Novo Nordisk scored approval last September for what it heralded as a "holy grail" diabetes medicine in Rybelsus, but it was waiting to deploy its full launch effort until securing access through payer negotiations.
That time has come. Novo has negotiated 70% combined access for the medicine in the U.S., CEO Lars Fruergaard Jørgensen said on a conference call Thursday, and it's now in “strike mode." Novo’s sales reps are back in the field in the U.S. amid the COVID-19 pandemic, but they aren’t back up to full steam in terms of scheduling meetings. Those are running at about 80% of a full schedule before the pandemic, including some video and phone calls, Jørgensen said in an interview.
Throughout the pandemic, physicians have become “increasingly receptive” to video and phone interactions, the CEO said. While launching during a pandemic is clearly tougher, he said the company is "very pleased" with uptake so far.
The Rybelsus ramp-up comes as Novo’s injectable version of the medicine, Ozempic, continues its ascent. In the first half, the med surpassed older GLP-1 diabetes drug Victoza to become the company’s bestselling medicine two and a half years after its U.S. rollout. Ozempic sales grew 152% to $1.5 billion in the first half of 2020, while Victoza sales slipped 18% to $1.47 billion.
The newer Rybelsus generated $92 million, beating analyst expectations. Looking forward, Novo aims to "repeat what we did with Ozempic," Jørgensen said, which he said was "among the best launches ever in diabetes."
Overall, Novo’s GLP-1 sales grew 28% at constant exchange rates to more than $3 billion during the first half. COVID-related stocking boosted sales, but patient starts decreased and mostly offset that benefit. Jørgensen said he expects some "normalization" of patient starts during the second half of the year.
It wasn't all good news for the drugmaker, though. Global insulin sales fell 3% at constant exchange rates, dragged down by a 23% decline in North America. Lower prices, higher rebates, new affordability programs and other factors hurt insulin revenues. Novo saw an insulin stocking boost due to the pandemic, but like with other medicines, fewer patients started treatment, in turn hurting sales.
First-half savings from the pandemic amounted to 1 billion Danish kroner, CFO Karsten Munk Knudsen said on the conference call, or about $160 million. Some of that total will be funneled into future launches, and some is expected to become permanent savings, such as money that would have been spent on airline travel. Airplane ticket spending was down 90% in the second quarter, Knudsen said.