We’ve Got A Pill For That, Currency Debasement, Inflation Subterfuge
Friday 21st June Commentary - apologies for the delay
We’ve Got A Pill For That
The American College of Cardiology recommended today that doctors should consider prescribing GLP-1 medications for patients with heart failure with preserved ejection fracture (HFpEF). That’s about half the number of people over 60 that present with heart failure.
Here is a quote from the press release:
"Given emerging evidence of the benefits of semaglutide and tirzepatide in individuals with HFpEF and obesity in concert with healthy behavioral interventions, clinicians should be aware of optimal diagnosis, risk assessment, and management of obesity in individuals with HF,"
There are approximately 79 million people in the USA over the age of 60 and 41% of them are obese. Heart disease remains the biggest killer and complications due to obesity are a significant burden for many people.
Estimates for the number of people globally with diabetes are more than 500 million. Not everyone will have access to or can afford treatment but that is a significant addressable market.
Diet and Exercise are difficult to maintain and particularly if someone has never engaged in either before. Bariatric surgery feels extreme for many people, so that leaves GLP-1 medications as a favourable alternative.
There is widespread reporting on the loss of appetite GLP-1’s engender and less about the nausea, vomiting, diarrhea, and constipation that contribute to that loss of appetite.
There has been a significant boom for the companies that pioneered this market segment. Their success has attracted competition and the business model is evolving rapidly.
Novo Nordisk was the originator of the treatments which grew out of its dominant position in diabetes medications. The share peaked a year ago as generics flooded the market and ate into margins.
The company has market leading production capacity but will need to adjust to a high volume, low margin model to thrive. That is proving painful and the share will need to hold the low near DKK400 if recovery is going to be credible.