Obesity has become a major global public health challenge. Obesity is associated with more than 200 diseases, such as cardiovascular disease, certain types of cancer, type 2 diabetes, etc. Obesity is the sixth leading risk factor for mortality and disability in China. Currently, about 180 million adults in China suffer from obesity, and the incidence rate continues to rise.
On November 17th, Novo Nordisk announced the world's first and currently the only glucagon like peptide-1 receptor agonist (GLP-1 RA) weekly formulation for long-term weight management, Novo Nordisk&Co; reg; Formally listed in China. Nuohe Ying& reg; Simeglutide injection, used for long-term weight management, can achieve an average weight loss of about 17%.
Smeaglutide has always been regarded as the "magic drug" for weight loss. Tesla CEO Elon Musk's "planting grass" once made Smeaglutide the "popular Crispy fried chicken" in the weight loss industry, which is also due to the considerable weight loss effect of the drug. According to publicly available information, as the world's first and currently only glucagon like peptide-1 receptor agonist (GLP-1 RA) weekly formulation for long-term weight management, Novogene&Co; reg; It can achieve an average weight loss of about 17%.
Professor Ji Linong, director of the Department of Endocrinology of Peking University People's Hospital, told 21st Century Business Herald that the "Internet style" weight loss method of obese patients may cause "weight shock" that is harmful to the body, and even lead to more serious health problems due to improper methods.
Therefore, patients with clinical weight loss needs should go to formal medical institutions for evaluation and diagnosis, and undergo scientific weight loss treatment. Obesity treatment should focus on the overall health of patients and improve long-term outcomes. When weight loss goals cannot be achieved through lifestyle management, medical weight loss treatment, including weight loss drugs, can be combined on the basis of lifestyle management, "said Professor Ji Linong.
Novo Nordisk told 21st Century Business Herald reporters that the company has started applying for the provincial bidding and online listing of Novo Nordisk, and the specific pricing can refer to the online listing price. After going public, Novo Nordisk will expand its network to cover all channels including public hospitals, private hospitals, and pharmacies based on the distribution of obese patients nationwide.
The obesity challenge urgently needs new solutions
With changes in lifestyle and dietary structure, the range of obese individuals continues to expand. The 2024 World Obesity Map shows that in 2020, 42% of adults worldwide were overweight/obese, and it is expected to further increase to 54% by 2035.
Despite the severe challenge of obesity, the public has insufficient awareness of obesity as a chronic disease and the health problems it brings, and has little understanding of professional obesity diagnosis and treatment.
Facing the real dilemma of obese patients, their journey of weight loss faces many insurmountable "obstacles". Firstly, there are still barriers to disease awareness. Patients often attribute obesity to personal responsibility and attempt to lose weight on their own, delaying the opportunity to seek professional help.
Secondly, metabolic adaptation after weight loss limits the long-term maintenance of weight loss. ACTION China et al. found that over half of obese patients in China have experienced a cycle of weight loss followed by weight gain, including those who have experienced it multiple times.
In addition, in the long run, obesity can lower the quality of life of patients or reduce their life expectancy. Therefore, scientific treatment of obesity is imperative. While achieving effective weight loss, attention should also be paid to improving overall health, extending lifespan, and enhancing patient happiness.
Nowadays, "Simei", GLP-1, and weight loss have become hot topics among the public. On June 25th, Novo Nordisk announced that the National Medical Products Administration (NMPA) had approved the company's R&D and production of Novo Nordisk; reg; The application for marketing of semaglutide injection for long-term weight management in China. According to publicly available information, Novo&Ying; reg; It can achieve an average weight loss of about 17%, and its weight loss effect can last for at least 2 years.
According to STEP 1 research, Novo&Ying; reg; The weight loss brought about is mainly due to the reduction of adipose tissue. In addition, Novo&Ying; reg; It brings multiple health benefits beyond weight loss to patients, including but not limited to reducing waist circumference, reducing visceral fat, improving blood lipids, reversing pre diabetes, etc.
A pharmaceutical industry analyst from a securities firm told 21st Century Business Herald reporters that GLP-1 drugs, represented by Novo Nordisk's semaglutide, have achieved great success in weight loss. As the weight loss market continues to heat up, it is estimated that by 2024, the sales of Smeglutide will exceed $28 billion, which may surpass Keytruda and become the new champion of global drug sales.
