Today, Explained - The Ozempic economy
Episode Date: February 23, 2024The weight loss drug is so profitable that its parent company, Danish health care giant Novo Nordisk, is propping up Denmark’s entire economy. It’s poised to transform America’s too. This episod...e was produced by Victoria Chamberlin edited by Jolie Myers, fact-checked by Kim Eggleston, engineered by Rob Byers, and hosted by Noel King. Transcript at vox.com/todayexplained Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices
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Almost certainly, you know someone who's on one of the big weight loss drugs,
Ozempic, Wagovi, or someone who would like to be.
But probably you haven't thought a ton about the company that makes those drugs, Novo Nordisk.
The company's based in Denmark, but just bought a big manufacturing site in New Jersey,
100-plus acres in North Carolina, another huge plant in Indiana,
one in Italy, another in Belgium.
This is not normal, guys. This is the kind of expansion you can do only if you've created
the airplane or the iPhone or the next Wonder Truck.
Novo Nordisk is reshaping the Danish economy. It's bigger than the country's entire gross
domestic product. And today on Today Explained,
we'll hear an argument that it could reshape the American economy too.
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Oh, hey, it's Today Explained. I'm Noelle King.
For a long time, Denmark's biggest company was shipping giant and recent Red Sea wilding victim Maersk.
And if you feel like one day you were just hearing about Ozempic everywhere,
same, same for Michael Tukier, who covers economics for the Danish newspaper Politiken.
It came about very quickly, I think.
And I think most people have that impression that suddenly it was all over,
on top of every conversation, especially in Denmark.
Did it permeate the pop culture there?
I think it did, but I think that came from the U.S. actually.
Jolo, you look thin.
Thank you.
Ozempic?
Yep.
When I look around this room, I can't help but wonder, is Ozempic right for me?
Plus, if you tell your family you're on Ozempic, they'll know you were lying when you said you lost the way the old-fashioned way.
Cocaine.
Elon Musk was tweeting about that he was on Regovi.
Obviously, we get a lot of pop culture from America, so we got it that way, let me tell you that.
Okay, so you guys export the groundbreaking medication and the United States exports the culture trash.
Tell me about the company that makes Ozempic and Wachowi.
Novo Nordisk is worth about $530 billion at the moment.
Totally staggering numbers. It's in the top 20 most valuable companies
in the world right now.
Novo Nordisk is Europe's most valuable company. It takes the top spot away from luxury goods
giant LVMH, which sells Louis Vuitton handbags and Hennessy cognac.
And for a small country like Denmark, that is like a huge thing and something that I
don't think any economist
or analyst would have expected just like five years ago. Novo's market capitalization has
surged from about 100 billion dollars in 2020 to a high of 461 billion dollars earlier this month,
bigger than Denmark's entire GDP. Novo Nordisk has more than doubled its market value in the last three years.
It was a big company in Danish terms, but it was nowhere near the top of the world
when we look at market value. What does Denmark's economy look like in this height of Ozempic kind
of age? A good way to describe that is just to referring to an interview I did with a
top analyst in the Danish National Bank a few months ago. He said that basically, if it wasn't
for Denmark's pharmaceutical industry, and by that he really means Novo Nordisk, because they are by
far the biggest, the Danish economy wouldn't have seen any growth last year.
If you strip out the pharmaceutical sector,
which is now dominated by Novo,
the Danish economy actually shrank by 0.3%.
We have seen countries close to us in Europe
where the economy has not looked great at all for the last year or so.
So it makes a huge difference for Danish economy at the moment. And, you know, on top of
that, Novo Nordisk is by far the largest taxpayer in this country. And it also is contributing
a lot to Danish education, to Danish science. So it plays a huge role in the Danish economy
these years. Do you see those changes? Do the average Dane feel that the country is becoming richer?
Maybe they don't, but they can see that in certain parts of the country
where Novo Nordisk has its largest activity,
Novo Nordisk is completely reshaping these parts of the country.
I myself grew up in a quite small town where Novo Nordisk has
its largest factory and they have invested hundreds of millions of dollars into that
small town for the last couple of years. When I go back to visit my mom who lives in Kalembo,
when you drive into the city now, there is like huge factories.
Located just one hour drive from the capital city of Copenhagen,
you will find the industrial cluster of Kalemboor,
home to the world's largest insulin manufacturing plant,
where NOVA Nordisk employ around 3,500 staff.
