It could take years before Novo Nordisk has fulfilled demand for its highly popular weight loss drug, the company’s chief executive told CNN, noting that there are more than 100 million Americans with obesity and that “many of those would like to be on treatment.”
The Danish drugmaker has limited starter doses of Wegovy, which was approved in the US in 2021 for chronic weight management, as it struggles to meet demand, and CEO Lars Fruergaard Jorgensen said it’s not clear when that will stop.
“If I knew how big the demand would end up being, I could tell you,” Jorgensen said in an interview. “But I have the sense that it could actually take quite some years before we have actually fulfilled the demand out there. … We are just scratching the surface, so to say.”
Starter doses are lower doses of Wegovy that patients gradually increase over time, a process known as titration. That’s done so they can adjust to the medicine and to try to limit side effects like nausea, vomiting and constipation.
Novo Nordisk initially said in May that it would limit the availability of those lower doses “in an effort to support continuity of care for existing patients.”
Jorgensen said that effort to “dampen” some demand for Wegovy was to ensure a better patient experience for those already on the medicine, even though “we could have perhaps sold even more by just letting it run.”
Novo Nordisk is investing up to $4 billion a year in expanding its manufacturing capacity and running all its factories “24/7,” Jorgensen said.
Wegovy contains a higher dose of the same active ingredient, semaglutide, that’s in Novo Nordisk’s Type 2 diabetes drug Ozempic and has been shown in clinical trials to help people lose around 15% of their body weight, on average, along with diet and exercise.
Studies just this month have shown heart benefits as well, reducing the risk of heart attack, stroke or heart-related death in people with cardiovascular disease by 20% and, separately, improving symptoms in people with heart failure and obesity.
Wegovy is available in only a few countries outside the US now, and Jorgensen said it wasn’t initially clear what demand would be like globally. It’s turned out to be high, he said.
In the first countries, the US, Denmark and Norway, “all the launches had very, very steep uptakes,” Jorgensen said. “In Denmark, we have 1% of the population on Wegovy.”
It’s just now starting to become available in Germany and the UK as well.
Paying for the drug can be another challenge, if patients are able to start treatment. It costs $1,350 a month in the US before insurance, and coverage can be spotty, doctors have told CNN.
And studies of Wegovy and other similar drugs in the class, known as GLP-1 receptor agonists, suggest that people must keep taking them to maintain weight loss. Jorgensen argued that treating obesity with medications is similar to treating chronic diseases like high blood pressure or Type 2 diabetes.
“You need to keep treating it or else the symptoms will come back,” he said. Changing the body’s “set point,” where weight naturally returns without treatment, isn’t something that’s possible with medicines now, he argued.
“Maybe we can address that over time, but all the evidence so far suggests that it’s actually chronic treatment,” Jorgensen said.
Doctors who prescribe the medicine for obesity told CNN that they agree, although they have noted it may be possible for patients to use the medication less often over time. And US Food and Drug Administration Commissioner Dr. Robert Califf questioned in April whether patients were receiving the right “behavioral interventions” to try to sustain their weight loss without medication.
As more and more people take the medicines for longer and longer periods, doctors and regulators are paying close attention to potential safety risks.
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CNN reported in July on three patients who took Ozempic or Wegovy and developed stomach paralysis, which their doctors suggested could be related to the medicines. And in Europe, regulators have an ongoing review into whether the medicines may be connected to suicidal thoughts.
Jorgensen said that the GLP-1 class of medicines has been on the market for 15 years and that the company has a lot of data that makes it feel the drugs are safe.
“When you get into very large patient populations and have millions of patients using your medicine, you have different types of medical conditions among those patients,” Jorgensen said.
When there are suggestions of causality, like in the cases of stomach paralysis, he said, “of course, we have to look into that, but so far there’s nothing in what we can see that indicates any particular safety concerns.”