17. Novo Nordisk

Novo Nordisk Kalundborg, Denmark site
The pandemic created challenges for Novo's launch of oral diabetes med Rybelsus.

Novo Nordisk 
2020 revenue: $20.24 billion (converted from DKK 126.9 billion) 
2019 revenue: $19.57 billion (converted from DKK 122 billion)  
Headquarters: Bagsværd, Denmark 

At the start of 2020, Novo Nordisk was focused on getting its much-anticipated oral diabetes drug Rybelsus off the ground. The med had won FDA approval in September 2019, but the company didn’t immediately put its full marketing muscle behind the launch as it worked through payer negotiations. 

The company planned to enter “strike mode" on the launch in 2020, but then the pandemic hit. As Novo Nordisk and other companies learned, launching a new drug during the pandemic brought big challenges as fewer patients were visiting doctors, which meant there were fewer chances to switch from another drug or start a new treatment regimen. 

In a recent note to clients, Jefferies analysts highlighted Rybelsus as one of the meds most “disproportionately” affected by the pandemic.  

Still, Rybelsus generated $300 million in revenue during its first full year on the market, a performance that CEO Lars Fruergaard Jørgensen celebrated, considering the pandemic's strictures. The company finally went into “strike mode” last summer and has negotiated 90% market access across private insurers and Medicare. 

“Despite a challenging launch environment where, on several occasions, we have had to stop face-to-face interactions between our sales force and doctors, we are pleased with the Rybelsus performance,” he said on the company’s fourth-quarter call. 

RELATED: Novo Nordisk, unscathed by COVID-19, enters 'strike mode' with diabetes launch Rybelsus 

Meanwhile, sales of Novo’s injectable version of the GLP-1 drug, Ozempic, soared in 2020. The drug generated around $3.4 billion last year, surpassing the company’s older GLP-1 drug Victoza, which pulled in around $3 billion. In 2019, Victoza’s sales were nearly double Ozempic’s. 

Outside of its crucial GLP-1 franchise, Novo’s insulin sales fell 3% at constant exchange rates thanks in part due to lower realized prices and new legislation from the U.S. forcing companies to give bigger discounts to Medicare. The pandemic also affected growth for Novo’s obesity drug Saxenda as fewer patients started treatment. 

RELATED: Lilly has its Ozempic-beating data from a head-to-head diabetes trial. Should Novo Nordisk be worried? 

Looking forward, Novo recently posted strong data for Ozempic in obesity treatment, but a showdown could loom with an Eli Lilly medicine. In a phase 3 trial of Novo’s Ozempic that ran for 68 weeks, one-third of patients on the drug lost more than 20% of their body weight. Lilly’s tirzepatide also posted impressive data, but analysts think Novo’s Ozempic can vie for a share of the market. 

17. Novo Nordisk