Novo Nordisk is betting on the Wegovy pill to win beyond America
Wegovy semaglutide tablets.
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Novo Nordisk He told CNBC how he was preparing to launch the Wegovy pill outside the U.S. as the battle for dominance in the weight loss market went global.
“We’re going to give it our all when we start,” Emil Kongshøj Larsen, Novo’s Executive Vice President of International Operations, said in an interview with CNBC on Tuesday. “This is a great opportunity.”
Novo announced last week that it expects to begin initial launches outside the US later this year, awaiting approvals, after the pill continues to impress with unprecedented uptake in the US.
The US market accounts for more than half of both Novo’s and its chief rival’s sales Eli Lilly. But companies are now increasingly looking for ways to expand the market for weight loss drugs that have revolutionized the pharmaceutical field in recent years.
Larsen did not name specific countries where Novo might launch its Wegovy pill first, saying the drugmaker “will act on the potential,” highlighting factors such as patient interest in treating obesity, how well-trained doctors are and the availability of potential telehealth partners.
Telehealth is a way to expand access to patients, Larsen said, noting that in Germany “it’s been slow for a while, and suddenly telehealth is helping patients access treatment in a very convenient and appreciated way.”
A new phase in the Novo-Lilly rivalry?
Novo raised its forecast slightly last week, but still expects profits and sales to fall between 4% and 12% in 2026 due to lower prices in the U.S. and generic competition in markets such as India, Canada, Brazil and China.
This is despite Novo gaining an early lead in oral weight-loss drugs with the U.S. launch of the Wegovy pill in January. Last week, Novo said total prescriptions surpassed 2 million as sales largely exceeded expectations in the first quarter despite the lower price point.
“We couldn’t have done a better pre-launch in a world that has become so small when it comes to social media, digital, sentiment, etc.,” Larsen said, referring to the US launch. “This is also very exciting for our injectable line because it energizes the entire Wegovy brand,” he added.
Wegovy has become the number one brand for at-home weight loss in the U.S., according to Google Trends data aligned with prescription trends, Nordea analysts said in a note to clients.
Meanwhile, Lilly said on April 30 that more than 20,000 people had started taking rival pill Foundayo since its launch earlier that month.
Foundayo recorded far fewer prescriptions than the Wegovy pill over the similar period, according to IQVIA data, which does not capture all prescriptions but gives market watchers an indication of demand, according to analysts who closely follow weekly U.S. prescription data.
Lilly CEO David Ricks told CNBC late last month that establishing Foundayo as a brand “will take some time.” While Foundayo uses a different active ingredient than Lilly’s blockbuster injectable drugs Mounjaro and Zepbound, Novo’s Wegovy pill is essentially an extension of the company’s injectable equivalents.
“Our ramp will be a little different because it’s a new brand, a new molecule,” Ricks said. “This will take quarters, not days…ask people to get into a rhythm and let us execute.”
Barclays analyst Emily Field noted last week that oral Wegovy and Foundayo are aimed at different patient segments, with the former having “injectable-like activity” and the latter perhaps being viewed more as “starter” GLP-1.
Both Ricks and Novo CEO Mike Doustdar say the pills expand the market rather than significantly increasing demand for injectable drugs.
Worldwide launches
The pill format is appealing to many patients and “we believe [it] It will be copied in our part of the world, Larsen told CNBC, referring to former US markets.
Larsen said the Wegovy pill’s “superior efficacy” meant he wouldn’t worry if it was launched after competition in certain markets.
Novo expects “very strong uptake” of its Wegovy pill internationally, but not necessarily the same kind of curve as in the U.S., Larsen said.
He said the U.S. isn’t a good comparison to other countries because uptake will depend on the relative price difference compared to injectable versions.
“We’re not detailing our pricing approach so far, but you can tell it’s a great product in the U.S., but it’s at another price point compared to injectable treatments.”
He predicted that international sales could have “an optical curve that’s maybe a little bit skewer than the U.S. curve.”
Sydbank analyst Soren Hansen told CNBC on Wednesday that Wegovy will launch outside the US It may be “more selective” and will reflect the company’s “ability to meet demand.” He highlighted that Novo’s home country of Denmark, as well as major European markets such as the UK and Germany, could be early markets for launch.
Larsen told CNBC that Novo sees most of the increase in obesity GLP-1s coming from customers paying with cash rather than national health systems or insurance companies.
“Even in socialized healthcare systems like Denmark, 99% of patients pay out of pocket. We could not have imagined this when we started treating obesity a few years ago,” he added.
In late April, Lilly CEO Ricks told CNBC that international launches gave the company “huge runway.”
“There are a billion people on the planet who could benefit from these drugs…we’re reaching about 20 million now,” he said.
Lilly’s first-quarter revenue outside the U.S. rose 81% to $7.7 billion, driven by a 95% increase in volume. In the US, revenue rose 43% in the quarter to $12.1 billion. “It seems like people love losing weight all over the world,” Ricks said.
President Donald Trump’s so-called most preferred country drug pricing policy, in which prices in the U.S. market are tied to prices in a set of reference countries, has complicated drug launches for many pharmaceutical companies.
How European countries handle drug prices will not affect out-of-pocket launches, Novo’s Larsen said.
“Of course, it is critical that European governments also agree to pay for quality innovations that will change public health, because otherwise investments and clinical trials etc. will continue to move towards the US or China as we are seeing now,” Larsen said.
