WEBVTT
1
00:00:00.550 --> 00:00:03.700
Hi, I'm Wendy Zuckerman from Science Versus. Today, we've got
2
00:00:03.740 --> 00:00:06.299
something a little different for you. We are sharing an
3
00:00:06.339 --> 00:00:09.900
episode from The Journal about the rise of Ozempic and
4
00:00:10.019 --> 00:00:12.750
other blockbuster drugs that are being used for weight loss.
5
00:00:13.580 --> 00:00:15.439
And this episode is part of a series that the
6
00:00:15.480 --> 00:00:18.199
journal is doing called Trillion Dollar Shot.
7
00:00:18.679 --> 00:00:21.780
Now, if you listen to Science Versus a lot, thank you.
8
00:00:22.489 --> 00:00:25.269
But you'll know that we've covered these kinds of drugs
9
00:00:25.469 --> 00:00:27.629
a bit and we've talked about how they work and
10
00:00:27.690 --> 00:00:31.050
what their potential side effects are. But in this episode today,
11
00:00:31.079 --> 00:00:34.479
you're going to hear the details of how these medications
12
00:00:34.679 --> 00:00:38.259
first got made. and how for a moment there, it
13
00:00:38.280 --> 00:00:41.460
looked like Big Pharma was going to stop their development.
14
00:00:42.119 --> 00:00:44.799
Trillion Dollar Shot is coming up just after the break.
15
00:00:53.350 --> 00:00:56.229
It's been a busy week, right? Sounds like it's time
16
00:00:56.270 --> 00:01:01.009
for that takeaway. Deliveroo's on it. Whether it's extra saucy
17
00:01:01.090 --> 00:01:05.290
wings from Nando's, a tasty taco bowl from Sprout & Co,
18
00:01:05.769 --> 00:01:09.790
or maybe even some California birria from Boojum. We'll deliver
19
00:01:09.810 --> 00:01:14.950
in as little as 25 minutes. Order now. You've earned it. Deliveroo.
20
00:01:15.519 --> 00:01:20.040
That finish line Friday feeling just got even better. Geographical restrictions,
21
00:01:20.079 --> 00:01:22.340
teas and season fees apply. Delivery times vary. See app
22
00:01:22.359 --> 00:01:23.060
or web for info.
23
00:01:33.859 --> 00:01:39.590
I admit to a slight bit of syringe anxiety. I'm
24
00:01:40.129 --> 00:01:43.030
not happy to admit that, but, you know, that is
25
00:01:43.069 --> 00:01:44.829
something that I've dealt with.
26
00:01:45.140 --> 00:01:47.799
Back in January, I hopped on a video call with
27
00:01:47.840 --> 00:01:52.060
my colleague Bradley Olson, who's out in San Francisco. Brad
28
00:01:52.079 --> 00:01:54.319
was about to give himself a dose of a drug
29
00:01:54.519 --> 00:01:57.569
he'd been taking for weight loss. It was an unusual
30
00:01:57.689 --> 00:01:59.810
and personal moment for a coworker to share.
31
00:02:00.489 --> 00:02:02.650
Whenever I would get it, like, the first couple times,
32
00:02:02.709 --> 00:02:05.129
I would, like, just breathe in, breathe out, you know?
33
00:02:06.390 --> 00:02:08.590
And then it would feel, like, ridiculous because it's, like,
34
00:02:09.090 --> 00:02:11.789
a very small pinprick that you barely feel.
35
00:02:12.030 --> 00:02:14.439
You know? Brad has struggled with his weight for more
36
00:02:14.479 --> 00:02:18.180
than 20 years. And he said this medication made it
37
00:02:18.360 --> 00:02:20.919
easier than it had ever been for him to lose weight.
38
00:02:21.740 --> 00:02:24.759
In five months, Brad had lost about 40 pounds.
39
00:02:25.219 --> 00:02:27.740
You know, the thing that was in the beginning like
40
00:02:27.780 --> 00:02:33.870
a revelation— I know that sounds crazy, but like without medicine,
41
00:02:35.389 --> 00:02:38.610
when I would eat well, when I would kind of
42
00:02:38.729 --> 00:02:43.770
follow a good course, I would just feel very hungry
43
00:02:45.050 --> 00:02:48.490
and it wouldn't be a good hungry. It would just
44
00:02:48.550 --> 00:02:57.349
be annoying, annoying and disruptive and frustrating. When you're on
45
00:02:57.370 --> 00:03:01.669
the medicine, it was just great. Those voices, which I
46
00:03:01.750 --> 00:03:04.770
came to really hate, were just silent.
47
00:03:08.490 --> 00:03:11.569
This medicine is part of a new class of pharmaceuticals
48
00:03:11.889 --> 00:03:14.849
that has exploded in popularity over the last few years.
49
00:03:16.060 --> 00:03:20.879
The most well-known is Ozempic. Brad was taking one called Manjaro.
50
00:03:20.900 --> 00:03:25.139
Anyway, so I'm going to take my syringe out of
51
00:03:25.159 --> 00:03:25.639
the box.
52
00:03:25.680 --> 00:03:27.020
It's five milligrams.
53
00:03:27.879 --> 00:03:28.340
And, um.
54
00:03:29.419 --> 00:03:34.319
You know, it's refrigerated, so it feels vaguely cold. You
55
00:03:34.340 --> 00:03:37.620
can put the injection in your upper thigh or in your, like,
56
00:03:37.719 --> 00:03:41.780
belly or stomach. I have never done the belly, just
57
00:03:41.819 --> 00:03:44.969
because I don't want a syringe in my belly. And
58
00:03:45.000 --> 00:03:47.120
so the thigh was always kind of where I put it.
59
00:03:52.069 --> 00:03:57.930
That day, that dose, was Brad's last shot. he had
60
00:03:57.969 --> 00:04:00.090
decided to stop taking the medication.
61
00:04:01.569 --> 00:04:02.610
So without further.
62
00:04:02.330 --> 00:04:04.289
Ado, here we go.
63
00:04:04.460 --> 00:04:13.000
Here's the last hurrah of Brad's time with Manjaro. All right,
64
00:04:13.300 --> 00:04:13.819
there we go.
65
00:04:16.879 --> 00:04:17.600
How do you feel, Brad?
66
00:04:20.399 --> 00:04:22.610
It's done. I think I feel good. I feel a
67
00:04:22.639 --> 00:04:24.730
little bit of Anxiety?
68
00:04:24.750 --> 00:04:25.269
Yeah.
69
00:04:25.769 --> 00:04:29.329
Because when you're on the medicine, it's so easy to
70
00:04:29.480 --> 00:04:32.680
lose weight that you don't really have to use any
71
00:04:33.279 --> 00:04:36.560
willpower or plan or anything. It just is going to
72
00:04:36.620 --> 00:04:38.160
happen and you know it's going to happen.
73
00:04:39.720 --> 00:04:43.819
Brad documented his journey on and off the medication because
74
00:04:43.860 --> 00:04:46.560
his time on the medicine and his decision to stop
75
00:04:46.600 --> 00:04:52.040
taking it stirred up a lot of feelings. Surprise, anger, uncertainty.
76
00:04:52.060 --> 00:04:56.230
It was a lot. So after Brad took his last shot,
77
00:04:56.730 --> 00:04:58.939
he and I decided to report on the impact of
78
00:04:58.980 --> 00:05:02.660
these drugs. We set out to understand, are they a
79
00:05:02.699 --> 00:05:06.579
true turning point for America's struggle with obesity? And if so,
80
00:05:07.339 --> 00:05:11.699
are we ready for everything that would mean? Because people
81
00:05:11.740 --> 00:05:15.439
who've taken these medications told us the same things over
82
00:05:15.620 --> 00:05:18.649
and over again. All of a sudden, just the weight
83
00:05:19.069 --> 00:05:21.990
starts falling off. You know, eight pounds the first month.
84
00:05:22.170 --> 00:05:24.209
I felt like it was a miracle. Three pounds the
85
00:05:24.269 --> 00:05:24.750
second month.
86
00:05:24.949 --> 00:05:26.199
Life-changing for sure.
87
00:05:26.319 --> 00:05:30.720
Ten pounds the third month. That's how powerful this medication is.
88
00:05:30.980 --> 00:05:33.180
Then it just was like, how is this happening?
89
00:05:33.379 --> 00:05:36.009
I could tell it was working and I could tell
90
00:05:36.069 --> 00:05:39.850
that it was changing my relationship with food and I
91
00:05:39.949 --> 00:05:40.569
liked that.
92
00:05:41.930 --> 00:05:45.730
This type of success has meant huge windfalls for drug makers.
93
00:05:46.069 --> 00:05:49.310
We said, oh, Jesus, this can become a big, big drug.
94
00:05:49.410 --> 00:05:51.430
It's been a boon. There's no denying that.
95
00:05:51.449 --> 00:05:54.290
You know, the demand is higher than what we can
96
00:05:54.329 --> 00:05:55.769
deliver to people today.
97
00:05:56.629 --> 00:06:00.300
And that demand for these drugs is reverberating across society.
98
00:06:00.959 --> 00:06:03.199
And I thought, well, I'll stay on this for life
99
00:06:03.339 --> 00:06:07.540
because it's so helpful. And then I realized what it
100
00:06:07.579 --> 00:06:08.480
was going to cost me.
101
00:06:08.660 --> 00:06:10.220
They're just bank breakers.
102
00:06:10.660 --> 00:06:10.920
Okay.
103
00:06:11.529 --> 00:06:14.649
If I can't get the drug, what can I take instead?
104
00:06:15.189 --> 00:06:15.990
What's close?
105
00:06:16.370 --> 00:06:20.350
There are so many people even selling bathtub Ozempic.
106
00:06:20.470 --> 00:06:21.529
There was a lot of excitement.
107
00:06:21.629 --> 00:06:22.850
There was a lot of skepticism.
108
00:06:22.949 --> 00:06:25.230
And I can imagine a future where life expectancies are
109
00:06:25.310 --> 00:06:28.509
actually increasing because of this class of drugs.
110
00:06:30.389 --> 00:06:32.990
Whether you think these drugs are a miracle or you're
111
00:06:33.009 --> 00:06:36.550
skeptical of what they promise, they're changing how we approach
112
00:06:36.769 --> 00:06:39.310
one of the most intractable issues in our society.
113
00:06:40.050 --> 00:06:40.509
Obesity.
114
00:06:41.410 --> 00:06:50.370
And it's just the beginning. From the Journal, this is
115
00:06:50.470 --> 00:06:53.220
Trillion Dollar Shot. I'm Jessica Mendoza.
116
00:06:53.459 --> 00:06:54.420
And I'm Bradley Olson.
117
00:07:01.870 --> 00:07:27.129
This is Episode One, Birth of a Blockbuster. So, why
118
00:07:27.269 --> 00:07:28.529
did you want to lose weight?
119
00:07:37.230 --> 00:07:40.060
I'm trying to be as honest as I can as
120
00:07:41.069 --> 00:07:41.860
I think about it.
121
00:07:41.879 --> 00:07:44.019
It's a hard question.
122
00:07:44.680 --> 00:07:45.350
Yeah. And.
123
00:07:50.490 --> 00:07:56.709
I wanted to look better. I know that some people
124
00:07:56.730 --> 00:07:59.670
will say it was for my kids and it was,
125
00:07:59.689 --> 00:08:05.699
I wish that I had some noble reason. I'm just
126
00:08:05.720 --> 00:08:10.759
being honest. The noble reason is like, I've got kids
127
00:08:10.819 --> 00:08:12.620
and I wanna run with them. And I would think
128
00:08:12.680 --> 00:08:16.029
about that, but I would run with them. And I
129
00:08:16.050 --> 00:08:20.019
would think about other things, but in the end, I
130
00:08:20.060 --> 00:08:26.839
felt like I'm not supposed to be like this. You know,
131
00:08:28.000 --> 00:08:28.750
this isn't me.
132
00:08:30.689 --> 00:08:35.490
Brad's story is familiar to millions of Americans. For decades,
133
00:08:35.830 --> 00:08:39.570
obesity has been on the rise. The CDC says one
134
00:08:39.610 --> 00:08:43.320
in three adults in the U.S. is obese. The condition
135
00:08:43.379 --> 00:08:47.340
is linked to shorter life expectancy, to diabetes, heart disease,
136
00:08:47.659 --> 00:08:51.179
and to some cancers. not to mention larger healthcare bills.
137
00:08:52.139 --> 00:08:55.500
And billions have been poured into addressing the issue. But
138
00:08:55.559 --> 00:08:58.639
nothing's been able to bring the numbers down. What most
139
00:08:58.679 --> 00:09:03.100
doctors recommend, diet and exercise, they don't work long-term for
140
00:09:03.139 --> 00:09:08.360
most people. And short of surgery, the great minds of industry, technology,
141
00:09:08.399 --> 00:09:11.350
and medicine just haven't been able to find an effective
142
00:09:11.379 --> 00:09:14.210
treatment until this new class of drugs.
143
00:09:15.169 --> 00:09:20.629
Every doctor interaction that you have when it's about weight loss,
144
00:09:20.659 --> 00:09:24.220
it's always the doctor's like, I'm telling you things that
145
00:09:24.240 --> 00:09:26.899
you're not going to do. They don't say that, but
146
00:09:26.919 --> 00:09:30.200
it's just the subtext is basically like this conversation of,
147
00:09:30.820 --> 00:09:33.120
I'm telling you things to do, and I don't think
148
00:09:33.139 --> 00:09:35.299
you're going to do them. It was like we were
149
00:09:35.360 --> 00:09:39.139
performing in a play. He was pretending to be a
150
00:09:39.179 --> 00:09:41.940
doctor that believed he was giving good advice, and I
151
00:09:41.960 --> 00:09:44.720
was pretending to be a patient that was listening and
152
00:09:44.779 --> 00:09:47.340
was really going to make a change. Neither was true.
153
00:09:48.970 --> 00:09:51.980
And the difference with this conversation was like, this is
154
00:09:52.009 --> 00:09:55.840
going to work. Like, there was no doubt about whether
155
00:09:55.860 --> 00:09:57.409
or not it was going to work. And that was
156
00:09:57.470 --> 00:09:58.210
such a difference.
157
00:09:59.870 --> 00:09:59.950
And.
158
00:10:00.460 --> 00:10:03.139
How did it go? Like how quickly did you start
159
00:10:03.159 --> 00:10:05.639
to lose weight and what were your reactions?
160
00:10:07.039 --> 00:10:12.129
I was just shocked. I had heard people talk about
161
00:10:12.750 --> 00:10:16.679
being on the medicine and how it really zapped their cravings.
162
00:10:16.799 --> 00:10:19.350
You know, I had read that. But to experience it
163
00:10:19.659 --> 00:10:21.330
is another thing entirely.
164
00:10:23.169 --> 00:10:25.590
Brad's going to share more of his own story throughout
165
00:10:25.629 --> 00:10:29.009
this series. But first, we want to go back to
166
00:10:29.049 --> 00:10:32.610
where it all started. Ozempic was developed by a Danish
167
00:10:32.649 --> 00:10:37.889
pharmaceutical company called Novo Nordisk. The story starts in the
168
00:10:38.690 --> 00:10:41.490
1990s with a woman named Lara Bjerre Knudsen.
169
00:10:41.980 --> 00:10:44.779
I did a lot of work in the laboratory. I
170
00:10:44.820 --> 00:10:46.570
was the lab rat.
