Ozempic is the hot drug for weight loss, but its original purpose was to help diabetics – putting its creator in a bit of a bind. Wired contributor Virginia Heffernan joins host Krys Boyd to discuss how Danish drugmaker Novo Nordisk is stretched thin as demand for the drug skyrockets – and how President Trump’s designs on Greenland might actually affect supply. Her article is “The King of Ozempic Is Scared as Hell.”
- +
Transcript
Krys Boyd [00:00:00] Imagine you’re in charge of a huge pharmaceutical company if your scientists develop the buzziest new medication in decades, something in unprecedented demand that patients might need for the rest of their lives. That would be a very big thing. And the potential profits might surely justify any ramping up of production facilities around the world to meet demand. Given that thought exercise, it might surprise you to learn that at the Danish company Novo Nordisk, the astonishing success of Ozempic is generating mixed emotions. From KERA in Dallas, this is Think I’m Krys Boyd. Ozempic was originally developed to help people with type two diabetes and it can. But its most celebrated side effect a significant diminishment of appetite that often leads to weight loss. Has convinced many millions of people that they want this drug or a competitor in the same class. And that has created some conflicts for Novo Nordisk, which has long operated first and foremost in service to people with diabetes, including those who cannot live without supplemental insulin. Virginia Heffernan is a contributor at Wired. She’s co-host of the podcast “What Rough Beast.” Her article, “The King of Ozempic Is Scared as Hell” appears in Wired. Virginia, welcome back to Think.
Virginia Heffernan [00:01:15] Thank you so much for having me back. Hi, Krys.
Krys Boyd [00:01:17] Honestly, when a headline sets us up for a story about a major global pharmaceutical company, I think most of us brace ourselves to read about corporate greed at the expense of patient welfare. This story is fascinating because it’s far more complicated than that. How did the company, now known as Novo Nordisk, come into existence in the first place?
Virginia Heffernan [00:01:37] Well, I’m so glad you said that, that it turned out not to be about corporate greed. I mean, the pressure to write about a pharmaceutical companies, including internally to me, to write about them as monstrous and rapacious and cutting corners is really enormous. And I did I did face that down a little bit in myself. And I had when I when I went to Copenhagen, when I went to Denmark, to their headquarters to try to understand the company, I had to almost suspend my American sense that runaway capitalism was driving every decision made shareholder value. It market cap was driving every decision made by CEOs of giant companies like Novo. And what I found was surprising, this sort of moral anguish at the heart of the company, which which I found, which I found really interesting. And, you know, I took I tried very hard not to be overly enchanted by the company. And it does have some problems, but it is fixated on improving the lives of patients. And it’s run by a foundation. And the story of its founding is really interesting. And and it really is unlike, say, companies, when they develop more cheaply made medications that have a lot of pop culture value like Viagra. They have this very expensive, very beautifully developed, elegant drug ozempic. And then wegovy which is the same product, but in a higher dose for weight loss, that that doesn’t actually lend itself to this kind of blockbuster commercialization. And that’s a little bit what they’re stuck with. So I can tell you a little bit about the company or tell you about the straights they’re in right now. The situation the company is so enormously interesting and the culture in which it’s found itself. It’s true that there’s a lot to cover.
Krys Boyd [00:03:44] Well, let’s do the background first. You mentioned, you know, its unique founding. You spent some time with a spry 85 year old named Erik Hageman. What is his story in relation to Novo Nordisk?
