Forbes India 15th Anniversary Special

EXCLUSIVE: We are overwhelmed with the demand for Ozempic and Wegovy, says Lars Fruergaard Jørgensen

Novo Nordisk, maker of the blockbuster drugs for diabetes and weight loss respectively, has a market capitalisation of $592.02 billion, making it larger than the entire Danish economy. The company's global CEO talks about its India plans and the need for competition to ramp up innovation in pharma

Naini Thaker
Published: May 23, 2024 11:09:52 AM IST
Updated: May 23, 2024 06:38:15 AM IST

EXCLUSIVE: We are overwhelmed with the demand for Ozempic and Wegovy, says Lars Fruergaard JørgensenLars Fruergaard Jørgensen, CEO, Novo Nordisk; Image: Chris Ratcliffe/Bloomberg via Getty Images

Novo Nordisk, the maker of blockbuster drugs, Ozempic for diabetes and Wegovy for weight loss, is a 100-year-old company. Riding on the success of these two drugs, it is Europe's most valuable company with a market capitalisation of $592.02 billion (as of May 21), making it larger than the entire Danish economy.

The Denmark-based drugmaker has had a sharp focus on four key areas: Diabetes, obesity, rare diseases, cardiovascular and emerging therapy areas. Its insulins have been present in India since 1935. But it began operations in the country in 1992, with its headquarters in Bengaluru. With 1,300 employees currently, Novo Nordisk is one of the fastest growing pharmaceutical MNCs in India.

India is known to be the diabetes capital of the world. As per the World Health Organization (WHO), in India, there are close to 77 million people aged above 18 who are suffering from diabetes (type 2) and nearly 25 million are prediabetics (at a higher risk of developing diabetes in the near future). So, the question on everyone's mind is when is Ozempic being launched in India. Forbes India finds out during an exclusive conversation with Lars Fruergaard Jørgensen, CEO, Novo Nordisk. Edited excerpts:

Q. Diabetes drug Ozempic and weight loss drug Wegovy have seen an incredible response from doctors and patients. Was this expected?

The fact that we have not managed to scale up manufacturing in time kind of hints to the fact that we have also been overwhelmed by the demand.

Q. How long did research and development for these drugs take?

This has been a result of decades of research in diabetes, dating all the way back to the 1990s. Similarly, for obesity, we have been doing research in this area for close to 25 years. So, this ongoing research effort to help our patients resulted in the molecule we know today: Semaglutide. It is one of the many molecules that we have been engineering and testing out. After years of clinical research, where there were a lot of failures, we finally got to a profile that we believed was working.

From a market perspective, the surprise was the steep uptake, because we know from prior generations that medicines in this category did not really take off. The willingness from both prescribers and also patients wasn’t really there—clearly, that has dramatically changed.

Now that we have Ozempic and Wegovy, we can help patients who have been struggling with these diseases for a good part of their life. Not just that, we can also help mitigate some of the other comorbidities that might follow [for those] living with obesity and diabetes.

Also read: All about Ozempic, the diabetes med turned weight-loss 'wonder drug'

Q. How would you rate Big Pharma's recent track record when it comes to innovation? And how would you compare the same to Novo Nordisk?

I think there are two companies who have been in the space of diabetes, particularly sterile liquid products in high volumes—Eli Lilly and Novo Nordisk. While many companies have been active in this [segment] for years, we had a head start. And even now many are trying to get in using different technologies. It will take time for them to build the full capability platform that is required to compete in this space, ranging from research and development to conducting clinical trials, and then also being able to ramp up manufacturing capacity. So, it takes a lot.

This also means that many more companies will be successful, and will help people live with obesity and diabetes. So, competition is good, because it keeps us on our toes. We intend to stay among the top innovators, based on all the experience and learnings we’ve had over the years.

Q. What kind of investments are being made to expand operations in India?

India is one of our biggest footprints from an employee base point of view. We have both a large commercial organisation and a very large service centre, where a number of our strategic services are done out of Bengaluru. We also do clinical development and trials in India, and we have a local manufacturing partnership with Torrent Pharma. So, we also do manufacturing of insulins in India. I think our majority owner, The Novo Nordisk Foundation, is also looking to invest in India and potentially also invest in biotech here. So, India is an important market for us, and we have most of our value chain functions actively taking place in India.

Q. In that case, when can we expect Ozempic and Wegovy to launch in India?

I cannot give you a date. Unfortunately, we are still rolling out. We have a policy of not mentioning dates before we start the launch.

Q. Affordability may be a big concern in India… to the extent when you launch your latest blockbusters here, which part of the Indian market will you address: The mass market or the top end?

It depends a lot from product to product, and how that development goes. Some products are only developed in the Western world and never get to the low and middle-income countries. And in some low- to middle-income countries, you have private segments where there are patients who can pay out of their pockets.

Our belief is that we have perhaps the best opportunity of all players in ramping up manufacturing. In the years of our robust business cycle, we have also invested to get to many more patients, and we continue to do that.

The product we make are biological medicines, steroid liquid products being injected on a weekly basis. This is highly complex as compared to tablets. Had it been tablets, perhaps you could scale easier, but these are biological medicines.

But we are committed to ramp up capacity as much as we can. There's a limit to how much we can do in one go, because these are huge construction projects, but we are aiming to ramp up capacity so that we can serve our patients, also over time in markets with a lower price point.

Q. There are reports suggesting that many Indian pharma companies are looking to recreate their versions of Ozempic. Your thoughts.

Competition is important. If you look at Novo Nordisk and our 100-year-old history, we only ended up as a strong 100-year-old company because we had competition. In fact, two small Danish companies, Nordisk Insulinlaboratorium and Novo Terapeutisk Laboratorium, were competitors until they merged. Now we compete with Eli Lily and the likes.

This means that competition helps you stay under pressure, and that leads to more innovation and commercial success. I welcome competition here. Given the potential customers in India, it takes several products and most likely several companies to build enough capacity to really have an impact and meet the demand.

Q. Looking back, are there certain decisions that you feel you could have made differently?

Yes, I would say in the area of investing in capacity. We could have dared to make some bolder decisions. It's interesting how we are all impacted by our biases. Back in 2017, when I took over as CEO, the company was in no growth or very low growth phase. Access to resources was not as easy as it is today when we’re growing more—last year we grew by 36 percent. So, that low growth territory somehow also biased our view on the future… it was hard for us to push and make those bold decisions.

Looking back, I feel I should have dared to think even bolder and make the decision to invest in capacity earlier. We could have helped even more patients today. It's good to base decisions on your experience, but sometimes your experience actually limits you from seeing the opportunity. So yes, we have a big baggage of experience, which is good. But we also have to be open-minded about future opportunities.

Now we are driving some cultural themes in the company about daring to think bold, and looking at the future in a non-linear way.

Q. What is your vision for Novo Nordisk?

It would be a vision of driving a huge population towards health intervention. So, getting to many more patients than we're serving today, and helping them live the fullest possible life they can. As a company with sustainability at its core, we want to help society turn sustainable as well. Simply put, our vision is to transform our health care system and our population’s health perspective in the coming decades.