Novo Nordisk A/S
The latest investment analysis on Novo Nordisk A/S
Group Research - Equities22 Apr 2024
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Company Overview
Novo Nordisk A/S is a Denmark-based pharmaceutical company engaged in diabetes care. The company operates through two business segments: diabetes and obesity care, and biopharmaceuticals. The diabetes and obesity care segment (93% of FY23 sales) covers insulin, GLP-1, oral anti-diabetic drugs. The biopharmaceuticals segment (7% of FY23 sales) covers hemophilia care, growth hormone therapy and hormone replacement therapy. The company focuses on the US (55% of FY23 sales) and European (22% of FY23 sales) market.


Investment Overview
Since 2017, Novo Nordisk’s once weekly anti-diabetic injections have moved its share price. In 2017, Novo launched its first glucagon-like peptide-1 (GLP-1) receptor agonist, Ozempic, for treatment of type 2 diabetes using the active ingredient Semaglutide. Patients observed significant weight loss, prompting the indication expansion of Semaglutide to weight loss under the brand name Wegovy in 2021. These two products caused Novo’s revenue to grow at 20% CAGR from 2020-23, with Ozempic and Wegovy making up 41% and 13% of FY23 sales respectively.

Meteoric rise coming to a halt as competitors catch up. Novo Nordisk doubled its revenues in 3 years from DKK127m to DKK232m from FY20 to FY23 and tripled its share price from DKK213 to DKK698 over the same time period. This was largely due to its GLP-1 product line, which made up >50% of its FY23 revenue. Novo made full use of its first-mover advantage to gain market share, with its GLP-1 product Ozempic for type 2 diabetes obtaining FDA and EU approvals in 2017 and 2018 respectively, being 4 years earlier to these markets than its closest rival, Eli Lilly, which obtained both approvals in 2022. However, Novo’s throne is wavering, with Eli Lilly seeing its GLP-1 Mounjaro racking in sales amounting to 37% that of Novo’s Ozempic in FY23 despite being launched 4 years later. Eli Lilly is catching up, as its GLP-1 products have demonstrated stronger clinical data compared to Novo, such as oral GLP-1 drugs for weight loss (14.7% weight loss in 36 weeks vs 17.4% weight loss in 68 weeks) and weight loss injections (13.6% weight loss in 52 weeks vs 14.9% weight loss in 68 weeks).

Catalysts coming to an end. Apart from riding on its first-mover advantage, Novo’s strategy also included indication expansion of GLP-1. Novo’s Semaglutide obtained FDA approval for type 2 diabetes in 2017, weight loss in 2021, cardiovascular disease in 2024, and is expected to expand to chronic kidney disease in end-2024. However, indication expansions are increasing the potential patient size by a smaller percentage compared to previous indication expansions, as exemplified by expansion to obesity in 2021 grew market size by 121%, while expansion to cardiovascular disease in 2024 grew market size by 21% only. With competitors catching up rapidly and Novo’s valuation hitting all-time-highs, the next indication expansion catalyst would cause a much smaller spike in its share price compared to previous expansions, with the most recent expansion to cardiovascular disease moving share price c.7% over 1 month after FDA approval in 8 Mar 2024. Novo now suffers from a lack of catalysts, as many key clinical data and product launches have already been announced.

We have a SELL rating on Novo Nordisk, with TP of DKK625. Our TP is based on 26.6x 24F PE, which is on par with its five-year average due to competitors catching up to its clinical efficacy and catalysts coming to an end, likely leading to loss in market share and an end of its meteoric rise.


Risks
Huge influx of competitors may endanger market share. Large numbers of drug makers are desperately fighting to enter the GLP-1 market, which is still largely dominated by Novo Nordisk with >50% market share. Novo is at danger of getting pushed off the throne with competitors demonstrating better clinical efficacy at similar price.

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