Virginia Heffernan [00:03:56] So, Erik, it’s actually Hageman in Danish. It looks like Hageman when he was two years old. So in 1942, the Nazis were occupying Denmark. And that year that he was two, he was a working class kid. He tripped over literally his clogs. So just to put it into context, he was out in the ice and then he was coming in from having helped his janitor father shovel a walk at two and then tripped over these clogs. So that sets the scene a little bit. While he was recuperating, he from this quite traumatic fall, he started shrieking for water. His urine turned sticky and sweet. In those days, one of the tests for sugar urine was actually tasting urine or seeing how much it stuck to, say, a piece of toilet paper. The doctor diagnosed diabetes type one, and we sort of think we’re familiar with what the differences among the two types of. Between the two types of diabetes. But just to be clear, that’s an autoimmune condition in which the body attacks the pancreas. So he could not produce insulin. And the Nazis considered this like a bloodline poisoning. That eugenics was very much in the air. And Erik told me that, you know, there was a lot of discussion that possibly the trauma had triggered this problem in his bloodline. And his doctor the doctor ended up saying to the Hagemans, to Erik’s parents that their little son, they didn’t have to worry because if they did nothing, their little son would kind of no longer be a burden to them because he would die of acidosis or starvation.
Krys Boyd [00:05:49] Why did he not die?
Virginia Heffernan [00:05:51] Well, he didn’t die because his father and as I said, he was a custodian and he went to work in the in the few days that they can for short periods of time with basically a starvation diet. They were keeping children alive with like coffee and some greens. And the pictures of them are just essentially emaciated children that live without insulin. So he was facing that possibility or just the possibility of letting his child die. And he mentioned this in anguish to his colleagues. And Denmark is so small that one of these coworkers essentially knew a guy who was working on insulin. And that person was named. Hagedorn, very close, Hageman. Hagedorn and he and his partner, who won a Nobel Prize, were already getting famous by refining insulin from the pancreas of cows and pigs and using it to using their particular formulation of it to work well in humans. So they were taking it out of animal pancreas and making a way for it to stay and be metabolized in the body of human beings. He went to see Hagedorn and he found him kind of crazy, and he was indeed crazy. Their stories of how he went to try to synthesize pancreas, synthesize insulin from the pancreas of Wales in South America, I mean, sat out a lot of I think Antarctica and and he he that failed. But anyway, he was exactly your idea of a kind of mad scientist with a mission. And he managed to get Erik on a kind of insulin that he developed as Hageman was hospitalized, developed it to stay in his body. And by the time he was five, Eric was injecting himself with with insulin himself. And he is very mischievous way. And he would say it’s cheating. It’s sort of part of being part of being diabetic and that sometimes he would let himself eat a little extra sugar by giving himself a little more insulin. And and he just. There was an idea when I talked to him that these conditions, any kind of hormonal condition like this or autoimmune condition is not your fault. And I think that paved the way to thinking about obesity and weight gain and pre-diabetic conditions, metabolic syndrome as simply not your fault. It’s not obviously a bloodline poisoning or eugenic problem, but it’s also not a moral failing. And that’s something that Erik has been saying. You know, he’s 80. What is he now? I think he’s he may be 85 now and he is alive and well. He’s the oldest living diabetic in Denmark. And he is just wants to talk about these conditions as actual just medical conditions that can be treated. And I was very moved by his story.
Krys Boyd [00:09:13] So this has been part of Novo Nordisk founding mission from the beginning. As you reported, the company’s executives seemed genuinely proud of this role. They have carved out serving people with diabetes. How much of the world’s supply of insulin is currently produced at Novo Nordisk?
Virginia Heffernan [00:09:31] I mean, that is that is the great question. So, you know, we are Americans. We’re used to so many things going on in our country. Denmark is I think Denmark is much, much smaller than the in population than New York City with only 6 million people. And the pride of their country is the biotech’s first golden molecule, which is like synthesized insulin. They supply half of the insulin in the world. So all the other companies that make insulin make the same amount that they make at Novo Nordisk on this tiny in this tiny Scandinavian country. So it is the pride of the country that they they keep so many of the world’s population alive, the type one diabetics.
Krys Boyd [00:10:22] This is a very wealthy company. Now, I think you said it is the wealthiest in Europe. It does have shareholders to answer to as a publicly traded company. But you alluded to this. The controlling shareholder is this philanthropic foundation. What is the mission of the Novo Nordisk Foundation?
