What’s next for Novo Nordisk’s obesity drug CagriSema?
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Novo Nordisk is not taking a break this year.
Shares of the Danish drugmaker plunged on Monday after the company released data showing its next-generation obesity drug failed to keep up with weight loss Eli LillyZepbound is in a Phase 3 study.
The results showed that Novo’s drug CagriSema promoted slightly less weight loss than Zepbound after 84 weeks in the study – a difference that calls into question the experimental treatment’s sales potential. All analysts raise the same point: Why should patients or doctors choose Novo’s drug over a more effective and widely known agent like Zepbound?
“We are hard-pressed to find a reason why a patient would be prescribed CagriSema” instead of Zepbound if the product comes to market, BMO analyst Evan Seigerman said in a note Monday.
In a separate note Monday, JPMorgan analyst Chris Schott said the results “will make it difficult for the product to win.” [market] Share” from Lilly. If anything, it confirms Zepbound as a “clear market leader” and positions Lilly to capture even more market share, he added.
Nevertheless, Novo is not giving up on the product.
It’s too late anyway: The company has already applied for approval of CagriSema from the Food and Drug Administration, with a decision expected at the end of 2026. That means the drug could hit the market at the end of the year or early 2027.
“To say it’s obsolete is, quite frankly, quite a disparagement of a fantastic drug,” Novo CEO Mike Doustdar told analysts on Monday, dismissing concerns about CagriSema’s commercial potential. He said he believes the drug has better weight loss effectiveness than anything else on the market.
Novo was “pleased” with the 23 percent weight loss caused by CagriSema, showing that it provides “clinically meaningful additive weight loss effects” that are superior to those seen with drugs that only target GLP-1, Chief Scientific Officer Martin Holst Lange said in a news release Monday. This includes semaglutide, the active ingredient in Novo’s existing obesity injection product Wegovy. CagriSema combines semaglutide and cagrilintide, another hormone released in the pancreas that affects appetite.
Lilly’s Zepound helped people in the study lose about 25% of their weight, but Doustdar called this an “abnormality” not seen in any other study.
Novo is also pinning its hopes on further upcoming studies to demonstrate CagriSema’s full potential for weight loss.
This includes the REDEFINE 11 study, a phase III study comparing CagriSema with placebo in 600 adults with obesity. The first results of this study are expected in the first half of 2027.
But Novo has a lot to prove to Wall Street. BMO’s Seigerman said he is not convinced the upcoming trial will “change the narrative around CagriSema.”
Novo also expects to begin a Phase 3 trial evaluating a higher dose of CagriSema in the second half of 2026. On the call with analysts, Doustdar suggested that the greater effectiveness of a higher dose of Wegovy could translate to CagriSema.
The standard doses of Wegovy resulted in weight loss of about 15 to 16%, while the high dose was closer to 21%, he said.
Regardless of CagriSema’s performance, Novo needs to find a strong competitor to Lilly’s drugs. Zepbound’s greater potency has allowed it to gain significant market share, and Lilly plans to launch a next-generation obesity drug that targets three gut hormones and has resulted in weight loss of more than 28% in clinical trials.
Novo paid $2 billion last year for the rights to an experimental drug from a Chinese drugmaker that works in the same way as Lilly’s upcoming treatment.
However, with Novo’s product still in early stages of development, mergers and acquisitions could offer a quicker path forward.
Doustdar told me in January that Novo plans to be an active dealmaker to “see if anyone out there has something that can complement our own pipeline.”
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