical trial showed that its obesity drug tirzepatide (sold as Mounjaro) led to greater weight loss in adults than semaglutide (sold as Wegovy). India's anti-obesity drug market quadruples in five years India's anti-obesity drug market has expanded more than fourfold over the past five years, driven by a surge in lifestyle-related diseases, greater affordability, and a growing willingness among affluent consumers to pay for weight-loss treatments. Data from PharmaTrac, an industry tracker, shows the market reached ₹576 crore as of March 2025, up from ₹133 crore in March 2021. The growth has been spearheaded by GLP-1 receptor agonists, particularly semaglutide, which accounts for 69 per cent of the market at ₹397 crore. Novo Nordisk's oral semaglutide pill, Rybelsus, launched in 2022, has emerged as the key growth driver, overtaking older molecules such as orlistat and liraglutide. Also read: However, price remains a key barrier to wider access. Eli Lilly's Mounjaro is priced between ₹14,000 to ₹17,500 per month in India, depending on the dosage, making it unaffordable for most patients outside the top-income bracket. Analysts estimate that even if just 0.5 per cent of India's 101 million diabetics adopt these injectable therapies, the market could generate $1.5 billion in annual revenue. Despite the premium pricing, market experts expect significant expansion post-2026, when semaglutide goes off-patent and generic versions become available. According to Vishal Manchanda, senior vice-president of institutional research at Systematix Group, generics are likely to be priced up to 95 per cent lower, triggering a dramatic rise in volumes. Meanwhile, non-GLP-1 weight-loss drugs continue to maintain a limited footprint. Orlistat holds a market value of ₹72 crore, followed by dulaglutide (₹72 crore) and liraglutide (₹34 crore), according to Pharmarack data. Additionally, scientists have found that certain weight-loss drugs, originally developed to treat type 2 diabetes, might not only help people shed kilos but also significantly lower the risk of obesity-related cancers. Can Novo Nordisk regain its global weight-loss drug dominance? Despite its setbacks, Novo Nordisk is not out of the picture. It has ramped up investment in production, including a $16 billion deal through its foundation to acquire contract manufacturer Catalent. In the US, it recently partnered with CVS to make Wegovy the preferred weight-loss drug under the pharmacy chain's benefit plans. The battle between Novo Nordisk and Eli Lilly is far from over. Both companies dominate the GLP-1 market, and the cost, efficacy, and safety of future therapies will determine how market share evolves.
Mint
3 days ago
- Business
- Mint
How Ozempic's maker lost its grip on the obesity market it created
In 2023, Novo Nordisk was the most valuable company in Europe, surpassing LVMH on the back of soaring demand for Ozempic and Wegovy. Today, the Danish company has lost its grip on the anti-obesity market it carved out. The company has lost market share amid production missteps and a bungled rollout of Wegovy that led to shortages. Its U.S. rival Eli Lilly—initially in the rearview mirror—has been proven to have the more effective weight-loss drug and a more promising pipeline of next-generation treatments. Novo Nordisk's research-and-development machine has disappointed, and a key marketing strategy was slow to get off the ground. Novo Nordisk's ability to stay atop a market that analysts see growing to $150 billion in annual sales is now in doubt. Its controlling shareholder this month forced a surprise ouster of the company's chief executive, Lars Fruergaard Jørgensen. And while it is still generating multibillion-dollar sales for Ozempic and Wegovy, shares have tumbled more than 50% over the past year. If Novo Nordisk doesn't turn things around, it could join a long list of companies that blew a first-mover advantage, from Sunshine Biscuits—whose Hydrox cookies were overtaken by now-iconic Oreos—to the Myspace social network. 'Everyone wants to be the first footprints on the empty beach," said Americus Reed, marketing professor at the Wharton School of the University of Pennsylvania. 'But it depends on how you land on that first move. The second mover is watching them make mistakes. You're able to identify those and not make those mistakes." Lars Fruergaard Jørgensen, who was pushed out as CEO of Novo Nordisk earlier this Nordisk lost market share after miscalculating demand in the launch of weight-loss drug Wegovy. A Novo Nordisk spokeswoman said the company remains the global-volume market leader in GLP-1 drugs, serving nearly two-thirds of patients taking them for diabetes and obesity. Some investors and industry watchers say Novo Nordisk's troubles stem from a cautious, reactive approach starting when the market first burst onto the scene, in contrast with a faster, more aggressive tack in production and marketing by Lilly. 