Virginia Heffernan [00:10:40] I’m so glad you brought this up, because this was especially difficult to explain to my editors because just like we can’t imagine having only 6 million people in such a carefully regulated market. It’s almost impossible to imagine a huge company like this. As you say, the biggest in Europe, bigger now than LVMH, the luxury goods company that makes Louis Vuitton in France. And it is controlled by an altruistic foundation so that the controlling shareholder to whom they’re responsible is this is this foundation. And so why, while Novo is acting coldly and tactically like an oil and defense or defense company, you know, doing these a more like as, you know, as if it were an amoral company as it has to do that to please some shareholders. It is ultimately responsible to the Novo Nordisk Foundation, which is the biggest foundation in the world. I think maybe it’s twice as big as the Gates Foundation. And, you know, for aspiring biotech people and scientists and people in medicine go to their site because they it is amazing how many scholarships and fellowships and grants they give small projects. And then they also work with the Gates Foundation on massive vaccination programs and environmental programs. And, you know, to be in the presence of of the Novo Nordisk Foundation, you would not think that we are at a time of political crisis elsewhere in the world. They are sort of persisting as though they can make some enormous good in the world.
Krys Boyd [00:12:26] Virginia, How many people in the world have diabetes?
Virginia Heffernan [00:12:30] So it’s 830 million people. It’s given us the estimate for people who have diabetes and projected to increase to well over a billion by 2050. So type two is rising everywhere. Type one diabetes is pretty constant.
Krys Boyd [00:12:49] Is there any possibility that President Trump’s stated desire to possess Greenland, which is largely self-governing but still under the control of Denmark, could have an effect on Americans access to Novo Nordisk product?
Virginia Heffernan [00:13:03] I’m also glad you brought this up because the the fact I was in Denmark and at the headquarters after the election, but before the inauguration and before the saber rattling by the current president about buying or occupying Greenland or somehow terrifying Novo Nordisk so much that Denmark would be forced to accede to his wishes about Greenland. And I know that they are quite not no novo, but Denmark itself has expressed like quite a bit of agitation and and and fear about Trump’s designs on on Greenland, even as they say they are completely unwilling to sell Greenland or let it be occupied. As for Novo, they the threat to novo currently comes less from Trump’s threats of tariffs than two things. One is especially strange and the other one is as to be as like as we might expect. So Eli Lilly, you mentioned that the drugs ozempic and wegovy that are called semaglutide drugs have competition and other drugs in their class. And the main competition comes from these Eli Lilly drugs, which came out after ozempic so they were following on the research at Novo Nordisk that use another version of the same drug. And they have been really good about getting out their studies. They are not controlled by a foundation and don’t have the same environmental obligations, social justice obligations. You can see that for me, the thumbs on the scale for Novo, but also do extraordinarily good research and have always been in the insulin business, same as Novo. But anyway, they make these two drug stores that you may also have heard of called Zep Bound for Weight and Mounjaro for type two diabetes that operates very much the same way as Semaglutide does at Novo. So that’s one of the main things that they have competition from a company that had some some very good results. And also this goes to the second thing maybe affecting Novo. The studies that came back for the Lily drugs show more weight loss then wegovy. So basically the elegant molecule, this golden molecule sort of second gold molecule on semaglutide, this incredible, extraordinary drug that does so much even for your kidneys, for your heart, for your diseases like sleep apnea or PCOS, but also causes weight loss is now seen by the market as entirely about weight loss and weight loss by the numbers. So people are now wanting to see not 12 pounds, you know, which is what was what happened to happen with the first iteration of ozempic. But they’re wanting to see like 30, 50 pounds. They’re wanting to see people lose huge proportions of their body weight. And the market has just and it’s like clumsy reading of pharmaceuticals just decided that it all comes