171
00:10:48.629 --> 00:10:51.950
Lada was a young scientist at Novo Nordisk. When she
172
00:10:51.990 --> 00:10:54.669
was just starting her career, she was focused on what
173
00:10:54.769 --> 00:10:58.129
most scientists at Novo were there to do, develop drugs
174
00:10:58.220 --> 00:10:59.340
for treating diabetes.
175
00:11:00.039 --> 00:11:03.100
I always wanted to work for this company.
176
00:11:03.240 --> 00:11:08.059
And I was very set on wanting to make product-related research.
177
00:11:08.159 --> 00:11:10.950
I never wanted to be an academic researcher.
178
00:11:11.990 --> 00:11:15.070
I just knew that I wanted to make products that
179
00:11:15.129 --> 00:11:16.929
could somehow be useful.
180
00:11:17.009 --> 00:11:17.870
For human beings.
181
00:11:18.669 --> 00:11:20.950
And Lara had a bit of a reputation.
182
00:11:20.970 --> 00:11:24.389
I won't say that I have a temper. Maybe some
183
00:11:24.429 --> 00:11:27.549
people would say that about me. But I'm very dedicated
184
00:11:28.070 --> 00:11:29.049
and energy.
185
00:11:29.090 --> 00:11:33.929
I had ideas. I wasn't really shy and I did
186
00:11:34.490 --> 00:11:35.789
not give up too easily.
187
00:11:38.309 --> 00:11:40.179
And so what was it that you were working on?
188
00:11:41.049 --> 00:11:43.519
We had all kinds of ideas, you know. At that
189
00:11:43.580 --> 00:11:48.059
point in time in pharma for diabetes, there was a
190
00:11:48.139 --> 00:11:52.600
big desire to do something new, you know. And then
191
00:11:52.659 --> 00:11:56.690
GLP-1 was just one of those ideas that were around
192
00:11:56.750 --> 00:11:58.090
in the community.
193
00:11:57.570 --> 00:11:58.190
At that time.
194
00:12:00.850 --> 00:12:06.169
GLP-1. It stands for glucagon-like peptide. It's a gut hormone,
195
00:12:06.669 --> 00:12:08.539
and it's the basis for this new class of drugs.
196
00:12:09.639 --> 00:12:11.970
When Lada started working on it, there was research that
197
00:12:12.019 --> 00:12:16.169
showed that the GLP-1 hormone lowered blood sugar levels, which
198
00:12:16.210 --> 00:12:19.529
is important for treating diabetes. But no one had figured
199
00:12:19.590 --> 00:12:22.470
out how to make GLP-1 work as an effective treatment.
200
00:12:23.149 --> 00:12:25.029
It didn't hold up in the human body for long.
201
00:12:25.490 --> 00:12:26.990
It was gone in two minutes.
202
00:12:27.809 --> 00:12:31.250
That was really the problem to be solved was to
203
00:12:31.330 --> 00:12:33.210
make GLP-1 long-acting.
204
00:12:33.990 --> 00:12:36.850
So when you say gone in two minutes or making
205
00:12:36.889 --> 00:12:39.480
it long-acting... Does that mean it like breaks down in
206
00:12:39.500 --> 00:12:41.279
the body as soon as it like appears?
207
00:12:41.960 --> 00:12:45.360
Yeah, there are several ways that things can disappear from
208
00:12:45.399 --> 00:12:49.240
the body, right? One is that metabolic enzymes can degrade it,
209
00:12:49.799 --> 00:12:54.509
but then also things can be taken out via the kidneys.
210
00:12:55.549 --> 00:12:57.850
Lotto worked with a team to try to solve this puzzle,
211
00:12:58.429 --> 00:13:00.850
to try to get this powerful hormone to stay in
212
00:13:00.870 --> 00:13:04.250
the body long enough to work. But then she went
213
00:13:04.309 --> 00:13:07.970
on maternity leave. And when she came back in 1994,
214
00:13:07.970 --> 00:13:09.809
Novo had gone through some restructuring.
215
00:13:10.610 --> 00:13:12.490
Most of the people I'd worked with, they were gone.
216
00:13:13.009 --> 00:13:16.549
So I was kind of like the only one that
217
00:13:16.990 --> 00:13:20.610
knew anything about those projects. And the new leadership said
218
00:13:20.629 --> 00:13:23.470
to me, you know, you are the one that kind
219
00:13:23.529 --> 00:13:26.549
of knows this biology, so you figure out what we
220
00:13:26.580 --> 00:13:26.909
should do.
221
00:13:27.980 --> 00:13:29.600
What did you do? Did you freak out?
222
00:13:30.539 --> 00:13:34.129
Not so that anyone could see it, right? But it
223
00:13:34.750 --> 00:13:36.950
was a little bit of a lonely time, right? Because
224
00:13:36.970 --> 00:13:40.409
the people that I considered my closest work friends, they
225
00:13:40.450 --> 00:13:43.149
were gone, right? So I still had a group of
226
00:13:43.250 --> 00:13:46.750
laboratory technicians that were working with me and doing cool
227
00:13:46.789 --> 00:13:49.769
things in a lab. But this thing about figuring out
228
00:13:49.850 --> 00:13:53.220
how to lead the project, which idea to focus on,
229
00:13:53.669 --> 00:13:57.940
I was completely alone with that. So I was basically
230
00:13:57.980 --> 00:14:01.590
sitting in my in my office for a couple of months,
231
00:14:01.710 --> 00:14:03.210
kind of staring at the walls.
232
00:14:06.669 --> 00:14:10.230
Lada was now leading the GLP-1 team. But they weren't
233
00:14:10.269 --> 00:14:14.169
making much headway towards a functional drug. And leaders at
234
00:14:14.250 --> 00:14:17.929
Novo started to get antsy. Leaders like this guy.
235
00:14:18.450 --> 00:14:21.850
Yeah, my name is Lars-Oribian Sorensen. I used to be
236
00:14:21.929 --> 00:14:23.850
the CEO of Novo Nordisk.
237
00:14:25.450 --> 00:14:29.919
GLP-1 research was not the company's priorities. So Lars was like,
238
00:14:30.379 --> 00:14:32.259
why were they even messing around with this hormone?
239
00:14:33.340 --> 00:14:35.740
Well, I have to admit at the time, I thought
240
00:14:35.759 --> 00:14:40.639
it was a strange idea. We were primarily selling insulin.
241
00:14:40.750 --> 00:14:40.919
Right.
242
00:14:41.779 --> 00:14:46.950
And competition in the area of insulins were quite fierce.
243
00:14:47.669 --> 00:14:52.269
This GLP-1 compound was very, very short-lived.
244
00:14:52.610 --> 00:14:52.830
Right.
245
00:14:52.950 --> 00:14:55.970
And really, it was difficult to create a drug out
246
00:14:56.009 --> 00:14:59.320
of it. Quite frankly, I was worried that we were
247
00:14:59.549 --> 00:15:03.379
spreading our resources too thinly. We were a small company,
248
00:15:03.419 --> 00:15:06.059
so I knew everybody. And they would come into my
249
00:15:06.179 --> 00:15:09.320
office and, you know, ask for more resources.
250
00:15:10.899 --> 00:15:13.090
I asked Lars if Lotta was one of those people.
251
00:15:13.879 --> 00:15:17.529
Oh, yeah, all the time. I could not meet Lotta
252
00:15:17.570 --> 00:15:22.889
without her really getting on my case to prioritize her
253
00:15:22.950 --> 00:15:27.980
projects better. Lotte Knudsen is a person that's very, very
254
00:15:28.299 --> 00:15:29.379
difficult to say no to.
255
00:15:33.259 --> 00:15:36.799
Even with Lotte pushing the project, Lars considered canning the
256
00:15:36.840 --> 00:15:37.279
whole thing.
257
00:15:37.299 --> 00:15:40.360
I do recall that we did give him 12 months
258
00:15:40.419 --> 00:15:41.980
to say, you've got to come up with something which
259
00:15:42.039 --> 00:15:47.220
is more convincing. And my recollection is it was extraordinarily
260
00:15:47.259 --> 00:15:50.730
slow developing at the time. And I'm sure a lot
261
00:15:50.750 --> 00:15:52.870
of people will say this is because we had no resources.
262
00:15:53.669 --> 00:15:57.629
But anyway, because of their stubbornness and their skills and
263
00:15:57.669 --> 00:16:03.759
their professionalism, they eventually were able to create a molecule
264
00:16:03.799 --> 00:16:07.039
that was protracted so it became a real drug that
265
00:16:07.059 --> 00:16:09.879
we could start to make clinical trials on.
266
00:16:10.879 --> 00:16:14.419
Lada and her team had met the deadline. By then,
267
00:16:14.440 --> 00:16:18.659
it was 1997. All told, it had taken about four
268
00:16:18.759 --> 00:16:21.340
years for them to create a compound that mimicked the
269
00:16:21.379 --> 00:16:25.090
effects of GLP-1, and didn't immediately break down in the body.
270
00:16:26.029 --> 00:16:29.509
They called this compound liraglutide, and it stayed in the
271
00:16:29.549 --> 00:16:33.169
body for 24 hours. Think of it as a precursor
272
00:16:33.250 --> 00:16:38.639
to Ozempic. Same scientific idea, just not as powerful. The
273
00:16:38.679 --> 00:16:42.899
next step was to test liraglutide on patients. But inside
274
00:16:42.940 --> 00:16:46.620
Novo Nordisk, Lada's team still had to fight for limited resources,
275
00:16:47.320 --> 00:16:49.580
and that problem felt to Lada's boss.
276
00:16:50.240 --> 00:16:52.970
As a very young lad, I had Big hair, big
277
00:16:52.990 --> 00:16:57.620
curly hair, lots of hair, not anymore. And so I
278
00:16:57.629 --> 00:16:59.820
look like a typical young, nerdy scientist.
279
00:17:00.620 --> 00:17:04.380
That's Mads Krogsgaard-Thomsen, a former senior vice president at the
280
00:17:04.420 --> 00:17:07.539
company and a big champion of Lottas. And he wasn't
281
00:17:07.579 --> 00:17:09.920
afraid to get creative to keep her project going.
282
00:17:10.819 --> 00:17:13.279
Well, the first stumbling block was that we were a
283
00:17:13.279 --> 00:17:16.660
little bit behind in production capacity for insulin. So we
284
00:17:16.740 --> 00:17:21.309
literally had no utilization of any production facility in the company.
285
00:17:21.799 --> 00:17:24.390
So I had to give the team money to go
286
00:17:24.430 --> 00:17:27.849
to Belgium to ask another pharmaceutical company to produce.
287
00:17:27.569 --> 00:17:27.930
It for us.
288
00:17:28.470 --> 00:17:30.829
And so you had to do it basically off campus
289
00:17:31.509 --> 00:17:32.470
to get this stuff done?
290
00:17:32.809 --> 00:17:34.130
In a competing company already.
291
00:17:34.170 --> 00:17:35.089
In a competing company.
292
00:17:35.130 --> 00:17:35.730
Another company.
293
00:17:37.890 --> 00:17:41.490
Eventually, they did get enough medicine for human trials. But
294
00:17:41.539 --> 00:17:44.220
at first, it produced a really nasty side effect.
295
00:17:45.769 --> 00:17:47.430
The people in the phase one trial, they vomited.
296
00:17:47.710 --> 00:17:47.970
Wow.
297
00:17:48.279 --> 00:17:49.579
So they literally felt sick.
298
00:17:50.240 --> 00:17:52.759
And this, of course, didn't convince management that this was
299
00:17:52.799 --> 00:17:53.980
very exciting at all.
300
00:17:54.440 --> 00:17:54.660
Right.
301
00:17:54.680 --> 00:17:56.480
They were like, I don't know what you guys are
302
00:17:56.500 --> 00:17:59.079
doing over there, but it doesn't seem to be working. No.
303
00:17:59.519 --> 00:18:02.869
So there was actually a feeling of, OK, is this
304
00:18:02.960 --> 00:18:05.950
the end stage for this GLP-1 project?
305
00:18:07.329 --> 00:18:09.890
And then there was a concern about cancer.
306
00:18:10.529 --> 00:18:13.829
We saw tumors in rats and mice up here in
307
00:18:13.849 --> 00:18:18.269
the thyroid gland. And suddenly these tumors seem to be
308
00:18:18.369 --> 00:18:22.369
happening dose-dependently over time in rodents. Luckily, we didn't see
309
00:18:22.410 --> 00:18:25.019
them in rabbits. We didn't see them in dogs. We
310
00:18:25.059 --> 00:18:28.599
didn't see them in monkeys. But the regulators, FDA and
311
00:18:28.640 --> 00:18:31.920
so on, were not happy with seeing tumors in two species.
312
00:18:35.400 --> 00:18:39.009
The team did more testing. And ultimately, they concluded that
313
00:18:39.049 --> 00:18:42.190
the tumors they saw in rodents were not relevant in humans.
314
00:18:43.049 --> 00:18:45.950
But it would take years before the FDA was satisfied
315
00:18:46.309 --> 00:18:50.009
that Novo's liraglutide was safe for people. And Novo Nordisk
316
00:18:50.130 --> 00:18:53.119
still advises against taking GLP-1 drugs if you have a
317
00:18:53.160 --> 00:18:59.920
history of thyroid cancer. So the FDA approved liraglutide in 2010.
318
00:18:59.920 --> 00:19:02.140
Do you remember the moment you heard about it?
319
00:19:02.920 --> 00:19:05.549
My wife and kids had gone to bed. And then
320
00:19:05.609 --> 00:19:09.450
I actually, I get a phone call at like 11.30
321
00:19:09.450 --> 00:19:14.339
in the evening. Mads, we've got it. We've got an approval. And,
322
00:19:14.359 --> 00:19:18.220
you know, you just shout out loud. I just got
323
00:19:18.259 --> 00:19:21.039
extremely excited, so much that my family woke up and
324
00:19:21.079 --> 00:19:22.640
was really annoyed with me.
325
00:19:22.660 --> 00:19:25.839
They're like, why are you so excited? It's the middle
326
00:19:25.859 --> 00:19:26.160
of the night.
327
00:19:26.200 --> 00:19:26.589
Yeah, yeah.
328
00:19:26.609 --> 00:19:30.950
I had to apologize. So I took a good McGowan whiskey,
329
00:19:31.349 --> 00:19:33.289
took a good shot of that and celebrated over the
330
00:19:33.329 --> 00:19:34.690
phone with the colleagues.
331
00:19:36.529 --> 00:19:39.970
Yes, I was in my bed, but the minute I
332
00:19:40.069 --> 00:19:44.019
saw the number on my phone, I knew we got this.
333
00:19:44.839 --> 00:19:47.549
I felt a great sense of accomplishment.
334
00:19:48.009 --> 00:19:49.630
It was more than 10 years.
335
00:19:50.119 --> 00:19:53.380
In the making, and if we hadn't gotten that U.S. approval,
336
00:19:53.819 --> 00:19:57.339
maybe it would have been just not going anywhere. That
337
00:19:57.380 --> 00:20:01.089
would have been a great shame for the people who
338
00:20:01.109 --> 00:20:02.509
need this kind of medicine.
339
00:20:04.150 --> 00:20:08.119
Liraglutide went on sale under the brand name Victoza. It
340
00:20:08.150 --> 00:20:10.799
was approved to treat type 2 diabetes, and it was
341
00:20:10.819 --> 00:20:15.119
a modest success. More importantly, though, it was a proof
342
00:20:15.140 --> 00:20:19.579
of concept. Lotta's GLP-1 research had led to an effective drug.
