Novo Nordisk's CEO Has a Comeback Plan

Summary

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Podcast Summary: "Novo Nordisk's CEO Has a Comeback Plan"

The Journal. | Hosted by Jessica Mendoza | May 26, 2026

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Overview

This episode centers on Novo Nordisk's fight to reclaim leadership in the rapidly evolving market for weight loss drugs. Jessica Mendoza interviews Novo Nordisk CEO Mike Dustar, who took the helm nine months prior to execute a turnaround as the company faces stiff competition from Eli Lilly. The discussion explores how Novo Nordisk is adapting to consumer expectations, the lessons learned from key setbacks, and the strategic vision for future growth and innovation.

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Key Discussion Points & Insights

Novo Nordisk: From Pioneer to Challenger (00:06–03:55)

• Early Dominance & Shift in Fortunes

  • Novo Nordisk, creator of Ozempic and Wegovy, revolutionized the weight loss drug market.
  • Recently, competitor Eli Lilly, with its Zepbound shot, has surpassed Novo in market share and efficacy metrics.
  • Novo’s new CEO, Mike Dustar, was brought in to revitalize the company and drive transformation.

  Notable Quote:

  "Novo Nordisk, the Danish drug maker behind Ozempic and Wegovy, basically kickstarted an entire industry. But now the race looks very different."
  —Jessica Mendoza (00:20)

Leadership and Company Transformation (03:55–07:07)

• Background & Vision

  • Mike Dustar is a Novo Nordisk “lifer” who started over 30 years ago, reflecting deep institutional knowledge.
  • He stresses the need for transformation to stay competitive, noting that survival depends on adapting to faster-paced, consumer-oriented markets.

  Notable Quote:

  “I think companies that transform are the ones that survive. The ones that basically operate as 10 years ago, or in our case 103 years ago, will not have the license to operate.”
  —Mike Dustar (04:22)

• Understanding Patients as Consumers

  • Distinguishes between diabetes and obesity patients: Diabetes brings fear, obesity brings shame and stigma.
  • Novo had to learn these emotional drivers and respond not just through physicians but via digital and consumer-centric channels.

  Notable Quote:

  “Ask the exact same question to a patient that's suffering from obesity. Fear doesn't come around. It's often around shame. ... That difference means that you need to act very differently.”
  —Mike Dustar (05:22)

The Competitive Landscape & Lessons from Setbacks (07:07–11:24)

• Eli Lilly's Leap Ahead

  • Zepbound’s higher weight loss efficacy forced the market to focus on weight reduction percentages.
  • Dustar suggests this focus on “magnitude of weight loss” is fleeting, predicting future emphasis will be on broader health outcomes (“health gain”).

  Notable Quote:

  “While today everyone is obsessed with the magnitude of weight loss... Five years from now, that will be part of the dialogue and not the main part.”
  —Mike Dustar (08:00)

• Key Product Disappointment

  • Novo Nordisk’s next-gen drug, Cagrcema, failed to beat Zepbound in trials, causing a massive valuation drop.
  • Dustar acknowledges the financial blow but insists the focus should remain on the long-term value and health outcomes.

  Notable Quote:

  “When you're on the high, everyone feels like there's nothing you can do wrong. When you're an underdog, people have to get their trust back on you before they go forward with you again.”
  —Mike Dustar (10:53)

Turning Point: Weight Loss Pills & Market Expansion (13:16–15:37)

• Wegovy Pill’s Blockbuster Launch

  • The January launch of the Wegovy pill was historic—1.3 million prescriptions in the first quarter, largest launch since COVID vaccines.
  • The pill is bringing in a new patient group reluctant to use injectables.
  • Novo’s leadership in oral weight loss drugs is a point of differentiation.

  Notable Quote:

  “80% of the people that are coming and picking up these products are not my Wegovy customers. They're new customers...they just didn’t want to take an injection for whatever reason.”
  —Mike Dustar (14:21)

• Future of Pills vs. Injectables

  • Dustar suggests flexibility is key: The company can shift production in response to market demand for pills versus injections.

  Notable Quote:

  “If tomorrow people buy more pills from me than injection, then I'll turn the knob in the raw material factory to the right hand side. And if people want more injections, then I turn it to the left.”
  —Mike Dustar (15:36)

Strategic Pricing & Accessibility (15:58–18:02)

• Major Price Cuts Announced

  • Novo will halve Wegovy’s list price and reduce Ozempic’s by 35% in the US, starting next year.
  • Rationale: The real price paid is already deeply discounted; the list-to-net gap has become “out of whack.”
  • Aim is to balance broad accessibility with sustaining R&D investment—not “just products for the rich” or a low-margin generic model.

