Novo Nordisk’s Diverse Obesity Drug Portfolio Holds Promise To Maintain Leadership: John C. Dawber
The Glucagon-like peptide-1 (GLP1) drugs are set to be the star performers for insulin drug makers across the globe as the menace of diabetes and obesity is in line to rise exponentially in the years to come. GLP1 drugs are medications which have traditionally been used to treat type 2 diabetes and more recently for obesity.
The pharma majors making GLP1 drugs globally are racing to get their drugs on the shelves with the demand for these drugs outstripping the supply in many markets. GLP1 drugs have become highly recommended due to their diverse treatment profile effective in lowering sugar levels, reducing obesity and providing cardiovascular risk benefits.
Since your company is one of the leading drug makers in GLP1 medicines, how are you viewing the market growth rate here in India and globally?
Globally the GLP1 market was growing at a rate of 60 per cent in 2022 and we see it continuing to grow at a similar pace going forward. This has happened due to the benefits of these particular groups of medicines, which control blood glucose for people with diabetes and also reduce weight. And some of those molecules have evidence to show prevention of other complications of diabetes such as a heart attack and cardiovascular complications.
Novo Nordisk's journey goes back several decades with its research beginning over 20 years ago and the company is continuing to see a great interest in GLP1 molecules across the world and in India. We began with a once-daily injection, Victoza back in 2010, and then moved to a once-weekly injection Ozempic in 2017 and then further introduced a daily oral drug Rybelsus in 2019.
All three of these innovations continue to do pretty well. And, as you might imagine, the tablet has done particularly well, in certain markets where people don't like injections. The GLP1 Rybelsus was launched in India a year ago and so far has been one of the most successful diabetes launches ever in India.
How is Novo Nordisk addressing the capacity problem for its GLP1 drugs; the diabetes drug Ozempic and weight loss drug Wegowy, the demands of which have outstripped supply? And in India Novo Nordisk has partnered with Torrent Pharma, going forward will you be exploring more such partnerships with other pharma companies?
In the last year or two post-Covid, we have seen a dramatic uptake in both Ozempic and also the equivalent treatments that are licensed for obesity. The capacity and demand in some cases have outstripped supply. We have had to be very careful and responsible about where we launch these products, so that we can maintain supply. Our current manufacturing bases for GLP1 are running on a 24/7 capacity and we are on a hiring spree into our product supply organisation to continue to expand our own demand.
In addition, the company has taken some steps to work with a few contract manufacturing firms particularly in the US to meet the demand going forward. Whilst there were some significant concerns about a year ago, particularly in the US now I think we find ourselves being able to supply all those strengths in America having both the diabetes and obesity products. And it's much easier to plan over the next two to five years.
In India, the partnership with Torrent Pharma for manufacturing insulin treatments has been running for the last few years. There are discussions ongoing, about whether we develop that partnership further into other parts of our portfolio. I think that we will continue our partnership with Torrent rather than try to diversify into other partnerships. Torrent has been a good partner for insulin and the company is presently investigating whether it can partner with Torrent for Semaglutide or for other parts of the portfolio to build capacity.
The latest clinical results from the obesity drug – higher dose semaglutide which has shown 15 per cent reduction in weight have been positive. What can you tell us about its availability? With more and more players entering the obesity drug turf, how will Novo maintain its lead?
The semaglutide molecule at high dose looks very interesting and with obesity and its complications rising going forward, we will look to raise the innovation bar even further to manage it all. The last four or five years of obesity treatments available in the market have about two decades of research and a conscious decision from Novo Nordisk to invest in an entire business unit, both commercial and research to investigate the aetiology and methodologies behind the development of overweight and obesity.
What that means is that not only do we have two products on the market today, but we have got a pipeline, stacking up over the next 10-15, maybe the next 20 years to tackle obesity. So the starting point for Novo Nordisk was quite some years ago, and the results of that R&D and pipeline development will come out over the coming 10 years.
The obesity drugs market is enormous, and there is plenty of room for other players who are innovating but for Novo Nordisk, the diverse portfolio in obesity has got a lot of promise and the company will continue to maintain its leadership.
Is the company keeping track of obesity drug’s side effects being reported in the global media or carrying out any long term studies to analyse possible side effects as we go up the dose range of semaglutide which for Novo stands at 50 mg?
Our own internal pharmacovigilance is incredibly strong and robust. We have several hundred drug safety experts, and pharmacovigilance experts sitting here in Bengaluru, who are reviewing all the side effects reports for the globe and adjudicating whether those are assigned to the drug, assigned to the dose, assigned to attempt the particular patient type, and constantly reporting that to the authorities.
For us the drug's safety profile is a priority and it's very important to evaluate the safety and efficacy profile as you go up the dose ranges of any drug. As exciting as you may be, for increased efficacy, it always has to be traded off on the drug’s safety and a good balance. So far, it seems that Semaglutide is a molecule which doesn't produce new side effects that we don't know about as we go up the dose range. But the diligence around that is quite strong because patient safety is at the heart of our reputation.
