ResearchPulse

1/8 CagriSema data – better than the market reaction This is a longer analyse of the CagriSema Redefine 1 data. Enjoy your reading and please don’t hold your comments back. "I will throughout this analyze try and show what that “extra” potential WL looks like. I also zoom in at one of the most often conclusions I have seen. “Only 57% finished the trial at max dose CagriSema. That means it had seriously tough side effects”. I believe that is both a hasty and wrong conclusion." $NVO $LLY $VKTX $GUBRA $ZEAL @GLP1

China extends patent protection for Ozempic in CKD (chronic kidney disease) 5 years extra patent protection but only CKD patients. How much this will have actual meaningful impact on Ozempic sales are hard to quantify. We don’t have any numbers of how many current Ozempic users in China are CKD patients. My guess is less than 5%. $LLY $NVO $VKTX m.jiemian.com/article/153157…

$HIMS Q3 ER cc confirms they will launch CagriSema when it’s made available shortly after approval. Aprproval is expected late December for launch early January. Likely either January 1 or January 4. HIMS also confirms they are about to launch prescriptions models with $NVO. I guess it’s the same model as other Telehealth currently offers. With subscriptions you can get the price for both high doses wegovy pill, and all wegovy pen, including wegovy HD down to $249 per month. $VKTx

Ozempic pill was up by 1.8% to about TRx 67.6K with last weeks IQVIA data. Up by about 35% since rebranding Rybelsus to Ozempic pill. ASP for Ozempic pill is about 2x of Wegovy pill. So the increase has a bit larger impact than what the TRx numbers suggest when comparing with wegovy pill. As a reminder 25mg Ozempic pill will be approved in December with launch in January backed up by a larger promotion campaign. $LLY $NVO $VKTX

Another country with parallel imports of Wegovy pill. Launching before official $NVO launch. That makes it at least 5 countries. This will likely continue growing throughout EU $LLy $VKTX

Here’s a summary of what happened this week in $NVO and GLP1 space. You don’t want to miss this. $LLY $VKTX

This is the true picture of difference between wegovy pill and Foundayo TRx in US. Wegovy TRx numbers are much larger than what the weekly IQVIA data shows $LLY $NVO $VKTX

Wegovy TRx up with 50K since launch of wegovy HD…….That’s including the headwind from CVS started covering Zepbound again per 10/1. $NVO gained 46K TRx through first 4 weeks after CVS stopped covering Zepbound. But wegovy TRx has only dropped 15K in first 4 weeks after CVS started covering Zepbound again. Guess some of those who were forced to move from Zepbound to wegovy have chosen to stay on wegovy and have moved up to wegovy HD. Wegovy HD main challenge is that so few know it even exists. That you can get above 20% WL with wegovy. When I see people compare wegovy with Zepbound, then far far more use 2.4mg data than HD data in that comparison. They don’t know HD exists. With that said about 110k US consumers are currently on Wegovy HD and it keeps growing week by week. Outpacing growth percentage for total wegovy pen almost every week. At Q3 ER call they said 80% of HD users titrate from 2.4mg. They didn’t specify the last 20%. Presumably Zepbound users who have lost insurance coverage? But I wouldn’t make such switch directly to another molecule at top dose. Definitely start lower to adjust. But can’t see who else than Zepbound users would make such entry. Ohh maybe also some who jumps from wegovy compounding. $LLY $VKTX

@semodough short GLP1 IQVIA update Wegovy pill about 184000. Up from 183k last week. Previously record is 183,988. This might mean a new record with a few hundreds but could also be just below 184k since the number is rounded to nears 1000. 184k is equal about TRx 297K when adjusted for the capture rate about 62% that was the number from Q3 ER Run rate about $2.9B + rest of world. Foundayo up 3% to TRx 65,047. New record with 1% over former record from 5 weeks ago Wegovy pen down 1.5% Zepbound up with 1.9% Mounjaro down with 0.4% Ozempic pen down with 0.2% No Ozempic pill number and wegovy HD yet. $LLY $NVO $VKTX

