What is the sales ceiling for Semaglutide? Currently, no one can provide an exact answer, but it is certainly not $30 billion.

On February 5, Novo Nordisk announced its 2024 results: total revenue of DKK 290.403 billion (approximately $42.1 billion), a 26% year-on-year growth.

Driving Novo Nordisk’s performance is the various versions of Semaglutide. In the past year, Novo Nordisk’s three Semaglutide products generated DKK 201.849 billion (approximately $29.3 billion), nearly doubling the sales from 2023 ($21.2 billion).

Semaglutide is rapidly closing the gap with the king of drugs, Keytruda. In 2024, Keytruda’s sales were $29.482 billion.

The outstanding performance of Semaglutide illustrates Novo Nordisk’s "elephant dance" miracle and showcases the strong profitability of pharmaceutical industry blockbuster products. In RMB terms, Novo Nordisk "earns" 580 million yuan per day in 2024.

Even with challenges from competitors and the harsh realities of the U.S. healthcare system, Semaglutide is highly likely to become one of the best-selling drugs of all time, benefiting patients while continuously refreshing profitability "myths".

Exceeding Expectations at Novo Nordisk

In 2024, Novo Nordisk exceeded market expectations.

According to its financial report, the Danish pharmaceutical giant saw a 29% year-on-year increase in its Q4 net profit, reaching DKK 28.23 billion ($3.98 billion), surpassing the market’s forecast of DKK 26.09 billion. The full-year net profit grew 21%, totaling DKK 100.99 billion, above the market’s expected DKK 99.14 billion.

The largest contributor to Novo Nordisk’s stellar performance is its star drug, Semaglutide. In 2024, Semaglutide's total sales reached $29.3 billion, accounting for about 69.5% of Novo Nordisk’s total revenue. Among its versions, the weight-loss version, Wegovy, showed the highest growth.

Specifically, 

• Ozempic (diabetes injection version) sales reached DKK 120.342 billion, a 26% year-on-year growth; 
• Rybelsus (diabetes oral version) sales reached DKK 23.301 billion, also growing by 26%; 
• Wegovy (weight-loss version) sales reached DKK 58.206 billion, an 86% increase.

The soaring demand for Wegovy was a major factor that led to Novo Nordisk’s net profit exceeding expectations. This also indirectly reflects the extraordinarily strong demand for weight-loss drugs in the U.S. market.

From a regional revenue perspective, the U.S. is undoubtedly Novo Nordisk’s main market. In 2024, nearly 80% (DKK 45.7 billion) of Wegovy’s sales came from the U.S., with other countries and regions contributing only about 20%.

It seems that for any drug, expanding into the U.S. market is a must-do.

Semaglutide’s Future: Firepower Not Fully Unleashed

Where is Semaglutide headed? There is a lot of disagreement in the market.

This is understandable. The demand for weight-loss drugs is booming, but the market is filled with competition and challenges, especially with long-time rival Eli Lilly eyeing the market.

Novo Nordisk itself predicts a slight slowdown in sales in 2025. They forecast that sales growth will slow to between 16% and 24% in 2025, down from the 18% to 26% growth predicted for 2024.

Of course, for a company of this scale, achieving this growth would not be considered bad. Moreover, Semaglutide’s growth will not be limited to just the weight-loss indication.

In the past year, Semaglutide has made significant progress:

• Wegovy received approval for a new indication to reduce cardiovascular event risks.
• Ozempic’s new indication for treating peripheral artery disease (PAD) is under review in Europe and the U.S.
• Rybelsus has a new indication to reduce the risk of major cardiovascular events in Type 2 diabetes patients with cardiovascular and/or chronic kidney disease, which is also under review in Europe and the U.S.
• Wegovy’s Phase 3 MASH study has achieved success in the first part.

These indications share a common characteristic: broad patient populations with an urgent need for more effective treatments, and GLP-1 may be the key solution to addressing these issues, with significant commercial potential.

A typical example is the MASH market.

On November 1st of last year, Novo Nordisk announced the preliminary results of the Phase 3 ESSENCE trial for Wegovy in the treatment of MASH, showing that compared to the placebo, Wegovy improved liver fibrosis without worsening steatohepatitis, and achieved regression of steatohepatitis without worsening liver fibrosis.

Specifically, at Week 72, 37% of patients in the Wegovy group had improved liver fibrosis without worsening steatohepatitis, compared to 22.5% in the placebo group; 62.9% of Wegovy patients had steatohepatitis regression without worsening liver fibrosis, compared to 34.1% in the placebo group. Both endpoints showed significant differences.

After placebo adjustment, the values for these two endpoints were 14.5% and 28.8%, respectively. Compared to other mechanisms like THRβ and FGF21, Wegovy also showed competitive potential in improving fibrosis endpoints.

Although the data is only the preliminary result of the ESSENCE study, and final performance needs time for validation, it still shows that Semaglutide’s total sales have not yet hit a ceiling.

Serious Medicine Going Mainstream

The Semaglutide story is quite rare in the pharmaceutical industry—it is essentially an example of serious medicine going mainstream.

Serious medicine refers to treatments aimed at curing diseases and saving lives. Initially, Semaglutide had little to do with consumer healthcare. After all, it was first developed as a diabetes drug, falling strictly within the category of serious medicine, not consumer healthcare.

Even Semaglutide’s well-known weight-loss indication falls within the realm of serious medicine. Its target patient group has strict prescription requirements, and the patient population is also tightly regulated.

However, Semaglutide’s emergence has brought innovative solutions to obesity treatment, while also bringing the issue of obesity back into the public's focus as a health topic. By successfully raising global awareness about healthy weight management, Semaglutide has become a huge success, skyrocketing its brand recognition.

The success of Semaglutide has also ignited the GLP-1 market. Currently, the market's enthusiasm for this field is soaring, and many companies are benefiting from the spillover effect of Semaglutide.

However, while enjoying the benefits, Novo Nordisk has also provided valuable lessons to many pharmaceutical companies: no matter how famous Semaglutide becomes, it is built on rigorous clinical research.

For example, Wegovy’s success is due to the STEP series of studies, which were meticulously conducted. As Wegovy’s global large-scale clinical trials, the STEP series included about 25,000 overweight and obese participants, providing clear answers through significant financial and time investments.

This not only raises the competitive bar but also serves as a reminder to all pharmaceutical companies: when chasing hot market trends, solid clinical research must be the foundation. Blindly following trends is a mistake. Only by being genuinely responsible for patients can companies hope to achieve commercial success.