lars: we are only scratching the surface in the number of patients we're treating. and it takes quite some time to scale manufacturing to get to many more millions of patients. fraine: this is the man in charge of europe's most valuable company, novo nordisk, and its blockbuster diabetes and obesity drugs ozempic and wegovy. both contain the key ingredient semaglutide, revolutionizing the weight loss market and generating billions in sales. celebrities have helped their

popularity soar. sharon osbourne, chelsea handler, and elon musk have all publicly talked about taking ozempic or wegovy, and they've had further backing from oprah winfrey. it's a global phenomenon, reaching millions on social media apps, including tiktok. but it's not without controversy, including possible side effects, high prices, and the company's lobbying efforts receiving criticism around the world. and, in some cases, patients might also need to take the drugs indefinitely to avoid regaining the weight. chief executive lars fruergaard jorgensen says obesity is a disease and thinks the company will learn from its growing number of patients. lars: when i ask the scientists, they say the priority and mechanism will tell you that it is chronic treatment. my personal view is that we will learn that patients are much different, and there will be different avenues, so, we will have to build a portfolio of interventions. francine: on this episode of "leaders with lacqua," i travel

to the firm's headquarters in copenhagen, denmark. i asked lars fruergaard jorgensen about the global sensation, how he is navigating the company's meteoric rise, and the sweeping changes they could bring across a range of industries. lars, thank you so much for being on bloomberg with us. lars: francine, thanks for having me. francine: after decades of research, basically, novo finds a molecule that changes everything, in terms of weight loss drugs. were you taken by surprise at the appetite for these drugs and how mainstream they are? lars: yeah, i would actually say francine: after decades of research, basically, novo finds a molecule that changes everything, in terms of weight loss drugs. were you taken by surprise at the appetite for these drugs and how mainstream they are? lars: yeah, i would actually say there are many surprises when you get a product like that. it starts with surprises in the innovation. because there are many shots being made on goal, and most fail. and the winner is often the one that surprises people the most. francine: so, why do you think this, i guess, surprise or success was unexpected?

did it capture something in society that you were not ready for? lars: i think we have seen, first, many decades of our company was focused on type 1 diabetes. then, because of lifestyle changes, perhaps genetics, there was an increase in type 2 diabetes. and -- but for many years, type 2 diabetes was not intensively treated. then there was a so-called ukpds study that really showed you really need to treat type 2 diabetes to prevent comorbidities. and that increased the diabetes market a lot. now, we are kind of seeing the same with obesity. that, for years, we felt perhaps obesity was not a real disease, not something you should treat, but that is now being established by understanding the underlying causes of obesity, that there's a lot of play, for

instance, in genetics, but now, also, innovations that can actually treat the disease, help people reduce weight, and prevent the comorbidities. so, i think it's a repeat, in a way, of what happened with type 2 diabetes, and that then suddenly opens the market that turns out to be way bigger than the diabetes market. francine: so how difficult is it to have a lifelong treatment, and, again, how do you see that changing? lars: i think we are yet to learn how patient journeys will be much different. some will be on lifelong treatment. some will have, say, progressive obesity that will, you know, keep you putting more weight on, and they will need more and more efficacious medicine. but perhaps there will be some who will be on treatment for some time, almost prevents them, and they will have a different trajectory. i don't think we have seen much of this yet. when i ask the scientists -- i'm not a scientist myself -- they say the priority and mechanism will tell you that it is chronic treatment. my personal view is that we will also hear, learn that patients are much different, and there

will be different avenues, so we will have to build a portfolio of interventions. lifestyle will also play into it for some of them, and i think we can help many patients get down to a weight that they can maintain and live the life they want to live and avoid many comorbidities for the health care systems. francine: i mean, we also heard from some of the food companies, the chief executives of some of the big groups are having crisis talks, and does this mean that there is going to be a wider adoption of these drugs? does it mean people are going to eat and drink 30% less? do you see it really changing our societies? lars: i think there will be many changes, but i think with that also comes opportunities. there will perhaps be a different preference for snacking, so i think we still need to eat. so maybe, perhaps a bit less of the unhealthy snacking and a preference for more of the healthy stuff. so, i think for companies, it is also about following the trend and evolving your business and moving toward where the market is. and i think there is probably, say, an 80/20 perspective here,