Very good visualisation of $NVO Q3 ER headlines. Especially the blowout beating of concensus expectations stands out. Back to growth in profitability just around the corner. $LLY $VKTX

$NVO Q3 ER blowout. NVO released Q3 today and beat analysts consensus with 8% on revenue. 79.2B vs 73.4B. New ATH revenue for NVO. 6% increase over Q3 2025 and Q1-3 1% drop. Sales in IO (all markets outside US) had 10% growth in Q3. Even with patent expiration of semaglutide. Guidance upgraded from revenue -6% to 0 CER. New revenue guidance-2% to plus 2% Old EBIT guidance from -6% to 0% New EBIT guidance-2% to 2% increase. This was much better than what analysts expected. My expectations for new guidance was -3% to 0% Adjusted gross profit margin at 82.1% vs 78.2% in Q2 and 81.0% in Q1 Even with high growth in wegovy pill sales gross margin increased. Important note. The quarter had 4B impairments in production capacity. And 4.6B in R&D related to the failed P3 with ziltivekimab. To reach their new top range revenue guidance they would need 88B in Q4 or 10% growth on Q3 sales. That seems very stretched. Even though wegovy pill sales will increase significantly here in Q4 above the 5.4B dkk (about $830 million) in Q4. Further gains on currency…But still. 2025 revenue 309B dkk. 2% increases would then be 315B. But with 88B revenue in Q4 would be 355B run rate (no it’s not that simple and they will guide conservative anyway) Just to say growth will be back in 2027. And not just with 2% as analysts concensus was before today’s ER. Obesity growth in Q3 at 22% to 26B. $16B run rate Wegovy pill 5.4B - 4.2B in US (about $830m) +1.2B in IO Wegovy pill 3.6 million TRx in US vs IQVIA 2.22 million. That means even lower capture rate than 64% i have used. Capture rate only 61-62% Wegovy pill NBRx 80% MS per 10/2 Bridge about TRx 60k weekly.Overall Bridge is most of volume growth. Says total obesity marked about flat without Bridge since May. May- October low season for AOM. Volume picks up from November and especially from January. IO Wegovy Pill launched in 3 countries by Q3. 4 more including Mexico launched in Q4. No mentioning of Bahrain and Israel. So possibly parallel imports? Launch of wegovy pill accelerated. Expects now launch in more than 20 countries by 1H vs by year end 2027 at CMD presentation two months ago. Says production delivers higher volumes than expected. Those plus 20 countries covers 2/3 of current wegovy pen market sales outside US. I guess we will see substantial number of those launch by 1/4 2027. Ready for New Year’s resolution. Wegovy pill share 90% in UK and 80% in UAE. The latter despite Foundayo was launched two months before wegovy pill. UK TRx droped to 60k weekly from 65k at CMD. Seasonality. Expect to increase again. Germany 100k TRx in first 6 weeks. Launching subscriptions in IO as in US (monthly 55k TRx in US) 35% wegovy pen self pay. (4.1 mill TRx total) HD 5% of total Pen Wegovy HD launched in two countries in EU/UK. 17 countries by end October and planned for more than 30 by year end. Wegovy HD has about 5% of total wegovy pen TRx in US and UK. Believe it can reach about 15% as Zepbound 15mg share of Zepbound. 80% wegovy HD titrating from wegovy 2.4mg. They dident specify what the last 20% was. But guess it’s Zepbound users? Likely people who have lost coverage for Zepbound. And with subscription for Wegovy HD price can go as low as $250. Surprising strong Ozempic revenue at 29.7B. Only down 5% vs Q3 2025 despite loss of patent and loss of MS in US. 4B above my estimate in US. They in general guide for 10-15% reduced price per year. But here in Q3 there was hardly any reduced price. Ozempic pill NBRx up with 100% since rebranding. (70% up at CMD) 6-12k and still 60% of NBRx are new to GLP1. This doubling of NBRx also means TRx for obesity pill will continue growing the coming weeks. Already up from about 50k to about 66k last Week. IO Ozempic 2.0. Increasing share of NBRx since launching. Focus on launching Ozempic 2.0 before considering rebranding Rybelsus to Ozempic pill in EU. $LLY $VKTX

