The Drug that Broke the Internet

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If you’re new here, I’m Pumulo Ngoma. I analyse the people, playbooks and strategies behind viral products every month.

The Anatomy of Ozempic

Lotte

In 1989, Lotte Bjerre Knudsen a freshly graduated researcher joins the newly merged Novo Nordisk. Novo Nordisk is a pharmaceutical company specialising in diabetes medication.

She begins working on Novo’s pre-diabetic medication offering. At the time, Novo Nordisk only produced diabetic medication but needed a diabetes-preventative product.

But by 1996, her efforts have been fruitless.

That is, until she stumbles on a tiny sentence in another scientist’s discovery:

Diabetes is controlled by a hormone called GLP-1.

GLP-1 is a hormone that communicates with the brain about insulin in the gut.

Since GLP-1 is a hormone, it could be produced synthetically.
The only problem is that GLP-1 dissolved in the body almost instantly.

Lotte becomes obsessed with this new piece of information - all she has to do is figure out how to extend the life of GLP-1 in the body, right?

What could go wrong?

Biological Breakthrough

In the 90s, the biological sciences experiences a radical breakthrough that would change medicine forever.

Recombination.

Researchers can produce medicine synthetically through a process called recombination technology. This technology consists of using proteins called restriction enzymes to cut bacterial DNA. These enzymes leave uneven cuts on the DNA chain, allowing foreign DNA to be inserted into the original DNA. Once complete, the bacteria treats the new genetic information as if it was its own. (Fun fact - this is how COVID vaccines were made).

With these new technological advances, all Lotte and her team have to do is replicate the GLP-1 hormone.

But Novo Nordisk's management is less than enthusiastic. Every day Lotte’s team fails to produce a substantial replica of GLP-1, is a day management’s frustration increases. “What had Lotte been doing for the last decade?”

They threaten to shut down Lotte’s team unless the team generate a substantial replica of the GLP-1 molecule. 

The Ultimatum

Faced with an ultimatum, Lotte and her team get to work and recreate the GLP-1 molecule and adapt it to prevent it from breaking down in the body.

Remember, the body naturally breaks down the GLP-1 molecule in 2 minutes, Lotte’s replica breaks the hormone down in 13 hours.

They name the drug liraglutide and over a 10 year period, the molecule goes through mandatory clinical trials. 

But in 2007, Lotte notices something strange.

During the rat trials, the liraglutide negatively affects the rat’s appetite. Higher doses of the drug result in decreased appetite and increased weight loss. And while most diabetic drugs would cause weight gain, liraglutide was causing weight loss. 

So in 2007, Novo Nordisk begins clinical trials for weightloss. In 2010, the trial included 9000 patients across 32 countries without major side effects. 

And even though the Novo Nordisk’s CEO is against the production of liraglutide, this drug is fundamentally different - it acts as hormone control. But Ozempic would change the fate of Novo Nordisk forever.

Novo Nordisk

At the beginning of 2004, Novo Nordisk is posting revenues of $4 Billion on the back of their Insulin products alone. 

Then just a few short years later in 2011, Victoza - a competing product - launches and becomes a Billion Dollar drug for the treatment of diabetes - and in 2013, Saxenda, the weightloss version of Victoza which contains a higher dose of liraglutide, is released. 

In 2015, Novo Nordisk hits $16 billion.

Then they release Semaglutide - which only needs to be injected once a week and is twice as effective as liraglutide for weightloss. 

When Ozempic launched in 2021 it sold more in one month than Saxenda did in 8 years (between 2013-2021).

The demand for diabetes-related drugs and obesity-related drugs will not decrease. Novo Nordisk’s marketcap goes from $16 billion in 2015 to $400 billion in 2023. 69% of their revenue comes from Lotte’s discovery - Liraglutide. 

How does it work

Drugs like Ozempic “tell your brain that you’ve had enough to eat and your stomach and intestines to slow the movement of food along the digestive tract to allow for digestion. This system even has a name: the colonic brake.” These scientists also say that the rise of diabetes and nutrition-related illnesses is related "food processing, aimed at improving shelf stability and enhancing taste, removes the bioactive molecules like fibre and polyphenols that help regulate this system. Removal of these key food components and the resulting decrease in gut microbiome diversity.” may be an important factor contributing to the rise in obesity and diabetes.”