  Notable Quote:

  “We cannot expect that we sell at current prices to 2 billion people these medications. That’s just naive.”
  —Mike Dustar (17:54)

Innovation Pipeline & Long-term Vision (18:02–20:05)

• What’s Next?

  • Early, mid-, and late-stage pipelines accelerating—new pills, easier-on-the-stomach drugs, and treatments for comorbidities (fatty liver, cardiovascular, kidney disease).
  • Novo’s triple agonist (UBT251) may outperform even Lilly’s retatrutide (28% weight loss)—an arena watched closely by Wall Street and medical professionals.

  Notable Quote:

  “We have a triple agonist ... in early results... it is best in class in a number of parameters.”
  —Mike Dustar (19:03)

• Will It Beat Retatrutide?

  • Early-stage comparison indicates “the short answer ... yes it can,” though success depends on late-stage results (19:34).

CEO Reflections: Pressure & Purpose (20:05–21:27)

• Personal Motivation & Focus

  • Despite market setbacks and leadership pressure, Dustar maintains optimism and a long-term outlook.
  • Emphasizes purpose-driven work serving widespread, relatable conditions, and stresses not overreacting to day-to-day share price fluctuations.

  Notable Quote:

  “We should not get too quickly nervous about the daily disruptions and the daily fluctuations ... What got us here for 100 years was not pure luck.”
  —Mike Dustar (21:07)

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Notable Quotes & Moments

• “Novo Nordisk ... basically kickstarted an entire industry. But now the race looks very different.”
  —Jessica Mendoza (00:20)

• “Ask any patient suffering from diabetes ... They will often put a sentence or two together with fear in the center... Ask ... a patient that's suffering from obesity... It’s often around shame.”
  —Mike Dustar (05:07)

• “We cannot expect that we sell at current prices to 2 billion people these medications. That’s just naive.”
  —Mike Dustar (17:54)

• “If tomorrow people buy more pills from me than injection, then I'll turn the knob in the raw material factory...”
  —Mike Dustar (15:36)

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Important Timestamps

• Novo’s Early Leadership and Competitive Shift – 00:06–03:55
• CEO’s Perspective: Company Transformation – 03:55–04:49
• Learning from Obesity Patients & Consumerization – 04:49–07:07
• Zepbound, Cagrcema, and Market Setbacks – 07:07–11:24
• Wegovy Pill Success & Impact – 13:16–15:37
• Pricing Strategy Announcement – 15:58–18:02
• Pipeline & Future Innovations – 18:02–20:05
• CEO Reflections & Outlook – 20:05–21:27

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Closing Thoughts

Novo Nordisk’s CEO Mike Dustar outlines a multipronged comeback strategy—betting on innovation, changing patient engagement, addressing affordability, and not shying away from past missteps. While competition is fierce and market expectations are volatile, Dustar’s optimism hinges on Novo’s culture of transformation and a purposeful approach to long-term healthcare challenges. The episode captures a pharmaceutical giant at a pivotal crossroads, determined to reclaim its edge by keeping both patients and wider consumer trends at the center of its vision.

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Transcript

[Jessica Mendoza]

Not long ago, it seemed pretty clear who was winning the war of the weight loss drugs.

[Mike Dustar]

Novo Nordisk.

[Commercial/Announcer]

Novo Nordisk.

[Jessica Mendoza]

Ozempic maker Novo Nordisk.

[Mike Dustar]

Novo Nordisk, king of the weight loss people.

[Jessica Mendoza]

Novo Nordisk, the Danish drug maker behind Ozempic and Wegovy, basically kickstarted an entire industry. But now the race looks very different. Really bad news for what was the first mover in this space? Shares of Novo Nordisk plunging by the most on record today. The weight loss trailblazer is rapidly ceding market share to rival Eli Lilly. Novo's biggest rival, the American pharma giant Eli Lilly, has surged ahead. Lilly's obesity shot Zepbound helps patients lose more weight than Novo's Wegovy. But Novo has an edge in one critical area. Weight loss pills. The company released the Wegovy pill earlier this year, and it quickly became the biggest drug launch in recent history. At the center of all this is Mike Dustar, the CEO who was hired nine months ago to breathe new life into Novo Nordisk. Mike Dustar, welcome to the Journal.

[Mike Dustar]

It's nice to be here. Thank you very much, Jesse.

