Novo Nordisk R&D spend jumps 35% thanks to soaring sales as oral obesity plans advance

It's early days, but Novo Nordisk’s oral, long-acting, GLP-1 and amylin weight loss drug was found to be safe and effective in a phase 1 trial, spurring plans to widen the development plan, Martin Holst Lange, EVP and head of development, told investors Wednesday. 

Lange wouldn’t elaborate on the fourth-quarter earnings call when asked for any details on amycretin’s efficacy but said the fact that the company is expanding development means it’s properly differentiated from “whatever is out there.” While Novo has been the first to the weight loss market, competitors are closing in, including Eli Lilly, which recently got approval for Zepbound in the indication, and other major pharma players like Pfizer. 

Amycretin is essentially a single molecule meant to do the work of CagriSema, a combination treatment of obesity and weight-loss drug semaglutide and amylin analogue, cagrilintide. The oral version is intended for once-daily use, compared to once-weekly for CagriSema. 

Novo also launched a phase 1 trial in September testing a subcutaneous version of amycretin to diversify options for patients. 

“When it comes to the efficacy ... we want to see differentiated products, and that goes for both the subcutaneous and the oral in the marketplace,” Lange said. “And what we had seen so far for amycretin brings us confidence that amycretin, in both oral and subcutaneous, when we see the data, has that potential.”

He later affirmed that differentiated means in part that the data competes with CagriSema. 

Novo's pipeline has been bolstered by skyrocketing R&D spending thanks to semaglutide sales. Research and development expenses jumped 35% in 2023 compared to 2022, as sales jumped 36% at constant exchange rates. The 10.5 billion Danish kroner (~$1.5 billion) spent on R&D in the fourth quarter was 15.9% of sales. 

Novo has also turned to business development for reinforcement, particularly to collect even more options for obesity. Swiss biotech EraCal is the most recent partner, with Novo tapping into the biotech’s phenomic drug platform two years after the two companies linked up for a research collaboration. EraCal stands to make up to $255 million in exchange for rights to a small molecule targeting a novel mechanism of action to control appetite. It remains unclear whether that's EraCal’s lead asset, Era-379, with executives declining to elaborate on Wednesday's call.