down to one number. I was joking in the piece that until they see 100% weight loss, well, the market go crazy. So recently the market Wall Street has even sued or investors have even sued Novo because their latest drug did not induce weight loss more than 22% of the body. I mean, there are a lot of people I know who, you know, are sturdy sized but could not stand to lose 22% of their body weight and 22% by the new drug at Novo is more than wegovy causes, but it’s less that Novo predicted. So they thought that their law and these are very long studies that they’re that they would get to 25%. It came in at 22%. And Wall Street just, you know, slammed back at them. And so the price dropped just as we were going to press they lost a lot of market cap. I think it was it’s funny. I keep forgetting. Do you lose more weight or did they lose more market cap? It’s something like 22%, 25%. I just started to think that this, like whole model of all the drug should do is just eat away our flesh. It’s just such a crazy way to think of it. And of course, it’s the way American investors thought of it. You know, at Novo and I don’t want to say this company is all noble, but at Novo they were really thinking about other effects that the new drugs have. But anyway, so those are the two main threats that people are more interested in. Lily now because they’re American. Their drugs have shown some have gotten some good results lately. They were initially showing more weight loss and now this disappointing study by Novo once again, hardly disappointing at 22%, still more than still more than the Lily drugs, but disappointing to Wall Street really cost them this kind of market crash. So I’m not sure if there are more. There are. They’re worried about tariffs as much as they are about kind of scrambling back in the race with Lily. That said, yeah, this is a very worrisome time for them and they do the vast majority of their business in the United States. So that’s a place they’re watching, clearly.
Krys Boyd [00:18:24] How did Nova’s commitment to diabetes care play into the development of Ozempic?
Virginia Heffernan [00:18:31] It’s actually amazing that we believe that ozempic just kind of sprung on the world. I was very surprised to learn that they’ve been working on a type two diabetes drug along these lines since the 90s. And even earlierm, they were doing tests and developing. Yeah. 91 I guess that’s the year that Lott. So a lot of women work in high places at this company which I also want to flag. You know, it’s an egalitarian society, but also they’ve made a real effort to make it an egalitarian business. Anyway, she was trying to think of a new treatment for type two, and she ultimately, over 18 years, developed a medicine for type two called Liraglutide. And I urge anyone interested in this stuff to look it up because it is just such an elegant solution to the ends up being a solution to the problem of runaway hunger. Essentially so Liraglutide though, only worked for a day in the body, so you would have to do a shot every day and type two diabetics or pre diabetics or people with obesity don’t like and aren’t used to doing that many injections. So Liraglutide didn’t catch on in some powerful way, but people were amazed at this feeling of I call it blood sugar equanimity. Like even with Liraglutide, you would take it and it sort of says to the body, like peace, food is available. It’s like the hungry soul is briefly satisfied. And then from there, though, but remember, it’s only satisfied for a day. So people’s hunger would kind of come roaring back after it. And also the blood sugar volatility. So Gasper Lao, who was the next scientist to take this over under his direction, invented Semaglutide the French for some men for a week. A week infuses the body and the brain for seven days. So that’s the one we see now. Semaglutide. And so one of the interesting things about it is the sort of hormone that causes this feeling of such satiety and the slower stomach emptying is secreted in the brainstem. So we really are talking about a hormonal and not a it’s not it’s not so much a function of like intestinal or appetite or all the places that we think appetite exists. It works somewhat more like an antidepressant than like a, you know, a diet pill.
Krys Boyd [00:21:08] So it was a huge breakthrough to be able to just make an injection dose that could be given just once a week. Ozempic, as we all know, has taken off.
Virginia Heffernan [00:21:17] Yeah. But what you kind of want to sing the jingle?
Krys Boyd [00:21:22] I have it memorized.
Krys Boyd [00:21:31] What’s so interesting is that those jingles are not heard hardly anywhere else in the world. Right?