Ozempic and Wegovy, obesity and diabetes drugs made by Novo Nordisk, have seen a surge in demand and sales in recent years. This has led to a significant increase in Novo Nordisk's stock price, making it the largest listed company in Europe with a valuation of almost £350 billion. The weight loss drug market is expected to grow to over £100 billion per year within the next decade.

Market Cap

Currently Novo Nordisk has a marketcap of $415 Billion Dollars. Novo Nordisk's stock has risen almost sixfold in the past five years, from 160 Danish krone to 903 krone.

That’s greater than the GDP of Denmark - it’s home country. It’s also greater than the combined market cap of Daimler, Bayer, Lufthansa and BMW.

Novo Nordisk plans to invest £7 billion per year by 2030 to capitalize on the Ozempic and Wegovy windfall. The weight loss drug market is expected to grow to over $80 billion per year within the next decade.

Market Opportunity

But serious health concerns such as diabetes directly impact the quality of one’s life. The mostly chronic nature of diabetes and obesity signals recurring revenue for drugs like Ozempic.

Let’s break it down.

Almost 1 billion adults are clinically obese globally, with another 1.5 billion classified as overweight, more than 40% of the 18+ population.

In America alone, the obesity market is a $500 million strong market.

And demand for Wegovy is soaring, with at least 25,000 new patients signing up every week in the US.

In the US, the price of Ozempic to treat diabetes is north of $964, and the cost of Wegovy for weight loss, in some cases exceeds $1300 per month before insurance.

It costs $169 and in Canada, of course, Ozempic is $147 a month and in the UK, it's $93 a month. 

The UK has less of an obesity problem with over 60% of adults being considered overweight by doctors.

Competitive Landscape

Novo Nordisk dominates the market with Ozempic, Wegovy, and Saxenda.

Eli Lilly & Co. also has a competing drug, Mounjaro which is actually considered more effective than Ozempic for weight-loss.

Other companies like Amgen Inc. and Vertex Pharmaceuticals are also involved in the space.

But how did Ozempic become viral?

Ozempic and its sister drug WeGovy have massively benefited from social media.

In 2022, when Kim Kardashian lost weight in order to wear Marilyn Monroe’s famous dress, rumours circulated that Ozempic was behind Kim’s dramatic weightloss.

Around the same time, Elon Musk tweeted about using Wegovy to lose weight.

This spurred a trend across Tiktok called the #OzempicChallenge where users would share before and after weightloss images from using the drug.

In 2022, the hashtags #Ozempic and #OzempicChallenge had over 250 million views.

Tiktok has followed a similar trajectory. Medical professionals began making tiktok videos sharing information on the benefits of Ozempic for weightloss.

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The only issue was that these drugs are specifically prescribed for diabetes, obesity and diabetes-related health issues. The demand for them caused a shortage of the drug.

Oprah and Weightwatchers 

In Feb 2024, Oprah announced that she was stepping down from the board of WeightWatchers.

Essentially, her announcement was an indication that she had lost confidence in WW because she was using a weight loss drug called Ozempic. 

If Ozempic exists, why would someone want to use WeightWatchers?

Let’s talk about the different use cases.

Use Case 1 - Weightwatchers 

Imagine, you’re someone like Oprah who has access to cutting-edge weightloss solutions and who has been calorie-counting programmes like WW for the last 18 years, but nothing has significantly helped. 

WW and other calorie-counting programs are ideal for consumers who want to lose weight using the following methods: 

1. Behavioural Change (meal plans, calorie-counting)

2. Community Support 

3. Losing weight over a longer time frame 

4. Budget-sensitive 

5. Gastrointestinal side effects like nausea, vomiting, diarrhoea and constipation.

Usecase 2 - GLP-1

GLP-1 drugs like Ozempic and Wegovy are ideal for users who: 

1. Want somewhat immediate or guaranteed results/ outcomes 

2. Needs/ wants medical intervention (diabetes, obesity, insulin management or hormone management)

3. Shorter time frame 

4. Financial ability - not price-sensitive 

But then, there’s the middle use case that forms - a user who wants the best of both worlds. This user wants one of the benefits of WW, like behavioural change, combined with the benefits of GLP drugs like Ozempic. 

GLP X Weightwatchers Usecase

1. Needs/ wants medical intervention (diabetes, obesity, insulin management or hormone management)

2. Behavioural Change (meal plans, calorie-counting)

3. Community Support 

4. Lose weight over a longer-time frame 

5. Budget-sensitive 

The story of Ozempic is incredible.