- Novo Nordisk CEO acknowledges company’s first-mover advantage has become a competitive liability as Eli Lilly gains market share
- Doustdar says the company will break with Danish culture of humility to more aggressively defend its GLP-1 products
- CEO positions oral Wegovy and higher-dose injectable semaglutide as key weapons to reclaim market leadership
‘We Created the Scene for Everyone Else’
Novo Nordisk CEO Maziar Mike Doustdar delivered a candid assessment of his company’s competitive position at the J.P. Morgan Healthcare Conference, characterizing the Danish drugmaker’s pioneering role in obesity treatment as both a blessing and a burden as Eli Lilly rapidly gains market share.
“It’s the curse of a leader,” Doustdar told the JPM26 audience, reflecting on Novo Nordisk’s 30-year journey developing obesity therapies while competitors dismissed the disease. “We became the voice of 2 billion people and created a scenario that today pretty much almost every participant at JPMorgan is getting excited about entering this field.”
The acknowledgment marked an admission from the newly appointed CEO, who succeeded Lars Fruergaard Jørgensen just five months ago amid a turbulent year that saw Novo Nordisk’s share price decline approximately 40% as Lilly’s Zepbound (tirzepatide) captured significant market share.
Market Pioneer
“That’s great. That’s fantastic,” Doustdar said of competitors entering obesity. “But it is great and fantastic if we can deal with it and compete with them. Not if we create a scene for everyone else and then leave it to them.”
The CEO characterized 2025 as “a critical year for us to recognize this: we’re no longer on our own, and we need to hurry up.” He emphasized that Novo Nordisk cannot continue operating as it did “in the previous couple of years, where we were left alone just because we had a head start.”
When Novo Nordisk first entered obesity research three decades ago, Doustdar noted, “many of our peers who have sat in this stage now or will sit here in the future were making fun of us. They thought obesity was not a disease. Obesity, there is no money in it.”
Oral Wegovy: Staking Lead Position
Doustdar positioned Novo Nordisk’s recently approved oral Wegovy as a critical competitive advantage ahead of Lilly’s investigational oral GLP-1 orforglipron, which awaits FDA review.
Responding to a question characterizing Novo Nordisk’s timing advantage as “a little lead,” Doustdar corrected: “I don’t see it as a little lead. If you’re thinking about the time element of it, perhaps it’s a little. Life is longer than the distance between us and Lilly’s launch.”
He emphasized multiple differentiating factors beyond timing:
Efficacy: Oral Wegovy demonstrated 16.6% weight loss matching injectable formulations. “To the best of our knowledge today, no one has been able to show that in any Phase III clinical trials,” Doustdar stated.
Tolerability: Only 7% of trial participants discontinued oral Wegovy due to tolerability issues, compared to 22-24% discontinuation rates “at the highest dose from my competitors,” according to Doustdar.
Label advantages: Unlike investigational competitors, oral Wegovy carries the established Wegovy brand and cardiovascular benefit labeling.
Addressing Lilly’s Competitive Advantages
Doustdar confronted potential advantages for Lilly’s orforglipron, which lacks the fasting requirements associated with oral Wegovy.
“If I were sitting on the other side, I would try to drill on that one,” he acknowledged. However, Doustdar noted approximately 1.5 million patients currently use oral Rybelsus (semaglutide for diabetes) with identical fasting requirements, “and we have not seen this being an issue.”
He also highlighted restrictions in orforglipron’s clinical trial protocol requiring patients taking statins (commonly used by people with obesity) to wait 2-4 hours before dosing. “I don’t know about you, but I know how many obese patients take statins,” Doustdar said.
Breaking Danish Culture
In a departure from predecessor Jørgensen’s approach, Doustdar signaled a more aggressive communication strategy to counter competitive narratives.
“I love the company’s culture and the Danish-ness of the company. But I tell my Danish colleagues that sometimes when you’re too humble, and you don’t talk about things, people won’t read your mind, so they don’t hear it,” Doustdar said. “That’s why it gets lost in translation. We need to talk about it. So we’re going to start talking about these things more without thinking that we’re showing off too much.”
He specifically highlighted comparative data points previously understated by Novo Nordisk, including oral Wegovy’s tolerability profile and the cardiovascular and renal benefits demonstrated by semaglutide that “so far has not been proven elsewhere.”
2026: Year of Response
Doustdar outlined immediate priorities for reclaiming competitive position:
- Expanding direct-to-patient channels through partnerships with Ro, LifeMD, Amazon Pharmacy, Weight Watchers, and Costco
- Launching NovoCare Pharmacy, offering oral Wegovy starting doses at $149 monthly
- Rolling out 7.2-mg injectable semaglutide, demonstrating 20% of total body weight lost
- Advancing CagriSema (semaglutide/cagrilintide combination) showing 23% weight reduction with improved tolerability
“Our job this year is to recognize what we can do better,” Doustdar said. “2026 cannot be like the previous couple of years.”
The CEO concluded with a determination to maintain leadership in the market Novo Nordisk created: “I am really happy that I work for a company that became the voice of 2 billion people. But we need to make sure we can deal with it and compete.”