343
00:20:20.539 --> 00:20:24.170
And the next drug, a new invention building off liraglutide,
344
00:20:24.690 --> 00:20:31.250
was already in the pipeline. It would be a blockbuster.
345
00:20:32.170 --> 00:20:34.589
One that would turn Novo Nordisk into a company that
346
00:20:34.630 --> 00:20:38.390
was known for more than diabetes. Because here's the thing.
347
00:20:39.170 --> 00:20:42.170
Since almost the beginning of Lotta's research, she knew that
348
00:20:42.250 --> 00:20:48.690
GLP-1 had another effect. Weight loss. Did that surprise you
349
00:20:49.210 --> 00:20:52.210
that it was weight loss really that made these drugs
350
00:20:52.289 --> 00:20:55.190
kind of soar to the top and make it kind
351
00:20:55.230 --> 00:20:57.009
of a household name at this point?
352
00:20:57.769 --> 00:21:00.109
Yes and no, because I remember I've heard it for
353
00:21:00.170 --> 00:21:04.049
such a long time. Ever since back to the early 2000s,
354
00:21:04.109 --> 00:21:06.910
when I was first lucky enough to be able to
355
00:21:07.009 --> 00:21:10.569
actually hear from some patients, they had tears in their eyes.
356
00:21:10.789 --> 00:21:13.069
And they said, you know, I've been hungry for 20 years.
357
00:21:13.650 --> 00:21:15.289
Now I can manage to have.
358
00:21:15.170 --> 00:21:15.789
A normal life.
359
00:21:18.269 --> 00:21:21.819
So how did a diabetes drug turn into a weight
360
00:21:21.859 --> 00:21:24.440
loss phenomenon? That's after the break.
361
00:21:31.079 --> 00:21:33.980
It's been a busy week, right? Sounds like it's time
362
00:21:34.019 --> 00:21:38.740
for that takeaway. Deliveroo's on it. Whether it's extra saucy
363
00:21:38.819 --> 00:21:43.019
wings from Nando's, a tasty taco bowl from Sprout & Co,
364
00:21:43.500 --> 00:21:47.539
or maybe even some California birria from Boojum. We'll deliver
365
00:21:47.660 --> 00:21:52.700
in as little as 25 minutes. Order now. You've earned it. Deliveroo.
366
00:21:53.259 --> 00:21:57.759
That finish line Friday feeling just got even better. Geographical restrictions,
367
00:21:57.799 --> 00:22:00.059
teas and season fees apply. Delivery times vary. See app
368
00:22:00.079 --> 00:22:00.779
or web for info.
369
00:22:01.529 --> 00:22:04.049
Hey, it's Wendy from Science Versus, and I want to
370
00:22:04.089 --> 00:22:07.420
tell you about a podcast that I love, Science Friday.
371
00:22:07.599 --> 00:22:10.140
They cover all sorts of amazing things in the weird
372
00:22:10.180 --> 00:22:14.200
and wonderful world of science, from how concussions affect our
373
00:22:14.269 --> 00:22:17.329
brain to the inner secrets of a snake with a
374
00:22:17.430 --> 00:22:19.950
spider on its tale. It's a lot of news that
375
00:22:20.009 --> 00:22:22.450
you can use and some that you can't, but you're
376
00:22:22.470 --> 00:22:25.490
going to love anyway. It's hosted by Ira Flato and
377
00:22:25.670 --> 00:22:28.779
Flora Lichtman, who is an old friend of the show
378
00:22:28.920 --> 00:22:31.680
and loves a pun as much as we do. Science
379
00:22:31.740 --> 00:22:34.900
Friday is on every day, wherever you get your podcasts.
380
00:22:45.900 --> 00:22:48.759
Welcome to what we call the factory of the future.
381
00:22:48.359 --> 00:22:49.460
Within Novo Nordisk.
382
00:22:50.109 --> 00:22:53.750
At the drug company Novo Nordisk, they're very serious about
383
00:22:53.829 --> 00:22:55.289
how you wear your socks.
384
00:22:56.390 --> 00:22:58.450
When you put your socks on, it would be something
385
00:22:58.470 --> 00:22:58.849
like this.
386
00:22:59.769 --> 00:23:00.490
You put them on.
387
00:23:02.190 --> 00:23:06.119
Novo Nordisk is based near Copenhagen, Denmark. The factory there
388
00:23:06.200 --> 00:23:07.359
is a hive of activity.
389
00:23:07.380 --> 00:23:10.980
All right, just keep an eye out.
390
00:23:11.019 --> 00:23:12.599
Now we're in the area with a little bit more
391
00:23:12.660 --> 00:23:13.519
robot traffic.
392
00:23:14.200 --> 00:23:17.200
On an assembly line, a machine places vials of clear
393
00:23:17.259 --> 00:23:20.880
liquid into blue syringes. You can see the pens clattering out.
394
00:23:25.240 --> 00:23:26.920
What's on the line there?
395
00:23:26.940 --> 00:23:27.569
Uh, semaglutide.
396
00:23:30.769 --> 00:23:31.529
Semaglutide.
397
00:23:31.990 --> 00:23:32.210
Or.
398
00:23:32.529 --> 00:23:33.369
Semaglutide.
399
00:23:33.470 --> 00:23:34.170
Semaglutide.
400
00:23:34.289 --> 00:23:34.970
Semaglutide.
401
00:23:34.990 --> 00:23:36.769
Semaglutide. Semaglutide.
402
00:23:36.789 --> 00:23:36.849
Or.
403
00:23:37.549 --> 00:23:38.990
We've been saying semaglutide.
404
00:23:39.049 --> 00:23:39.569
Is that right?
405
00:23:39.750 --> 00:23:40.819
That is so correct.
406
00:23:40.890 --> 00:23:41.769
Okay, because we.
407
00:23:41.670 --> 00:23:45.880
Hear like semaglutide or... So that's incorrect. It is.
408
00:23:46.119 --> 00:23:46.980
It's semaglutide.
409
00:23:47.079 --> 00:23:52.720
For the record. Thank you. However you say it, semaglutide
410
00:23:52.900 --> 00:23:59.460
is Novo's successor to liraglutide. It came with some side effects. Nausea, vomiting,
411
00:23:59.819 --> 00:24:04.990
gastrointestinal issues. But semaglutide is a more effective GLP-1 compound.
412
00:24:05.609 --> 00:24:07.190
And you only need to take it once a week
413
00:24:07.630 --> 00:24:11.170
instead of once a day. It's also the key ingredient
414
00:24:11.309 --> 00:24:19.150
in Ozempic. In 2017, the FDA approved Ozempic specifically to
415
00:24:19.210 --> 00:24:23.559
treat type 2 diabetes. That year, Novo Nordisk geared up
416
00:24:23.599 --> 00:24:29.759
for a big U.S. campaign. Did people inside Novo realize
417
00:24:29.799 --> 00:24:33.099
they had a hit or a blockbuster in Ozempic around
418
00:24:33.119 --> 00:24:33.880
the time of the launch?
419
00:24:34.539 --> 00:24:39.619
So there was a lot of excitement and preparation. We
420
00:24:39.640 --> 00:24:42.000
thought this could be one of the most important products
421
00:24:42.400 --> 00:24:44.500
that the company had brought to market to date.
422
00:24:45.339 --> 00:24:47.829
That's Dave Moore. He was in charge of sales and
423
00:24:47.869 --> 00:24:51.970
marketing when Ozempic launched in the U.S. in 2018. With
424
00:24:51.990 --> 00:24:54.910
a possible hit on their hands, Dave says the company
425
00:24:54.930 --> 00:24:57.690
started to get the word out. They promoted the drug's
426
00:24:57.730 --> 00:25:00.920
ability to lower blood sugar levels to specialists and doctors.
427
00:25:01.660 --> 00:25:04.000
And they spent a lot of money on branding and marketing.
428
00:25:05.000 --> 00:25:08.119
But you probably know that already because of this catchy tune.
429
00:25:11.500 --> 00:25:14.319
People with type 2 diabetes are excited about the potential
430
00:25:14.339 --> 00:25:15.799
of once-weekly Ozempic.
431
00:25:15.960 --> 00:25:17.359
Who came up with the idea for the jingle?
432
00:25:18.059 --> 00:25:22.119
We test these, and there was a really strong recall,
433
00:25:22.440 --> 00:25:24.720
which is important in any of these campaigns.
434
00:25:25.599 --> 00:25:27.119
Did you like the song? Did it resonate with you?
435
00:25:27.759 --> 00:25:29.869
I did know the song, and I can actually tell
436
00:25:29.880 --> 00:25:31.970
you the first time I heard it, and I'll date myself,
437
00:25:32.029 --> 00:25:34.990
but I was roller-skating. back when I was in school
438
00:25:35.009 --> 00:25:38.829
in 75. And, you know, it was a hit, right?
439
00:25:40.210 --> 00:25:41.170
I don't know if you'll hear this.
440
00:25:42.339 --> 00:25:51.400
Oh, oh, oh, it's magic, you know. Never believe it's
441
00:25:51.460 --> 00:25:52.579
not so.
442
00:25:55.220 --> 00:25:55.680
There you go.
443
00:25:56.039 --> 00:25:57.519
That's incredible.
444
00:25:58.940 --> 00:26:04.069
My name's David Payton. I'm the singer-songwriter with the band pilot,
445
00:26:04.509 --> 00:26:09.970
and I wrote the song Magic, being used by Ozempic extensively.
446
00:26:11.009 --> 00:26:14.900
David Payton wrote Magic 50 years ago. He didn't think
447
00:26:14.920 --> 00:26:16.720
too much of the fact that it was recently picked
448
00:26:16.799 --> 00:26:19.259
up for a drug ad, not even when he saw
449
00:26:19.299 --> 00:26:23.490
the company Novo Nordisk on his royalty statement. David figured
450
00:26:23.789 --> 00:26:25.529
Magic had been used many times before.
451
00:26:26.470 --> 00:26:30.109
When it first came out in 74, Coca-Cola got in
452
00:26:30.150 --> 00:26:33.490
touch with me and they, yeah, it's been used extensively
453
00:26:33.630 --> 00:26:37.990
for a long time. And even Selena Gomez, you might know,
454
00:26:38.049 --> 00:26:41.450
she had a pretty big hit with it in the
455
00:26:41.490 --> 00:26:47.019
States around about 2009 or thereabouts. I've heard lots of
456
00:26:47.099 --> 00:26:51.180
hip hop versions, which are very strange because, you know,
457
00:26:51.200 --> 00:26:53.500
there's a lot of rapping going on and then the
458
00:26:53.539 --> 00:26:57.990
chorus is used. Flo Rida did a version of Magic.
459
00:26:58.799 --> 00:27:02.880
But something about this version seemed to land differently. About
460
00:27:02.920 --> 00:27:05.500
a year after Ozempic hit the market, David was at
461
00:27:05.539 --> 00:27:07.950
home in Scotland when he got a call from a friend.
462
00:27:08.589 --> 00:27:11.690
And he phoned me up really excited and said, David,
463
00:27:12.099 --> 00:27:15.660
do you realize your song is on television here in
464
00:27:15.700 --> 00:27:18.359
the States? And I said, it must be every 20
465
00:27:18.359 --> 00:27:22.099
minutes I'm hearing your song. And I said to him, well,
466
00:27:22.160 --> 00:27:24.680
I knew it was being used, but I didn't realize
467
00:27:25.200 --> 00:27:28.089
it was that much coverage that was going on in
468
00:27:28.130 --> 00:27:28.650
the States.
469
00:27:29.809 --> 00:27:35.029
Ozempic was really starting to pick up steam. Except the
470
00:27:35.049 --> 00:27:39.170
hype wasn't because it was a drug for diabetes. People
471
00:27:39.210 --> 00:27:42.779
were talking about it for weight loss. It's known as
472
00:27:42.859 --> 00:27:47.279
Hollywood's worst kept secret as celebrities dropped noticeable amounts of
473
00:27:47.380 --> 00:27:48.220
weight quickly.
474
00:27:48.720 --> 00:27:52.619
I mean, I cannot scroll through my social media without
475
00:27:52.799 --> 00:27:56.319
someone mentioning the Ozempic diet.
476
00:27:56.599 --> 00:27:58.900
By the way, you've been working on your body and
477
00:27:58.940 --> 00:27:59.460
on your health.
478
00:27:59.619 --> 00:28:00.960
No, that's Ozempic.
479
00:28:01.559 --> 00:28:05.380
The topic Ozempic has over 300 million views.
480
00:28:05.619 --> 00:28:07.700
When I look around this room, I can't help but wonder,
481
00:28:08.440 --> 00:28:09.660
is Ozempic right for me?
482
00:28:14.690 --> 00:28:18.960
Now, companies can't promote their medicines for off-label use. But
483
00:28:19.000 --> 00:28:22.980
it's not unusual or necessarily unethical for doctors to prescribe
484
00:28:23.019 --> 00:28:27.339
a drug for something it isn't FDA approved for. I
485
00:28:27.420 --> 00:28:29.839
asked Dave Moore about all this. He's the guy who
486
00:28:29.859 --> 00:28:34.380
led the launch of Ozempic in the U.S. As you know, today,
487
00:28:34.400 --> 00:28:38.579
a lot of people don't necessarily associate Ozempic with diabetes.
488
00:28:38.940 --> 00:28:43.049
They associate it with obesity treatment and weight loss. How
489
00:28:43.069 --> 00:28:45.849
did that happen? And when did people at Novo start
490
00:28:45.910 --> 00:28:49.869
realizing that it was being prescribed off-label for weight loss?
491
00:28:51.069 --> 00:28:54.250
Yeah, I'm glad you asked that question. I'll start with
492
00:28:54.390 --> 00:28:58.730
the first part. It's really important, and I'd love to
493
00:28:58.769 --> 00:29:03.299
stress to your listeners that Ozempic is for type 2 diabetes.
494
00:29:04.039 --> 00:29:04.309
And I.
495
00:29:05.990 --> 00:29:10.220
Would ask everyone to really think about the uses of
496
00:29:10.279 --> 00:29:14.799
these medicines based on what they're intended for. The second
497
00:29:14.819 --> 00:29:19.440
part to your question, we knew that there was a
498
00:29:19.769 --> 00:29:24.490
need for new medicine for people living with obesity. And
499
00:29:24.509 --> 00:29:31.329
we were studying higher doses of semaglutide for chronic weight management.
500
00:29:31.829 --> 00:29:37.230
And that was in clinical trials while Ozempic, of course,
501
00:29:37.410 --> 00:29:39.950
was being launched into the market as a type 2 diagnosis.
502
00:29:40.490 --> 00:29:41.130
Medication.
503
00:29:41.450 --> 00:29:45.140
I totally understand what you're saying. However, it did happen
504
00:29:45.200 --> 00:29:48.740
that doctors prescribed Ozempic off-label. I mean, they were making
505
00:29:48.779 --> 00:29:51.779
jokes about it at the Oscars. Like, what do you
506
00:29:51.859 --> 00:29:52.240
do in a.
507
00:30:00.359 --> 00:30:04.539
Play our role and do our part to ensure that
508
00:30:04.900 --> 00:30:10.460
we try to correct, you know, anytime that happens. We,
509
00:30:10.500 --> 00:30:17.450
of course, you know, are not denying that those things happen, right?
510
00:30:17.789 --> 00:30:24.009
We're not being shy. You know, we see the media.
