Under pressure, Novo lays out blockbuster launch plans

Facing considerable pressure in its diabetes and obesity franchises, Novo has revealed a plan to launch five or more blockbusters between now and 2030 that it estimates will swell its annual revenues by around $23 billion.

The optimistic assessment of the next few years was revealed in comments by chief executive Mike Doustdar at Novo's Capital Markets Day in London today, where the company will present details of its key R&D projects in obesity and diabetes and its progress in diversifying into new therapeutic categories.

The company is trying to reassure shareholders in the face of lost market share in obesity/diabetes to arch-rival Eli Lilly, some late-stage pipeline disappointments, and the looming loss of patent protection to semaglutide-based blockbusters – Wegovy for weight loss and Ozempic for type 2 diabetes – in the early 2030s.

Initial signs of that are not promising. Shares were down almost 5% at the time of writing, despite Doustdar's assertions that Novo is "adapting to a changing environment while positioning for new growth opportunities."

He pointed to an "ambitious and competitive" launch of CagriSema (cagrilintide and semaglutide) early next year – which has generated disappointing phase 3 results in obesity and diabetes – and the ongoing rollout of the Wegovy pill, which has been used by around 1.5 million people since its launch at the start of the year.

That will be followed by the launch of a cagrilintide-only product and a high-dose version of CagriSema in 2028, and zenagamtide (formerly amycretin), which is being developed in both injectable and oral formulations.

Novo hopes to boost patient numbers for oral Wegovy tenfold as it tries to extend a lead over Lilly's competing oral therapy, Foundayo (orforglipron). It also plans to grow its blood and endocrine business by 50% between now and 2030, fuelled by the launches of products like haemophilia A therapy Frehemgo (denecimig), sickle cell disease therapy etavopivat, and zaltenibart for paroxysmal nocturnal haemoglobinuria (PNH).

Doustdar said the company aims to achieve "multi-blockbuster launches every year through 2030," resulting in a much more diversified company with products across diabetes, obesity, blood and endocrine disorders, liver diseases, cardiovascular disease, and "consumer Rx," a nascent category that draws on the rise of direct-to-patient sales of prescription products like Wegovy in the US.

Novo is looking at other opportunities for consumer Rx products – balancing "scientific evidence and…consumer-like decision-making" – in areas like immune-mediated inflammatory diseases, pain and addiction, and men/women's health.

The CEO also said the company intends to expand and strengthen its pipeline through external innovation, something that investors and analysts have been calling for after high-profile R&D setbacks like failed late-stage trials for IL-6 inhibitor ziltivekimab in heart failure and atherosclerosis.

Has CagriSema come good?

Alongside the analyst and investor update, Novo also reported some much-needed good news for CagriSema from the head-to-head REIMAGINE 5 trial, which showed that it was able to achieve superior weight loss to Lilly's Zepbound (tirzepatide).

In the study, which involved adult patients with type 2 diabetes, a 1mg/1mg dose of CagriSema achieved weight loss of 12.4% at week 60, compared to 9.1% with Lilly's drug, and was as effective at controlling blood glucose measured using haemoglobin A1c levels.

"CagriSema remains investigational, but these findings strengthen our confidence in its potential, add to the growing evidence for amylin biology and reinforce our ambition to advance the next generation of treatments for obesity and type 2 diabetes," said Novo's head of R&D, Martin Holst Lange.