[Jessica Mendoza]

I reached Mike last week at Novo's headquarters near Copenhagen. I wanted to understand how the company that started this whole boom found itself playing catch up. When you look back, where did Novo mess up?

[Mike Dustar]

Yeah, I wouldn't call it messing up. I would say the curse of a leader. When you basically go forward in a dark tunnel trying to pave the road for everyone else, there will be issues that no one has told you about because no one has been there before.

[Jessica Mendoza]

But can Novo Nordisk change fast enough to keep up with the revolution it started?

[Mike Dustar]

Many of our colleagues feel like, okay, there's a new CEO now in town and he started his transformation. And great. After we get the sales back on track, it can go back to what it was and it will never go back to what it was. You need to move forward.

[Jessica Mendoza]

Welcome to the Journal, our show about money, business and power for I'm Jessica Mendoza. It's Tuesday, May 26th. Coming up on the show, the CEO of Novo Nordisk on the company's rescue plan.

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[Jessica Mendoza]

Mike Dustar is a Novo Nordisk lifer. He started as an office clerk more than 30 years ago before rising through executive jobs and becoming CEO. When he took the top job in August, he was brought on to make the company more aggressive and to view patients also as consumers. It's a big shift for a company that spent a century focusing on insulin and diabetes. But Mike believes Novo needs to change with the times.

[Mike Dustar]

I think companies that transform are the ones that survive. The ones that basically operate as 10 years ago, or in our case 103 years ago, will not have the license to operate. We found ourselves now in obesity and that's a very different ball game, much more fast paced and much different patient profiles. And in some ways you need different skill sets now to lead it into the next decades.

[Jessica Mendoza]

So when you say you know Novo had to learn new skills, what are those skills?

[Mike Dustar]

What I think we have learned the last few years. You could argue that the tough way, the difficult way, is how different a patient with obesity feels compared to a patient with diabetes. We thought from a science point of view these are very closely linked because especially type 2 diabetes. The leading cause of type 2 diabetes is obesity. But take any patient suffering from diabetes and ask them, how do you feel about tomorrow, about the future, about your life? They will often put a sentence or two together with fear in the center of that. They will say, I'm afraid of tomorrow. I'm afraid of dying young. I'm afraid of amputation. I'm afraid of blindness. Ask the exact same question to a patient that's suffering from obesity. Fear doesn't come around. It's often around shame. They say, I'm ashamed. I'm ashamed of going out of the door. I'm ashamed of being judged. I'm ashamed of being bullied. That difference means that you need to act very differently. For one thing, we thought that the only way an obese patient will get its product will be through a physician because that's how a diabetic and many other chronic diseases are procruded. And that was not the case. You can See that both for us as well as for our main competitor Eli Lilly, the fastest growing segment is through the E Health channels. Channels that patients go and find their doctors online and actually then receive their products also online. And the reason is many of those patients, they don't want to go to a physician and be judged while they're sitting.

[Jessica Mendoza]

You're having to create. So as a company, you're having to create these avenues for these patients is what you're saying.

[Mike Dustar]

Absolutely. We needed to learn, while we are still very patient centric, how we can also tell ourselves that many of these patients are acting more like a consumer, a fast goods consumer, rather than a traditional patient. And the doctor and hospital setting is, by the way, neither or it's both.

[Jessica Mendoza]

I mean there's no question that Ozempic changed the game, but you can't kind of operate in this space and not be aware of what your competitors are doing. So with Zepbound in the market, it's both clinically more effective drug than Wegovy now has greater market share. How did that happen?

[Mike Dustar]

What happened with Zeb Bound, I would say is they saw our product into the market first and they basically saw that it has a 15, 16% weight loss efficacy. I have not been in their boardroom. I could only imagine that someone said, well, if we come with a 15, 16% weight loss drug, it's a me too product. And then they came with 21%. Now the other thing I think your audience should know is while today everyone is obsessed with the magnitude of weight loss and 1 or 2% up and down on that moves people's share prices dramatically. I will promise you that five years from now that will be part of the dialogue and not the main part.

[Jessica Mendoza]

So what do you think the main part will be?

[Mike Dustar]

The main part will be health gain. When is the last time you found a single person anywhere that you know of that died from obesity? No one dies from obesity. Obesity does not kill. Obesity causes other issues. You die from heart attack, you die from kidney failure, you die from fatty liver, you die from number of other conditions that is linked to obesity. But they're health issues. We basically said the stuff beyond weight health, kidney, liver, heart, stroke, that's what matters. I think that was right, but it was ahead of its time.

