ResearchPulse

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ResearchPulse

ResearchPulse

@ResearchPulse1

Katılım Haziran 2024
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ResearchPulse
ResearchPulse@ResearchPulse1·
1/8 CagriSema data – better than the market reaction This is a longer analyse of the CagriSema Redefine 1 data. Enjoy your reading and please don’t hold your comments back. "I will throughout this analyze try and show what that “extra” potential WL looks like. I also zoom in at one of the most often conclusions I have seen. “Only 57% finished the trial at max dose CagriSema. That means it had seriously tough side effects”. I believe that is both a hasty and wrong conclusion." $NVO $LLY $VKTX $GUBRA $ZEAL @GLP1
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ResearchPulse
ResearchPulse@ResearchPulse1·
If you follow $NVO and the obesity space, then this weekly update is highly recommended
Investseekers@investseekers

The Week of $NVO: Wegovy HD Approval, India Price War, Oral Competition and Rising Global Stakes Another packed week for Novo Nordisk. Here are the key developments. Wegovy HD raises the bar • FDA approves higher-dose Wegovy (7.2 mg) • ~20.7% weight loss in trials, close to $LLY’s Zepbound • Launch expected April 2026 Oral GLP-1 race intensifies • Structure Therapeutics reports ~16% weight loss with oral GLP-1 in phase 2 • Citi flags it as a potential challenger to Novo’s pill • $LLY ’s orforglipron shows stronger A1C and weight loss in diabetes India becomes a major disruptor • Semaglutide patents expire • 40+ generics entering, 50+ brands expected • Prices collapsing >50% Investor sentiment remains divided • Bernstein initiates “underperform”, PT DKK 175 (lowest on the Street) • HSBC cuts PT to DKK 280 (Hold) • CCB initiates Outperform Protean buys back Novo after selloff • Cites strong oral Wegovy launch - “The pill is magical.” • Highlights SNAC tech edge (patented into 2030s) • ~8% FCF yield at ~DKK 250 Competition keeps building • Lilly expands access with Employer Connect (~$449/month) • Retatrutide shows strong Phase 3 data • Roche says the market will segment, not winner-takes-all Regulatory and structural shifts • GLP-1 trials challenged as patients drop out (placebo issue) • Growing pressure to compare new drugs vs existing treatments instead of placebo • Sweden reimbursement rejected, Novo appeals Geopolitics and global expansion • Iran conflict could impact operations near Tehran • China signals support for Novo’s presence • Japan: Novo expanding self-pay access and national partnerships New data expands the story • Semaglutide linked to lower risk of depression and anxiety • Suggests GLP-1s may impact more than weight Distribution is evolving fast • $HIMS now offering real Wegovy and Ozempic from ~$149/month • Shift away from compounded GLP-1s Share buybacks continue • 6.58M shares repurchased since Feb • Value: DKK 1.78B #stocks #Investing