Virginia Heffernan [00:21:38] It’s astounding. So, yes, Ozempic is not considered like a commercial product that you’re like trying to go online to get or or that all these small companies exist to give to people or there’s not discussions of Does she or doesn’t she?In the rest of the world except New Zealand, because the United States and New Zealand are the only countries in the world that allow advertising prescription pharmaceuticals to consumers. These are like doctor made decisions. So while they’ve heard of ozempic, they don’t go to their doctors asking for it. They have like elaborate hour long hours long meetings with their, of course, socialized, you know, universal health care providers. And then they sort out their hormones, their neurotransmitters, their sort of depression, their sleep cycles. And this is one of the things that they might be given for pre-diabetic conditions or for weight loss. But there’s nothing like the kind of let’s go get this stuff. Like women of the 70s used to go get speed pills for to lose weight. That’s it. Just not how it’s considered. And that’s almost entirely because it’s not advertised.
Krys Boyd [00:22:52] It is advertised in the United States. There’s also a lot of lobbying spending being done by Novo Nordisk here now, right?
Virginia Heffernan [00:22:59] That’s right. So that is something that I started to look back and see how. Yeah. So Novo pays about $5 million a year to lobbyists to get lawmakers on its side. And I’m not totally sure where that stands in relation to say I might have looked it up, but to. That’s a lily or, you know, it’s God manufacturers or other big lobbies, but they actually do have to handle the law and lawmakers a lot because of the chaos of American health care. And and that goes down to, you know, these obscure businesses that many of us only found out about actually after Brian Thompson of United Health was assassinated, including just all kinds of red tape that makes it different, difficult for consumers to get get pharmaceuticals at a fair price and also difficult for pharmaceutical companies to keep their drugs on the list of of benefits are covered drugs that that that people who have insurance can get access to. The reason I’m stumbling is that these things are so crazy in the United States that a huge amount of Novos business is dealing with legal complexities and political complexities in the U.S..
Krys Boyd [00:24:29] It is complicated, but it’s really important to understand you’re referring here, I think, to pharmacy benefit managers. Companies like Novo Nordisk have been raked over the coals very publicly by lawmakers because this drug is so expensive here and saying you need to lower your prices. It’s not like Novo Nordisk isn’t entirely in control of how much people pay at the consumer level.
Virginia Heffernan [00:24:55] That’s right. And so there was there was a kind of amazing hearing led by Bernie Sanders last year where he grilled Lars Jorgensen, the CEO of the company, and Lars Jorgensen, whom I spoke to, had been very eager to go testify because he wants on television to sort of hopefully educate lawmakers and the public about the bind that Novo finds itself in. So PBMs are yes, as you say, pharmacy benefit managers, and they are like CVS Caremark. There’s a division of UnitedHealth, a kind of associated part with UnitedHealth. And they maintain the list of drugs covered by insurance. Now, they also are just frankly, middlemen who they yeah, they administer drugs for health plans and they negotiate with insurance companies and they maintain this list. So there’s this crazy catch 22. It must be the definition of a catch 22, where politicians, including Bernie Sanders, have made much of how how drug companies inflate or like if they’re just selling widgets that they could sell all these drugs at much less, but they choose to sell it much more at much higher rate. And yes, there are like shipping costs and other things. But but mostly there’s a lot of given the price and the greedy companies always keep the price high. And Jorgensen came to the US and just tried to say no, that this the reason that we have low prices in places at lower prices in places like Germany are not just because, you know, as Sanders had said, we want to prey on overweight Americans, but because every other place in the world practically had socialized medicine or as universal health care. And they don’t have or have middlemen like PBMs who do this crazy thing where they if you drop the price of your drug too low, the PBMs will drop it from the list of covered drugs because they don’t get their cut so novo in response to pressure from lawmakers drops the price of some of the drugs. Then the PBMs drop them. I’m afraid to miss their cut, drop the drugs and then no one can get them. In the US, this happened with one of their drugs, which was an insulin product that just vanished December 31st, not long ago because it he said they lowered the price in the US by 65% in response to people saying insulin is so expensive. And just to realize that they when they dropped the price, the PBMs dropped coverage and then they just couldn’t make the numbers work.
