Is Obesity a disease? A landmark study led by the World Obesity Federation sought to address this important question. By studying more than 14,000 patients and about 3,000 doctors from a dozen countries, the study leaders purported to show 68% of patients and 88% of doctors consider obesity a chronic disease. The expert committee for the study was $164 billion Danish pharmaceutical company Novo Nordisk, the only company worldwide TrialSite News had identified as a tier 1 pharma company fully committed to bankrolling obesity drugs.
Recently covered in Australia by INQ’s David Hardaker, Georgia Wilkins, Amgen Schultz and Kishor Napier-Raman and picked up at MSN, it turns out the following trial attributes could raise an eyebrow:
- The study was funded by Novo Nordisk.
- Novo Nordisk arranged for specialist medical communicators to write the survey report.
- The 17 members of the study’s steering committee included eminent specialists with the World Obesity Federation. All were remunerated by Novo Nordisk for other work.
- Three pane members were Novo Nordisk employees and two of them held company shares.
- Novo Nordisk was lead sponsor of the European Congress where the study results were presented.
- Novo Nordisk provides significant financial support to the group that organized the study, The World Obesity Federation.
Obesity, Politics, Money and Land of Beowulf
Denmark’s Novo Nordisk combines the best of a soft, “triple bottom line,” socially conscious-leaning company originating from a hip, enlightened, thoroughly liberal social-democratic welfare state leaning nation, and a globally marauding scientifically-driven aspiring monopolist.
It applies scientific welfare-state principles when rationalizing for a drug’s public subsidy—gently, with empathy and methodically educating others worldwide as to the scientific and medical benefits of a new drug and the importance of collective responsibility. Once sold, well, the Viking emerges, taking no prisoners along the way. They apply seemingly opposing and contradictory elements and attributes into a tried and true formula that long ago won massive success in diabetes markets—establishing the most valuable company in Denmark along the way.
Perhaps they learned how to get along in this way from such a tough, violence-filled history. After all, Denmark has been invaded many times over the past few thousand years, and in ancient times it was perhaps one of the most violent locations on earth– with marauding “battle axe people” and later, aggressive and notoriously feared Vikings. The superhero of ancient times, Beowulf, had to violently slay the monster known as Grendel to help the King of the Danes Hrothgar. Hollywood originally got a lot of its violent inspiration from folklore from around the North Sea and the little sliver of land jutting out into it, the home of the Danes.
To project the valuable wealth accumulation vehicle (like an ancient marauding Viking boat), the modern Novo Nordisk has structured the ownership so the Nordic venture control is held by a company foundation that ensures power and control stays within the “line of the Danes.”
Back to the main story and far, far away from the North Sea, this discussion originated by INQ down under in Australia. The story’s authors infused a critical perspective perhaps not commonly seen in the States where obesity will be considered a chronic disease that only pharmaceuticals will be able to treat. Ultimately, there are forces that seek to convince the Australian government that obesity is a disease that should be treated by a taxpayer-subsidized drug.
As TrialSite News wrote about obesity and Novo Nordisk’s emerging dominant position last year, they stand to make a fortune on this present epidemic.
Obesity in Australia
Almost a third of Australians are classified as obese, and that number grows every year. In Australia alone, the market will be huge. If cardiovascular medicine is any guide, the total value in Australia alone is $1.8 billion with taxpayers subsidizing nearly $1.3 billion through the Pharmaceutical Benefits Scheme there.
28% of adults in Australia could be classified as obese—meaning a BMI of 30 or greater. This represents 6.8 million people that could represent an annuity. As TrialSite News wrote about in the NASH crisis, once the obesity train leaves the station, there is probably not much that can be done for much of the population but to put them on pharmaceuticals. The Danes saw and capitalized on this trend.
Some Sample Market Metrics
For example, if only one in 10 took Novo Nordisk’s obesity drug saxenda at a cost of $400 per month, the company will generate $272 million a month or $3.2 billion a year. The stakes are huge. Other pharmas have their eye on this “widening” market from Roche to iNova, but Novo carries that smart, aggressive and expansionary DNA from the Viking past and has sailed into Australia to dominate this market.
Now they will work to mobilize using a tried and true expansionary formula that worked well with diabetes drugs. For example, by localizing, convincing doctors that its product is scientifically superior (which it very well could be) and by infusing some Danish collectivist rationale into local government, the taxpayer subsidies come thereafter the fortunes are collected and the great proceeds are returned back up to the small but highly prosperous small peninsula jutting into the North Sea. In fact, INQ reports that a company presentation touts this very strategy—see the link to the source at MSN.
Sad but True
The reality is that Novo Nordisk can’t be blamed for being smart, science and medically-driven and aggressively business oriented. In fact, our society celebrates these attributes. They didn’t create modern obesity as we know it. This is a social phenomenon above and beyond one cause. A lot of blame can go around—food systems, lack of exercise, wide-spread laziness, land-use patterns that favor driving over cycling or walking (ironically the Danes have little obesity, partly due to the fact they design and plan so a majority of the population cycles to work—even in the freezing cold!).
The obesity crisis is real. In the United States—far from Australia—we face a crisis of unprecedented proportions. We discussed this in a TrialSite News article—the co-morbidities alone lead to unbelievable crisis’ around the corner. Just a visit to a suburban mall anywhere in America and the reality sets in—most people now have too much weight at best—and in many cases—serious obesity conditions are the new norm.
At TrialSite News, we don’t blame Novo Nordisk for capitalizing on this unfortunate social and health crisis. They saw it coming decades ago and started preparing and methodically executing, and the proceeds will probably go to them for anticipating, investing and developing to FDA gold standards. The sad reality is that so many people have become so obese that there is no easy way out of this crisis. Past a certain point one can’t merely diet or start exercising. The medical establishment gets involved because obesity has in fact turned into a chronic disease. And only one company put the extensive number of chips down to make the bet years ago—from that small sliver of land jutting out into the North Sea that had a rough past but now encourages work-life balance, welfare state principles and a lot of bike riding for keeping slender.