Zenagamtide

Novo CEO Mike Doustdar faced a tough crowd as the Danish pharma gathered investors in London this morning for the company’s Capital Markets Day. The meeting took place a week after Novo streamlined its brand, with the pharma trying to turn the page on a bruising period of disappointing readouts, cancelled collaborations and ongoing challenges in the U.S. Doustdar explained to Fierce last week that the company’s leadership “felt strongly that we needed to make some radical changes” to adjust to a “radically changed environment.” With reports leaking out of investors eager to hear concrete details on Novo’s roadmap to sustainable growth, Doustdar opened proceedings this morning by acknowledging that the company’s leadership “have to convince” the audience that “there is a bright future for Novo.” Referencing the speed of change in the obesity space, the CEO pointed out that “so many things are different today” than when investors gathered for Novo’s last Capital Markets Day in 2024. “‘Consumers’ … was not in our vocabulary last time we met,” Doustdar told attendees. “We created an incredibly attractive market, and now almost every single pharma company, big or small, is trying to come and compete with us. We need to be ready for that.” To rise to this challenge, Doustdar unveiled plans for Novo to develop a so-called ‘Consumer Rx’ segment. “What is that? This is where serious condition prescription medication meets incredibly strong consumer demand,” the CEO explained. Doustdar was keen to point out that this initiative is not an attempt to provide consumer care or enter the over-the-counter market. Instead, it’s an opportunity for the pharma to take advantage of the fact that over the last few years Novo has “become second to none … in our ability to take a prescription medication and directly provide that to the consumers.” Disease areas under consideration for this platform include immune-mediated inflammatory diseases, pain and addiction, women’s health and men’s health. Alongside this new consumer-focused avenue, Doustdar tried to rev up investors by promising to “launch at least five multi-blockbusters by 2030.” Unleashing a new blockbuster “pretty much every year” would deliver combined sales of more than 150 billion Danish kroner ($23 billion) in “less than 10 years,” the CEO claimed. In a nod to the fact that Novo’s big hopes for its pipeline haven’t always panned out in the clinic, Doustdar stressed that this blockbuster ambition is “risk adjusted, which means it allows for development risks.” The potential blockbusters include CagriSema—a combination of the amylin analog cagrilintide with the company’s well-known GLP-1 quantity semaglutide—which Novo announced today had beaten Eli Lilly’s Moujaro when it came to helping diabetes patients lose weight. An FDA approval decision on CagriSema is expected next year. Other assets that Novo is banking on include denecimig, a next-gen FVIII mimetic bispecific antibody for hemophilia, as well as zenagamtide, a long-acting co-agonist of GLP-1 and amylin that is being developed as both an injection and pill for obesity. With one and half million people already taking oral Wegovy, meanwhile, Doustdar also made a promise to investors that the company’s manufacturing capabilities will be able to cater to 10 times this number by the end of the decade. However, the sales pitch didn’t seem enough to convince investors, who pushed Novo’s stock down 8% to $39.69 after the first hour of trading on Monday from a Friday closing price of $43.24. One area of disappointment may have been the lack of detail on future M&A strategy. Reuters reported this morning that investors had been expecting a signal for increasing appetite by the pharma for bolt-on deals. But Doustdar’s comments in that regard sounded suspiciously like business as usual. “We have a pipeline almost second to none with regards to obesity and I would even say diabetes,” the CEO said in response to a question from investors. “With some of the other [indications], where you see a gap, you should also expect we probably will be more active in looking in business development acquisitions.” “But we will not start with the size of the deal,” Doustdar added. “We'll start with the quality of the assets and see where that will take us.” One area where the company is looking to grow is blood and endocrine disorders, which are being given their own business segment. As for Novo’s bread-and-butter obesity and diabetes businesses, Jamey Millar, the company’s EVP of U.S. operations, broke down the current and near-term game plan for the ever-important American market, where the pharma is trying to ride the momentum of its head start oral obesity launch over Lilly with the Wegovy pill in January. To that end, Novo wants to “expand the Wegovy franchise overall” in obesity and make inroads with the first potential launch of a combination amylin-GLP-1 product in CagriSema, Millar said. In diabetes, “stabilizing the Ozempic share erosion has been a priority,” alongside the rollout of Novo’s rebranded and reformulated Ozempic pill, which took the place of Rybelsus in the U.S. back in May. Another potential catalyst for Novo—and its metabolic rivals—comes in the form of the Trump administration’s Medicare “bridge” model for Part D beneficiaries, rolled out in July, offering those patients certain GLP-1 medicines for weight loss or management at just $50 a month. The program is currently slated to remain in place through the end of 2027. To hear Millar tell it, the program likely means that many older Americans will now be able to affordably access GLP-1s for weight management for the first time. To keep hold of that momentum, Novo will prioritize efforts to boost access and affordability and strive to build unique offerings in the commercial space, including through its NovoCare patient support platform. The company will also adopt an “outside-in view” from “any customer”—whether that be doctor, payer or patient consumer—and aim to ramp up competitiveness via a newly installed “measurement culture” set against key metrics, Millar explained. Amid Novo’s rebrand last week, the company also set out four new pillars of its business culture, one of which revolves around the concept of “customer obsession.” In framing the philosophy refresh, CEO Doustdar told Fierce last week that adopting the new “Novo Way” means considering the patient in “everything we do, from the onset of research to the delivery of the product to them.” As for the competition piece, the recently installed helmsman also told Fierce that the current fire under the company isn’t about “judging ourselves by what good looks like compared to yesterday”—a likely reference to Novo’s market share and R&D struggles in recent months and years—but rather “how fast others in the same field are running, and how can we be competitive vis-à-vis them.” While acknowledging the changing nature of an increasingly consumer- and telehealth-directed market for GLP-1s and other segments of the drug business, Ed Cinca, Novo’s SVP of marketing and patient solutions, told investors this morning that “as much as things change, some things still remain the same.” “We need strong science,” Cinca said. “We need really strong execution and, of course, strong patient demand—and I think the Wegovy pill is a perfect example of that.” Pointing to the pill launch as a lodestar for how Novo wants to capitalize on future product debuts, Cinca noted the oral medicine’s 17% weight loss data, unique cardiovascular risk reduction label versus Lilly’s rival pill GLP-1 obesity pill Foundayo and positive patient adherence trends. Coupled with all of that, which the executive noted was “pretty heady stuff,” Novo’s swift launch operations allowed the company to make the most of its early U.S. marketing window, Cinca explained. “There’s been no letup,” he added, citing an average of some 285,000 total Wegovy pill prescriptions per week as of today. That same metric for Foundayo presently stands at around 45,000 total scripts, per Cinca. Despite these bold ambitions for both the development and commercialization, Novo has also been on a drive to shrink its headcount. Beyond the 9,000 employees laid off as part of a previously announced cost-cutting drive, Doustdar revealed this morning that a “further 4,000 have left the company.” “These are not easy decisions for us, but they were necessary,” the CEO explained. “They were incredibly important, as we’re using the funds coming through this exercise to fuel for the future, fuel the R&D organization, as well as, of course, make ourselves more competitive.” It leaves Novo with a global workforce of 66,000—15% below the 77,000 employees the company touted two years ago.