[Jessica Mendoza]

So the focus now for Novo Nordisk is not so much the magnitude of weight loss of its products that are coming out and more the additional benefits for people who have obesity.

[Mike Dustar]

I think one of the learnings coming back to your first question is that I think they're not exclusive of one another. I think Novo was a bit, you could say traditional, maybe stubborn, even that thought. Okay. It's a chronic serious disease and it's only about beyond weight. To some, the magnitude of the weight loss matters and Novo needs to be there for them.

[Jessica Mendoza]

And on that note, I mean, I wanna look at something that you've had in the pipeline for a while. Novo had high hopes for your next generation drug, Cagrcema. It was supposed to be a huge deal because it would combine, you know, an existing GLP1 drug with a compound that targets amylin, this different hormone. But in a head to head trial, you know, we're talking magnitude of weight loss here again. But Cagracema did fail to beat Lilly's Zepbound. And the results wiped out a hundred billion dollars more in Novo's valuation in one day. I mean, how big of a setback was that for you guys?

[Mike Dustar]

Well, if you look at it from that single day, share price, we lost people's money that were invested in our share price on the back of that news. So you could. I do not belittle that, but having said this, I like to also bring you and your audience back to exactly what we were just speaking about.

[Jessica Mendoza]

Sure.

[Mike Dustar]

On that single trial, it was called Redefine 4. Yes. We showed that Calgary SEMA does 23% weight loss. We showed that our competitor's product does 25%. Now, just take that at face value, the distance between 23% and 25% is 8% difference between those two numbers.

[Jessica Mendoza]

Was it a question of expectations that you had set with Kagusama?

[Mike Dustar]

No. Look, you have to of course ask all those who sold on that day why. And I think that the reasons will be very different from one person to the other other. But I do think when you're on the high, everyone feels like there's nothing you can do wrong. When you're an underdog, people have to get their trust back on you before they basically still, you know, go forward with you again.

[Jessica Mendoza]

But Novo has had a huge success recently with its weight loss pill.

[Mike Dustar]

It is becoming very, very clear that Novo Nordisk is the pill leader in the world. And we need to really make sure we keep that leadership.

[Jessica Mendoza]

That's next.

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[Jessica Mendoza]

Novo Nordisk launched its Wegovy pill in January, and almost immediately, it became one of the hottest drug launches in America. The power of Wegovy now in the palm of your hand. The pill generated more than 1.3 million prescriptions in the first quarter. Strong sales of the Wegovy pill gave Novo one of its biggest stock jumps in months and helped beat Wall street expectations in its latest earnings. Importantly, it also helped Novo score a scientific win. The Wegovy pill helps patients lose more weight on average, than Lilly's rival pill foundeo. Although taking the Wegovy pill involves food and water restrictions, Fundea doesn't have those. You did have a big success with the Wegovy pill. How important is this to your overall strategy?

[Mike Dustar]

It's very important. This has become the best product launch in the US history in volume outside of a single vaccine, I believe. I think that's great and I'm very proud of that. Don't get me wrong, but the part that I Look more is 80% of the people that are coming and picking up these products are not my Vigovy customers. They're new customers. There are people that have been waiting and waiting and maybe with envy. They see their friends and family members lose weight, but they just didn't want to take an injection for whatever reason. That could be the taboo of injection doesn't really matter. They simply didn't want an injection. We decided to go the difficult way of putting a peptide in a pill. Peptides are getting very famous nowadays. I would say when we started doing this, no one knew what peptide is, but now we have.

[Jessica Mendoza]

Yeah, nobody is using that word at all.

[Mike Dustar]

Now we have the first and the only peptide in a pill in the world. And that's why I can brag about 16.6% weight loss, 17% weight loss versus a lower efficacious version of those that happens to be chemically induced. So that means that the patient does not have to compromise between injection and a pill. And in that context, of course, then we have seen a very good uptake.

[Jessica Mendoza]

So if you look ahead in 10 years, what proportion of your weight loss patients do you think will be on a pill versus taking a shot?

[Mike Dustar]

Yeah, I don't know.

[Jessica Mendoza]

Does it matter?

[Mike Dustar]

It doesn't matter. At the core of it, it's the same raw material. If tomorrow people buy more pills from me than injection, then I'll turn the knob in the raw material factory to the right hand side. And if people want more injections, then I turn it to the left and basically make sure that I have flexibility on that.