For a lot of years, where you would see young people,
when they've gone to high school or gone to college,
they would move away from the city.
There have really been not many reasons for them to return.
I think that has changed a lot.
When you get closer to the city, you can see buildings,
you can see huge cranes, a lot of trucks are driving past you. When you go there in the afternoon, a lot of trucks are driving past you when you
go there in the afternoon a lot of cars is there people are commuting to
Calumbo and that is a huge difference from from what you saw before there are
so many jobs already for engineers that's that's the good part about having
the education here in Calumbo is because we have all these companies so we are
surrounded so it's so easy to get a job afterwards.
This has become a city that is thriving.
People are suddenly speaking English at the bakery
and they are demanding, you know, like international schools
and even in the suburbs.
So it has brought about a lot of change.
Do you know the concept of resource curse?
Let me end on that.
That is when an economy becomes over,
it becomes over dependent on one thing.
So you will see this in the Middle East
with a country that only has oil.
Yeah.
Does anyone ever say,
what if we become too dependent on Wagovi and Ozempic?
What if we're an Ozempic economy in 10 years and then bop, bop, bop?
Some economists stress that there is a risk to countries who is significantly dependent on just one or a few companies. And one example of that is a country very close to us,
is Finland, who in the early 2000s,
heavily dependent on their biggest company at the time,
Nokia, the cell phone manufacturer, as I'm sure you know.
But when Apple and other producers overtook Nokia
in the late 2000s, the Finnish economy
stagnated for almost 10 years.
Most economists do not consider this as a very imminent threat to Novo Nordisk, but
more as a thing worth thinking about.
And the reason for Novo Nordisk and Danish businesses to stay frontrunners
on pharmaceutical issues, but also other high technology businesses.
This has me wondering about your predictions for this drug, because so many people want
it and so many people could be helped by it.
It seems to me that there is no end to just how big Wegovia and Ozempic could be.
What are your predictions for what this might mean in five years,
in 10 years for your country's economy and for its people?
The market for weight loss drugs, if you ask most analysts, is, you know, like huge.
The market potential is, I would say, almost unlimited.
And the demand outlook is incredible.
And the biggest problem right now for Nordisk is producing enough.
They cannot meet demand.
It's quite difficult to get your head around what would this mean for Danish economy, how
large can Novo Nordisk become, but also what do these drugs mean for our perception of
what obesity is.
Would we at some point get to where almost everyone is taking some kind of medication
to control your weight.
And who's going to be selling that? Is that Novo Nordisk?
It might be.
Michael Tukier of Politiken newspaper in Denmark.
Coming up, a man who says Osempi could prove to be a bigger economic driver
than artificial intelligence.
And yes, he's serious.
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It's Today Explained. We're back.
People taking these GLP-1 agonists, they're called, like Ozempi,
they eat less than they did before taking the drugs.
Some people also say they drink less, they shop less, they don't want to smoke anymore.
Now, a notable thing about a consumer economy such as ours is that it does require people to consume.
And so some companies have experienced a bit of a freakout.
Josh Barrow, who writes the very serious Substack, has been covering this. I write mostly about politics and the economy. And so obviously that's extremely broad and can encompass, you know, almost everything as part of the economy. And then I also write about interesting industries, especially that may have larger economic effects. And I think that's where Ozempic comes in. Okay. So last summer, I saw you tweeted,
10 years from now, it'll be obvious GLP-1 drugs were a way bigger deal than AI. Okay. So you're saying Ozempic is going to be a bigger deal than JAT, GTP, GPT, and the end of the world and
everything. That's a major thing to say. Can you make the case? Well, sure. So first of all, I think
AI and software more broadly have generally been oversold in terms of their economic effects. And I think that GLP-1 drugs are from them. And in the long run, they're not going to be prohibitively expensive
and difficult to obtain like they have been in the last few years. So I think that it's going to be
really widely used medical intervention that is going to have a lot of positive effects for people.
And so for someone who says, who's listening to this and says,
yeah, that's actually really great. Like half of all people potentially could get this drug.
Make the case that this is a big deal for the economy,
for people whom that might slide past.
Well, so I think it's in a few ways. One is that being overweight and especially being obese
is a significant medical risk factor.
And that has costs.
It has costs in terms of medical care that people need
because of conditions that are related to that, whether that's heart disease or diabetes or even joint problems.
And then it also causes an increase in risk of disability.
And that obviously is a human problem, but it's also an economic problem.