like in many other sectors, that you will have a few patients who are really heavy consumers, and if those start up treatment, i think there will be a relative bigger impact on some of these companies. but i would say, in general, i think it is a bit hyped when we see the reactions we see. because we are only scratching the surface in the number patients we are treating, and it takes quite some time to scale manufacturing to get to many more millions of patients. francine: hollywood has also adopted, actually, you know, your weight loss drugs. is that a good or a bad thing? lars: we now have the situation where social media, you know, is filled with communication around our products, and that is completely new for us. we are focused on educating

physicians. in most countries, we cannot do direct to consumer advertisement. and in all countries, it is really important for physicians to understand which products are approved for type 2 diabetes, which are approved for obesity. what is the mechanism and how should that be used? when we see, get data from insurance companies, etc., we can see the profile of those who use our medicines. we can see that they are, on average, people with very high bmi, well above 30. so, there is also the approved label to feel comfortable about that it is people in need of intervention to treat serious obesity situations. francine: but you have become such a phenomenon. and there are memes. you are right, it is all over social media. and some are saying, well, the problem with this is it could actually lead to more eating disorders. this is probably because of the increase in social media. what do pharma companies do? can they do anything to kind of balance this? lars: yeah, i think we have quite spent some time on

understanding what does this mean, and we have come to realize we cannot control social media. we try to be present and get our messaging in, but then all our medicines take a physician writing a script. so, we really focus on the physician, to make sure they understand what are the mechanisms, who are the appropriate patients? what's the label? and then, i think we have to also trust that the physicians do what is right for their patients, and they should for sure not prescribe for people living with an eating disorder. francine: coming up, i ask lars fruergaard jorgensen about criticism the company has faced over its prices, with some analysts predicting the weight loss drug industry could be worth $150 billion a year. worth $150 billion a year. ♪do you want to close out?

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francine: globally, more than one billion people are thought to be obese. it's a crucial market for weight loss drug makers like novo nordisk, but challenges remain. the company's patents expire in the u.s. and the e.u. at the end of the next decade, and rival drugs are already emerging, like zepbound by eli lilly. i asked the chief executive, lars fruergaard jorgensen, about regulatory pressures and future growth. so, how do you think about pricing? again, you must have gotten some difficult questions from governments, but also, this goes back to innovation. lars: most products are priced according to the value they bring. and i feel really good about the value of our medicines, what they bring to the individual patient, but also the value to the health care system. and we have, today, health care systems around the world who were typically designed for acute care. but finding that 80% of the cost in the health care system is linked to chronic care.

and we have portfolio products that are really addressing some of the chronic diseases of our day and age, diabetes, obesity, and the comorbidities that follow that. we know that there are projections that say, by 2035, the world obesity organization predicts that the cost burden to society will be $4 trillion of people living with obesity. and that cost is going to, to a large degree, turn out to be taken up by health care systems, who are already struggling today, by aging populations and a shortage of labor. a lot of workers left the health care systems during the pandemic or after the pandemic. so really articulating what is the actual value of the medicine we have? and if you invest in that, yes, there is a cost upfront. maybe we can discuss how we deal with that. but there is actually tremendous value, in terms of preventing

cost and keeping people out of hospital. francine: but this is a crucial moment, because your price will probably go down as you have more competitors coming in. we know of eli lilly. we know amgen could be a competitor. this is, i guess, the crucial time, when you have to make investment decisions, when prices are high and you have more cash coming in. is that how you view it? lars: yes. to put a bit of color around it, the same forecast predicts that there will be, say, a billion people living with obesity in 3035. we are perhaps serving one million or two million of those today. so there is a huge market of opportunity, and there is a place for more. and then, you're right. in most markets, when you get more competition, and also, over time, pricing starts moving down, because you start treating those who accept, say, the higher price point -- in the u.s., that is commercial insurance -- and over time you get broader access, and you get patients paying a lower price.