The new weight loss drugs represented by GLP-1RA have significant weight loss efficacy and good safety, and can bring more health benefits to overweight and obese individuals, which is expected to become the main means of treating obesity in the future, "said Professor Ji Linong; reg; The marketing and clinical application of medical weight loss treatment methods will also be further enriched and improved.
How is weight loss safe and effective?
On December 15, 2023, the top international academic journal "Science" published the "Top 10 Scientific Breakthroughs of 2023". Glucagon like peptide-1 receptor agonists (GLP-1 RA) were ranked first among the top 10 scientific breakthroughs for changing the treatment pattern of obesity, and it was clearly stated that; quot; GLP-1RA drugs have not only changed the treatment of obesity, but also altered people's understanding of obesity as a chronic disease rooted in biology rather than simply willpower failure.
Novo Nordisk also seized the opportunity in the layout of GLP-1RA drugs and delivered impressive performance.
According to the third quarter financial report released by Novo Nordisk, its revenue for the first three quarters was 2.047 billion Danish kroner, equivalent to 29.46 billion US dollars, a year-on-year increase of 23%. Net profit was 72.758 billion Danish kroner, equivalent to 10.47 billion US dollars, a year-on-year increase of 18%. Among them, the revenue contributed by semaglutide is very impressive, with a total sales of 141.213 billion Danish kroner (approximately 20.59 billion US dollars) in the three quarters.
Currently, Novo Nordisk has three types of semaglutide products available for sale globally, including Ozempic (Novotai) for subcutaneous injection of hypoglycemic agents, Rybelsus (Novozymes) for oral tablets of hypoglycemic agents, and Wegovy (Novozymes) for weight loss products. In terms of specific performance, Ozempic's sales revenue was 29.804 billion Danish kroner, a year-on-year increase of 26%; Wegovy's sales revenue was 17.304 billion Danish kroner, a year-on-year increase of 81%. In addition, Rybelsus (oral tablets of semaglutide) generated sales revenue of 5.453 billion Danish kroner, a year-on-year increase of 23%. According to this calculation, the total revenue of the three products in the third quarter was 52.561 billion Danish kroner, approximately 7.553 billion US dollars.
Novo Nordisk's third quarter revenue was 71.311 billion Danish kroner, a year-on-year increase of 22%, and net profit was 27.301 billion Danish kroner, a year-on-year increase of 21%, higher than market expectations. Based on the situation in the first three quarters, Simeglutide's total sales revenue was 20.306 billion US dollars, accounting for 69% of Novo Nordisk's revenue.
Professor Zhu Dalong, Director of the Endocrine and Metabolic Disease Medical Center at Nanjing Gulou Hospital, told 21st Century Business Herald reporters that there are various methods for treating obesity, including behavioral and psychological intervention, exercise intervention, medical nutrition treatment, medication treatment, surgical treatment, and traditional Chinese medicine treatment. In addition, in recent years, digital health tools such as wearable devices, mobile health applications, remote monitoring devices, etc. have been researched and applied in obesity management.
Professor Zhu Dalong further pointed out that the treatment of obesity focuses on health rather than weight, and weight loss is only one of the results of obesity treatment. The currently approved weight loss drugs in China include orlistat (lipase inhibitor), liraglutide 3.0mg (GLP-1 RA), benazepril (GLP-1 RA), and semaglutide 2.4mg (GLP-1 RA). Enoch and Ying& reg; GLP-1RA drugs, represented by, provide an important clinical option for doctors and patients to jointly develop weight loss strategies. It can achieve safe and effective weight loss, and also help patients comprehensively manage cardiovascular metabolic risk factors, improve long-term prognosis, and enhance quality of life.
It is worth reminding that the application of such prescription drugs requires strict adherence to indications. Patients should strictly follow the prescribed medication guidelines to ensure the effectiveness and safety of the medication, "Professor Zhu Dalong pointed out; reg; It is a prescription drug mainly used for the treatment of adult obesity, and the safety of patients' medication must be ensured in clinical practice. This medication is indeed helpful for obese patients, but it is still necessary to maintain a healthy lifestyle after discontinuing the medication to prevent weight regain.
When prescribing this medication, doctors must communicate fully with patients to ensure they understand these precautions. Professor Zhu Dalong emphasized that in terms of medication duration, doctors need to evaluate and judge based on the patient's BMI value and physical health indicators. From current research, long-term use of this medication will not bring side effects.
