It has the ring of a Hans Christian Andersen fairytale—if a supremely ironic one. Tiny Denmark is home to six million of the world’s wealthiest and healthiest people—all those muesli-munching cyclists…. even their letter O sometimes comes slashed in half. But, Denmark is also home to what is suddenly Europe’s largest company—Novo Nordisk…. a pharmaceutical firm with a market cap of a half trillion dollars… thanks to products that…wait for it… combat obesity. Novo’s drugs Ozempic and Wegovy have slimmed down Hollywood stars and millions of non-celebrities worldwide—while adding great heft to Denmark’s economy. We travel to the Baltic to see how a country with a slender ego is coping with this most unlikely injection of fantastic wealth.
Just another Copenhagen commuter headed off to work in the morning… Lotte Bjerre Knudsen goes unnoticed… first on the train… then, pep in her step, walking from the station to the office she shares with two others. Understating matters—as one does in Denmark—you’d never know from appearances that she is the scientist whose research at Novo Nordisk led to perhaps the most revolutionary drug this century.
Lotte Knudsen: I’m so grateful. I was always just been a nerdy little scientist (laugh) who kind of found home here in this company for 35 years.
Jon Wertheim: Is that really your sense of self still these days?
Lotte Knudsen: I’m proud, but I’m also humble, and really very focused on the fact that it was– it was a team– it was a team effort.
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Modesty aside, her discoveries helped create Ozempic and Wegovy, which not only treat Type 2 diabetes and obesity but are now approved for treating cardiovascular, kidney, and liver disease as well. This, of course, has made her a billion–…ehh, not so fast.
Lotte Knudsen: You know, I’m actually not super interested in actually having a whole lot of money. I don’t think that it doesn’t look like it’s making people happy, right?
Jon Wertheim: Money’s not something that’s important to you–
Lotte Knudsen: I– I like to pay my taxes, I like the society that we live in. I like that there’s equal access to– to healthcare. I really like that.
Long as she brought it up, let’s get this out of the way: there is very little rotten in the State of Denmark. This is the land that gave us Lego… province of pedaling… all fishing nets and safety nets. And today, Novo Nordisk’s success and the spike in demand for Ozempic is fattening the country’s economy—creating thousands of jobs, bolstering national pension plans, keeping mortgage rates low. Novo now has a market cap larger than the entire country’s GDP.
Giving rise to a new national emblem: drugs so popular they’ve become embedded in pop culture… at least in the U.S. where the company advertises liberally—including on this broadcast…. But in Denmark, pharmaceutical advertising is illegal.
Peter Lund Madsen: This is very, very unfamiliar for Danish persons. This kind of advertisement. They wouldn’t like it. It’s not very Danish.
Peter Lund Madsen is a celebrated neurologist and writer… and like most Danes, delighted that America’s demand for Novo Nordisk’s drugs is Denmark’s gain.
Jon Wertheim: Help us understand where this company fits in the Danish national consciousness right now.
Peter Lund Madsen: Novo is a part of Denmark. Because we’re a small country and, finally, we have a big company in Europe. Much bigger than anything the Swedes have. So, so we like that notion.
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Jon Wertheim: You can hold this over the Swedes?
Peter Lund Madsen: Yes. Yes. Because they’ve always had cars and airplanes and big companies. But now we have Novo.
Jon Wertheim: Take that, Ikea.
Peter Lund Madsen: Yes, yes, yes. It’s a first time.
Danishness courses through Novo Nordisk’s bloodstream…The company was founded in the early 1920s, by August Krogh, a Nobel Laureate, and his wife Marie, a doctor. Their motivation wasn’t financial; it was personal. Marie was diagnosed with diabetes… at the time, a death sentence.
Jon Wertheim: This drug that we’re seeing right here helped save the life of Marie.
Hanne Sindbaek: It did. She was very discreet about it, she did not want anybody to know that she was diabetic. Because Marie was a doctor, she was “not a patient.”
Hanne Sindbaek, a Danish journalist, has written two books about Novo Nordisk and the Kroghs. We spoke to her in a lecture theater in what was the Danish Medical School where the Kroghs first met.
