In the Epicenter of Ozempic | Weekly Country

A white building inspired by the insulin molecule holds the secrets of the latest rock stars of the pharmaceutical industry: Ozempic and Wegovy (the obesity version just approved in Europe). Both molecules have been on the US FDA’s list of “short” drugs for months, while in Spain Ozempic appears on the list of drugs with supply problems of the Spanish Agency for Medicines and Health Products.

Sky-blue pens filled with an almost miraculous active ingredient have become the object of desire for millions of people who, for the first time, have managed to control their weight to some extent without suffering too much and with some side effects – nausea and digestive discomfort are the most common – it seems to compensate for them. “For the first time, a drug meets the patient’s expectations for weight loss,” summarizes Markus Schindler, scientific director of the pharmaceutical company Novo Nordisk, which in 2017 received FDA approval for an injection supposedly intended only for the treatment of type 2 diabetes.

It’s not clear how exactly people started using Ozempic for weight loss, but it worked like a shot and the news spread like wildfire. From endocrinologist consultations to social media, from luxury clinics to red carpets. Elon Musk said he used it, and at the last Oscars, Jimmy Kimmel joked about how good everyone looked and wondered if he should also consider getting an Ozempic injection. In 2021, Novo Nordisk presented early data showing that its diabetes drug, when dosed weekly, can reduce body weight by up to 15% in obese people.

Ozempic’s sudden global fame took the directors of the Danish pharmaceutical company, which was on the verge of success, by surprise. “The continued increase in demand surprised us and simultaneously led to shortages in several countries,” admits Camilla Sylvest, executive vice president of commercial strategy at Novo Nordisk.

There is frustration among those who started weekly Ozempic injections, managed to lose weight and then had to stop treatment because of unstable supplies, and among the many diabetes patients who used Ozempic to control their glucose levels and who have had to switch to other options because their drug of choice is growing on the black market and has become a TikTok star with videos getting up to 1 billion views of people documenting their weight loss.

The blue injection pen gave a boost to the modest Danish pharmaceutical company, which has been trying to live up to that principle ever since. At the height of the summer 2023 vertigo, Novo Nordisk became the most valuable company on the European stock market (€565 billion), eclipsing the luxury department store LVMH. Last year, when the pharmaceutical company celebrated its centenary, CEO Lars Fruergaard Jørgensen, between pride and amazement, admitted: “Nobody, not a single analyst inside or outside the industry, could have predicted that a 100-year-old company would grow by 30%.” According to the company, Novo Nordisk’s expansion was responsible for all of Denmark’s economic growth in 2023. Economist.

We enter the epicentre of Ozempic’s operations in Bagsværd, on the outskirts of Copenhagen. In the modern building, a spiral staircase leads up to a large atrium where several glass offices converge, revealing the goings-on on the executive side. The day is starting and there are already several meetings underway. In the centre of each office is a table with fresh fruit, which is omnipresent in all the offices we enter. No chips, chewy candies or other chewy, fatty and sugary foods meant to kill the restlessness and boredom typical of children. meetings first thing i do in the morning The elevators don’t seem to be used much either, the stairwells are very busy. Employee metabolism is a corporate issue here. Semaglutide, the active ingredient in Ozempic and Vegovi, is perhaps the most coveted and copied molecular structure in the industry, so we’ve signed several confidentiality agreements and started hearing elusive phrases like “we can’t give you specific numbers” or “for reasons of course, we’ll only see the packaging process, not the texture or appearance of semaglutide.”

This is the crown jewel. Novo Nordisk has managed to create a synthetic version of the hormone glucagon-1 peptide (GLP-1), which we secrete naturally and which, among other functions, helps regulate blood glucose levels and influences feelings of satiety and stomach emptying. It is normally destroyed within minutes of circulating through the intestines. The patent developed by the Danish company mimics the human hormone, helps regulate hunger pangs and makes us feel full while eating smaller portions. It belongs to a family known as GLP-1 receptor agonists, a class of drugs that doctors believe will change the obesity paradigm.

Semaglutide works. The latest in a clinical trial of 18,000 obese adults without diabetes was published in May in the journal Nature, and showed that those who took the drug for four years lost an average of 10% of their body weight.

