诺和诺德起源于 1940 年代丹麦的胰岛素研制，让 1 型糖尿病患者得以存活；一位早期病患于 1942 年确诊，如今 85 岁。该公司仍供应全球约一半的胰岛素，即使它的名声已转向司美格鲁肽（Ozempic/Wegovy）。司美格鲁肽对 2 型糖尿病非常有效；2 型约占糖尿病病例的 95%，但对全球 840 万 1 型糖尿病患者而言，它很少能取代胰岛素。

在 GLP‑1 研究催生每日注射的利拉鲁肽（美国于 2010 年核准治疗糖尿病、2014 年核准减重）之后，诺和诺德于 2018 年推出每周一次的司美格鲁肽；其后 Wegovy 使用 2.4× 更高剂量，并在 2021 年取得减重适应症核准，且获 FDA 标示可降低高体重患者严重心脏风险。在允许直接药品广告的美国，据称诺和诺德每年行销支出接近 2 亿美元，而目前约有 1,500 万人正在使用司美格鲁肽。

这波热潮拉紧了制造产能（新的生物制剂工厂每座需 20–30 亿美元，且约需 5 年）并与美国的定价中介冲突：在 2024 年参议院听证会上，诺和诺德对比德国约 59 美元与美国在折扣后约 600 美元的价格，并称将 Levemir 在美国的定价下调 65% 后，PBM 反而取消给付，随后该药于 2024 年 12 月 31 日退出美国市场。2024 年末竞争加剧：礼来报告 Zepbound 减重 20% 对比 Wegovy 的 14%；诺和诺德的 CagriSema 达到 22.7% 对比 25% 目标，股价下跌约 20%。

Novo Nordisk grew from 1940s Danish insulin work that kept type 1 patients alive; one early patient, diagnosed in 1942, is now 85. The company still supplies about half of the world’s insulin, even as its fame shifted to semaglutide (Ozempic/Wegovy). Semaglutide is highly effective for type 2 diabetes, which is roughly 95% of diabetes cases, but it rarely replaces insulin for the 8.4 million people with type 1 diabetes worldwide.

After GLP‑1 research led to daily liraglutide (US approvals 2010 for diabetes, 2014 for weight loss), Novo introduced weekly semaglutide in 2018; Wegovy later used a 2.4× higher dose and won a 2021 weight‑loss approval plus an FDA label for lowering serious heart‑risk in heavier patients. In the US—where direct drug ads are allowed—Novo reportedly spent near $200 million a year on marketing, and about 15 million people now take semaglutide.

That boom strains manufacturing (new biologics plants cost $2–$3 billion and take ~5 years) and collides with US pricing middlemen: at a 2024 Senate hearing, Novo cited Germany’s ~$59 price versus about $600 in the US after rebates, and said cutting Levemir’s US list price 65% led PBMs to drop coverage before the drug’s US exit on Dec 31, 2024. Late 2024 competition intensified: Lilly reported 20% weight loss on Zepbound vs 14% on Wegovy; Novo’s CagriSema hit 22.7% vs a 25% target, and shares fell ~20%.