Novo Nordisk announced on June 25 that semaglutide for long-term weight management has been approved for listing in China. As the world's first and currently the only glucagon-like peptide-1 receptor agonist (GLP-1RA) weekly preparation for long-term weight management, semaglutide injection can achieve an average weight reduction of 17% (16.8 kg). In terms of product structure, the operating income of products worth 10-30 billion yuan was 401/1288/60 million yuan, respectively.

It is worth noting that the potential of the Chinese weight loss drug market is enormous. According to institutional predictions, the scale of the Chinese diabetes (and weight loss) drug market will more than double in the next six years, exceeding 23 billion US dollars (approximately RMB 170 billion). Nomura predicts that the Chinese GLP-1 drug market may grow at a rate of 23% per year, with a growth rate exceeding the global average.

At the same time, Novo Nordisk recently released weight reduction data from using semaglutide for four years, demonstrating that in the semaglutide group, weight loss continued until the 65th week and was maintained for four years. The publication of this latest research provides important reference for clinical long-term treatment.

Major official announcement

Novo Nordisk announced on June 25 that semaglutide for long-term weight management has been approved for listing in China.

Novo Nordisk stated that as the world's first and currently the only glucagon-like peptide-1 receptor agonist (GLP-1RA) weekly preparation for long-term weight management, semaglutide injection (Wegovy for long-term weight management) can achieve an average weight reduction of 17% (16.8 kg), and bring patients multiple health benefits beyond weight loss, including but not limited to reducing waist circumference, lowering visceral fat, improving blood lipids, and delaying prediabetes onset. Its safety has been widely verified.

The approved population for semaglutide are overweight and obese patients (initial BMI greater than or equal to 30 kg/m²; or between 27 kg/m² and 30 kg/m², and with at least one weight-related complication, such as hyperglycemia, hypertension, dyslipidemia, obstructive sleep apnea, or cardiovascular disease).

Semaglutide injection belongs to the class of GLP-1 receptor agonists (GLP-1RA) drugs. GLP-1 is an incretin that promotes insulin secretion in a glucose-dependent manner, inhibits glucagon secretion, lowers blood glucose, and can also delay gastric emptying to inhibit appetite.

There are currently two products of semaglutide injection, the product name for treating type 2 diabetes is Ozempic, and the product name for weight loss indication is Wegovy. The approved Wegovy, with 'overweight or obesity' as the indication, was approved by the US FDA in April 2021, followed by the European Union's approval and now its listing in China.

On January 26 of this year, the National Medical Products Administration announced that Novo Nordisk's semaglutide tablets were approved for listing to treat type 2 diabetes.

When the weight loss indication of semaglutide could be approved in China has been highly anticipated. On June 3, 2023, semaglutide took an important step in China, and the application for the weight-loss indication has been formally accepted by the NMPA. Finally, Wegovy has been approved for listing in China.

The Chinese weight loss drug market is huge.

Although it was only approved for blood glucose lowering before, semaglutide has already been selling very well in the domestic market. In 2023 the Chinese semaglutide market was worth 5.2 billion yuan, a year-on-year growth of 108%. Analysts predict that the Chinese semaglutide market will reach 8 billion yuan this year.

Currently, China's demand for weight loss solutions remains high, with the obesity rate of Chinese adults increasing by more than twice in less than 20 years. In 2022, the proportion of overweight or obese Chinese adults reached 50.7%.

According to institutional predictions, the scale of the Chinese diabetes (and weight loss) drug market will more than double in the next six years, exceeding 23 billion US dollars (approximately RMB 170 billion). Chinese diabetics account for about a quarter of the world's diabetic population. Goldman Sachs estimates that the global weight loss drug market will soar to 100 billion US dollars (approximately RMB 720 billion) by 2030.

Nomura predicts that the Chinese GLP-1 drug market may grow at a rate of 23% per year, with a growth rate exceeding the global average.