Wegovy pill approved I Brazil. At today’s Q3 CC it was also said between the lines that wegovy pill will be launched in Brazil. NVO says it will be launched in next quarter. If possible they want to do it latest by January 4 2027 Great find @Aktieland $LLY $NVO $VKTX

Camurus starts P2 with their once monthly semaglutide. Camurus have deal with $LLY for developing once monthly Tirzepatide. Plus multiple other of LLY molecules. Camurus semaglutide will be for markets where $NVO patent has expired $NVO made a new deal with $Nanexa in September for development of up to 5 programs of once monthly or once quarterly administration. Nanexa being a very small Swedish listed biotech. While the total value of the deal was €1.165B ($1.3B) it was not revealed what upfront payments were. But that should be revealed tomorrow at their Q3 ER web.quartr.com/link/pressrel…

$NVO about to start 4 P3 trials with Zenagamtide in T2D Ambition 1 T2D not in adequate glycaemic control on diet and exercise alone. 44w 200 patients End date 8/24 2028 Ambition 2 T2D plus CKD Basel insulin alone or in combination with metformin, SGLT2i, or both 52w 450 patients Enddate 9/25 2028 Ambition 3 (Higher dose levels - up to 40mg) T2D inadequately controlled on metformin, SGLT2i, or both 60w vs semaglutid 1200 patients End date 8/8 2028 Ambition 4 (low dose levels- up to 5mg) inadequately controlled on metformin, SGLT2i, or both 52w vs semaglutid 1060 patients End date 8/28 2028 With these 4 Zenagamtide P3 trials it will make 19 P3 trials started this year. With more to come including oral Zenagamtide for T2D early 2027. This shows the challenges for other BP to enter obesity. No one can develop as fast as $LLY and NVO who already have a ton of data and experience doing obesity trials and several other indications. And it’s all other indications than pure obesity where there’s reimbursement possibilities = much cheaper for the patients = accelerated growth It’s not just about sourcing a molecule from a biotech. They also needs to invest multiple billions in capacity expansion as well as multiple billions for development. $VKTX

Confirmed launch of wegovy pill in Spain. $NVO just had a press conference in Spain with official launch of wegovy pill This means 9 launches (4 launches within last week) + plus confirmed launch’s by NVO in 3 more countries. Plus I also expect launches in Italy, Sweden and Norway this year. Making 14 countries outside of US. This seems like an accelerated launch process than what NVO shared at CMD in September. My guess is they have just fired up the second out of 6 new mega lines in their API capacity expansion. consalud.es/industria/innova… $LLY $VKTX

Anthropic Q3 ER and AI business economics explained:)

New Zealand one step closer to reimbursement for GLP1 in high risk patient group with recommendations for it. But details not out yet. NZ government would also need to agree with $NVO on wegovy price. There’s also a recommendation in Australia for reimbursement for wegovy in high risk patient groups. But they have not been able to agree on price for more than 1 year. UK has such a deal in place with NVO for wegovy. Covers about 1.1 million. That program started in July/august. France also saw the launch of 2/3 reimbursement in June this year. Covering both Mounjaro and wegovy. But with a rather low cap on spending. I do believe we in the future will see more of this kind of agreements. Covering BMI 35-40+ with several co-morbidities that leads to higher cardiovascular disease. NZ and AUS will continue working on potentially deals with NVO for wegovy. $LLY $VKTX

Wegovy HD keeps the steady growth week over week. Run rate has passed $520 million. 2.4mg TRx still above 3x HD. And it’s from 2.4mg group HD recruits from. $LLY $NVO $VKTX.