511
00:30:25.089 --> 00:30:29.210
And ultimately, clinicians make the choice, right?
512
00:30:29.390 --> 00:30:29.549
Right.
513
00:30:29.900 --> 00:30:34.680
And our position is firm and clear. We don't want
514
00:30:34.779 --> 00:30:38.019
Ozempic used off-label, and we only want it to be
515
00:30:38.119 --> 00:30:39.480
used as it's intended.
516
00:30:41.319 --> 00:30:44.869
As Dave mentioned, Novo was doing research into their GLP-1
517
00:30:44.890 --> 00:30:48.009
drugs and weight loss. But for a long time, it
518
00:30:48.109 --> 00:30:52.750
wasn't the priority. Diabetes was. Because drugs to treat obesity
519
00:30:52.869 --> 00:30:57.190
look like a risky proposition. Here's Lars Rabian Sorensen, the
520
00:30:57.210 --> 00:30:58.230
former Novo CEO.
521
00:30:59.039 --> 00:31:02.680
I was not against that. I actually thought it was
522
00:31:02.720 --> 00:31:07.680
a good idea. However, I was a little bit cautious
523
00:31:07.859 --> 00:31:15.410
about expressing this publicly because at the time, almost all
524
00:31:15.470 --> 00:31:21.670
without exception, weight-lowering drugs have failed, some even so badly
525
00:31:21.750 --> 00:31:27.079
that companies were sued. So I knew that If we
526
00:31:27.130 --> 00:31:32.259
started talking too much about the obesity effect of GLP-1,
527
00:31:32.299 --> 00:31:36.779
we might taint a very good diabetes drug.
528
00:31:37.559 --> 00:31:40.210
There was a quote that's been circulating the internet a
529
00:31:40.230 --> 00:31:43.269
little bit that is attributed to you from 2005, where
530
00:31:43.309 --> 00:31:47.210
you say that obesity is primarily a social and cultural problem.
531
00:31:47.789 --> 00:31:50.450
It should be solved by means of a radical restructuring
532
00:31:50.470 --> 00:31:53.660
of society. There's no business for Novo Nordisk in that area.
533
00:31:54.099 --> 00:31:55.000
Do you remember saying that?
534
00:31:55.930 --> 00:31:59.009
I remember that, and I believed it at the time.
535
00:31:59.349 --> 00:31:59.609
Yeah.
536
00:32:00.109 --> 00:32:03.710
I was not aware at that time of the great
537
00:32:03.809 --> 00:32:10.039
difficulty number of people with severe overweight. I have absolutely
538
00:32:10.099 --> 00:32:11.380
no doubt that I said this.
539
00:32:12.259 --> 00:32:17.460
What ultimately changed your mind about developing GLP-1s for obesity treatment?
540
00:32:18.200 --> 00:32:20.519
First of all, you get in contact with these individuals
541
00:32:20.579 --> 00:32:23.980
that are struggling with this for their entire life. That
542
00:32:24.019 --> 00:32:28.230
has an enormous impact. impact on you as an individual,
543
00:32:29.049 --> 00:32:33.049
then there's also a commercial motive in this. This is
544
00:32:33.109 --> 00:32:38.759
a huge potential commercial market for the company. So it
545
00:32:38.779 --> 00:32:46.519
was composite of patient consideration, but also pursuing a commercial
546
00:32:47.220 --> 00:32:48.400
opportunity for the company.
547
00:32:49.539 --> 00:32:53.460
So Novo Nordisk released Wigovi in 2021, a higher dose
548
00:32:53.480 --> 00:32:58.539
of semaglutide approved specifically for weight loss. In one major trial,
549
00:32:58.980 --> 00:33:02.069
patients lost an average of about 15% of their body
550
00:33:02.109 --> 00:33:08.130
weight in just over a year. And it wasn't just Novo.
551
00:33:08.869 --> 00:33:12.750
Another pharmaceutical giant, Eli Lilly, had also been working on
552
00:33:12.809 --> 00:33:15.869
GLP-1s for years. And in 2022, they were hot on
553
00:33:15.890 --> 00:33:23.640
Novo's heels. Eli Lilly answered Novosemaglutide with her own compound, Terzepatide.
554
00:33:25.420 --> 00:33:30.500
Terzepatide mimics two gut hormones, GLP-1 and another one called GIP.
555
00:33:31.269 --> 00:33:35.650
That made Terzepatide even more effective. In the spring of 2022,
556
00:33:35.650 --> 00:33:40.369
Eli Lilly released Manjaro, which was approved for type 2 diabetes.
557
00:33:40.910 --> 00:33:44.150
I started taking Manjaro, and I've lost 65 pounds.
558
00:33:46.299 --> 00:33:50.099
Last year, they came out with Zepbound for weight loss. Zepbound,
559
00:33:50.279 --> 00:33:51.359
made by Eli Lilly.
560
00:33:51.799 --> 00:33:54.900
Potentially more effective for losing weight than any other drug
561
00:33:54.960 --> 00:33:55.509
on the market.
562
00:33:57.849 --> 00:34:01.630
And GLP-1 medications also got a huge endorsement from one
563
00:34:01.650 --> 00:34:03.630
of the most trusted voices in America.
564
00:34:03.930 --> 00:34:08.159
For 25 years, making fun of my weight was national sport.
565
00:34:09.539 --> 00:34:12.199
In my lifetime, I never dreamed that we would be
566
00:34:12.260 --> 00:34:16.480
talking about medicines that are providing hope for people like
567
00:34:16.599 --> 00:34:20.989
me who have struggled for years with being overweight or
568
00:34:21.030 --> 00:34:21.699
with obesity.
569
00:34:25.110 --> 00:34:29.309
Suddenly, Novo Nordisk and Eli Lilly were leading a booming market.
570
00:34:30.230 --> 00:34:33.389
Novo is now the most valuable company in Europe. It's
571
00:34:33.429 --> 00:34:35.369
locked in a race with Lilly to become the first
572
00:34:35.550 --> 00:34:40.000
trillion-dollar pharmaceutical company by market cap. And demand for these
573
00:34:40.039 --> 00:34:43.530
drugs has gotten so high that Novo and Lilly cannot
574
00:34:43.590 --> 00:34:47.409
keep up. The FDA put semaglutide on an official shortage
575
00:34:47.449 --> 00:34:53.510
list in 2022. Terzepatide followed just months later. Here's Novo's
576
00:34:53.570 --> 00:34:56.559
Mads Thomsen again. Did you ever dream that it could
577
00:34:56.579 --> 00:34:58.820
be this big, ultimately?
578
00:34:59.900 --> 00:35:02.119
My dream, but that was just a dream, was that
579
00:35:02.199 --> 00:35:04.059
one day it could be the number one drug class
580
00:35:04.239 --> 00:35:07.480
in the world. And right now, this year, the latest
581
00:35:07.519 --> 00:35:10.059
forecast is that the GLP-1 class is actually going to
582
00:35:10.099 --> 00:35:13.239
be the number one drug class in the world. But
583
00:35:13.340 --> 00:35:16.719
it's gone surprisingly fast to the extent that neither we
584
00:35:17.159 --> 00:35:20.449
nor our peers at Eli Lilly can deliver enough products
585
00:35:20.590 --> 00:35:21.969
to satisfy the market.
586
00:35:21.989 --> 00:35:27.750
Thank you for calling Walgreens Pharmacy.
587
00:35:27.769 --> 00:35:28.329
I can help you.
588
00:35:28.349 --> 00:35:29.190
Where are you from?
589
00:35:29.210 --> 00:35:29.659
I can help you.
590
00:35:29.710 --> 00:35:30.530
I'm trying to go to pharmacy.
591
00:35:30.550 --> 00:35:31.179
I can help you.
592
00:35:31.760 --> 00:35:37.110
Pharmacists can't stock the stuff fast enough. My colleague, Brad Olson,
593
00:35:37.510 --> 00:35:39.110
you heard from him at the start of the episode.
594
00:35:39.789 --> 00:35:41.869
He and I called a bunch of pharmacies all over
595
00:35:41.889 --> 00:35:42.369
the country.
596
00:35:42.389 --> 00:35:46.179
I'm just calling to see if you have any GLP-1
597
00:35:46.440 --> 00:35:49.039
drugs in stock, like Ozempic or Mount Jaro.
598
00:35:50.300 --> 00:35:50.960
No, we don't.
599
00:35:51.199 --> 00:35:52.679
No, unfortunately, we do not.
600
00:35:52.760 --> 00:35:54.780
We haven't gotten it in the past few months.
601
00:35:54.880 --> 00:35:56.199
No, it's not available.
602
00:35:56.219 --> 00:35:58.239
I think next month it's going to be available.
603
00:35:58.420 --> 00:36:01.309
Literally, like, every injection right now is so hard to get.
604
00:36:01.590 --> 00:36:02.730
We're out of stock on it.
605
00:36:03.030 --> 00:36:03.519
On all of it?
606
00:36:04.400 --> 00:36:04.880
Yeah.
607
00:36:09.130 --> 00:36:13.369
Today, there's no doubt Americans want these drugs. But almost
608
00:36:13.510 --> 00:36:16.670
everyone we spoke to for the series, from patients to
609
00:36:16.710 --> 00:36:21.480
doctors to lawmakers, pointed to the same big issue. Price.
610
00:36:22.519 --> 00:36:25.800
These drugs are very expensive, about $ 1, 000 a month out
611
00:36:25.820 --> 00:36:29.199
of pocket in the U.S. Insurance often won't cover them
612
00:36:29.219 --> 00:36:32.079
for weight loss. And it's recommended that the medicine be
613
00:36:32.099 --> 00:36:35.489
taken for life. Or else studies show people gain the
614
00:36:35.510 --> 00:36:40.489
weight back. My colleague Brad also ran into the affordability issue.
615
00:36:41.630 --> 00:36:45.050
And so you did stop taking Manjaro after about five months.
616
00:36:45.840 --> 00:36:46.090
Why?
617
00:36:46.110 --> 00:36:51.340
I would say it's mainly cost. I just can't afford,
618
00:36:51.360 --> 00:36:55.500
you know, that expense over the course of my lifetime
619
00:36:55.699 --> 00:37:01.110
out of pocket. And So for me, starting without insurance
620
00:37:01.190 --> 00:37:03.050
is sort of like a choice where you know in
621
00:37:03.090 --> 00:37:05.130
the end that the jig is up, like you're not
622
00:37:05.150 --> 00:37:07.010
going to be able to keep taking it.
623
00:37:08.150 --> 00:37:11.750
So how long after your last dose before you started
624
00:37:11.769 --> 00:37:13.190
to feel the cravings come back?
625
00:37:14.110 --> 00:37:15.210
It was probably three weeks.
626
00:37:16.090 --> 00:37:16.389
Okay.
627
00:37:16.769 --> 00:37:19.670
It became hard because it became like you're kind of
628
00:37:19.789 --> 00:37:23.860
without a net. You know, in the circus, you're on
629
00:37:23.900 --> 00:37:27.460
the tightrope and there's no net under you, you know.
630
00:37:28.059 --> 00:37:30.699
And the medicine was like having the net. You're like, oh,
631
00:37:30.739 --> 00:37:35.320
I can fall off this tightrope, no big deal. That's
632
00:37:35.340 --> 00:37:35.980
what it feels like.
633
00:37:36.139 --> 00:37:36.360
Yeah.
634
00:37:37.679 --> 00:37:41.250
Brad decided to go without a net. But as we
635
00:37:41.289 --> 00:37:44.130
reported the series, he and I talked to people who
636
00:37:44.190 --> 00:37:46.349
weren't so willing to give up a drug that they
637
00:37:46.389 --> 00:37:49.409
felt changed their lives, even if it was more than
638
00:37:49.429 --> 00:37:50.110
they could afford.
639
00:37:50.610 --> 00:37:53.829
Okay, if I can't get the drug, what can I
640
00:37:53.869 --> 00:37:54.590
take instead?
641
00:37:55.130 --> 00:37:59.780
What's close? And so... they resorted to riskier measures.
642
00:38:00.380 --> 00:38:03.579
What I received in the mail was a tiny vial
643
00:38:03.639 --> 00:38:05.179
filled with white powder.
644
00:38:05.719 --> 00:38:05.980
Okay.
645
00:38:06.000 --> 00:38:09.099
Which could, honest to God, be anything, because, like, who knows?
646
00:38:10.579 --> 00:38:24.550
That's next time on Trillion Dollar Shot. Trillion Dollar Shot
647
00:38:24.619 --> 00:38:26.980
is part of The Journal. which is a co-production of
648
00:38:27.039 --> 00:38:30.579
Spotify and The Wall Street Journal. This episode was hosted
649
00:38:30.619 --> 00:38:34.909
by me, Jessica Mendoza, with Bradley Olson. It was produced
650
00:38:34.969 --> 00:38:38.690
by Matt Kwong, with help from Jivika Verma. Additional production
651
00:38:38.769 --> 00:38:43.250
from Adrienne Murray-Nielsen. This series is edited by Catherine Brewer.
652
00:38:43.610 --> 00:38:48.579
Fact-checking by Sophie Hurwitz. Series art by Pete Ryan. Sound
653
00:38:48.599 --> 00:38:51.500
design and mixing by Peter Leonard. Music in this episode
654
00:38:51.539 --> 00:38:55.409
by Peter Leonard and Bobby Lord. Our theme music is
655
00:38:55.449 --> 00:38:58.610
by So Wiley. Remix for the series by Peter Leonard.
656
00:39:01.630 --> 00:39:06.829
Special thanks to Maria Byrne, Stephanie Ilgenfritz, Kate Leinbaugh, Peter Loftus,
657
00:39:07.210 --> 00:39:11.969
Sarah O'Brien, Enrique Perez de la Rosa, Sarah Platt, Suna Rasmussen,
658
00:39:12.309 --> 00:39:18.010
Jonathan Sanders, Nathan Singapak, Leying Tang, Rolf Winkler, Liz Esley-White,
659
00:39:18.329 --> 00:39:24.219
and Tatiana Zamise. Thanks for listening. Episode 2 drops next Sunday,
660
00:39:24.539 --> 00:39:32.940
May 19th. Hey, Wendy here again.
661
00:39:32.960 --> 00:39:36.239
So that was episode one of Trillion Dollar Shot from
662
00:39:36.280 --> 00:39:38.639
The Journal. You can listen to the series by finding
663
00:39:38.679 --> 00:39:41.940
The Journal wherever you get podcasts. We'll be back in
664
00:39:41.980 --> 00:39:45.260
your ears with an episode of Science Versus in just
665
00:39:45.300 --> 00:39:47.920
a couple of days. And we are diving into the
666
00:39:47.980 --> 00:39:52.050
science of protein. How much do you really need to
667
00:39:52.449 --> 00:39:57.050
get jacked or to, you know, just be healthy? It's
668
00:39:57.090 --> 00:39:59.630
a really, really fun episode. I can't wait to share
669
00:39:59.650 --> 00:40:02.400
it with you. I'm Wendy Zuckerman. Back to you in
670
00:40:02.420 --> 00:40:04.010
a couple of days. Order now.
671
00:40:11.090 --> 00:40:35.119
You've earned it. Deliveroo. That finish line Friday feeling just
672
00:40:35.199 --> 00:40:38.730
got even better. Geographical restrictions, teas and season fees apply.
673
00:40:38.769 --> 00:40:40.809
Delivery times vary. See app or web for info.
