Semaglutide (Novo Nordisk)

iStock, Man As Thep Speaking on the sidelines of the J.P. Morgan Healthcare Conference, Novo business development executive Tamara Darsow said the company is gunning for obesity and diabetes assets. Novo Nordisk’s business development team had 200 meetings at the J.P. Morgan Healthcare Conference, a staggering figure as the Danish pharma tries to get back into the game after a messy bidding war over Metsera in the fall. “[Metsera] was a company that was very interesting to us and very complimentary to what we do. Of course, we wanted it. We were sorry to see it go,” Tamara Darsow, senior vice president, global business development, told BioSpace on the sidelines of the J.P. Morgan Healthcare Conference on Wednesday. “But it also was, from our perspective, a bit of financial discipline and there was a limit to what we were willing to pay for it.” So it’s onward and upward for Darsow and her team. Novo is also reforming its business development strategy under new CEO Mike Maziar Doustdar, who is seeking to transform the 103-year-old Danish company into a modern pharma giant. “As with any time when there’s a leadership change, there’s some strategic thinking and some changes that come,” Darsow said. “I think we have some very good clarity now on what that looks like moving forward, and so that that gives us a lot of confidence on how to execute in 2026.” Not historically known as an acquirer, Novo began to earn a new reputation last year with—of course—the Metsera battle, but also successful deals helped showcase Doustdar’s new style. The company acquired Akero Therapeutics for $5.2 billion in October, tucking in a metabolic dysfunction-associated steatohepatitis (MASH) therapy to the pipeline. Acknowledging the rise of M&A for Novo, Darsow said her team is “relatively agnostic” about deal structure, noting simply that the buys made sense becuase the acquired companies fit nicely into the pipeline. The company has also signed a slew of licensing deals, including a partnership with China’s United Laboratories in March for a triple agonist of the GLP-1, GIP and glucagon receptors. The weight loss deal included $200 million upfront and up to $1.8 billion on the back end in milestones. Novo is hyperfocused on finding additional obesity and diabetes assets, Darsow said. She’s particularly excited about finding new novel mechanisms for the diseases and improving tolerability or dosing. In diabetes, she flagged insulin sensitizers and beta cell preservation as technologies she is keen to find. Semaglutide, Novo’s GLP-1, changed the way diabetes is treated for millions of people. Darsow said there’s still more to do in the weight loss space, despite a crowded market and dozens of biotechs offering options. That’s a good thing, according to Darsow. She remembers a time when there wasn’t a lot of choice for Novo. “Five years ago, if you were looking for novel obesity companies, they were few and far between. Now we see this huge expansion of interest and investments in this area,” Darsow said. “I think that is just good for the entire industry and the entire ecosystem.” Novo is the ideal partner in obesity, Darsow said, because of the “tremendous amount of expertise” it has developed with semaglutide and a pipeline of next-gen assets. Besides obesity and diabetes, Darsow said Novo is looking to pick up some rare disease assets. The company has an interest in rare blood diseases as well as diseases that are complications of obesity that could be complimentary to the existing portfolio. Akero is an example of the latter strategy. Darsow is pleased that Novo’s recent dealmaking has run the gamut from early to late stage. She also noted that the company has a scouting team in China looking at new obesity assets. While the Danish pharma’s bid for Metsera was unsuccessful, Darsow said it did show the industry that Novo is willing to fight hard for what it wants. “We need to know what we want and move with intention and expect competition,” she said.

Eli Lilly and Novo Nordisk have waged a bitter legal campaign against compounding pharmacies that have churned out custom versions of their blockbuster obesity drugs over the last couple of years. Now, one is fighting back. Arizona-based Strive Compounding Pharmacy filed an antitrust lawsuit Wednesday accusing the two pharma giants of shutting down competition in the market for GLP-1 medicines. Lilly and Novo struck exclusive deals with telehealth companies that barred them from working with compounders, Strive alleged in the suit filed in the US District Court for the Western District of Texas. Eli Lilly also disparaged compounded medicines and sought to interfere with Strive’s relationships with tech platforms and payment processors, it alleged. “Eli Lilly and Novo Nordisk’s conduct has unlawfully restricted competition and directly harmed GLP-1 patients in the United States,” the complaint states. “As a result, patients are forced to pay inflated prices and suffer reduced access to GLP-1 medicines — particularly personalized versions of those medicines. Strive seeks to restore competition to the world of GLP-1 medicines, allowing patients to benefit from improved access and lower costs.” The challenge comes after Lilly filed its own lawsuit against Strive in April 2025. Strive, like many other compounding pharmacies, makes its own version of tirzepatide, the drug sold by Lilly as Mounjaro and Zepbound, and semaglutide, sold by Novo as Ozempic and Wegovy. Lilly accused Strive of falsely claiming its tirzepatide products were safe, effective and personalized for each patient. That lawsuit was dismissed for lack of personal jurisdiction, but Lilly refiled it in Strive’s home state in October. “Strive’s lawsuit is wrong, on both the facts and law, and an attempt to shift focus away from its own conduct,” a Lilly spokesperson said in a statement. Novo did not immediately respond to a request for comment. Compounding pharmacies historically have made their own versions of branded medications when those drugs are in a supply shortage. They also customize branded medications by removing an ingredient if a patient is allergic, or altering the dose if a patient needs one that’s not commercially available. Compounding pharmacies’ medications are not FDA-approved, but their facilities are regulated by the FDA and state boards of pharmacy. Shortages of GLP-1s between 2022 and 2025 were a boon to compounding pharmacies because they were permitted to create copies of the drugs to fill gaps in access. Many continued making custom versions after the FDA declared the shortages resolved . Strive argued that it generated competition by producing and selling compounded GLP-1 drugs “at a fraction of the price” of Novo and Lilly’s medications. “But Eli Lilly and Novo Nordisk were not content to compete on the merits with compounding pharmacies,” the complaint states. Strive alleged that Lilly and Novo have worked to limit prescriptions for compounded GLP-1 drugs that are needed to sustain its business. Lilly and Novo partnered with well-known telehealth companies to provide access to their branded medications at discounts, and those partnerships required that the telehealth companies agree not to work with compounding pharmacies, Strive alleged. Such arrangements put limits on which medicines clinicians can prescribe and patients can access, it said. Strive further alleged that Eli Lilly anticompetitively disparaged the drugs made by compounding pharmacies by falsely stating that they aren’t safe and including them in the same category as “counterfeit” and “fake” medications. Lilly aimed to discourage doctors and telehealth providers from issuing prescriptions for compounded GLP-1s, Strive claimed. Finally, the complaint said Lilly has sought to interfere with Strive’s relationships with medical practitioners, tech platforms and payment processors to limit competition. By disparaging compounded medications, Lilly sought to have the pharmacies’ certifications revoked, Strive alleged. Lilly’s campaign against compounding pharmacies caused Meta to yank GLP-1-related social media groups, and payment processors such as Tebra and Stripe to warn that payment processing could be paused for prescribers issuing prescriptions for compounded medications, the complaint said. (This story is from our Health Tech newsletter. If you’d like to sign up, just click here. )