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ResearchPulse
ResearchPulse@ResearchPulse1·
Yes thats within reach. Especially since $NVO skipped a dose between 9mg and 25mg. That will cost unnecessary dropouts. I would be surprised if NVO has not launched 3.G before potential launch of oral vk2735. Bringen that “50” mg to the market. Hope they also prioritise to make a trial with that dose between 9mg and 25mg do That 3.G will also reduce API for oral Amycretin. Amycretin will bring higher WL but likely also more side effects. At least as oral
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Michael Albert, MD
Michael Albert, MD@MichaelAlbertMD·
Turns out all those studies that estimated you could make a month's worth of semaglutide for $5 or less were probably correct.
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ResearchPulse@ResearchPulse1·
I would not be surprised to see NVO launch “50”mg wegovy pill with next generation. That will improve bioavailability and thereby reduce the amount need to less than 50mg. But it’s anything but trivial, easy and cheap to develop those formulations. A ton of formulations fail in clinical trials
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ResearchPulse
ResearchPulse@ResearchPulse1·
And $NVO just confirmed through India court that India biosimilar cannot be formulated as Rybelsus. That’s patent protected. But one of the manufacturers want to launch with half the amount of SNAC that’s used in 1. Generation Rybelsus. I can’t see how that can be approved as a biosimilar since that will reduce bioavailability. But seems as they got the approval. That will not happen in Canada without them have data from a larger studie that show bio equivalence plus same effect. Can’t see that happen
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Jen Can NuSH
Jen Can NuSH@JCanNuSH·
That’s just for the injectables, which take far less API. It costs around $50 a month to make the pills in the 25mg Wegovy pill. It’s interesting that the pull is for lower costs on the pills when in fact, their ingredients are more costly. Certainly, not having to deal with sterile pen fills and cold chain storage is a giant improvement overall for distribution.
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ResearchPulse@ResearchPulse1·
India also has a more liberal stance on this than western countries. I will see it approved in Canada before I believe it. Canada and Brazil both push back on synthetic semaglutide for injection. Since its impurities is higher and different than $NVO prices. Both have demanded more data from the synthetic. I’m not saying synthetic will not be improved outside India. But it will take more resources and cost more. But that oral semaglutide from India. That I don’t think will be approved without a proper clinical trial to show bio equivalence and effekt.
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FollowTheFilings
FollowTheFilings@fdzmurillo·
Why no one can copy the pill: SNAC — the patented absorption technology that makes oral semaglutide work. Yesterday (March 20), Delhi High Court confirmed it: Indian generic Torrent Pharma forced to reformulate BELOW the effective SNAC range. If you can't copy it in India, you can't copy it anywhere. $NVO
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ResearchPulse
ResearchPulse@ResearchPulse1·
It’s normal for higher TRx growth than NRx when a new medication has been some time on market. With a new medication then it’s normal a doctor only write a prescription for one months a time. So you have a check-in before getting a new prescription. But when you are doing fine for some months then more and more doctors start to write prescription with refills I’m not a fan of NRx data. Give me NBRx in sted together with TRx
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FollowTheFilings
FollowTheFilings@fdzmurillo·
This is the data point people are missing. NRx +4.5%. TRx +6.7%. TRx growing faster than NRx means refills are accelerating. Doctors are writing multi-month scripts. Patients are staying on the pill. Week 10. No oral competitor. Retention building. And $NVO guided -13% for 2026 while this was happening. At some point the prescription data and the guidance will collide. Q1 earnings is that moment. $NVO #GLP1 #Wegovy
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ResearchPulse
ResearchPulse@ResearchPulse1·
Symphony GLP1 data is out Media reports wegovy pill sales of 70,151 in week 10, but I can see that’s yet again NRx and not TRx Numbers. But NRx is up with 4.5% Surprising small growth this week. Let’s see the TRx data $LLY $NVO $VKTX
ResearchPulse@ResearchPulse1

Week 10 preview of Wegovy Pill sales Tomorrow will bring us wegovy pill sales data from week 10 TRx data from Symphony will be released between 7-8 AM CET. Just before the Danish stock exchange opens at 9 AM. Later at 11 CET IQVIA TRx data will be released. Last week IQVIA data was TRx 81,184 up 10.4% and just above my 80,000 estimates. Last week Symphony TRx 71,990 up with 12.2% and was well above my 69,000 estimates. Week 9 was the first week of “real”data for up titration to 9mg.  Those who strictly follow the titration plan. They will hit 9mg after 9weeks. We should therefore see a new and likely even bigger jump in 9mg with w10 data. Just to reiterate the reason why this is very important to follow. 1.5mg and 4mg cost $149. But that jumps to $299 for 9mg and 25mg doses. With more than 80% of current wegovy pill users that pay cash, it’s only natural that a higher percentage than those covered by insurance will not titrate to the higher and more expensive doses. But what level of up titration should we expect for those paying cash? That’s one of the most interesting/important questions to ask. It will take some months more before we know. Also, since quite a few takes an extra month on 4mg because they still lose more weight. And the best way to use all these GLP1 are to not titrate up to higher doses, when you still lose more at current dose. W9 had 8.1% (up from 6.9%) on 9mg and 25mg.  I expect that to pass 10% in w10. The share of those who have insurance coverage for wegovy pills has been steady at 19% for the last 3 weeks. It’s important to see that number increase before expected Orforglipron launch in about 4 weeks. When IQVIA data is released tomorrow, I will be looking for above TRx 94,000 or more than 15% up. However, we know that it’s still not much more than 50% of total sales that gets reported. And both IQVIA and $NVO have said they expect a much higher share of online sales to be included in IQVIA reporting towards the end of Q1. So, we could potentially see a significantly higher jump than those 14% I mentioned above. I have TRx +175,000 for week 10 when all online sales are included. Bonus info. NVO will have their AGM next Thursday. Followed by an investor meeting. I see it as highly likely that they will show full data up to w11.   Symphony data does not track online data well. But we should get a bigger jump this time. For tomorrow I will be looking for above TRx83,000. Up above 15% Media has for some weeks been reporting the wrong Symphony numbers. They report NRx instead of TRx. TRx = total. So might be a bit confusing until we know exactly what data is released. For comparison Zepbound week 10 from Symphony was TRx 62,516 and IQVIA TRx 55,672 Besides wegovy pill, I would also keep an eye open for wegovy pen and Zepbound data. Both have had some quite good increases the last to week. Will we see a retraction or confirmation….. $LLY $NVO $VKTX PS if any of you readers should happen to have axes access to IQVIA NBRx data I would be very interested

