By Maggie Fick
LONDON (Reuters) - Novo Nordisk (CSE:NOVOb)'s decision to launch its weight-loss drug Wegovy in Britain last week despite severe supply constraints may partly have been motivated by a desire to get ahead of rival Eli Lilly (NYSE:LLY)'s own similar drug, industry sources said.
They said Novo may also have been responding to concerns voiced by the British government and patient advocacy groups over the off-label use for weight loss of its diabetes drug Ozempic, which contains the same active ingredient as Wegovy.
The Danish company has said it wants to get Wegovy to those most in need.
"Even though the launch is limited and controlled, we are doing our best to get access to Wegovy for people with obesity in the UK," a Novo spokesperson said. "It is important that people with obesity have access to this medication and that our semaglutide products are used for their appropriate indication."
Wegovy has helped Novo become Europe's most valuable listed company, even though it has been unable to produce enough to meet demand in its existing markets. Before Monday's British launch, the self-injection drug was already being sold in the United States, Norway, Denmark and Germany.
Based on obesity statistics and prescription criteria, several million Britons could potentially be eligible for Wegovy. A 2019 Organisation for Economic Co-operation and Development (OECD) report said nearly one in three adults are obese in Britain, the highest level in Europe.
CEO Lars Fruergaard Jorgensen told Reuters on Aug. 25 that while supplies are limited, Novo would "constrain" and "target" launches to ensure Wegovy reaches the neediest patients.
But some medical experts warned its decision to distribute Wegovy in Britain through private prescribers as well as the National Health Service (NHS) could stoke demand and mean people who can afford to pay themselves find it easier to access.
Novo has had to limit supplies of starter doses in the United States as demand gallops ahead of supply while German doctors also say stocks are low.
Three private companies now prescribing Wegovy in Britain told Reuters the amounts they had received last week from a wholesaler were a small fraction of the demand they had registered from potential patients.
The figures they gave Reuters suggested deliveries of several thousand per provider, while the NHS has repeatedly declined to comment this week on volumes it has received.
Novo said on Monday that it would allocate a portion of available supply to the NHS, which said at present around 50,000 patients could be eligible in England.
CONTINUITY OF SUPPLY
An industry source, who did not have knowledge of Novo's decision-making process, said wanting to stay ahead of Lilly could have been a contributing factor.
Lilly's drug, Mounjaro, launched in the United States last year for type 2 diabetes but is expected to be approved there for weight-loss by year-end. Studies have demonstrated more weight loss than with Wegovy.
Mounjaro is expected to become available through the NHS for the treatment of type 2 diabetes later this year. On Friday Britain's drug cost-effectiveness watchdog NICE endorsed Mounjaro as a good option for patients with poorly controlled type 2 diabetes.
Novo's type 2 diabetes drug Ozempic has been on the market in Britain since 2019.
A Lilly spokesperson declined to comment on Wegovy's launch or when exactly it would launch Mounjaro for diabetes treatment.
In July, Britain's Department of Health and Social Care issued a medicine supply notification which did not name Ozempic but said there were "very limited, intermittent" supplies of the GLP-1 receptor agonist drugs approved to treat Type 2 diabetes.
"The thing that (Novo) has pulled off with Ozempic is they are the brand name associated with weight loss, and if they lose that market because they can't get continuity of supply and Eli Lilly take it, that would be seriously concerning for them," the industry source, who declined to be named, told Reuters.
To increase production, Novo is spending billions on new plants and hiring additional contract manufacturers.
Another factor behind the timing of the Wegovy launch could have been criticism by advocacy groups like Diabetes UK - and the government - over the widespread off-label use of Ozempic for weight loss and shortages for diabetes patients.
UBS analysts this week predicted that as U.S. and other insurers restrict access to weight loss drugs because widespread use at current prices is too costly, "more efficacious products will likely gain greater new patient share".
Studies have shown that, used alongside exercise and lifestyle changes, Wegovy led to 15% weight loss over 68 weeks, while Mounjaro led to more than 22% over 72 weeks.
UBS, which rates Novo shares a "sell", said that given Mounjaro's higher efficacy, it is unlikely the Danish company will ultimately dominate the obesity market.