if you just take our leading diabetes product in the u.s., since launch in 2018, the price we get after rebates, discounts, etc., is some 40% lower than when we launched. that is often not mentioned in, say, the political debate. instead, the list price is mentioned, which is not actually what we book in our account. because that's after rebates. francine: the u.s. is such a large market. would you ever delist or even change headquarters to the u.s.? lars: that is unlikely. we are controlled by a foundation that's anchored in denmark. we have a lot of, say, footprint in denmark. having said that, we do invest and expand a lot globally. most of what we sell in the u.s. we also produce in the u.s. so, in many aspects, we are as much a u.s. company as we are a danish company.

but the corporate headquarters is based in denmark for the foreseeable future. francine: you think of denmark, and really, now, you think of novo, because of the size of revenues, which is, i think, bigger than gdp. is that uncomfortable? lars: i think maybe the perspective should be corrected a bit. because there is this comparison about our market cap with the danish gdp. we all know that gdp is an economic flow matrix for the flow on a yearly basis, and the market cap is the total value of the company. i'm sure if we compare the market cap of novo nordisk with the market cap of everything that is in denmark, we would be tiny. but, of course, there's also the point that, with our expansions, our more than 30,000 employees in denmark, huge capex investment, we are fueling the gdp growth. and, you know, we take that quite seriously. so, the jobs we create i don't think will disappear again. and, now we talk about expanding in the u.s. it does not come in the shape or form of moving activities from

denmark to the u.s. it is growth in the u.s. so, we will be careful and respectful in how we grow, so we can do that in a sustainable way. francine: and that's also increasing supply with new factories? lars: yeah, we have made huge investment decisions, and these are, you know, billion-dollar commitments per year. and it takes four or five years to build some of these facilities. we luckily started already, years back. so, we have more and more lines kicking in on an ongoing basis, but some of them will also be kicking in in the future. francine: are you also looking for acquisitions? lars: yes, we are. we are in the unique situation that most of the products we have came from our in-house r&d efforts, which is a bit unusual compared to some of our peers. we expect to carry on with that, but we can also see that we can complement that via some acquisitions. typically, it will be early stage biotech where they have great science. we have disease understanding and we have the infrastructure, so we can express that science in a better way than they can do

on their own. so, merging makes a perfect marriage, and the sum of the parts is bigger than what each can do on their own. francine: but are pharma companies having a harder time after covid? there seems to have been an explosion of not trusting pharmaceutical companies. even vaccines being questioned. have you felt any backlash? lars: yes, and to me, that is a so, merging makes a perfect marriage, and the sum of the parts is bigger than what each can do on their own. francine: but are pharma companies having a harder time after covid? there seems to have been an explosion of not trusting pharmaceutical companies. even vaccines being questioned. have you felt any backlash? lars: yes, and to me, that is a really, really sad situation to be in, because, had it not been for some of the very innovative small biotechs who came up with

vaccines and then teaming up with some of the largest forces of our industry to, in record time, get approval and scaling manufacturing, i think the world would have looked much different today. and i respect there are some who do not like vaccines, but the majority of us had a number of shots, and that led to a lot of debate about, are patents really needed? unless we have an ability to patent innovation, there's not going to be any innovation, so there will be no new products. so, i think there is something about equality, how we distribute products. and, honestly, i think a lot of the rich countries ended up grabbing products for their own population at the expense of some of the developing countries who did not get access. and that then leads to a debate whether ip is the right way to go. but that, for me, is the wrong discussion.

we have to figure out how we can show solidarity in a way where we actually acknowledge that the whole world needs to benefit in a fair way? but if you take away from innovation, we all suffer. francine: coming up, lars fruergaard jorgensen tells me about his leadership style at the helm of europe's most valuable company. ♪

francine: the market value of novo nordisk is bigger than the danish economy, and its philanthropic foundation is now the world's largest, with more than double the assets of the gates foundation. i asked lars fruergaard jorgensen how he handles the company's success and his approach to corporate culture. so, are you enjoying success, or with it, does it also bring a lot of responsibility? lars: i took over as ceo at a time when our share price had just been cut by 40%. we were in no growth, low single-digit growth, and it is much harder to invest in the business, do things you want to do, compared to what the opportunities are today. so i enjoy that, but obviously, it also comes with many challenges about how to sustain the success of a company that is enjoying success. francine: what kind of leader are you, or what kind of leader