Industry analysts predict that Novo Nordisk's sales of weight loss and diabetes treatment drugs in China will reach 4.8 billion US dollars by 2030, accounting for 7% of the total global sales.

This may also be an opportunity for Chinese domestic pharmaceutical companies. According to Nomura, by 2033, Chinese pharmaceutical companies may occupy one-fifth of the market share. Currently, there are more than 100 Chinese GLP-1 class new drugs in the clinical stage. These domestically-manufactured drugs are not far from listing.

The latest research findings

In May of this year, Novo Nordisk announced the weight-loss effect data of using semaglutide for four consecutive years at the European Obesity Conference. The research results were also published online in Nature Medicine.

This trial is part of the SELECT multicenter, randomized, double-blind, placebo-controlled study. In addition to BMI, researchers also tested indicators of body fat composition and distribution, including waist circumference and waist-to-height ratio (WHtR), because central abdominal fat, compared to general obesity, can lead to greater cardiovascular risk.

The results showed that in the NovoLet group, weight loss continued for 65 weeks and was maintained for four years on this basis. Patients' weight decreased on average by 10.2%, and waist size decreased on average by 7.7 centimeters. The corresponding statistics for the placebo group were 1.5% and 1.3 centimeters.

The study showed that overweight or obese adults without diabetes, regardless of region, ethnicity, body type, or gender, can safely and effectively lose weight and reduce waist size for at least four years by taking semaglutide once a week.

Due to the lack of evidence, it has been a concern as to how long semaglutide's weight-loss effect can last, and whether the drug will be resistant or rebound. The release of this latest research provides important references for long-term clinical treatment.

At the European Obesity Conference, Novo Nordisk also reported the relationship between baseline weight, weight changes during the study, and cardiovascular outcomes, including the time between the occurrence of the first major adverse cardiovascular event (MACE) and heart failure when using semaglutide in the SELECT trial.

The study found that semaglutide treatment can bring cardiovascular benefits regardless of initial weight or weight loss. Even patients with relatively mild obesity or insignificant weight loss may improve cardiovascular outcomes.

John Deanfield, a researcher at University College London, said that these study results indicate that the drug's role in reducing cardiovascular risk does not depend entirely on weight loss and may be related to affecting blood sugar, blood pressure, inflammation, or directly affecting the myocardium and blood vessels.

Global hot sale.

Semaglutide, known as the "weight loss drug," is currently very popular worldwide. Tesla CEO Elon Musk once posted that he lost 9 kilograms in a month by regularly fasting and using Wegovy (semaglutide injection).

With the help of celebrity effects and weight loss effects, Wegovy's sales are extremely hot, and it has once been out of stock globally.

In 2023, Novo Nordisk's semaglutide contributed revenue of 145.811 billion Danish kroner (approximately RMB 154 billion), second only to the "king of medicine" K medicine. Among them, NovoLet's sales revenue increased by 407% year-on-year, reaching 4.6 billion US dollars.

JPMorgan once expected that under the promotion of semaglutide and dulaglutide, the annual sales of this type of drug would exceed 100 billion US dollars in 2030. Only half a year later, BMO Capital Markets raised its estimate to 150 billion US dollars.

The surge in sales has boosted Novo Nordisk's stock price. As of the latest closing, its stock price was US$142.28, with a cumulative increase of 38.5% since the beginning of the year, and the latest total market value was as high as US$633.68 billion (approximately RMB 4.6 trillion).

In order to cope with the strong market demand, Novo Nordisk is vigorously building factories and expanding production capacity. On June 24th, Novo Nordisk announced the investment of US$4.1 billion (approximately RMB 30 billion) to expand the company's manufacturing capacity in the United States. Among them, Novo Nordisk plans to build a second filling and precision processing manufacturing plant in Clayton, North Carolina, USA to enhance its production capacity for semaglutide-related drugs Wegovy and Ozempic.

Editor/Emily