Jon Wertheim: Is it fair to say that this origin story of Novo Nordisk starts as a– as a love story?
Hanne Sindbaek: It is absolutely fair to say. He was teaching her, as she was a medical student. He fell in love with her right away.
When, in 1922, they heard that Canadian scientists had stumbled upon a miracle cure for diabetes: insulin… They traveled to Toronto and came home with the rights to manufacture the drug in Scandinavia.
Jon Wertheim: Sounds very nice of the Canadians scientists. Do they ask for anything else in return?
Hanne Sindbaek: They asked that nobody should– person should profit from it, it should be to the benefit of humanity. That was the “price,” you can say. It was a way to get this life-saving drug out in the world fast.
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Back in Denmark, within months, they set up the Nordisk Insulin Company. In keeping with their agreement, they established a non-profit foundation which today controls 77% of the company’s voting shares.
Mads Krogsgaard: So the agreement was that if there were revenues and proceeds from the sales of insulin here in Scandinavia, it should be returned to society in the form of support for research into physiology, and medicine.
Mads Krogsgaard is the foundation’s CEO. Today it is THE largest philanthropic organization in the world, bigger than the Gates Foundation.
While Novo Nordisk always focused on diabetes drugs, it did branch out beyond medicine. In the late 80s, young Lotte Knudsen was assigned to the enzyme team, which had the noble goal of making sure reds and whites didn’t run in the wash.
Jon Wertheim: You started with laundry detergent.
Lotte Knudsen: Yes, I did. Yup. It’s the same story, right, of just wanting to make a product that’s useful.
In the early 90s, she came across a new study about a naturally occurring gut hormone: GLP-1, that lowered blood sugar levels and suppressed appetite… She thought, if it could be harnessed into a drug, it could revolutionize treatment for diabetes AND obesity. She went to her boss, Novo’s head of research Mads Krogsgaard… yes, the same guy who now heads the foundation.
Jon Wertheim: What do you remember about her?
Mads Krogsgaard: She was the first one to march into my office with red hair, and very fired up, showing me a publication that was not even published yet. She was talking very agitatedly about this. And I was getting excited.
Jon Wertheim: I understand you also had to convince senior management about obesity, and– and what it was, that this wasn’t a behavioral choice necessarily.
Mads Krogsgaard: They felt, “Just go up on a bike. Do some jogging. Do some biking.”
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Jon Wertheim: Just get off the couch and exercise.
Mads Krogsgaard: Yeah. And I started trying to convince them that it’s not getting on the bike. If you’re genetically predisposed living in the environment we are in today, you are at very high risk. And something should be done about that.
For the next 20 years, they worked on that GLP-1 molecule before Ozempic finally made it to market as a type 2 diabetes drug; it took another four years for Wegovy to be approved for weight loss. It turned Novo Nordisk from niche player, to a company bigger than Coca Cola and Procter and Gamble…
The CEO is Lars Fruergaard Jørgensen… so typically Danish, his compensation package of roughly $10 million, is dwarfed by his U.S. counterparts. His office is a co-working space atop Novo’s Copenhagen headquarters… designed in the shape of an insulin molecule.
Jon Wertheim: So your next building needs to be the molecule of an anti-obesity drug.
Lars Fruergaard Jørgensen: Yes, it should.
Jørgensen is only the fifth chief executive since the company was founded. Ask him about the weight of the job, and—no CEO God complex here—he defaults to the company mantra. The Novo Nordisk way.
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Lars Fruergaard Jørgensen: So the Novo Nordisk way is the basic thinking of our founders. And– and key elements linked to how we treat each other, how we collaborate. And that’s about being open and honest. It’s all about being accountable.
Jon Wertheim: This sounds almost like a cult, a religious movement, and not so much a pharmaceutical firm.
Lars Fruergaard Jørgensen: I think the values are based on ordinary human decent values.
Jon Wertheim: You appreciate you’re not sounding very much like an American CEO right now.
Lars Fruergaard Jørgensen: Well, I think I’m very grounded as an individual. My upbringing has– has given me a lot of say, groundness.