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ResearchPulse@ResearchPulse1·
@fdzmurillo Ahhh that’s not a fair comparison between wegovy pill and Orforglipron. You compare completer data for wegovy with ITT data for Orforglipron. Orforglipron has been pushed 2 weeks. That was announced back in late January I believe. I have not heard of any new delays
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FollowTheFilings
FollowTheFilings@fdzmurillo·
20.7% vs Zepbound's ~22%. Injectables are now at parity. That narrative is over. But the real question isn't injectable pricing. It's this: why is nobody talking about the oral gap? $NVO Wegovy pill: 16.6% weight loss. Approved. 600K Rx in 2 months. $LLY orforglipron: 11.2%. Not approved. Delayed. 48% more efficacy in oral. No competitor on the market. Protected by the SNAC patent that Delhi High Court just confirmed untouchable (Mar 20). Everyone is debating injectable pricing. The oral monopoly is where the margin lives. At $149-$299/month with no injection, no cold chain, no needle aversion — that's how you reach the 100M+ Americans with obesity who haven't started treatment yet. $NVO at 14x P/E. $LLY at 32x. With inferior oral data and no approved pill. $NVO $LLY #GLP1 #Wegovy #SNAC
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ResearchPulse
ResearchPulse@ResearchPulse1·
Wegovy 7.2mg just approved by FDA. Will be launched in April. Patients in Wegovy 7.2mg trial reached 20.7% WL. With 31% losing more than 25%. This should make wegovy more competitive vs Tirzepatide. What about the price……? $NVO does not mention anything about that. I think it will be either same price as 2.4mg ($349) or $399 $LLY $VKTX
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ResearchPulse@ResearchPulse1·
@chiragontwtr @fdzmurillo With only half the amount of SNAC than 1. Generation Rybelsus (3/7/14mg) then I can’t see how they will get same bioavailability and thereby same effect? It’s not the same formulation
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ResearchPulse
ResearchPulse@ResearchPulse1·
@fdzmurillo NVO foundation typically sells the same amount when there’s a buy back. So they will have same share after the buy back.
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FollowTheFilings
FollowTheFilings@fdzmurillo·
Now the part no one talks about: The Novo Nordisk Foundation controls 77% of votes. Under Danish law, 90% of capital = mandatory squeeze-out & delisting. Every share $NVO buys back at $37 and cancels increases the Foundation's ownership — for free. The $2.1B buyback started the day after the pessimistic guidance.
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ResearchPulse@ResearchPulse1·
It’s almost 3 months since sema patent expired in Canada and still no approval of biosimilar. Those produced synthetic have a challenge of get to that “similar” since semaglutide from $NVO is produced by a very different organic process. Canada authorities mentioned this some months ago. And yesterday the same message from Brazil authorities. We will Eventually see some going through to the market. But when, who and how many.
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Ashwin Sharma
Ashwin Sharma@Ashwinreads·
one reason why i’m less bullish on canada as d2c telehealth play when the sema patent expires is because the likelihood is very, very high that insurers will start reimbursing for glp-1s which kinda destroys the incentive for the consumer to pay out of pocket.
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Jen Can NuSH
Jen Can NuSH@JCanNuSH·
🚨Big news day: $NVO Wegovy HD (7.2mg injection) has now been approved by the FDA. Novo Nordisk expects to launch Wegovy® HD in a single-dose pen in the US in April 2026. 18.8% weight loss over 72 weeks compared to 15.5% for 2.4mg. (Efficacy estimand was 20.7% for 7.2mg) ml-eu.globenewswire.com/Resource/Downl…
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ResearchPulse@ResearchPulse1·
It’s symphony data. Meaning no vials. Only insurance. And therefore no cost influence from patients side. It doesn’t get more expensive to titrate up. There’s 3 maintenance doses for Zepbound. 5/10/15. When using insurance you MUST titrate to one of those doses. As you also just mentioned. At least LLY has been clever enough to be sure there’s several maintenance doses which makes it much more flexible for insurance users. Wegovy pill only has one maintenance. 25mg. That’s a BIG mistake. That will for sure lead to higher drop out due to side effects in those using insurance than those paying cash. More cash pay will stay at 9mg for more than just 1 month
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Jen Can NuSH
Jen Can NuSH@JCanNuSH·