[Jessica Mendoza]

So it's answering to what the market wants, basically is right. Okay, I want to talk about pricing now. Novo is slashing the official US prices for WeGovy and Ozempic to $675 a month starting next year. That's 50% dropping, drop for WeGovy, about 35% for Ozempic. By doing this, you're dramatically reducing the margins for the drugs that made you at one point the most valuable company in Europe. Why take an ax to your margins like that?

[Mike Dustar]

Yeah. So first of all, you have to think that very few people were paying the least price.

[Jessica Mendoza]

Sure.

[Mike Dustar]

To us or anyone else for that matter. Every pharmaceutical company in US typically gives enormous double digit discounts to bring you to the net. And the distance between the list and the net has become, in my opinion, out of whack.

[Jessica Mendoza]

And so is the idea here to make these affordable to as many people as possible on a, on a mass scale, to get Wegovy and Ozempic to as many people as possible.

[Mike Dustar]

So the vision, I think for our company is to have multiple assets available within the area of, let's say, diabetes, obesity, and cater to all people. Not have products only for the rich, but also not end up to be a generic high volume, low margin business that cannot innovate anymore.

[Jessica Mendoza]

When do you expect this pricing strategy to show that it's paying off?

[Mike Dustar]

I think it's again, not a one off event. It's a gradual thing if you take a look at it. As volumes go up, prices usually come down on any, any product. We cannot expect that we sell at current prices to 2 billion people these medications. That's just naive. On the other hand, of course you also don't want to run it too fast without having the next generations of the products and without having the needed cash flow to put into R and D and innovate again. So it's a balance.

[Jessica Mendoza]

Speaking of innovations, we already know about Kagur Samaritan, what's next in the pipeline?

[Mike Dustar]

We have a lot of exciting things and some of which of course I can openly share, some of which I have to simply wait and see.

[Jessica Mendoza]

Are you sure? I mean, you could just give us a little peek.

[Mike Dustar]

We were planning a capital market day later on this year and we will reveal more than right now is public at that point. But I can tell you that we are really making sure that early stage pipelines, mid stage and late stage are all progressing faster than anyone thought it was actually possible.

[Jessica Mendoza]

Mike did tell me about some of the things Novo has in the pipeline. A next generation obesity pill to succeed. The Wegovy pill. Drugs designed to be easier on patients stomachs and medicines aimed at illnesses related to obesity like late stage fatty liver disease, cardiovascular disease and kidney disease. And Novo is still competing to make the most powerful weight loss drug.

[Mike Dustar]

We have a triple agonist which we just announced called UBT251, which was from actually a Chinese acquisition. And in early results of midphase stage that we have seen, it is best in class in a number of parameters.

[Jessica Mendoza]

On UBT 251, when you talk about best in class, does it have the potential to achieve greater weight loss than Lilly's retatrutide which has been shown to have 28% weight loss? I believe is the number that just came out correct.

[Mike Dustar]

So my hope is the answer is yes. But early results of the comparative data from their mid stage results versus ours shows the benefit and points the benefits to our asset versus theirs. Of course you have to progress into late stage clinical development and eventually bring it to the market so things can change. But based on Apple to Apple comparison of early results, I would say the short answer to your question, yes it can. Hmm.

[Jessica Mendoza]

Mike, it sounds like you have plans for dealing with the challenges that Novo is facing. I'm taking away from this conversation. You're a pretty optimistic guy. But I'm curious what keeps you up at night these days.

[Mike Dustar]

I think I, well, I sleep well. Um, but I, I, I sleep well. I don't sleep enough. You know this, this job is a bit taking away from the hours of sleep but, but when I sleep I feel good about what we're doing. I think there the sense of purpose the ability to actually see people benefiting from what you're doing is second to none. And we are dealing with not rare diseases. We're dealing with conditions that we all know someone in our family and circle of friends suffering from. This is a journey that's going to take a long time. And we should not get too quickly nervous about the daily disruptions and the daily fluctuations, let's say, of the share price. We should take it serious, but we should not get too nervous. We're going to lose our job just because the share price is down today. And that also makes me sleep better. You know, what got us here for 100 years was not pure luck. There was something behind it. So why not the next hundred years?

[Jessica Mendoza]

Well, Mike Dustar, CEO of Novo Nordisk, thank you so much for joining us.

[Mike Dustar]

It's a pleasure to be here. Thank you very much for having me.

[Jessica Mendoza]

That's all for today. Tuesday, May 26 the Journal is a co production of Spotify and the Wall Street Journal. Special thanks to Peter Loftus. Thanks for listening. See you tomorrow.