And in Denmark, chief executives are expected to be grounded…
Peter Lund Madsen: In Denmark, it’s very unrespectable to flash your money. Rich people in Denmark, they tend to buy cheaper cars in order to stay out of trouble.
Jon Wertheim: So the CEO of Novo Nordisk. If he’s driving around Copenhagen in a Ferrari or a limousine, how– how does that play?
Peter Lund Madsen: Poorly. But the other way around, if– if he was driving around in a cheap car, that would be a very good thing for him. “Oh, I like his driving such a car.” He’s a true Dane.
But for all of Novo Nordisk’s Danish high-mindedness, there is a growing chorus of complaints in America.
As an avowed socialist, Bernie Sanders may find plenty to like about Denmark. But at a Senate hearing in September, Sanders excoriated Jorgensen over allegations of price gouging… the CEO told the committee what he told us: the benefits of Novo’s drugs to global health will, ultimately, save trillions of dollars… and if anything is to blame for the high prices, it’s the fractured U.S. health care system.
Jon Wertheim: What is the response to the skeptical American that says, “Come on. This is Big Pharma, this pricing is predatory. They’re making money off people with health problems. This is not Utopia. This is just another big, greedy business”?
Hanne Sindbaek: Of course it’s– it’s “greedy.” You have to compete in the world as it is, and I don’t think that Novo Nordisk has all these values just to be “nice.” They have it because it’s good business.
Jon Wertheim: They’re not blind to capitalism? (laugh) There– there– there will be rivals–
Hanne Sindbaek: Absolutely not. They are capitalists at heart.
Jon Wertheim: And in this–
Hanne Sindbaek: But you can be a capitalist with great values.
And to keep up with the global demand for Novo’s drugs—less than 1% of sales come from inside Denmark—the company is sinking billions into new plants worldwide… and just a few miles down the road from the cranes, in the Danish countryside, sits this quintessential Scandinavian institution… Half boarding school, half summer camp (and state subsidized of course)… it’s a health facility for the small portion of Danes who are diagnosed with obesity. Recently, enrollment has declined by almost half… and some of the empty beds are being filled by, get this, newly recruited Novo employees as they try to find permanent housing.
Lars Jorgensen: That’s a way we can gain a little money. Now we have less students. So…
Jon Wertheim: Bit of an irony right that–
Lars Jorgensen: Yeah, it is.
Lars Jorgensen has been a therapist and life coach here for 20 years.
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Jon Wertheim: When you heard these drugs were coming on the market from Denmark, did– did you think, “Oh, boy, this–
Lars Jorgensen: We did.
Jon Wertheim: –this could impact us?”
Lars Jorgensen: Yes, we did.
Jon Wertheim: So if somebody says, “I’m just gonna take these anti-obesity drugs rather than come here,” what would you tell them?
Lars Jorgensen: I would tell them to think about what made you eat too much in the first place. What was that about? Why do you need to take medicine? And for some people, it would be a perfect solution. No doubt about that. But for many people, it will not be. Because they still have the problem, the obesity is just a symptom.
Jon Wertheim: That this goes way beyond–
Lars Jorgensen: Exactly.
Jon Wertheim: –what the scale says.
Lars Jorgensen: Exactly.
On a more macro level, Novo Nordisk’s runaway success is beginning to shrink entire sectors of the global economy… fast food.… big box stores…. even Krispy Kreme. They’re already tightening their belts in a universe where people are less hungry. Still, there are competitors and counterfeits out there. And Chinese companies are already in clinical trials for generics.
But for now, the world’s weight surplus remains the Danes’… and Peter Lund Madsen’s… economic surplus…
Jon Wertheim: Do you own Novo Nordisk stock?
Peter Lund Madsen: Yes. I have for many years, like many other people in Denmark
Jon Wertheim: How (laugh) are you feeling about your investment?
Peter Lund Madsen: Everybody has the feeling that this will go on forever. And they are very– they’re very– yes, happy.
Produced by Michael H. Gavshon. Associate producer, Nadim Roberts. Broadcast associate, Elizabeth Germino. Edited by Matthew Lev.
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