'Novo is always a step behind," said Yuri Khodjamirian, chief investment officer at Tema ETFs, which owns Novo Nordisk shares. One of Novo Nordisk's early stumbles was underestimating the demand for Wegovy—the weight-loss version of semaglutide, the same compound as diabetes drug Ozempic—ahead of its 2021 launch. The company's planning was informed by its experience generating modest sales for an earlier weight-loss drug, Saxenda. Doctors were skeptical of it, and many health-insurance plans in the U.S. didn't cover weight-loss drugs. Novo Nordisk thought Wegovy might run into the same market constraints as Saxenda, so the company planned modest production levels, using a combination of in-house and contract manufacturing capacity. It wasn't enough. It took only five weeks for the prescription rate of Wegovy to exceed the level that Saxenda had taken five years to reach. Jørgensen recalled later, in an interview in 2024, that he initially thought: ''That's patients who've been lined up, there's pent-up demand, it will normalize.' It didn't. It just kept growing." The company responded by limiting demand—the last thing a drugmaker wants to do with a new product. Sales representatives asked doctors not to start new patients. The company resorted to rationing by withholding the lower, starter doses for new patients, to conserve supplies for existing patients taking the higher doses. The shortages opened the door for competition. They made it legal for special pharmacies in the U.S. to make compounded, copycat versions of semaglutide that sold for much less than list prices for Ozempic and Wegovy. Telehealth firms capitalized on the new, lower-cost supply by hawking the compounded versions, taking away market share from Novo Nordisk. Eli Lilly activated a manufacturing plant in Concord, N.C., to keep up with a surge in demand for Mounjaro and Zepbound. The shortages gave rival Eli Lilly time to catch up. Lilly introduced Mounjaro for diabetes in 2022, followed by Zepbound, a weight-loss version of the same drug, in 2023. Zepbound has been shown in studies to induce greater weight loss than Wegovy, more than 20% of body weight. Although Lilly also encountered shortages due to high demand, it was able to resolve them more quickly than Novo Nordisk. Now, weekly U.S. prescriptions for Lilly's Zepbound have surpassed Wegovy's. Mounjaro still trails Ozempic but is closing the gap. Novo Nordisk has spent billions of dollars trying to expand manufacturing capacity, including an unusual deal last year for its controlling foundation to acquire the contract manufacturer Catalent for $16 billion. The R&D race for future weight-loss drugs also has tilted in Eli Lilly's direction. Lilly has reported favorable clinical-trial data for two closely watched experimental drugs, including a pill version that analysts think could be appealing to people who don't want injections. Novo Nordisk, meanwhile, has had some R&D disappointments, including studies of an experimental combination weight-loss drug dubbed CagriSema. The less-than-expected results of one study sent Novo Nordisk shares plunging more than 20% in one day in December, wiping out nearly $100 billion in stock-market capitalization for the company. Some analysts have cut their sales forecasts for the drug. Novo Nordisk's Wegovy has been surpassed in weekly U.S. prescriptions by Lilly's Zepbound. Lilly has gained an edge on the marketing front as well. The company beat Novo Nordisk to the punch in launching a direct-to-consumer, online service selling weight-loss drugs at discounted cash prices, aimed at people who don't have insurance coverage. And it was first to strike a deal with a big telehealth firm, Ro, to sell a discounted weight-loss drug. Novo Nordisk eventually made similar moves, but months after Lilly. 'They seem to be missing a lot of these kinds of strategic endeavors to help sell into a market that is different from a lot of pharma markets," said BMO Capital Markets analyst Evan David Seigerman. The Novo Nordisk spokeswoman said the company resolved its shortages before announcing its direct-to-patient service and striking telehealth deals. Novo Nordisk isn't out of the race. The company can still turn things around by leaning into CagriSema, which generated solid weight-loss data even if it missed expectations, and by developing other new drugs that target various segments of the growing market, Seigerman said. More recently, Novo Nordisk has shown signs of being more aggressive. It signed a deal with CVS to make Wegovy the preferred weight-loss drug for members of its drug-benefit plans. Author Hanne Sindbæk, who has written two books about Novo Nordisk, says there has been an eternal tug of war inside the company between those who are guided by values—the idea that the company works for the common good rather than simply to make a profit—and those who run the business. If Novo Nordisk wants to stay in the game, it may have to lean toward the latter in choosing its next CEO. Jørgensen, the outgoing CEO, is still in his role while the company searches for a new chief. His predecessor as CEO, Lars Rebien Sørensen, who is chairman of the foundation that has voting control of the drugmaker's shares, will join the Novo Nordisk board of directors. 'Now they need somebody more business-driven," Sindbæk said. Write to Peter Loftus at and Noemie Bisserbe at
Health Line
3 days ago
- Health
- Health Line
Is It Safe to Take a GLP-1 Medication with Digestive Health Conditions?