1
00:00:00.550 --> 00:00:03.700
Hi, I'm Wendy Zuckerman from Science Versus. Today, we've got
2
00:00:03.740 --> 00:00:06.299
something a little different for you. We are sharing an
3
00:00:06.339 --> 00:00:09.900
episode from The Journal about the rise of Ozempic and
4
00:00:10.019 --> 00:00:12.750
other blockbuster drugs that are being used for weight loss.
5
00:00:13.580 --> 00:00:15.439
And this episode is part of a series that the
6
00:00:15.480 --> 00:00:18.199
journal is doing called Trillion Dollar Shot.
7
00:00:18.679 --> 00:00:21.780
Now, if you listen to Science Versus a lot, thank you.
8
00:00:22.489 --> 00:00:25.269
But you'll know that we've covered these kinds of drugs
9
00:00:25.469 --> 00:00:27.629
a bit and we've talked about how they work and
10
00:00:27.690 --> 00:00:31.050
what their potential side effects are. But in this episode today,
11
00:00:31.079 --> 00:00:34.479
you're going to hear the details of how these medications
12
00:00:34.679 --> 00:00:38.259
first got made. and how for a moment there, it
13
00:00:38.280 --> 00:00:41.460
looked like Big Pharma was going to stop their development.
14
00:00:42.119 --> 00:00:44.799
Trillion Dollar Shot is coming up just after the break.
15
00:00:53.350 --> 00:00:56.229
It's been a busy week, right? Sounds like it's time
16
00:00:56.270 --> 00:01:01.009
for that takeaway. Deliveroo's on it. Whether it's extra saucy
17
00:01:01.090 --> 00:01:05.290
wings from Nando's, a tasty taco bowl from Sprout & Co,
18
00:01:05.769 --> 00:01:09.790
or maybe even some California birria from Boojum. We'll deliver
19
00:01:09.810 --> 00:01:14.950
in as little as 25 minutes. Order now. You've earned it. Deliveroo.
20
00:01:15.519 --> 00:01:20.040
That finish line Friday feeling just got even better. Geographical restrictions,
21
00:01:20.079 --> 00:01:22.340
teas and season fees apply. Delivery times vary. See app
22
00:01:22.359 --> 00:01:23.060
or web for info.
23
00:01:33.859 --> 00:01:39.590
I admit to a slight bit of syringe anxiety. I'm
24
00:01:40.129 --> 00:01:43.030
not happy to admit that, but, you know, that is
25
00:01:43.069 --> 00:01:44.829
something that I've dealt with.
26
00:01:45.140 --> 00:01:47.799
Back in January, I hopped on a video call with
27
00:01:47.840 --> 00:01:52.060
my colleague Bradley Olson, who's out in San Francisco. Brad
28
00:01:52.079 --> 00:01:54.319
was about to give himself a dose of a drug
29
00:01:54.519 --> 00:01:57.569
he'd been taking for weight loss. It was an unusual
30
00:01:57.689 --> 00:01:59.810
and personal moment for a coworker to share.
31
00:02:00.489 --> 00:02:02.650
Whenever I would get it, like, the first couple times,
32
00:02:02.709 --> 00:02:05.129
I would, like, just breathe in, breathe out, you know?
33
00:02:06.390 --> 00:02:08.590
And then it would feel, like, ridiculous because it's, like,
34
00:02:09.090 --> 00:02:11.789
a very small pinprick that you barely feel.
35
00:02:12.030 --> 00:02:14.439
You know? Brad has struggled with his weight for more
36
00:02:14.479 --> 00:02:18.180
than 20 years. And he said this medication made it
37
00:02:18.360 --> 00:02:20.919
easier than it had ever been for him to lose weight.
38
00:02:21.740 --> 00:02:24.759
In five months, Brad had lost about 40 pounds.
39
00:02:25.219 --> 00:02:27.740
You know, the thing that was in the beginning like
40
00:02:27.780 --> 00:02:33.870
a revelation— I know that sounds crazy, but like without medicine,
41
00:02:35.389 --> 00:02:38.610
when I would eat well, when I would kind of
42
00:02:38.729 --> 00:02:43.770
follow a good course, I would just feel very hungry
43
00:02:45.050 --> 00:02:48.490
and it wouldn't be a good hungry. It would just
44
00:02:48.550 --> 00:02:57.349
be annoying, annoying and disruptive and frustrating. When you're on
45
00:02:57.370 --> 00:03:01.669
the medicine, it was just great. Those voices, which I
46
00:03:01.750 --> 00:03:04.770
came to really hate, were just silent.
47
00:03:08.490 --> 00:03:11.569
This medicine is part of a new class of pharmaceuticals
48
00:03:11.889 --> 00:03:14.849
that has exploded in popularity over the last few years.
49
00:03:16.060 --> 00:03:20.879
The most well-known is Ozempic. Brad was taking one called Manjaro.
50
00:03:20.900 --> 00:03:25.139
Anyway, so I'm going to take my syringe out of
51
00:03:25.159 --> 00:03:25.639
the box.
52
00:03:25.680 --> 00:03:27.020
It's five milligrams.
53
00:03:27.879 --> 00:03:28.340
And, um.
54
00:03:29.419 --> 00:03:34.319
You know, it's refrigerated, so it feels vaguely cold. You
55
00:03:34.340 --> 00:03:37.620
can put the injection in your upper thigh or in your, like,
56
00:03:37.719 --> 00:03:41.780
belly or stomach. I have never done the belly, just
57
00:03:41.819 --> 00:03:44.969
because I don't want a syringe in my belly. And
58
00:03:45.000 --> 00:03:47.120
so the thigh was always kind of where I put it.
59
00:03:52.069 --> 00:03:57.930
That day, that dose, was Brad's last shot. he had
60
00:03:57.969 --> 00:04:00.090
decided to stop taking the medication.
61
00:04:01.569 --> 00:04:02.610
So without further.
62
00:04:02.330 --> 00:04:04.289
Ado, here we go.
63
00:04:04.460 --> 00:04:13.000
Here's the last hurrah of Brad's time with Manjaro. All right,
64
00:04:13.300 --> 00:04:13.819
there we go.
65
00:04:16.879 --> 00:04:17.600
How do you feel, Brad?
66
00:04:20.399 --> 00:04:22.610
It's done. I think I feel good. I feel a
67
00:04:22.639 --> 00:04:24.730
little bit of Anxiety?
68
00:04:24.750 --> 00:04:25.269
Yeah.
69
00:04:25.769 --> 00:04:29.329
Because when you're on the medicine, it's so easy to
70
00:04:29.480 --> 00:04:32.680
lose weight that you don't really have to use any
71
00:04:33.279 --> 00:04:36.560
willpower or plan or anything. It just is going to
72
00:04:36.620 --> 00:04:38.160
happen and you know it's going to happen.
73
00:04:39.720 --> 00:04:43.819
Brad documented his journey on and off the medication because
74
00:04:43.860 --> 00:04:46.560
his time on the medicine and his decision to stop
75
00:04:46.600 --> 00:04:52.040
taking it stirred up a lot of feelings. Surprise, anger, uncertainty.
76
00:04:52.060 --> 00:04:56.230
It was a lot. So after Brad took his last shot,
77
00:04:56.730 --> 00:04:58.939
he and I decided to report on the impact of
78
00:04:58.980 --> 00:05:02.660
these drugs. We set out to understand, are they a
79
00:05:02.699 --> 00:05:06.579
true turning point for America's struggle with obesity? And if so,
80
00:05:07.339 --> 00:05:11.699
are we ready for everything that would mean? Because people
81
00:05:11.740 --> 00:05:15.439
who've taken these medications told us the same things over
82
00:05:15.620 --> 00:05:18.649
and over again. All of a sudden, just the weight
83
00:05:19.069 --> 00:05:21.990
starts falling off. You know, eight pounds the first month.
84
00:05:22.170 --> 00:05:24.209
I felt like it was a miracle. Three pounds the
85
00:05:24.269 --> 00:05:24.750
second month.
86
00:05:24.949 --> 00:05:26.199
Life-changing for sure.
87
00:05:26.319 --> 00:05:30.720
Ten pounds the third month. That's how powerful this medication is.
88
00:05:30.980 --> 00:05:33.180
Then it just was like, how is this happening?
89
00:05:33.379 --> 00:05:36.009
I could tell it was working and I could tell
90
00:05:36.069 --> 00:05:39.850
that it was changing my relationship with food and I
91
00:05:39.949 --> 00:05:40.569
liked that.
92
00:05:41.930 --> 00:05:45.730
This type of success has meant huge windfalls for drug makers.
93
00:05:46.069 --> 00:05:49.310
We said, oh, Jesus, this can become a big, big drug.
94
00:05:49.410 --> 00:05:51.430
It's been a boon. There's no denying that.
95
00:05:51.449 --> 00:05:54.290
You know, the demand is higher than what we can
96
00:05:54.329 --> 00:05:55.769
deliver to people today.
97
00:05:56.629 --> 00:06:00.300
And that demand for these drugs is reverberating across society.
98
00:06:00.959 --> 00:06:03.199
And I thought, well, I'll stay on this for life
99
00:06:03.339 --> 00:06:07.540
because it's so helpful. And then I realized what it
100
00:06:07.579 --> 00:06:08.480
was going to cost me.
101
00:06:08.660 --> 00:06:10.220
They're just bank breakers.
102
00:06:10.660 --> 00:06:10.920
Okay.
103
00:06:11.529 --> 00:06:14.649
If I can't get the drug, what can I take instead?
104
00:06:15.189 --> 00:06:15.990
What's close?
105
00:06:16.370 --> 00:06:20.350
There are so many people even selling bathtub Ozempic.
106
00:06:20.470 --> 00:06:21.529
There was a lot of excitement.
107
00:06:21.629 --> 00:06:22.850
There was a lot of skepticism.
108
00:06:22.949 --> 00:06:25.230
And I can imagine a future where life expectancies are
109
00:06:25.310 --> 00:06:28.509
actually increasing because of this class of drugs.
110
00:06:30.389 --> 00:06:32.990
Whether you think these drugs are a miracle or you're
111
00:06:33.009 --> 00:06:36.550
skeptical of what they promise, they're changing how we approach
112
00:06:36.769 --> 00:06:39.310
one of the most intractable issues in our society.
113
00:06:40.050 --> 00:06:40.509
Obesity.
114
00:06:41.410 --> 00:06:50.370
And it's just the beginning. From the Journal, this is
115
00:06:50.470 --> 00:06:53.220
Trillion Dollar Shot. I'm Jessica Mendoza.
116
00:06:53.459 --> 00:06:54.420
And I'm Bradley Olson.
117
00:07:01.870 --> 00:07:27.129
This is Episode One, Birth of a Blockbuster. So, why
118
00:07:27.269 --> 00:07:28.529
did you want to lose weight?
119
00:07:37.230 --> 00:07:40.060
I'm trying to be as honest as I can as
120
00:07:41.069 --> 00:07:41.860
I think about it.
121
00:07:41.879 --> 00:07:44.019
It's a hard question.
122
00:07:44.680 --> 00:07:45.350
Yeah. And.
123
00:07:50.490 --> 00:07:56.709
I wanted to look better. I know that some people
124
00:07:56.730 --> 00:07:59.670
will say it was for my kids and it was,
125
00:07:59.689 --> 00:08:05.699
I wish that I had some noble reason. I'm just
126
00:08:05.720 --> 00:08:10.759
being honest. The noble reason is like, I've got kids
127
00:08:10.819 --> 00:08:12.620
and I wanna run with them. And I would think
128
00:08:12.680 --> 00:08:16.029
about that, but I would run with them. And I
129
00:08:16.050 --> 00:08:20.019
would think about other things, but in the end, I
130
00:08:20.060 --> 00:08:26.839
felt like I'm not supposed to be like this. You know,
131
00:08:28.000 --> 00:08:28.750
this isn't me.
132
00:08:30.689 --> 00:08:35.490
Brad's story is familiar to millions of Americans. For decades,
133
00:08:35.830 --> 00:08:39.570
obesity has been on the rise. The CDC says one
134
00:08:39.610 --> 00:08:43.320
in three adults in the U.S. is obese. The condition
135
00:08:43.379 --> 00:08:47.340
is linked to shorter life expectancy, to diabetes, heart disease,
136
00:08:47.659 --> 00:08:51.179
and to some cancers. not to mention larger healthcare bills.
137
00:08:52.139 --> 00:08:55.500
And billions have been poured into addressing the issue. But
138
00:08:55.559 --> 00:08:58.639
nothing's been able to bring the numbers down. What most
139
00:08:58.679 --> 00:09:03.100
doctors recommend, diet and exercise, they don't work long-term for
140
00:09:03.139 --> 00:09:08.360
most people. And short of surgery, the great minds of industry, technology,
141
00:09:08.399 --> 00:09:11.350
and medicine just haven't been able to find an effective
142
00:09:11.379 --> 00:09:14.210
treatment until this new class of drugs.
143
00:09:15.169 --> 00:09:20.629
Every doctor interaction that you have when it's about weight loss,
144
00:09:20.659 --> 00:09:24.220
it's always the doctor's like, I'm telling you things that
145
00:09:24.240 --> 00:09:26.899
you're not going to do. They don't say that, but
146
00:09:26.919 --> 00:09:30.200
it's just the subtext is basically like this conversation of,
147
00:09:30.820 --> 00:09:33.120
I'm telling you things to do, and I don't think
148
00:09:33.139 --> 00:09:35.299
you're going to do them. It was like we were
149
00:09:35.360 --> 00:09:39.139
performing in a play. He was pretending to be a
150
00:09:39.179 --> 00:09:41.940
doctor that believed he was giving good advice, and I
151
00:09:41.960 --> 00:09:44.720
was pretending to be a patient that was listening and
152
00:09:44.779 --> 00:09:47.340
was really going to make a change. Neither was true.
153
00:09:48.970 --> 00:09:51.980
And the difference with this conversation was like, this is
154
00:09:52.009 --> 00:09:55.840
going to work. Like, there was no doubt about whether
155
00:09:55.860 --> 00:09:57.409
or not it was going to work. And that was
156
00:09:57.470 --> 00:09:58.210
such a difference.
157
00:09:59.870 --> 00:09:59.950
And.
158
00:10:00.460 --> 00:10:03.139
How did it go? Like how quickly did you start
159
00:10:03.159 --> 00:10:05.639
to lose weight and what were your reactions?
160
00:10:07.039 --> 00:10:12.129
I was just shocked. I had heard people talk about
161
00:10:12.750 --> 00:10:16.679
being on the medicine and how it really zapped their cravings.
162
00:10:16.799 --> 00:10:19.350
You know, I had read that. But to experience it
163
00:10:19.659 --> 00:10:21.330
is another thing entirely.
164
00:10:23.169 --> 00:10:25.590
Brad's going to share more of his own story throughout
165
00:10:25.629 --> 00:10:29.009
this series. But first, we want to go back to
166
00:10:29.049 --> 00:10:32.610
where it all started. Ozempic was developed by a Danish
167
00:10:32.649 --> 00:10:37.889
pharmaceutical company called Novo Nordisk. The story starts in the
168
00:10:38.690 --> 00:10:41.490
1990s with a woman named Lara Bjerre Knudsen.
169
00:10:41.980 --> 00:10:44.779
I did a lot of work in the laboratory. I
170
00:10:44.820 --> 00:10:46.570
was the lab rat.
