none of this really explains why nvo has done so much worse than lilly in what is effectively an oligopoly.
(note ratio of actual differences relative to joint marketing spend is near infinite.)
in fact, novo is usually the first mover, most recent in mass market pill form.


The key difference is that Novo is indeed the first mover, but unfortunately for them that also means it is the first to have its patents expire, which is happening now with its glucagon-like peptide-1 agonist (GLP-1), semaglutide (brand names Ozempic, Rybelsus, Wegovy.)

Lilly has a better drug, tirzepatide (Mounjaro, Zepbound), which is a double agonist, acting on GLP-1, like semaglutide, but also on glucose-dependent insulinotropic polypeptide (GIP), and which is also much further from patent expiration.

And Lilly also has a triple agonist, retatrutide, which has activity as a GLP-1 and GIP agonist but also as a glucagon agonist (GCG), which works better than both Novo's semaglutide and Lilly's own tirzepatide, but which is not yet approved by the FDA (nor by any other regulatory body.)

As Novo's drug comes off patent protection in many countries, (although it still has a few more years in the USA), and with competitive pressure from tirzepatide, and soon from retatrutide too, it is natural that Novo's revenue and earnings have started to fall, as Lilly's rise. Novo is now just 10x last year's earnings, but this may make sense if earnings are going to fall back as they have started to do. How are they expected to halt the decline? It is true that they are part of a duopoly, but it would be much better to be the other half of the duopoly, not this one.

dtb