would your employees say you are? [laughter] lars: well, you should ask them. i hope they would say that i'm authentic, i'm relatively easy to read. i would also hope they say that i'm curious, because i'm not a specialist in anything, but i have found that there has not been yet a problem in the company we couldn't solve if we actually mobilized the right people. so, i'm born with a big nose and big ears, and i use the attribute of that each and every day to collect, say, opinions from the company. and then, it's my role to combine it into an opinion, together with my team, and make sure that we make the right choice. francine: so, does the perfect leader in 2024 need to be a visionary or a problem solver? lars: i would say, if i have to solve the problems, it's a problem. because if -- an example, when covid-19 arrived, we decided to close down the offices. we kept many factories and the laboratories running, and we all went home.

and what you do, well, you need to establish a crisis response team to deal with that. so, the first decision i made was i should not be part of that. francine: why? lars: i was a bit out of the loop for a couple of days. but i knew, if i put myself into that, i would become the bottleneck in the company, and the company will suddenly have lost its ceo. so, i asked our cfo to chair that, and then i could still be there for everybody. and people could come to me and check in, and i could try to get a view for what are other companies doing? what's happening? and give some input. so, if the ceo turns into the problem solver of the company, i think the company needs another

ceo. francine: have you changed as a ceo? lars: i believe i have. i, when i was promoted, i took a step up in the team. so, i went from, overnight, being colleague to being the leader of the team, and i think they would tell me today that they would have liked me, maybe, to a bit quicker act like the boss. but, for me, it was not natural to just be, say, bossy after one night. so, i think i have been growing into the role, and i feel more comfortable today in actually listening to my guts, which is a combination of your own feelings, but also your experiences, and, earlier, say what i believe in. and that creates clarity for an

organization with more than 60,000 people. francine: and so, saturday mornings, i understand, you have off? lars: yeah. saturday is always a day where i power down. so, i run at a relative high pace throughout the week, try to wrap things up, and saturday is a quiet day for me, in terms of work. and i start, typically, by playing tennis with my wife. we go for a swim all year-round. after that, have a nice lunch. and then i am onto a good trajectory for the weekend. and then sunday, i try to prepare for the coming weeks. but through a weekend, i would send either no emails or very few emails, because i want to drive a culture where all get an opportunity to spend the weekend as they fancy. i think what we do is so difficult, and it takes so much creative thinking to succeed that, if you're always on, always busy, the bandwidth of your reflection is just too narrow.

i generally believe that monday mornings i'm a better leader than i am, say, friday afternoon. i also take all my vacations. i generally believe i'm a much better ceo right after a vacation than i am before a vacation. francine: what is the best piece of advice you've ever received, and what is the worst piece of advice you've ever received? lars: the best advice would probably be give people a fair chance to succeed, and most can actually do much better than they believe themselves and perhaps also you believe, based on, say, short-term performance. the best advice would probably be give people a fair chance to succeed, and most can actually do much better than they believe themselves and perhaps also you believe, based on, say, short-term performance. so, trust people and give them what is needed for them to succeed. you will see people succeeding. francine: worst piece? lars: the worst piece would be something that was influenced by, say, politics or spinning

facts. i'm hyper-allergic to politics and when you try to take advantage of a position. so, i had one experience during my career where i gave my resignation because somebody, a close colleague, actually completely twisted some facts. we had just agreed how to approach. then, we met with our shared boss, and my colleague just turned it around. i said, ok. integrity is so holy for me that if people play tricks, you know, it's not my game whatsoever. so, i just said ok, that's it, i'm out of here. we sorted it out. i still stayed. so, any advice that is not based on honesty, decency, and, you know, following the facts, i have a really hard time with. francine: thank you so much for your time today. lars: thank you, francine. ♪ so, any advice that is not based on honesty, decency, and, you know, following the facts, i have a really hard time with. francine: thank you so much for your time today. lars: thank you, francine. ♪

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