171
00:10:48.629 --> 00:10:51.950
Lada was a young scientist at Novo Nordisk. When she
172
00:10:51.990 --> 00:10:54.669
was just starting her career, she was focused on what
173
00:10:54.769 --> 00:10:58.129
most scientists at Novo were there to do, develop drugs
174
00:10:58.220 --> 00:10:59.340
for treating diabetes.
175
00:11:00.039 --> 00:11:03.100
I always wanted to work for this company.
176
00:11:03.240 --> 00:11:08.059
And I was very set on wanting to make product-related research.
177
00:11:08.159 --> 00:11:10.950
I never wanted to be an academic researcher.
178
00:11:11.990 --> 00:11:15.070
I just knew that I wanted to make products that
179
00:11:15.129 --> 00:11:16.929
could somehow be useful.
180
00:11:17.009 --> 00:11:17.870
For human beings.
181
00:11:18.669 --> 00:11:20.950
And Lara had a bit of a reputation.
182
00:11:20.970 --> 00:11:24.389
I won't say that I have a temper. Maybe some
183
00:11:24.429 --> 00:11:27.549
people would say that about me. But I'm very dedicated
184
00:11:28.070 --> 00:11:29.049
and energy.
185
00:11:29.090 --> 00:11:33.929
I had ideas. I wasn't really shy and I did
186
00:11:34.490 --> 00:11:35.789
not give up too easily.
187
00:11:38.309 --> 00:11:40.179
And so what was it that you were working on?
188
00:11:41.049 --> 00:11:43.519
We had all kinds of ideas, you know. At that
189
00:11:43.580 --> 00:11:48.059
point in time in pharma for diabetes, there was a
190
00:11:48.139 --> 00:11:52.600
big desire to do something new, you know. And then
191
00:11:52.659 --> 00:11:56.690
GLP-1 was just one of those ideas that were around
192
00:11:56.750 --> 00:11:58.090
in the community.
193
00:11:57.570 --> 00:11:58.190
At that time.
194
00:12:00.850 --> 00:12:06.169
GLP-1. It stands for glucagon-like peptide. It's a gut hormone,
195
00:12:06.669 --> 00:12:08.539
and it's the basis for this new class of drugs.
196
00:12:09.639 --> 00:12:11.970
When Lada started working on it, there was research that
197
00:12:12.019 --> 00:12:16.169
showed that the GLP-1 hormone lowered blood sugar levels, which
198
00:12:16.210 --> 00:12:19.529
is important for treating diabetes. But no one had figured
199
00:12:19.590 --> 00:12:22.470
out how to make GLP-1 work as an effective treatment.
200
00:12:23.149 --> 00:12:25.029
It didn't hold up in the human body for long.
201
00:12:25.490 --> 00:12:26.990
It was gone in two minutes.
202
00:12:27.809 --> 00:12:31.250
That was really the problem to be solved was to
203
00:12:31.330 --> 00:12:33.210
make GLP-1 long-acting.
204
00:12:33.990 --> 00:12:36.850
So when you say gone in two minutes or making
205
00:12:36.889 --> 00:12:39.480
it long-acting... Does that mean it like breaks down in
206
00:12:39.500 --> 00:12:41.279
the body as soon as it like appears?
207
00:12:41.960 --> 00:12:45.360
Yeah, there are several ways that things can disappear from
208
00:12:45.399 --> 00:12:49.240
the body, right? One is that metabolic enzymes can degrade it,
209
00:12:49.799 --> 00:12:54.509
but then also things can be taken out via the kidneys.
210
00:12:55.549 --> 00:12:57.850
Lotto worked with a team to try to solve this puzzle,
211
00:12:58.429 --> 00:13:00.850
to try to get this powerful hormone to stay in
212
00:13:00.870 --> 00:13:04.250
the body long enough to work. But then she went
213
00:13:04.309 --> 00:13:07.970
on maternity leave. And when she came back in 1994,
214
00:13:07.970 --> 00:13:09.809
Novo had gone through some restructuring.
215
00:13:10.610 --> 00:13:12.490
Most of the people I'd worked with, they were gone.
216
00:13:13.009 --> 00:13:16.549
So I was kind of like the only one that
217
00:13:16.990 --> 00:13:20.610
knew anything about those projects. And the new leadership said
218
00:13:20.629 --> 00:13:23.470
to me, you know, you are the one that kind
219
00:13:23.529 --> 00:13:26.549
of knows this biology, so you figure out what we
220
00:13:26.580 --> 00:13:26.909
should do.
221
00:13:27.980 --> 00:13:29.600
What did you do? Did you freak out?
222
00:13:30.539 --> 00:13:34.129
Not so that anyone could see it, right? But it
223
00:13:34.750 --> 00:13:36.950
was a little bit of a lonely time, right? Because
224
00:13:36.970 --> 00:13:40.409
the people that I considered my closest work friends, they
225
00:13:40.450 --> 00:13:43.149
were gone, right? So I still had a group of
226
00:13:43.250 --> 00:13:46.750
laboratory technicians that were working with me and doing cool
227
00:13:46.789 --> 00:13:49.769
things in a lab. But this thing about figuring out
228
00:13:49.850 --> 00:13:53.220
how to lead the project, which idea to focus on,
229
00:13:53.669 --> 00:13:57.940
I was completely alone with that. So I was basically
230
00:13:57.980 --> 00:14:01.590
sitting in my in my office for a couple of months,
231
00:14:01.710 --> 00:14:03.210
kind of staring at the walls.
232
00:14:06.669 --> 00:14:10.230
Lada was now leading the GLP-1 team. But they weren't
233
00:14:10.269 --> 00:14:14.169
making much headway towards a functional drug. And leaders at
234
00:14:14.250 --> 00:14:17.929
Novo started to get antsy. Leaders like this guy.
235
00:14:18.450 --> 00:14:21.850
Yeah, my name is Lars-Oribian Sorensen. I used to be
236
00:14:21.929 --> 00:14:23.850
the CEO of Novo Nordisk.
237
00:14:25.450 --> 00:14:29.919
GLP-1 research was not the company's priorities. So Lars was like,
238
00:14:30.379 --> 00:14:32.259
why were they even messing around with this hormone?
239
00:14:33.340 --> 00:14:35.740
Well, I have to admit at the time, I thought
240
00:14:35.759 --> 00:14:40.639
it was a strange idea. We were primarily selling insulin.
241
00:14:40.750 --> 00:14:40.919
Right.
242
00:14:41.779 --> 00:14:46.950
And competition in the area of insulins were quite fierce.
243
00:14:47.669 --> 00:14:52.269
This GLP-1 compound was very, very short-lived.
244
00:14:52.610 --> 00:14:52.830
Right.
245
00:14:52.950 --> 00:14:55.970
And really, it was difficult to create a drug out
246
00:14:56.009 --> 00:14:59.320
of it. Quite frankly, I was worried that we were
247
00:14:59.549 --> 00:15:03.379
spreading our resources too thinly. We were a small company,
248
00:15:03.419 --> 00:15:06.059
so I knew everybody. And they would come into my
249
00:15:06.179 --> 00:15:09.320
office and, you know, ask for more resources.
250
00:15:10.899 --> 00:15:13.090
I asked Lars if Lotta was one of those people.
251
00:15:13.879 --> 00:15:17.529
Oh, yeah, all the time. I could not meet Lotta
252
00:15:17.570 --> 00:15:22.889
without her really getting on my case to prioritize her
253
00:15:22.950 --> 00:15:27.980
projects better. Lotte Knudsen is a person that's very, very
254
00:15:28.299 --> 00:15:29.379
difficult to say no to.
255
00:15:33.259 --> 00:15:36.799
Even with Lotte pushing the project, Lars considered canning the
256
00:15:36.840 --> 00:15:37.279
whole thing.
257
00:15:37.299 --> 00:15:40.360
I do recall that we did give him 12 months
258
00:15:40.419 --> 00:15:41.980
to say, you've got to come up with something which
259
00:15:42.039 --> 00:15:47.220
is more convincing. And my recollection is it was extraordinarily
260
00:15:47.259 --> 00:15:50.730
slow developing at the time. And I'm sure a lot
261
00:15:50.750 --> 00:15:52.870
of people will say this is because we had no resources.
262
00:15:53.669 --> 00:15:57.629
But anyway, because of their stubbornness and their skills and
263
00:15:57.669 --> 00:16:03.759
their professionalism, they eventually were able to create a molecule
264
00:16:03.799 --> 00:16:07.039
that was protracted so it became a real drug that
265
00:16:07.059 --> 00:16:09.879
we could start to make clinical trials on.
266
00:16:10.879 --> 00:16:14.419
Lada and her team had met the deadline. By then,
267
00:16:14.440 --> 00:16:18.659
it was 1997. All told, it had taken about four
268
00:16:18.759 --> 00:16:21.340
years for them to create a compound that mimicked the
269
00:16:21.379 --> 00:16:25.090
effects of GLP-1, and didn't immediately break down in the body.
270
00:16:26.029 --> 00:16:29.509
They called this compound liraglutide, and it stayed in the
271
00:16:29.549 --> 00:16:33.169
body for 24 hours. Think of it as a precursor
272
00:16:33.250 --> 00:16:38.639
to Ozempic. Same scientific idea, just not as powerful. The
273
00:16:38.679 --> 00:16:42.899
next step was to test liraglutide on patients. But inside
274
00:16:42.940 --> 00:16:46.620
Novo Nordisk, Lada's team still had to fight for limited resources,
275
00:16:47.320 --> 00:16:49.580
and that problem felt to Lada's boss.
276
00:16:50.240 --> 00:16:52.970
As a very young lad, I had Big hair, big
277
00:16:52.990 --> 00:16:57.620
curly hair, lots of hair, not anymore. And so I
278
00:16:57.629 --> 00:16:59.820
look like a typical young, nerdy scientist.
279
00:17:00.620 --> 00:17:04.380
That's Mads Krogsgaard-Thomsen, a former senior vice president at the
280
00:17:04.420 --> 00:17:07.539
company and a big champion of Lottas. And he wasn't
281
00:17:07.579 --> 00:17:09.920
afraid to get creative to keep her project going.
282
00:17:10.819 --> 00:17:13.279
Well, the first stumbling block was that we were a
283
00:17:13.279 --> 00:17:16.660
little bit behind in production capacity for insulin. So we
284
00:17:16.740 --> 00:17:21.309
literally had no utilization of any production facility in the company.
285
00:17:21.799 --> 00:17:24.390
So I had to give the team money to go
286
00:17:24.430 --> 00:17:27.849
to Belgium to ask another pharmaceutical company to produce.
287
00:17:27.569 --> 00:17:27.930
It for us.
288
00:17:28.470 --> 00:17:30.829
And so you had to do it basically off campus
289
00:17:31.509 --> 00:17:32.470
to get this stuff done?
290
00:17:32.809 --> 00:17:34.130
In a competing company already.
291
00:17:34.170 --> 00:17:35.089
In a competing company.
292
00:17:35.130 --> 00:17:35.730
Another company.
293
00:17:37.890 --> 00:17:41.490
Eventually, they did get enough medicine for human trials. But
294
00:17:41.539 --> 00:17:44.220
at first, it produced a really nasty side effect.
295
00:17:45.769 --> 00:17:47.430
The people in the phase one trial, they vomited.
296
00:17:47.710 --> 00:17:47.970
Wow.
297
00:17:48.279 --> 00:17:49.579
So they literally felt sick.
298
00:17:50.240 --> 00:17:52.759
And this, of course, didn't convince management that this was
299
00:17:52.799 --> 00:17:53.980
very exciting at all.
300
00:17:54.440 --> 00:17:54.660
Right.
301
00:17:54.680 --> 00:17:56.480
They were like, I don't know what you guys are
302
00:17:56.500 --> 00:17:59.079
doing over there, but it doesn't seem to be working. No.
303
00:17:59.519 --> 00:18:02.869
So there was actually a feeling of, OK, is this
304
00:18:02.960 --> 00:18:05.950
the end stage for this GLP-1 project?
305
00:18:07.329 --> 00:18:09.890
And then there was a concern about cancer.
306
00:18:10.529 --> 00:18:13.829
We saw tumors in rats and mice up here in
307
00:18:13.849 --> 00:18:18.269
the thyroid gland. And suddenly these tumors seem to be
308
00:18:18.369 --> 00:18:22.369
happening dose-dependently over time in rodents. Luckily, we didn't see
309
00:18:22.410 --> 00:18:25.019
them in rabbits. We didn't see them in dogs. We
310
00:18:25.059 --> 00:18:28.599
didn't see them in monkeys. But the regulators, FDA and
311
00:18:28.640 --> 00:18:31.920
so on, were not happy with seeing tumors in two species.
312
00:18:35.400 --> 00:18:39.009
The team did more testing. And ultimately, they concluded that
313
00:18:39.049 --> 00:18:42.190
the tumors they saw in rodents were not relevant in humans.
314
00:18:43.049 --> 00:18:45.950
But it would take years before the FDA was satisfied
315
00:18:46.309 --> 00:18:50.009
that Novo's liraglutide was safe for people. And Novo Nordisk
316
00:18:50.130 --> 00:18:53.119
still advises against taking GLP-1 drugs if you have a
317
00:18:53.160 --> 00:18:59.920
history of thyroid cancer. So the FDA approved liraglutide in 2010.
318
00:18:59.920 --> 00:19:02.140
Do you remember the moment you heard about it?
319
00:19:02.920 --> 00:19:05.549
My wife and kids had gone to bed. And then
320
00:19:05.609 --> 00:19:09.450
I actually, I get a phone call at like 11.30
321
00:19:09.450 --> 00:19:14.339
in the evening. Mads, we've got it. We've got an approval. And,
322
00:19:14.359 --> 00:19:18.220
you know, you just shout out loud. I just got
323
00:19:18.259 --> 00:19:21.039
extremely excited, so much that my family woke up and
324
00:19:21.079 --> 00:19:22.640
was really annoyed with me.
325
00:19:22.660 --> 00:19:25.839
They're like, why are you so excited? It's the middle
326
00:19:25.859 --> 00:19:26.160
of the night.
327
00:19:26.200 --> 00:19:26.589
Yeah, yeah.
328
00:19:26.609 --> 00:19:30.950
I had to apologize. So I took a good McGowan whiskey,
329
00:19:31.349 --> 00:19:33.289
took a good shot of that and celebrated over the
330
00:19:33.329 --> 00:19:34.690
phone with the colleagues.
331
00:19:36.529 --> 00:19:39.970
Yes, I was in my bed, but the minute I
332
00:19:40.069 --> 00:19:44.019
saw the number on my phone, I knew we got this.
333
00:19:44.839 --> 00:19:47.549
I felt a great sense of accomplishment.
334
00:19:48.009 --> 00:19:49.630
It was more than 10 years.
335
00:19:50.119 --> 00:19:53.380
In the making, and if we hadn't gotten that U.S. approval,
336
00:19:53.819 --> 00:19:57.339
maybe it would have been just not going anywhere. That
337
00:19:57.380 --> 00:20:01.089
would have been a great shame for the people who
338
00:20:01.109 --> 00:20:02.509
need this kind of medicine.
339
00:20:04.150 --> 00:20:08.119
Liraglutide went on sale under the brand name Victoza. It
340
00:20:08.150 --> 00:20:10.799
was approved to treat type 2 diabetes, and it was
341
00:20:10.819 --> 00:20:15.119
a modest success. More importantly, though, it was a proof
342
00:20:15.140 --> 00:20:19.579
of concept. Lotta's GLP-1 research had led to an effective drug.
