Medicare coverage creates opportunities for 15 million patients

novo nordisk CEO Mike Doesder said Wednesday that the company aims to add about 15 million new patients, at least initially, when Medicare first begins covering obesity treatment later this year.

About 67 million Americans are covered by Medicare, but “especially when you look at our product and our target group, I think about 15 million is a good number to cover,” he said in an interview with CNBC.

Later this year, Medicare plans to begin covering obesity drugs for the first time under a landmark “most-favored-nation” drug pricing agreement between Novo and its biggest rival. Eli Lilly He met with President Donald Trump in November.

Medical experts say the long-awaited insurance coverage could expand the market for the drug and encourage more private insurers to cover it. Some experts estimate that 20 million to 30 million Medicare patients suffer from obesity and related diseases.

Dusdahl said the launch of Novo’s new obesity drug and other factors, as well as Medicare coverage, will help the company gradually increase prescription volumes and offset price declines in the U.S. following the deal with President Trump.

But he said he doesn’t expect Medicare access to obesity treatment to open up overnight.

“It would be great if we could find a way to access it very quickly, but that would be a little naive,” Dusder said, pointing to slow adoption among commercially insured patients.

The tone is a little more conservative about the early impact of Medicare coverage, compared to Lilly, which said Medicare coverage was a key tailwind for its guidance this year. Lilly said last week that it expects Medicare coverage to begin by July.

Meanwhile, Dusdahl said Novo is negotiating with the government about “exactly what month and week the season will open.”

Novo is under pressure to regain market share in the fast-growing GLP-1 field of Lilly and cheaper composite knockoffs. Lilly announced last week that its share of the U.S. obesity and diabetes drug market rose to 60.5% in the fourth quarter, compared to Novo’s 39.1%.

Novo also highlighted the difference in “preferred market share” between its weight-loss treatment Wegovy and Lilly’s competing injectable drug. In the U.S., Novo estimates that 7 to 8 out of 10 patients go to Lilly.

Asked how Novo plans to close that gap, Dusdahl said one way is to “improve pill dosing.” The company’s Wegovy obesity drug has a head start compared to Lilly’s next oral drug, orforglipron, which is expected to receive approval from the Food and Drug Administration during the second quarter.

Dusdar said that based on a separate clinical trial, Novo’s tablets were slightly more effective than Lilly’s, showing 16.6% weight loss compared to 12.4% for Lilly’s oral medication.

“If you use those two numbers, you basically have a 40% difference in the effectiveness of these drugs,” he said. “I think this will be a very major selling point for this drug.”

However, Dusdahl also noted that a higher dose (7.2 milligrams) of Wegovy could be approved and launched in the future, which could help Lilly’s obesity drug Zepbound gain market share.

This high dose helped patients lose about 21% of their body weight, which is “almost equivalent” to Zepbound’s highest dose, he said. Zepbound’s high efficacy has been a key factor steering many patients and prescribers away from choosing Wegovy, which has shown average weight loss of approximately 15% in clinical trials.

“My thought, my hope, my hope, when it comes to market, is that I want people to realize, okay, there are two products that have similar effects,” he said.