According to publicly available information, Novo&Ying; reg; Suitable for long-term weight management of adult patients based on controlling diet and increasing physical activity, with an initial body mass index (BMI) that meets the following conditions: ≥ 30kg/m2 (obese), or ≥ 27kg/m2 to<; 30kg/m2 (overweight) and the presence of at least one weight related complication (such as hyperglycemia, hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease).
Reshaping the therapeutic market landscape
According to data disclosed by Novo Nordisk, as of now, semaglutide has accumulated over 22 million patient years of exposure experience.
For obese patients, long-term weight management requires a multi pronged approach, and mastering disease knowledge and self-management skills is particularly important. Novo Nordisk announces the launch of Novo Nordisk's digital patient service platform "Novo Care" and the simultaneous launch of Novo Health&Care; reg; Exclusive version, for both Fangnuo and Ying&amp; reg; The product provides patients with a one-stop health management service platform that integrates customized services such as professional medication guidance, disease education content, intelligent companion health management tools, and "pharmacy map" functions.
From the perspective of market structure, Novo Nordisk Smeaglutide has a strong dominant position in the market, but there are also competitors who can disrupt the market. On July 19th, the official website of the National Medical Products Administration announced that Mounjaro (Tirzepatide), a dual agonist of glucose dependent insulinotropic polypeptide (GIP) and glucagon like peptide-1 (GLP-1) receptors from Eli Lilly, has been approved for long-term weight management in overweight patients with adult obesity or at least one weight related complication, based on low calorie diet and increased exercise. It is worth mentioning that tilpotide is the first and currently the only approved GIPR/GLP-1R dual agonist.
In addition to Eli Lilly, according to the China Drug Clinical Trial Registration and Information Disclosure Platform and public information, at least 9 GIPR/GLP-1R dual target new drugs independently developed by Chinese companies or jointly developed by introducing equity have entered the clinical research stage. These products are from Hengrui Pharmaceutical, Zhongsheng Pharmaceutical, Borui Pharmaceutical, Hansen Pharmaceutical, etc. The indications under development include type 2 diabetes, overweight or obesity, MASH.
According to a research report by China Galaxy Securities, with the commercialization and volume increase of tilpotide and semaglutide after their listing, the global market size of GLP-1 drugs has grown rapidly, and multiple companies are competing to expand into the GLP-1 weight loss field. At the same time, there is still room for further improvement in the penetration rate of GLP-1 treatment in the hypoglycemic field. It is recommended to pay attention to domestic GLP-1 related leaders.
In the increasingly fierce market competition, semaglutide is also accelerating its breakthrough and expanding into more application markets. Previously, Novo Nordisk revealed that the Phase III OASIS 4 study on weight loss with oral administration of semaglutide Rybelsus (25mg) has been successfully completed.
In addition, in terms of expanding indications, in the third quarter of 2024, Novo Nordisk will submit a new indication application for semaglutide 1mg for the treatment of chronic kidney disease (CKD) in China; In the fourth quarter of 2024, Novo Nordisk will announce the results of a Phase III SOUL study on the improvement of cardiovascular outcomes (CVOT) with oral semaglutide 14mg; The results of the Phase III ESSENSE study on the treatment of metabolic dysfunction associated steatohepatitis (MASH) with semaglutide 2.4mg will also be announced in the fourth quarter of 2020.
When it comes to the future competitive landscape of the GLP-1 drug market, Zhou Xiaping, Senior Vice President and President of Novo Nordisk Greater China, told 21st Century Business Herald that competition can stimulate innovative research and development, and promote patients' opportunities to access more innovative treatment options. Currently, obesity has become a global public health challenge. Among the adult population in China, 16.4% suffer from obesity, which means that over 180 million patients need standardized treatment.
"But from the reality, the current situation of obesity diagnosis and treatment is not optimistic. Only a small number of people are being treated. We also hope to work together with more partners to build an ecosystem of obesity prevention and control in China." Zhou Xiaping said that the payment scope of Smeaglutide injection is limited to two cases related to adult type 2 diabetes. Weight loss is not within the scope of payment and cannot be reimbursed by medical insurance. Currently, Novo Nordisk is also promoting commercial insurance, hoping to improve patient medication accessibility.
The above analysts also pointed out that for mature players such as Novo Nordisk, it is necessary to do a good job in brand building and consumer education, and maintain online and offline sales channels on the basis of meeting current needs. More importantly, as an industry leader, it is necessary to further develop and expand oral, long-acting, new targets, and new indications to consolidate our leading position.