Insulin Degludec / Liraglutide

On February 5, Novo Nordisk officially released its annual report for 2024, revealing a remarkable revenue of 29.04 billion Danish kroner (approximately $42.13 billion), representing a 25% increase year-on-year. The operating profit also surged to 12.83 billion Danish kroner (around $18.62 billion), reflecting a 25% growth, while net profit reached 10.10 billion Danish kroner (about $14.65 billion), up 21%. Notably, Novo Nordisk's profit margin (operating profit/sales) stands at an impressive 44.19%, far surpassing many American pharmaceutical giants.   Novo Nordisk operates primarily in two business segments: Diabetes and Obesity Care and Rare Diseases. The majority of its revenue comes from the Diabetes and Obesity Care segment, which generated 27.18 billion Danish kroner in sales for 2024, while the Rare Diseases segment contributed only 1.86 billion Danish kroner.   The GLP-1 class of drugs has emerged as Novo Nordisk's biggest revenue driver. Rybelsus (oral semaglutide) achieved sales of 23.30 billion Danish kroner (approximately $3.38 billion), while Ozempic (injectable semaglutide) brought in 120.34 billion Danish kroner (around $17.46 billion). The weight-loss version, Wegovy, also performed well with sales of 58.21 billion Danish kroner (about $8.44 billion). The total sales for semaglutide reached $29.28 billion, showcasing its strong performance, although it has not yet dethroned Keytruda as the new king of drugs. In addition to semaglutide, Novo Nordisk's GLP-1 offerings include the previous generation liraglutide, with Victoza (liraglutide for diabetes) and Saxenda (liraglutide for weight loss) generating 5.48 billion Danish kroner (approximately $795 million) and 6.94 billion Danish kroner (around $1.01 billion), respectively.   Insulin remains Novo Nordisk's second-largest revenue generator, with total sales of 55.37 billion Danish kroner (approximately $8.03 billion) in 2024, driven by the success of degludec insulin, which saw a 15.3% increase in sales compared to the previous year. The three long-acting insulins—Tresiba (degludec), Xultophy (degludec/liraglutide), and Levemir (detemir)—achieved sales of 9.91 billion, 4.67 billion, and 4.50 billion Danish kroner, respectively. The two premixed insulins, Ryzodeg (degludec/aspart) and NovoMix (premixed aspart), generated revenues of 4.93 billion and 5.86 billion Danish kroner, respectively, with the former showing growth while the latter declined. Rapid-acting insulins, including Fiasp (ultra-rapid aspart) and NovoRapid (aspart), collectively sold 18.52 billion Danish kroner, an increase of approximately 2.6 billion compared to the previous year. Additionally, Novo Nordisk continues to sell second-generation human insulin, which generated 6.97 billion Danish kroner, although this segment saw a year-on-year decline.   In the Rare Diseases segment, Novo Nordisk's product pipeline primarily includes clotting factors and growth hormones, with total sales of only 1.86 billion Danish kroner, representing a small portion of overall revenue.   Unlike other major international pharmaceutical companies, Novo Nordisk has not pursued large-scale acquisitions and maintains a research and development investment intensity of around 15%. However, the company's sustained high revenue growth demonstrates its efficiency in product development. This efficiency can be attributed to four key factors: a strong focus on diabetes, extensive knowledge accumulation over a century, a commitment to user experience, maximizing market value from existing products, and the development of platform technologies. With advanced fatty acid acylation technology, peptide oral delivery technology, and yeast fermentation technology, Novo Nordisk is well-positioned to maintain its competitive edge in the market.

The European Medicines Agency (EMA) announced on Friday that it found no added risk of suicidal and self-injurious thoughts associated with GLP-1 receptor agonists, including the ones sold by Novo Nordisk and Eli Lilly."After reviewing the available evidence from non-clinical studies, clinical trials, post-marketing surveillance data and the available studies," the EMA said that "no update to the product information is warranted." The drugmakers will continue to monitor these events as part of their pharmacovigilance activities and "report any new evidence on this issue."The review started last July after it was reported that some patients using liraglutide and semaglutide experienced thoughts of suicide or self-injury. (For more, see Spotlight On: Heavy burden of obesity likely a factor in suicidal ideation signals, experts say). In November, the EMA widened its investigation, requesting additional data from the makers of Ozempic (semaglutide), Wegovy (semaglutide), Rybelsus (semaglutide),  Victoza (liraglutide), Saxenda (liraglutide), Xultophy (degludec/liraglutide), Byetta (exenatide), Bydureon (exenatide), Lyxumia (lixisenatide), Suliqua (glargine/lixisenatid), and Trulicity (dulaglutide).Additionally, the EMA said it analysed the results of an electronic health records study, published in Nature Medicine in January, which investigated the incidence of suicidal thoughts in nearly 241,000 patients with overweight and type 2 diabetes treated with semaglutide or other non-GLP-1 receptor agonists. The study found no causal association between the use of semaglutide and suicidal thoughts. Another recent electronic health records study, conducted by EMA, did not support a causal association between the use of GLP-1 receptor agonists and this risk of suicide-related and self-injury-related events in people with type 2 diabetes.In January, a preliminary FDA report found no link between GLP-1 receptor agonists and suicidal thoughts or actions.