343
00:20:20.539 --> 00:20:24.170
And the next drug, a new invention building off liraglutide,
344
00:20:24.690 --> 00:20:31.250
was already in the pipeline. It would be a blockbuster.
345
00:20:32.170 --> 00:20:34.589
One that would turn Novo Nordisk into a company that
346
00:20:34.630 --> 00:20:38.390
was known for more than diabetes. Because here's the thing.
347
00:20:39.170 --> 00:20:42.170
Since almost the beginning of Lotta's research, she knew that
348
00:20:42.250 --> 00:20:48.690
GLP-1 had another effect. Weight loss. Did that surprise you
349
00:20:49.210 --> 00:20:52.210
that it was weight loss really that made these drugs
350
00:20:52.289 --> 00:20:55.190
kind of soar to the top and make it kind
351
00:20:55.230 --> 00:20:57.009
of a household name at this point?
352
00:20:57.769 --> 00:21:00.109
Yes and no, because I remember I've heard it for
353
00:21:00.170 --> 00:21:04.049
such a long time. Ever since back to the early 2000s,
354
00:21:04.109 --> 00:21:06.910
when I was first lucky enough to be able to
355
00:21:07.009 --> 00:21:10.569
actually hear from some patients, they had tears in their eyes.
356
00:21:10.789 --> 00:21:13.069
And they said, you know, I've been hungry for 20 years.
357
00:21:13.650 --> 00:21:15.289
Now I can manage to have.
358
00:21:15.170 --> 00:21:15.789
A normal life.
359
00:21:18.269 --> 00:21:21.819
So how did a diabetes drug turn into a weight
360
00:21:21.859 --> 00:21:24.440
loss phenomenon? That's after the break.
361
00:21:31.079 --> 00:21:33.980
It's been a busy week, right? Sounds like it's time
362
00:21:34.019 --> 00:21:38.740
for that takeaway. Deliveroo's on it. Whether it's extra saucy
363
00:21:38.819 --> 00:21:43.019
wings from Nando's, a tasty taco bowl from Sprout & Co,
364
00:21:43.500 --> 00:21:47.539
or maybe even some California birria from Boojum. We'll deliver
365
00:21:47.660 --> 00:21:52.700
in as little as 25 minutes. Order now. You've earned it. Deliveroo.
366
00:21:53.259 --> 00:21:57.759
That finish line Friday feeling just got even better. Geographical restrictions,
367
00:21:57.799 --> 00:22:00.059
teas and season fees apply. Delivery times vary. See app
368
00:22:00.079 --> 00:22:00.779
or web for info.
369
00:22:01.529 --> 00:22:04.049
Hey, it's Wendy from Science Versus, and I want to
370
00:22:04.089 --> 00:22:07.420
tell you about a podcast that I love, Science Friday.
371
00:22:07.599 --> 00:22:10.140
They cover all sorts of amazing things in the weird
372
00:22:10.180 --> 00:22:14.200
and wonderful world of science, from how concussions affect our
373
00:22:14.269 --> 00:22:17.329
brain to the inner secrets of a snake with a
374
00:22:17.430 --> 00:22:19.950
spider on its tale. It's a lot of news that
375
00:22:20.009 --> 00:22:22.450
you can use and some that you can't, but you're
376
00:22:22.470 --> 00:22:25.490
going to love anyway. It's hosted by Ira Flato and
377
00:22:25.670 --> 00:22:28.779
Flora Lichtman, who is an old friend of the show
378
00:22:28.920 --> 00:22:31.680
and loves a pun as much as we do. Science
379
00:22:31.740 --> 00:22:34.900
Friday is on every day, wherever you get your podcasts.
380
00:22:45.900 --> 00:22:48.759
Welcome to what we call the factory of the future.
381
00:22:48.359 --> 00:22:49.460
Within Novo Nordisk.
382
00:22:50.109 --> 00:22:53.750
At the drug company Novo Nordisk, they're very serious about
383
00:22:53.829 --> 00:22:55.289
how you wear your socks.
384
00:22:56.390 --> 00:22:58.450
When you put your socks on, it would be something
385
00:22:58.470 --> 00:22:58.849
like this.
386
00:22:59.769 --> 00:23:00.490
You put them on.
387
00:23:02.190 --> 00:23:06.119
Novo Nordisk is based near Copenhagen, Denmark. The factory there
388
00:23:06.200 --> 00:23:07.359
is a hive of activity.
389
00:23:07.380 --> 00:23:10.980
All right, just keep an eye out.
390
00:23:11.019 --> 00:23:12.599
Now we're in the area with a little bit more
391
00:23:12.660 --> 00:23:13.519
robot traffic.
392
00:23:14.200 --> 00:23:17.200
On an assembly line, a machine places vials of clear
393
00:23:17.259 --> 00:23:20.880
liquid into blue syringes. You can see the pens clattering out.
394
00:23:25.240 --> 00:23:26.920
What's on the line there?
395
00:23:26.940 --> 00:23:27.569
Uh, semaglutide.
396
00:23:30.769 --> 00:23:31.529
Semaglutide.
397
00:23:31.990 --> 00:23:32.210
Or.
398
00:23:32.529 --> 00:23:33.369
Semaglutide.
399
00:23:33.470 --> 00:23:34.170
Semaglutide.
400
00:23:34.289 --> 00:23:34.970
Semaglutide.
401
00:23:34.990 --> 00:23:36.769
Semaglutide. Semaglutide.
402
00:23:36.789 --> 00:23:36.849
Or.
403
00:23:37.549 --> 00:23:38.990
We've been saying semaglutide.
404
00:23:39.049 --> 00:23:39.569
Is that right?
405
00:23:39.750 --> 00:23:40.819
That is so correct.
406
00:23:40.890 --> 00:23:41.769
Okay, because we.
407
00:23:41.670 --> 00:23:45.880
Hear like semaglutide or... So that's incorrect. It is.
408
00:23:46.119 --> 00:23:46.980
It's semaglutide.
409
00:23:47.079 --> 00:23:52.720
For the record. Thank you. However you say it, semaglutide
410
00:23:52.900 --> 00:23:59.460
is Novo's successor to liraglutide. It came with some side effects. Nausea, vomiting,
411
00:23:59.819 --> 00:24:04.990
gastrointestinal issues. But semaglutide is a more effective GLP-1 compound.
412
00:24:05.609 --> 00:24:07.190
And you only need to take it once a week
413
00:24:07.630 --> 00:24:11.170
instead of once a day. It's also the key ingredient
414
00:24:11.309 --> 00:24:19.150
in Ozempic. In 2017, the FDA approved Ozempic specifically to
415
00:24:19.210 --> 00:24:23.559
treat type 2 diabetes. That year, Novo Nordisk geared up
416
00:24:23.599 --> 00:24:29.759
for a big U.S. campaign. Did people inside Novo realize
417
00:24:29.799 --> 00:24:33.099
they had a hit or a blockbuster in Ozempic around
418
00:24:33.119 --> 00:24:33.880
the time of the launch?
419
00:24:34.539 --> 00:24:39.619
So there was a lot of excitement and preparation. We
420
00:24:39.640 --> 00:24:42.000
thought this could be one of the most important products
421
00:24:42.400 --> 00:24:44.500
that the company had brought to market to date.
422
00:24:45.339 --> 00:24:47.829
That's Dave Moore. He was in charge of sales and
423
00:24:47.869 --> 00:24:51.970
marketing when Ozempic launched in the U.S. in 2018. With
424
00:24:51.990 --> 00:24:54.910
a possible hit on their hands, Dave says the company
425
00:24:54.930 --> 00:24:57.690
started to get the word out. They promoted the drug's
426
00:24:57.730 --> 00:25:00.920
ability to lower blood sugar levels to specialists and doctors.
427
00:25:01.660 --> 00:25:04.000
And they spent a lot of money on branding and marketing.
428
00:25:05.000 --> 00:25:08.119
But you probably know that already because of this catchy tune.
429
00:25:11.500 --> 00:25:14.319
People with type 2 diabetes are excited about the potential
430
00:25:14.339 --> 00:25:15.799
of once-weekly Ozempic.
431
00:25:15.960 --> 00:25:17.359
Who came up with the idea for the jingle?
432
00:25:18.059 --> 00:25:22.119
We test these, and there was a really strong recall,
433
00:25:22.440 --> 00:25:24.720
which is important in any of these campaigns.
434
00:25:25.599 --> 00:25:27.119
Did you like the song? Did it resonate with you?
435
00:25:27.759 --> 00:25:29.869
I did know the song, and I can actually tell
436
00:25:29.880 --> 00:25:31.970
you the first time I heard it, and I'll date myself,
437
00:25:32.029 --> 00:25:34.990
but I was roller-skating. back when I was in school
438
00:25:35.009 --> 00:25:38.829
in 75. And, you know, it was a hit, right?
439
00:25:40.210 --> 00:25:41.170
I don't know if you'll hear this.
440
00:25:42.339 --> 00:25:51.400
Oh, oh, oh, it's magic, you know. Never believe it's
441
00:25:51.460 --> 00:25:52.579
not so.
442
00:25:55.220 --> 00:25:55.680
There you go.
443
00:25:56.039 --> 00:25:57.519
That's incredible.
444
00:25:58.940 --> 00:26:04.069
My name's David Payton. I'm the singer-songwriter with the band pilot,
445
00:26:04.509 --> 00:26:09.970
and I wrote the song Magic, being used by Ozempic extensively.
446
00:26:11.009 --> 00:26:14.900
David Payton wrote Magic 50 years ago. He didn't think
447
00:26:14.920 --> 00:26:16.720
too much of the fact that it was recently picked
448
00:26:16.799 --> 00:26:19.259
up for a drug ad, not even when he saw
449
00:26:19.299 --> 00:26:23.490
the company Novo Nordisk on his royalty statement. David figured
450
00:26:23.789 --> 00:26:25.529
Magic had been used many times before.
451
00:26:26.470 --> 00:26:30.109
When it first came out in 74, Coca-Cola got in
452
00:26:30.150 --> 00:26:33.490
touch with me and they, yeah, it's been used extensively
453
00:26:33.630 --> 00:26:37.990
for a long time. And even Selena Gomez, you might know,
454
00:26:38.049 --> 00:26:41.450
she had a pretty big hit with it in the
455
00:26:41.490 --> 00:26:47.019
States around about 2009 or thereabouts. I've heard lots of
456
00:26:47.099 --> 00:26:51.180
hip hop versions, which are very strange because, you know,
457
00:26:51.200 --> 00:26:53.500
there's a lot of rapping going on and then the
458
00:26:53.539 --> 00:26:57.990
chorus is used. Flo Rida did a version of Magic.
459
00:26:58.799 --> 00:27:02.880
But something about this version seemed to land differently. About
460
00:27:02.920 --> 00:27:05.500
a year after Ozempic hit the market, David was at
461
00:27:05.539 --> 00:27:07.950
home in Scotland when he got a call from a friend.
462
00:27:08.589 --> 00:27:11.690
And he phoned me up really excited and said, David,
463
00:27:12.099 --> 00:27:15.660
do you realize your song is on television here in
464
00:27:15.700 --> 00:27:18.359
the States? And I said, it must be every 20
465
00:27:18.359 --> 00:27:22.099
minutes I'm hearing your song. And I said to him, well,
466
00:27:22.160 --> 00:27:24.680
I knew it was being used, but I didn't realize
467
00:27:25.200 --> 00:27:28.089
it was that much coverage that was going on in
468
00:27:28.130 --> 00:27:28.650
the States.
469
00:27:29.809 --> 00:27:35.029
Ozempic was really starting to pick up steam. Except the
470
00:27:35.049 --> 00:27:39.170
hype wasn't because it was a drug for diabetes. People
471
00:27:39.210 --> 00:27:42.779
were talking about it for weight loss. It's known as
472
00:27:42.859 --> 00:27:47.279
Hollywood's worst kept secret as celebrities dropped noticeable amounts of
473
00:27:47.380 --> 00:27:48.220
weight quickly.
474
00:27:48.720 --> 00:27:52.619
I mean, I cannot scroll through my social media without
475
00:27:52.799 --> 00:27:56.319
someone mentioning the Ozempic diet.
476
00:27:56.599 --> 00:27:58.900
By the way, you've been working on your body and
477
00:27:58.940 --> 00:27:59.460
on your health.
478
00:27:59.619 --> 00:28:00.960
No, that's Ozempic.
479
00:28:01.559 --> 00:28:05.380
The topic Ozempic has over 300 million views.
480
00:28:05.619 --> 00:28:07.700
When I look around this room, I can't help but wonder,
481
00:28:08.440 --> 00:28:09.660
is Ozempic right for me?
482
00:28:14.690 --> 00:28:18.960
Now, companies can't promote their medicines for off-label use. But
483
00:28:19.000 --> 00:28:22.980
it's not unusual or necessarily unethical for doctors to prescribe
484
00:28:23.019 --> 00:28:27.339
a drug for something it isn't FDA approved for. I
485
00:28:27.420 --> 00:28:29.839
asked Dave Moore about all this. He's the guy who
486
00:28:29.859 --> 00:28:34.380
led the launch of Ozempic in the U.S. As you know, today,
487
00:28:34.400 --> 00:28:38.579
a lot of people don't necessarily associate Ozempic with diabetes.
488
00:28:38.940 --> 00:28:43.049
They associate it with obesity treatment and weight loss. How
489
00:28:43.069 --> 00:28:45.849
did that happen? And when did people at Novo start
490
00:28:45.910 --> 00:28:49.869
realizing that it was being prescribed off-label for weight loss?
491
00:28:51.069 --> 00:28:54.250
Yeah, I'm glad you asked that question. I'll start with
492
00:28:54.390 --> 00:28:58.730
the first part. It's really important, and I'd love to
493
00:28:58.769 --> 00:29:03.299
stress to your listeners that Ozempic is for type 2 diabetes.
494
00:29:04.039 --> 00:29:04.309
And I.
495
00:29:05.990 --> 00:29:10.220
Would ask everyone to really think about the uses of
496
00:29:10.279 --> 00:29:14.799
these medicines based on what they're intended for. The second
497
00:29:14.819 --> 00:29:19.440
part to your question, we knew that there was a
498
00:29:19.769 --> 00:29:24.490
need for new medicine for people living with obesity. And
499
00:29:24.509 --> 00:29:31.329
we were studying higher doses of semaglutide for chronic weight management.
500
00:29:31.829 --> 00:29:37.230
And that was in clinical trials while Ozempic, of course,
501
00:29:37.410 --> 00:29:39.950
was being launched into the market as a type 2 diagnosis.
502
00:29:40.490 --> 00:29:41.130
Medication.
503
00:29:41.450 --> 00:29:45.140
I totally understand what you're saying. However, it did happen
504
00:29:45.200 --> 00:29:48.740
that doctors prescribed Ozempic off-label. I mean, they were making
505
00:29:48.779 --> 00:29:51.779
jokes about it at the Oscars. Like, what do you
506
00:29:51.859 --> 00:29:52.240
do in a.
507
00:30:00.359 --> 00:30:04.539
Play our role and do our part to ensure that
508
00:30:04.900 --> 00:30:10.460
we try to correct, you know, anytime that happens. We,
509
00:30:10.500 --> 00:30:17.450
of course, you know, are not denying that those things happen, right?
510
00:30:17.789 --> 00:30:24.009
We're not being shy. You know, we see the media.