I think they know that with the price differentiation, they’re not going to get buy in from insurance for Reta for just anyone. With respect to 12.5: Some insurers only cover the .5 doses (2.5/7.5/12.5) for one box per year, and sometimes, to get prior authorizations renewed, the insurers require you be on 5/10/15. Some of that seems to be going away, but that certainly forced me off 12.5mg earlier than I actually wanted.
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ResearchPulse
ResearchPulse@ResearchPulse1·
62%. But there’s a clear line from 10mg. 12.5mg is the least used by a far margin. Only 11%. So we have 3 brackets. 5. 7.5/10 +10 Data clearly show that going above 20-21% there’s a very visible demand drop. And yet the market, including me, focus 95% on max WL. But interesting how $LLY has begun to frame Retatrutide. Clearly higher WL than Zepbound. By a large margin. But LLY believe GGG is only for a smaller share of the market. Tirzepatide will still be their main/1. Line choice. Could also have something to do with GGG significantly more expensive to produce. But data from the market shows its better to chase other parameters than just higher WL
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ResearchPulse
ResearchPulse@ResearchPulse1·
@bioinvestor24 Wegovy was launched August 2025 and Ozempic December 2025. Looking isolated at india, semaglutid patent expire has no impatch for 2026. NVO will likely get higher revenue of semaglutide in India this year than 2025.
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Bioinvestor24
Bioinvestor24@bioinvestor24·
There are dozens of boring posts on Sema getting generic in India. Not sure why is big deal for $NVO ? How much India contributed in 2024-2025 ? It does have large diabetes population though. And there are humans there who want better products such as $LLY TZP ( seen its rise there ..) and there is an emerging middle class as well that can afford $100-$200 critical drugs ? Why not novo focus on getting something better than Sema rather than just competing with generic companies in India and elsewhere. Something competitive with TZP ?
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Jen Can NuSH
Jen Can NuSH@JCanNuSH·
@ResearchPulse1 @GodSaveCharles That said, 10mg of Zep also has efficacy at the 20% mark. So you only have to go up to the 4th level of the med (6 levels total) to hit that 20% on Zep.
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ResearchPulse
ResearchPulse@ResearchPulse1·
Cmon. You’re clever enough to know there’s something that’s called titration. And you of course constantly needs an inflow of new starters titrate up. What you can conclude is that 2.4mg has an okay side effect profile for many to go up there, but also that 2.4mg is not enough for all in that group, hence xx share move to Zepbound. Looking at zepbound data it’s clear that it’s not all that needs the higher effect hence the biggest group is 5mg. With wegovy HD there’s now an option for those on 2.4mg that still wants to lose more. They now have the option of HD. Before they had to switch. Those who could afford to pay cash makes that switch while those using insurance have been more locked. It’s another tool for $NVO and consumers. It’s about more options
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GodSaveCharles
GodSaveCharles@GodSaveCharles·
@ResearchPulse1 @JCanNuSH 30% of users using 2.4 mg can also mean, many are not going for the highest dose. While you are right that it is the most used dose, it is strange to say that it is preferred. 70% dont want/need 2.4 mg. The question is how many of those 30% will want 7.2 mg.
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Jen Can NuSH
Jen Can NuSH@JCanNuSH·
I think quite a few Wegovy patients plateau before hitting their goals. Right now, if they want to see additional loss, they then switch to Zepbound from Lilly. This gives them an option for staying on Wegovy. Right now, the average Wegovy user with a starting BMI of 35 only gets to just under 30 (29.4) before plateauing (assuming 16% loss) , whereas on Zepbound, they’d make it to about 27.3 (assuming 22% loss) - which is closer to a normal BMI than to obese. (And Zep has multiple studies showing 25% loss, so they might even get to 26.3.) I do think that not adding a step between 2.4mg and 7.2mg (like 4.8mg, for instance) was bone-headed. Here are the jumps in the current titration schedule: O.25 to 0.5 - doubling the dose 0.5 to 1 - doubling the dose 1 to 1.7 - a 70% increase 1.7 to 2.4 - a 40% increase (but same 0.7mg step as between 1 and 1.7) And now 2.4 to 7.2 - a tripling of the dose. It boggles the mind. I think there will be plenty of users who try to make that jump and then regret it and give up. The side effect of dysesthesia (tingling/pain/sensitivity in the skin) - which affected 22% of 7.2mg users - could probably be mitigated with slower up titration - but they haven’t given patients any good way to accomplish that with this jump.
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