Krys Boyd [00:27:53] Lots of blockbuster drugs are relatively simple and inexpensive to formulate. That’s not the case for insulin, right? For a drug like Lev Amir.
Virginia Heffernan [00:28:03] Essentially, we can write, restructure DNA, but we can’t make life. So you need something that’s a cell that can reproduce. And in a biological drug like insulin or semaglutide, you don’t just make it out of chemicals, inert chemicals. So just like a factory that’s making tablets of Tylenol or Viagra. But to make something like insulin, which works biologically in the body, it works like a hormone. You need a living cell. Then you engineer the DNA in it and then let it reproduce. So one thing that’s crazy about it is you’re, you know, the facilities smell like breweries. They’re just yeast. And there it’s bubbling, living a living microorganism. Like I say in the piece, that’s a little more like tending a garden or raising an animal or a child than it is like building something out of metals or chemicals.
Krys Boyd [00:29:03] Virginia, as we mentioned earlier, Novo is a publicly traded company. A controlling shareholder is this foundation. But there are people who presumably put their money into Novo Nordisk because they want to make money back. What kind of pressure are leaders at Novo Nordisk facing to yield to the temptation to make a lot of money from Ozempic and take their eyes off the ball a little bit on producing insulin in its many forms?
Virginia Heffernan [00:29:33] Yeah. So you know this they’re not the only company that and in fact all pharmaceutical companies use their profits to fund research. And one of the arguments that they make that, you know, it should be pharmaceutical companies and not governments that do research is that they have a lot of money, especially if they have a highly commercial drug like ozempic. So that is built into their model. But at the same time, insulin is not a growing business. We’re not they’re not more type one diabetic to our insulin dependent. Year after year, the number is fairly consistent and there’s not a whole lot of room for innovation in insulin. You know, Novo invented the pens, you see. They track they now have invented more green products that let you that are reusable, not single use plastics. There are insulin that lasts longer and shorter in the body that’s better for like pregnant diabetics or or athletes or older diabetics. But in general, insulin is insulin. It’s still I mean, it’s engineered now, it’s not taken from animal pancreases, but that’s what it is. And it’s not a business other people want to get into. So. Rather but rather than just. But Novo has this longstanding responsibility to type one diabetics, and it sees that almost as a calling, as just something way more. It’s the beginning of the whole company. It’s you know, it’s Erik Hageman, who we talked about earlier. It’s it’s it’s just it’s whole reason for being. And they will never abandon type one diabetics. They just they talk about them. They talk about them like children. And they are like just dependents like that. They they feel like love and care for and almost talk like they’re social workers thinking about this population. And then it comes to pleasing shareholders. And, you know, they were always they always did did perfectly well. I should also add, by the way, that insulin, because of the pressure to bring the price down so low in the United States that they now they if if your insurance company doesn’t cover it and you have to pay for it, there are easy ways to get it paid for. Novo has a if you’re anywhere between 0 and 4 x the poverty line in the US, they’ll give it to you. Absolutely Free insulin. I mean, and the only other place they do this is at refugee camps and in war zones. The United States has just made it so difficult for people. So that is that that is the part of their business that is entirely mission driven. Now, then they have this other drug as epic. But there’s some crazy details but may not even be worth going into because they’re so complicated. But there’s a certain kind of basically government arbitrage. If someone comes up for it comes up. If one country comes up with a cheaper version of a drug and they start, then other nations have to start making that drug if they want to compete. Like, you can’t just keep controlling a market with your higher drugs. They just price fixing and drugs. That’s just immoral. So there are efforts to make the weight loss drugs or the type two drugs more cheaply. And if Novo has to shift some of its facilities to make non biologic drugs, we were talking about how complicated biologics are to make to make the chemical drugs. Then what if the chemical drugs don’t serve the insulin patients the way they the type one patients, the way they want them to be served, or other people lose interest in making chemical insulin. You can’t miss a day of this. And they take years to change a facility over to make this new drug. Then what’s going to happen to their original patients? And so that’s how governments and in the US markets, politics, lobbying, marketing all ends up affecting how patients get served. And when when Lars Jorgensen, the CEO of the company, told me he was scared as hell, that’s what he was talking about. The idea that people without a commitment to insulin patients will start making a cheaper version of it and then lose interest or not stay committed to type one diabetics and that they in turn would have to change their facilities over to it in order to accommodate this arbitrage. And then they couldn’t take care of them. So that’s the complicated finances of this. But also, I’ve never heard a company with such a moral mission that, you know, Jorgensen was practically in tears thinking about the prospect of not accommodating the half of the type one diabetics in the world that he feels responsible to.