It means that people can't work in the way that they once did, either that they can't work as many hours or they can't work as long into their lives. And so because I think it will reduce the disability rate, I think
that will show up in productivity. And then it's also going to change the way people consume.
There's been this sort of weird fixation in a lot of the press coverage on things that people
might consume less of. Well, switching gears here, Walmart seeing a slight pullback of shoppers. The company's U.S.
CEO has told Bloomberg that they're seeing an impact on shopping demand from people taking
the diabetes drugs of Zempik. And that might be true on some micro levels. And there are specific
businesses that you might be in where this drug is probably bad for you. But the thing is that
people, if they're not going out and spending their money on Doritos,
they still have that money.
And in fact, maybe they have a little bit more money because they're a little bit more
productive and then they can go out and find other new things to spend that money on.
So basically, if you're not in an industry that has specifically negative effects on
consumption demand from Ozempic, you should tend to be thinking of that as an industry
where there will be positive effects.
People will have more money around,
more time around to spend on your product.
Weight loss is a huge source of frustration for people.
It is widely desired.
People who are overweight,
they want to lose weight,
but most things don't work well.
Lose 10 pounds and 5 inches overall in your first month.
You won't just lose your weight.
1-800-94-JENNY
I lost 26 pounds and I have eaten bread every single day.
People bang their heads against the wall
and they end up feeling bad about themselves
and they spend tremendous amounts of time and money
on things in an often futile
pursuit of weight loss. And if you instead have this intervention that works quite well
and requires much less effort on the part of the consumer, that frees up time and money again to
go spend on other things. Okay, so business and Wall Street are paying attention to Ozempic.
Business and Wall Street are not the same thing, but I want you to kind of untangle those two for us. What has that looked like so far?
Is it entirely hand-wringing? Who's looking at the optimistic side of this and saying,
oh, guys, all this money could be good? Yeah, well, I mean, so obviously the first
answer is the drug companies that make these drugs, that they, you know, this is a tremendous
business for them. And we're just seeing a small part of the addressable
market here. And of course, weight loss is one of the major indications for these. They're also
diabetes treatments, and diabetes is a tremendous problem, and that is also a huge market.
And so you see Novo Nordisk, Eli Lilly, potentially Pfizer, which has a drug in the
pipeline. They're going to make a lot of money off this. And the prices that people are seeing right now are eye-watering.
List prices over $1,000 a month. The effective pricing for Wagovi seems to have come down this
year. Zepbound, which is the Eli Lilly competitor to Wagovi, that's going to be pricing at
approximately $550 a month for people whose insurance is not paying for it.
And so, you know, if the Pfizer drug comes onto the market and as Eli Lilly and Novo Nordisk ramp up production, I think there will be price competition that pushes those prices down somewhat farther.
But the market's very big.
So those drug companies are obviously going to make a lot of money from that.
I mentioned the junk food thing. You also see, you know, Wall Street analysts have been interested in asking questions about this on earnings calls. You know, I'm wondering your perspective on GLP-1, you know,
drugs and the impact on restaurant demand, maybe Darden's restaurant demand. I'm not going to ask
your average BMI for your customers, but any perspective, I know it's something that's on
investors' minds, so I figured I'd ask.
There was a discussion that United Airlines might save millions of dollars a year
because of passengers being lighter and therefore taking less fuel to carry them.
One study done by the Jeffries Financial Group found that if the average airline passenger lost
10 pounds, it could dramatically impact how much fuel planes need to fly,
equating to $80 million in savings in annual fuel costs per airline.
So, you know, it's sort of an interesting fact that you'll have, you know,
millions of dollars in fuel savings a year,
but it's not that large relative to the overall cost of running an airline.
I think part of the reason that you've had this fixation on the negative economic effects is that it's very easy to identify Doritos and products like that where you'll have the decline in consumption.
And basically, you're likely to see the increase in basically every other category.
So it's not necessarily going to be a large increase.
You're not going to look at the income statement of a company and say, these profits were due to Ozempic. But you should see a broad-based improvement in the areas where people are going and spending their time and
their money that they used to spend on other things on those. Just this morning, I was reading
a story in Fortune Europe. The CEO of Novo Nordisk says that scared CEOs are calling him
to like just discuss. And he wouldn't tell Fortune who it was.
And so they speculate that it's a lot of, like,
potentially fast food companies,
basically companies that deal with what we put in our mouths.
But, like, what you're saying sounds so sensible to me,
and I try hard to think of CEOs as sensible people
who, like, game things out.