When Schindler joined the company, researchers had been studying the mechanism of action of the hormone GLP-1 for more than 20 years. I ask whether semaglutide’s powerful weight-loss effects were discovered by chance and good fortune. “We knew from the first studies in mice that the drug reduced food intake and weight by at least 10%.” The surprise, if you can call it that, was the discovery that the result was reproducible in humans and how much weight could be lost – up to 15% of body weight in the latest clinical trials – but that it would work in obesity as little as possible. “We always knew because it confirmed many pre-existing scientific hypotheses.” Schindler, who is talking about the news that he became a scientist in record time, says: celebrity

had been studying obesity for more than 20 years when he joined Novo Nordisk, and remembers that at the beginning of the first decade of the 2000s, it was utopian to think about a molecule that could reduce body weight by 15–20%.

A clinical study published in Nature in May also describes the most common side effects that increase with increasing doses of Ozempic. These include gastrointestinal discomfort such as nausea, vomiting, diarrhea, constipation, acid reflux, and abdominal pain. Many doctors also note that rapid weight loss with these drugs does not differentiate between fat and muscle and can be dangerous, especially for older people.

Schindler insists that the drugs are used as intended: Ozempic for diabetes and Vegovy for obesity. “The active ingredient, semaglutide, is the same, but the doses vary. One regulates glucose levels very well, while the other, higher, affects food intake, appetite control and weight loss. Although these are overlapping biological mechanisms, they are slightly different; one works more in the pancreas, and the other in areas of the brain that regulate appetite,” explains the researcher. To further differentiate, Ozempic is funded in Spain only for the treatment of type 2 diabetes, while through Wegovy, although it requires a medical prescription, the full cost is paid, which ranges from 180 euros for initial doses to 292 euros for maintenance doses. doses.

You enter the Ozempic and Wegovy packaging and assembly area with sterilized shoes, hats and gowns. Once inside, to move around, you must follow the movements of the yellow robots that carry boxes of the famous blue feathers. Between 30,000 and 40,000 will leave the region for the United States, which, with 40% of adults obese, is the most voracious market and the place where the most money is paid for these drugs.

The boxes with handles are placed on pallets, which are transported by robots to the “aseptic zone”. “We do not organize visits to this zone because the process is complex and we have to protect the quality of the product,” they say. In this area, the cartridges are loaded with “liquid medicine”, which is stored in huge tanks. Semaglutide is transported as a white, dry, extremely cold powder from Kalundborg (16,000 inhabitants), the city with the highest GDP in Europe because of this.

The world is hungry for Ozempic and Wegovy, and these manufacturing plants are not stopping. They produce, develop, assemble and package 24 hours a day, 365 days a year. Bagsværd has 64,000 employees at its headquarters, and another 100,000 have been hired worldwide. According to Economist, 3% of Denmark’s workforce depends on Novo Nordisk. This year, the company has invested 6 billion euros to quadruple its production facilities and acquire new manufacturing plants. And yet, they are failing. “We are very busy with supply chain issues and combating counterfeit products because we want patients to be able to trust the high quality of our molecule,” confirms Camilla Sylvest.

Semaglutide, a compound derived from the saliva of a carnivorous lizard called the Gila monster, is the first molecule in a new generation of drugs that promises to change the world. Bloomberg projects annual sales growth of 26% for the Ozempic family of GLP-1 agonists, significantly outpacing the 16% annual growth forecast for oncology drugs.

Before the tough competition sets in – the patent expires in 2026 in China and India, and cheaper versions will follow – Novo Nordisk is enjoying its moment. Its success has distorted the Danish economy to such an extent that it grew 1.7% from the first half of 2022 to the first half of 2023. Without Novo, as the Danes call it, many analysts believe the country would have gone into recession. The drugmaker is so strong that it has even slashed its mortgage prices. It attracts so many dollars that the Danish bank has had to keep interest rates below the European Central Bank to keep the Danish krone from rising too much. A Danish economist celebrated this with a viral tweet that went viral around the world: “A warm hello to obese Americans. Thanks to them, my mortgage is still cheap.”