Krys Boyd [00:34:24] And it’s not even as simple as letting this blockbuster drug ozempic make all the profits. And there is will stipulate here there’s a medical need for ozempic for a lot of people, this is not a drug that is strictly being, you know, given to people who want to lose ten vanity pounds. But but it’s not even like Novo Nordisk can keep making this drug. And therefore, like finance, it sounds like finance. The work they really want to be doing, serving people who are insulin dependent.
Virginia Heffernan [00:34:52] Yeah, it’s the drugs are made the same way. They’re both made in yeast but with a different DNA structure. So a different protein, amino acid structure. But but it’s true that if they they can’t quite do it that way. First of all, there’s tons of competition now in the GLP one class, which is the Semaglutide class and also the class that the Lilly drugs fit into. There’s now more competition. Two, soon they’ll be a generic. I think they only have like 5 or 6 years left on the patent and as a generic they won’t you know the profits will the company will just go back to where it was. The profits are nowhere near what they are, what they are with a with a branded drug. And the ads will go away. And and so so yeah, it’s not a question of, you know, having one commercial product that doesn’t need that. You can just like release on the world and it’ll always sell like a mars. Or whatever. Snickers bar. And then. And then this kind of loss leader commitment. That is a nonprofit commitment. But I mean, OPEC also, there’s pressure. There’s downward pressure on the price for the semaglutide drugs, of course, because, as you say, they are not just vanity drugs. Right. Like if they were making speed diet pills to offset the losses from insulin, then it would be a different thing. But they’re also making a drug that’s very needed in in developing nations that’s very needed elsewhere, that is covered by insurance in many places. And so there is the same government pressure to make that as cheap as possible. And I just ended up very much not envying Novo Nordisk that they have to balance their moral commitments, their ethical commitments, their scientific commitments and all these commitments to governments and markets. And it’s just it’s very difficult business.
Krys Boyd [00:36:51] Given this competition from other companies sort of breathing down the necks of Novo Nordisk for the next innovation in GLP one. I know a lot of people are hoping to find a pill that you could take rather than even dealing with an injection. Yeah. Is Novo also trying to develop updates to this drug that has turned out to be quite problematic for it?