511
00:30:25.089 --> 00:30:29.210
And ultimately, clinicians make the choice, right?
512
00:30:29.390 --> 00:30:29.549
Right.
513
00:30:29.900 --> 00:30:34.680
And our position is firm and clear. We don't want
514
00:30:34.779 --> 00:30:38.019
Ozempic used off-label, and we only want it to be
515
00:30:38.119 --> 00:30:39.480
used as it's intended.
516
00:30:41.319 --> 00:30:44.869
As Dave mentioned, Novo was doing research into their GLP-1
517
00:30:44.890 --> 00:30:48.009
drugs and weight loss. But for a long time, it
518
00:30:48.109 --> 00:30:52.750
wasn't the priority. Diabetes was. Because drugs to treat obesity
519
00:30:52.869 --> 00:30:57.190
look like a risky proposition. Here's Lars Rabian Sorensen, the
520
00:30:57.210 --> 00:30:58.230
former Novo CEO.
521
00:30:59.039 --> 00:31:02.680
I was not against that. I actually thought it was
522
00:31:02.720 --> 00:31:07.680
a good idea. However, I was a little bit cautious
523
00:31:07.859 --> 00:31:15.410
about expressing this publicly because at the time, almost all
524
00:31:15.470 --> 00:31:21.670
without exception, weight-lowering drugs have failed, some even so badly
525
00:31:21.750 --> 00:31:27.079
that companies were sued. So I knew that If we
526
00:31:27.130 --> 00:31:32.259
started talking too much about the obesity effect of GLP-1,
527
00:31:32.299 --> 00:31:36.779
we might taint a very good diabetes drug.
528
00:31:37.559 --> 00:31:40.210
There was a quote that's been circulating the internet a
529
00:31:40.230 --> 00:31:43.269
little bit that is attributed to you from 2005, where
530
00:31:43.309 --> 00:31:47.210
you say that obesity is primarily a social and cultural problem.
531
00:31:47.789 --> 00:31:50.450
It should be solved by means of a radical restructuring
532
00:31:50.470 --> 00:31:53.660
of society. There's no business for Novo Nordisk in that area.
533
00:31:54.099 --> 00:31:55.000
Do you remember saying that?
534
00:31:55.930 --> 00:31:59.009
I remember that, and I believed it at the time.
535
00:31:59.349 --> 00:31:59.609
Yeah.
536
00:32:00.109 --> 00:32:03.710
I was not aware at that time of the great
537
00:32:03.809 --> 00:32:10.039
difficulty number of people with severe overweight. I have absolutely
538
00:32:10.099 --> 00:32:11.380
no doubt that I said this.
539
00:32:12.259 --> 00:32:17.460
What ultimately changed your mind about developing GLP-1s for obesity treatment?
540
00:32:18.200 --> 00:32:20.519
First of all, you get in contact with these individuals
541
00:32:20.579 --> 00:32:23.980
that are struggling with this for their entire life. That
542
00:32:24.019 --> 00:32:28.230
has an enormous impact. impact on you as an individual,
543
00:32:29.049 --> 00:32:33.049
then there's also a commercial motive in this. This is
544
00:32:33.109 --> 00:32:38.759
a huge potential commercial market for the company. So it
545
00:32:38.779 --> 00:32:46.519
was composite of patient consideration, but also pursuing a commercial
546
00:32:47.220 --> 00:32:48.400
opportunity for the company.
547
00:32:49.539 --> 00:32:53.460
So Novo Nordisk released Wigovi in 2021, a higher dose
548
00:32:53.480 --> 00:32:58.539
of semaglutide approved specifically for weight loss. In one major trial,
549
00:32:58.980 --> 00:33:02.069
patients lost an average of about 15% of their body
550
00:33:02.109 --> 00:33:08.130
weight in just over a year. And it wasn't just Novo.
551
00:33:08.869 --> 00:33:12.750
Another pharmaceutical giant, Eli Lilly, had also been working on
552
00:33:12.809 --> 00:33:15.869
GLP-1s for years. And in 2022, they were hot on
553
00:33:15.890 --> 00:33:23.640
Novo's heels. Eli Lilly answered Novosemaglutide with her own compound, Terzepatide.
554
00:33:25.420 --> 00:33:30.500
Terzepatide mimics two gut hormones, GLP-1 and another one called GIP.
555
00:33:31.269 --> 00:33:35.650
That made Terzepatide even more effective. In the spring of 2022,
556
00:33:35.650 --> 00:33:40.369
Eli Lilly released Manjaro, which was approved for type 2 diabetes.
557
00:33:40.910 --> 00:33:44.150
I started taking Manjaro, and I've lost 65 pounds.
558
00:33:46.299 --> 00:33:50.099
Last year, they came out with Zepbound for weight loss. Zepbound,
559
00:33:50.279 --> 00:33:51.359
made by Eli Lilly.
560
00:33:51.799 --> 00:33:54.900
Potentially more effective for losing weight than any other drug
561
00:33:54.960 --> 00:33:55.509
on the market.
562
00:33:57.849 --> 00:34:01.630
And GLP-1 medications also got a huge endorsement from one
563
00:34:01.650 --> 00:34:03.630
of the most trusted voices in America.
564
00:34:03.930 --> 00:34:08.159
For 25 years, making fun of my weight was national sport.
565
00:34:09.539 --> 00:34:12.199
In my lifetime, I never dreamed that we would be
566
00:34:12.260 --> 00:34:16.480
talking about medicines that are providing hope for people like
567
00:34:16.599 --> 00:34:20.989
me who have struggled for years with being overweight or
568
00:34:21.030 --> 00:34:21.699
with obesity.
569
00:34:25.110 --> 00:34:29.309
Suddenly, Novo Nordisk and Eli Lilly were leading a booming market.
570
00:34:30.230 --> 00:34:33.389
Novo is now the most valuable company in Europe. It's
571
00:34:33.429 --> 00:34:35.369
locked in a race with Lilly to become the first
572
00:34:35.550 --> 00:34:40.000
trillion-dollar pharmaceutical company by market cap. And demand for these
573
00:34:40.039 --> 00:34:43.530
drugs has gotten so high that Novo and Lilly cannot
574
00:34:43.590 --> 00:34:47.409
keep up. The FDA put semaglutide on an official shortage
575
00:34:47.449 --> 00:34:53.510
list in 2022. Terzepatide followed just months later. Here's Novo's
576
00:34:53.570 --> 00:34:56.559
Mads Thomsen again. Did you ever dream that it could
577
00:34:56.579 --> 00:34:58.820
be this big, ultimately?
578
00:34:59.900 --> 00:35:02.119
My dream, but that was just a dream, was that
579
00:35:02.199 --> 00:35:04.059
one day it could be the number one drug class
580
00:35:04.239 --> 00:35:07.480
in the world. And right now, this year, the latest
581
00:35:07.519 --> 00:35:10.059
forecast is that the GLP-1 class is actually going to
582
00:35:10.099 --> 00:35:13.239
be the number one drug class in the world. But
583
00:35:13.340 --> 00:35:16.719
it's gone surprisingly fast to the extent that neither we
584
00:35:17.159 --> 00:35:20.449
nor our peers at Eli Lilly can deliver enough products
585
00:35:20.590 --> 00:35:21.969
to satisfy the market.
586
00:35:21.989 --> 00:35:27.750
Thank you for calling Walgreens Pharmacy.
587
00:35:27.769 --> 00:35:28.329
I can help you.
588
00:35:28.349 --> 00:35:29.190
Where are you from?
589
00:35:29.210 --> 00:35:29.659
I can help you.
590
00:35:29.710 --> 00:35:30.530
I'm trying to go to pharmacy.
591
00:35:30.550 --> 00:35:31.179
I can help you.
592
00:35:31.760 --> 00:35:37.110
Pharmacists can't stock the stuff fast enough. My colleague, Brad Olson,
593
00:35:37.510 --> 00:35:39.110
you heard from him at the start of the episode.
594
00:35:39.789 --> 00:35:41.869
He and I called a bunch of pharmacies all over
595
00:35:41.889 --> 00:35:42.369
the country.
596
00:35:42.389 --> 00:35:46.179
I'm just calling to see if you have any GLP-1
597
00:35:46.440 --> 00:35:49.039
drugs in stock, like Ozempic or Mount Jaro.
598
00:35:50.300 --> 00:35:50.960
No, we don't.
599
00:35:51.199 --> 00:35:52.679
No, unfortunately, we do not.
600
00:35:52.760 --> 00:35:54.780
We haven't gotten it in the past few months.
601
00:35:54.880 --> 00:35:56.199
No, it's not available.
602
00:35:56.219 --> 00:35:58.239
I think next month it's going to be available.
603
00:35:58.420 --> 00:36:01.309
Literally, like, every injection right now is so hard to get.
604
00:36:01.590 --> 00:36:02.730
We're out of stock on it.
605
00:36:03.030 --> 00:36:03.519
On all of it?
606
00:36:04.400 --> 00:36:04.880
Yeah.
607
00:36:09.130 --> 00:36:13.369
Today, there's no doubt Americans want these drugs. But almost
608
00:36:13.510 --> 00:36:16.670
everyone we spoke to for the series, from patients to
609
00:36:16.710 --> 00:36:21.480
doctors to lawmakers, pointed to the same big issue. Price.
610
00:36:22.519 --> 00:36:25.800
These drugs are very expensive, about $ 1, 000 a month out
611
00:36:25.820 --> 00:36:29.199
of pocket in the U.S. Insurance often won't cover them
612
00:36:29.219 --> 00:36:32.079
for weight loss. And it's recommended that the medicine be
613
00:36:32.099 --> 00:36:35.489
taken for life. Or else studies show people gain the
614
00:36:35.510 --> 00:36:40.489
weight back. My colleague Brad also ran into the affordability issue.
615
00:36:41.630 --> 00:36:45.050
And so you did stop taking Manjaro after about five months.
616
00:36:45.840 --> 00:36:46.090
Why?
617
00:36:46.110 --> 00:36:51.340
I would say it's mainly cost. I just can't afford,
618
00:36:51.360 --> 00:36:55.500
you know, that expense over the course of my lifetime
619
00:36:55.699 --> 00:37:01.110
out of pocket. And So for me, starting without insurance
620
00:37:01.190 --> 00:37:03.050
is sort of like a choice where you know in
621
00:37:03.090 --> 00:37:05.130
the end that the jig is up, like you're not
622
00:37:05.150 --> 00:37:07.010
going to be able to keep taking it.
623
00:37:08.150 --> 00:37:11.750
So how long after your last dose before you started
624
00:37:11.769 --> 00:37:13.190
to feel the cravings come back?
625
00:37:14.110 --> 00:37:15.210
It was probably three weeks.
626
00:37:16.090 --> 00:37:16.389
Okay.
627
00:37:16.769 --> 00:37:19.670
It became hard because it became like you're kind of
628
00:37:19.789 --> 00:37:23.860
without a net. You know, in the circus, you're on
629
00:37:23.900 --> 00:37:27.460
the tightrope and there's no net under you, you know.
630
00:37:28.059 --> 00:37:30.699
And the medicine was like having the net. You're like, oh,
631
00:37:30.739 --> 00:37:35.320
I can fall off this tightrope, no big deal. That's
632
00:37:35.340 --> 00:37:35.980
what it feels like.
633
00:37:36.139 --> 00:37:36.360
Yeah.
634
00:37:37.679 --> 00:37:41.250
Brad decided to go without a net. But as we
635
00:37:41.289 --> 00:37:44.130
reported the series, he and I talked to people who
636
00:37:44.190 --> 00:37:46.349
weren't so willing to give up a drug that they
637
00:37:46.389 --> 00:37:49.409
felt changed their lives, even if it was more than
638
00:37:49.429 --> 00:37:50.110
they could afford.
639
00:37:50.610 --> 00:37:53.829
Okay, if I can't get the drug, what can I
640
00:37:53.869 --> 00:37:54.590
take instead?
641
00:37:55.130 --> 00:37:59.780
What's close? And so... they resorted to riskier measures.
642
00:38:00.380 --> 00:38:03.579
What I received in the mail was a tiny vial
643
00:38:03.639 --> 00:38:05.179
filled with white powder.
644
00:38:05.719 --> 00:38:05.980
Okay.
645
00:38:06.000 --> 00:38:09.099
Which could, honest to God, be anything, because, like, who knows?
646
00:38:10.579 --> 00:38:24.550
That's next time on Trillion Dollar Shot. Trillion Dollar Shot
647
00:38:24.619 --> 00:38:26.980
is part of The Journal. which is a co-production of
648
00:38:27.039 --> 00:38:30.579
Spotify and The Wall Street Journal. This episode was hosted
649
00:38:30.619 --> 00:38:34.909
by me, Jessica Mendoza, with Bradley Olson. It was produced
650
00:38:34.969 --> 00:38:38.690
by Matt Kwong, with help from Jivika Verma. Additional production
651
00:38:38.769 --> 00:38:43.250
from Adrienne Murray-Nielsen. This series is edited by Catherine Brewer.
652
00:38:43.610 --> 00:38:48.579
Fact-checking by Sophie Hurwitz. Series art by Pete Ryan. Sound
653
00:38:48.599 --> 00:38:51.500
design and mixing by Peter Leonard. Music in this episode
654
00:38:51.539 --> 00:38:55.409
by Peter Leonard and Bobby Lord. Our theme music is
655
00:38:55.449 --> 00:38:58.610
by So Wiley. Remix for the series by Peter Leonard.
656
00:39:01.630 --> 00:39:06.829
Special thanks to Maria Byrne, Stephanie Ilgenfritz, Kate Leinbaugh, Peter Loftus,
657
00:39:07.210 --> 00:39:11.969
Sarah O'Brien, Enrique Perez de la Rosa, Sarah Platt, Suna Rasmussen,
658
00:39:12.309 --> 00:39:18.010
Jonathan Sanders, Nathan Singapak, Leying Tang, Rolf Winkler, Liz Esley-White,
659
00:39:18.329 --> 00:39:24.219
and Tatiana Zamise. Thanks for listening. Episode 2 drops next Sunday,
660
00:39:24.539 --> 00:39:32.940
May 19th. Hey, Wendy here again.
661
00:39:32.960 --> 00:39:36.239
So that was episode one of Trillion Dollar Shot from
662
00:39:36.280 --> 00:39:38.639
The Journal. You can listen to the series by finding
663
00:39:38.679 --> 00:39:41.940
The Journal wherever you get podcasts. We'll be back in
664
00:39:41.980 --> 00:39:45.260
your ears with an episode of Science Versus in just
665
00:39:45.300 --> 00:39:47.920
a couple of days. And we are diving into the
666
00:39:47.980 --> 00:39:52.050
science of protein. How much do you really need to
667
00:39:52.449 --> 00:39:57.050
get jacked or to, you know, just be healthy? It's
668
00:39:57.090 --> 00:39:59.630
a really, really fun episode. I can't wait to share
669
00:39:59.650 --> 00:40:02.400
it with you. I'm Wendy Zuckerman. Back to you in
670
00:40:02.420 --> 00:40:04.010
a couple of days. Order now.
671
00:40:11.090 --> 00:40:35.119
You've earned it. Deliveroo. That finish line Friday feeling just
672
00:40:35.199 --> 00:40:38.730
got even better. Geographical restrictions, teas and season fees apply.
673
00:40:38.769 --> 00:40:40.809
Delivery times vary. See app or web for info.