Why do you think they seem so shook?
Well, I think first of all, it's uncertainty. And, you know, people, they know their business,
they have a view on their customers, their customers are about to change in some way.
I mean, I don't know what it's like to run a fine dining restaurant in New York right now,
where because, you know, the market penetration for these drugs is not that high yet. But if you
have, you know, certain settings with have certain settings with especially affluent customers
who might be trendsetters in certain areas,
you might be seeing a lot of your customer base on this.
Are they sending back way more food than they used to on their plates uneaten?
So I'm sure you're starting to see some industries
where you're actually starting to see critical mass with customers.
And the customers are different.
And even if in the long run it's going to be an opportunity,
they have to figure out how to capitalize on that opportunity. And that's challenging. There's also a specific matter in the United States, which is that employers pay
for healthcare expenses. Right now, the drugs are very expensive. And they're sometimes being
covered by insurance, even though they're very often not being covered by insurance.
And that's a really large expenditure for whoever is the payer.
And so that could be a private company if you have someone with private health insurance.
In the long run, this is also going to be an issue for the US government and therefore for taxpayers. There's currently a law that says that Medicare is not allowed to pay for weight loss
drugs. But I certainly expect there to be significant political pressure around that
because there are lots of people on Medicare for whom these drugs would be very appropriate for weight loss. And so when that pressure is
brought to bear, at some point, Medicare is going to be paying some price for that,
and that's going to fall on taxpayers. And so there is, you know, especially in that transition
before the prices have come down as far as they will, and before we're fully feeling those positive
economic effects, you know, someone is going to be paying those costs that are accruing to Novo Nordisk and to Eli Lilly as profits.
And that's a negative factor for people who might be payers, which obviously includes corporations.
Josh, you yourself are taking Wigovi.
Tell me about what your experience has been like.
I've been on it for about five months now.
I've lost 24 pounds.
And it's been great.
It's really changed my relationship to food.
The amazing thing to me is not that I've lost the weight,
but how easy it has been for me to lose the weight.
It causes you to just simply desire food less.
I still enjoy food.
Food is something that's very interesting to me,
and it's still interesting to me.
But if you put a plate of it in front of me,
I can be like, oh, that's fantastic. And I eat a few bites.
And then once I'm not hungry anymore, I stop. And that was always the thing that was so difficult
for me. I was always really cynical about these like food influencers with six pack abs. And I'd
see people like they bake these decadent cakes and then they, you know, they don't look like
they've ever eaten a cake in their life. And I always thought this was basically fake. And now I can understand what it must be like
inside their brains because they can make this cake and they can have a small slice of the cake
and then they've had enough. And that it really is possible to be wired like that.
And now it seems like with this drug that I am wired like that and I'm really happy about it.
Has Wagovi meant anything for your personal economy, the way you spend money, invest money?
At least my personal experience is I spend a lot of time thinking about my weight,
and I spend a lot of money and a lot of effort, you know, on exercise and, you know, trying to
focus on a diet and that sort of thing. And being relieved of that just, you know, sort of gives me
more bandwidth to spend on other things. I think that's one of the most exciting parts of this.
And one of the effects that isn't getting as much attention initially. So I think that's a positive
effect for me. I wasn't a compulsive shopper. That's another thing that's been showing up as
a discussion of, oh, this is going to be bad for retailers because there won't be compulsive
shopping. Again, those people, they still have that money.
If they're still working, they're going to want to consume on something, maybe something that makes them happier than whatever they would have impulse bought. But ultimately, I think, you know,
our economy works better if people are making considered spending decisions on things that
will actually make them happy. So if that's another shift that the drug is causing at the
margin, I think that's likely to be good for individuals and should even show up as a better functioning economy overall.
Josh Barrow, he writes the very serious Substack.
A year or so into the Ozempic Revolution, there's now a truth universally acknowledged
that some people with larger bodies don't want to lose weight.
They don't care for BS
peer pressure. They like the skin they're in. What they would like is a world that doesn't
penalize them for being fat. We're going to explore that Monday on Today Explained.
Today's show was produced by Victoria Chamberlain and edited by Jolie Myers.
It was fact-checked by Kim Eggleston and engineered by Rob Byers.
Thank you to economist Matthias Dahlrapp-Sprayl.
I'm Noelle King. It's Today Explained. សូវាប់ពីបានប់ពីបានប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពីប់ពី Thank you. you