Novo Nordisk’s CEO: ‘The future of obesity goes beyond weight loss’

You say that the value of these medicines should extend beyond weight loss. What outcome will define the next generation of treatments?

Our new slogan is ‘Lasting health starts now’. We believe that in five years’ time – perhaps even sooner – the main focus will no longer be on how much weight you can lose, but on the health benefits you achieve. We are very proud that semaglutide/Wegovy is the only anti-obesity medicine currently on the market to have demonstrated a reduction in cardiovascular risk and stroke, improvements in chronic kidney disease, and a reduction in the risk of fatty liver disease. Successful weight loss does not automatically mean a reduction in cardiovascular risk or fatty liver disease: these are health benefits. We are also investigating these medicines in other conditions. Some will be intended for people with advanced-stage NASH, with or without obesity; others will be tested in alcohol-related liver disease and in addictions. We are also investigating the benefits associated with reduced inflammation.

The Gipr and Gcgr co-agonist has reignited the debate over just how essential GLP-1 really is for weight loss. Is Novo exploring approaches that are entirely GLP-1-free, or does it believe that the future of metabolic medicine will remain tied to GLP-1?

There are many different approaches to treating obesity. We were amongst the first companies to enter this field and the first to launch a GLP-1 for obesity, first with a once-daily product and then with a once-weekly one. We have now also been the first to bring GLP-1 tablets to market. But we are not stopping there. We are interested in the biology of amylin in combination with GLP-1. We have two triple agonists in the pipeline that we hope to bring to market by the end of the decade: one combines GLP-1, GIP and amylin, the other GLP-1, GIP and glucagon. We also have single molecules and combinations, ranging from amylin as a stand-alone treatment to injectable and oral versions of some of these mechanisms. Taking into account the global number of people with diabetes, obesity and those who are overweight, the figure rises to two billion. They will have different needs, so we need to explore all these options.

You state that you intend to cater for every future market scenario with both oral and injectable treatments. How will you decide which patients should receive one formulation or the other?

We need to understand not only patients’ needs, but also their preferences. Our surveys show that the majority of people with obesity prefer a tablet. We must therefore make treatment simpler: a medicine only works if it is taken. There are around six million Italians with obesity, but at present we treat only 2 per cent of them. Many people prefer the tablet because they do not want to have injections. Our medicine enables a 17 per cent weight loss, whilst the competitor’s product enables a 12 per cent weight loss. In addition to weight loss, they recognise health benefits in our tablet that do not appear on the competitor’s product label. And they consider it easier to take.