Consider safety when combining GLP-1 medications with preexisting digestive health conditions. GLP-1 medications are prescribed to lower blood sugar levels in people with type 2 diabetes. They're also prescribed for weight loss in people with obesity. GLP-1 medications belong to a class of drugs that include semaglutide, liraglutide, dulaglutide, and several others. Semaglutide is the active ingredient in Wegovy and Ozempic, two popular GLP-1 drugs. Liraglutide is the active ingredient in Saxenda, and dulaglutide is the active ingredient in Trulicity. GLP-1 medications may cause uncomfortable side effects and increase the risk of gastrointestinal conditions. Digestive health and GLP-1 medications GLP-1 medications work by mimicking the effects of the GLP-1 hormone, which is produced within the small intestine. Like the naturally occurring hormone your body makes, GLP-1 medications slow digestion (stomach emptying) and signal your brain that you feel full and can stop eating. They also trigger the release of insulin from the pancreas and inhibit the secretion of glucagon, a hormone that raises blood sugar levels. Several GLP-1 medications, including Wegovy, list many side effects, including gastrointestinal side effects, directly on their labels. These side effects may include: vomiting nausea diarrhea constipation bloating gas and belching heartburn stomach flu dehydration, especially in people with kidney failure More serious side effects may include: What the research says GLP-1 agonists are approved for people with type 2 diabetes to manage their blood sugar levels, and some are approved for weight loss. Let's take a look at the research and implications of people who have taken GLP-1 agonists along with various gastrointestinal conditions. A large 2023 study including people without diabetes who were using GLP-1 agonists for weight loss found that this class of medications may increase the risk of gastrointestinal conditions, such as gastroparesis. Researchers found the drugs did not increase the risk of biliary disease (conditions of the gallbladder or bile ducts) in participants. These adverse effects are thought to be rare but should be considered by people who wish to use GLP-1 medications for weight loss. A 2022 study involving people with Irritable Bowel Syndrome (IBS) found that ROSE 010, a GLP-1 receptor agonist, reduced IBS pain during flare-ups, primarily in female participants. When given in higher doses, however, nausea became more pronounced. A large 2024 study found that adults treated with semaglutide for diabetes mellitus are not at higher risk of diverticulitis and seem to have a lower risk of diverticulosis. Much more research is needed to uncover the potential benefits, as well as risks, of these medications. Tips for managing GLP-1 use with digestive conditions Talk with your healthcare professional about the benefits of GLP-1 medications versus their risks. Your age, underlying health conditions, and other factors, such as needle phobia, should be taken into account. In many instances, you and a healthcare professional may determine that the benefits outweigh the risks. Or, you may decide that the side effects are not worth the benefits, or that they make you too uncomfortable to continue taking these drugs. To manage digestive conditions and side effects while taking a GLP-1 agonist, follow these tips: follow the dosage instructions exactly as prescribed slowly increase your fiber intake, as recommended by your healthcare professional consider taking fiber supplements if constipation occurs drink plenty of water to remain hydrated eat small, frequent meals rather than large meals avoid eating too close to bedtime avoid spicy or fatty foods exercise regularly to aid with digestion
Daily Mail
23-05-2025
- Health
- Daily Mail
EXCLUSIVE Forget needles, fat-jab PILLS are here: How much weight you could lose, how they work and the new side-effects. Special report by ANTONIA HOYLE
A weight-loss injection pen sits in Melanie Hinton's fridge amid the eggs and vegetables she's trying to train her brain to enjoy. She knows Saxenda, the brand she was prescribed, could help shift the fat that has crept on thanks to a double whammy of menopause and biscuit addiction. And, at 12st 10lb and 5ft, she's desperate for a solution where slimming clubs and willpower have failed.