Virginia Heffernan [00:37:11] Yes, it is. And that’s the drug we talked about earlier, the drug that has yielded 22% weight loss. But that’s not quite enough for the markets. So that is a hybrid that works on two different hormone sections. And I don’t know that much about it because frankly, these test studies, they were very secretive about it when I was there, and these two studies just came out. It’s not commercially available yet, but it does it is one of the things they’re working on. And then, of course, they’d love to have a monthly injection. One of the one of the ways that working on insulin on these drugs is similar and it would be harder, I think, for a company used to making chemical drugs so used to making like OxyContin or something could not really break into this business. Is that getting these drugs to last in the body is the first thing that they started to do at Novo with, you know, as we were talking about some of the first patients, the problem was they just had to have like a constant stream of insulin and even from animals. And even that wasn’t enough. And then making it last in the body is the major innovation for insulin. And similarly, it’s the major innovation for Semaglutide. So they’re trying to make versions of of example as epic. And we go we that last even longer than a week. So that could be a big innovation and also go under patent. And and and then of course their delivery system so they’re pretty committed to not giving it out in like single use pens because as I said, they have these obligations to the environment and also their facilities tend to be incredibly green. It’s astounding the lengths they go to. And so there are a lot there’s a lot of innovation in how the drugs are made. So in the facilities and how they’re verified, how they’re all that stuff, there’s lots of AI involved and also in how the R&D happens. So there’s innovation there. There’s ways that they can be produced at broader scale there. There’s so much demand for the drug so there is innovation possible and that innovation will keep Novo profitable after the epic patent ends.
Krys Boyd [00:39:27] You know, you made this point earlier, Virginia, that it’s important not to think about type two diabetes being anyone’s fault. It’s important to think about obesity not being anyone’s fault. This has been an interesting journey for the folks who run Novo Nordisk, hasn’t it?
Virginia Heffernan [00:39:42] It really, really has. So, I mean, I again, I’m five. I promise. I’ve never, you know, hero worshiped a CEO before, but he also was incredibly moved talking about his own what he called personal journey with thinking about weight in other people. He’s very slim and athletic. And he said specifically that he was guilty of stigmatizing people with overweight and obesity. I think that the company had dealt with diabetics for so long and had just thought, well, in addition to taking insulin, you know, you need to do all these things with your diet to bring down this. And weight does correlate with type two diabetes and also with low blood sugar issues. And that, you know, if they just picked up a marathoning habit and, you know, went down to a keto diet, that they would just be fine. And since then, he’s realized the complexity of body weight. And, you know, I myself stay away from calling it obesity because it’s difficult to call just the size of a body pathological. But he does talk a lot about the genetic dimension of. Body size where you live, your socioeconomic position. They’ve done a lot. They novo have done a lot of sociological studies about food deserts where you can’t access fresh vegetables. The culture you live and work in. And also just what seems like the exhaustion of many of our bodies to. The abundance in response to the food abundance in the United States. Now, I don’t want to speculate too much about this, but there are ways that the hormone in question that’s being treated by semaglutide drugs responds to the thought of food or the presence of food. And if it jacks up too much and then is fed a lot on top of that, it can have this confusing response on the satiety, on your satiety, and on your sense of satiety. I think this goes with people’s hunch that there’s something about living around this much bounty, this many images of food, this much food itself that has done something to confuse our intuitions about eating. And I think that this drug treats it that way. So I think he now sees this is Jorgenson again, just to bring this back around, he sees body size as not a result of some kind of discipline or moral moral failure, but as shaped by so many different components that maybe have effect on your on your hormones and that can be treated with a hormonal drug that could might be likened to like hormone replacement therapy for menopausal women or melatonin for sleep, that some hormone hormonal system is somehow out of balance.
Krys Boyd [00:42:31] Virginia Heffernan is a journalist. She’s a contributor at Wired, which published her reporting under the headline “The King of Ozempic Is Scared as Hell.” She is also co-host of the podcast “What Rough Beast.” Virginia, this has been so interesting. I really appreciate you making time to talk today.
Virginia Heffernan [00:42:48] Thank you, Krys. I’d love if we had another hour. I would ask you your whole impression ozempic. If your friends are taking it, if it interests you. But we’ll have to wait for another hour to do that.
Krys Boyd [00:42:59] We will. Think is distributed by PRX, the Public Radio Exchange. You can find us on Facebook and Instagram and listen to our podcast wherever you get podcasts, just search for KERA Think. Our website is think.kera.org and you can go there to sign up for our free weekly newsletter. Again, I’m Krys Boyd. Thanks for listening. Have a great day.
