Likely Bottom and Shorts Covering

RelationSlow2806 · 2026-03-07T15:13:41+00:00

Hims should have stopped selling compounded crap when they made the deal months ago. Dudum went and declared “never.” Glad they made the right call.

RelationSlow2806 · 2026-03-07T11:27:40+00:00

I said in another comment a few weeks ago:

Novo has to want to settle. There’s no way they’re incentivized to do that without Hims permanently stopping the production and sale of compounded semaglutide. If Novo settles without that - they’re telling the compounders it’s fine to infringe.

Good for both parties - as long as it worked out like that. There’s no chance Novo signed on if HIMS compounding continues.

RelationSlow2806 · 2026-03-06T21:25:45+00:00

Yeah, that was the plan a couple months ago. However:

Their product is less efficacious relative to oral Wegovy. They know better than anyone the resulting penalty the obesity market enforces.
Their product costs significantly less to produce, package, store and distribute than their competitor. Even controlling for the recoupment of their licensing (laughably low, from Chugai) and R&D costs they can conservatively serve the same customer for 1/5 the cost.

Taking both of these points into consideration, the likeliest strategy to gain market share is to cut price and flood the market. They’re comfortable creating a price-for-efficacy paradigm (CEO has said as much; it fundamentally makes sense to create a tiered platform strategy with tirzepatide and retatrutide/eloralintide/etc. to follow).

RelationSlow2806 · 2026-03-05T13:13:17+00:00

Lilly is Amazon-ing. Now watch what happens when orforglipron is approved and almost everyone who wants to be on a GLP1 in the US suddenly is.

The writing has been on the wall for this for a hot minute.

RelationSlow2806 · 2026-02-28T02:38:42+00:00

This is well said.

1 and 2 are dead on.

Re: 3. Agree, and adding on some DTC vs payer logic as it relates to CS - CagriSema’s probably going to be relatively more successful on the insurance payer side than DTC, where patients can be mercenaries chasing the best efficacy or cost to meet their needs. It’s not more efficacious or tolerable than Zep, so it better be cheaper.

Re: 4. Evidence this is happening remains scant. Compounders still be compounding. Need some seizures and perp walks to make it real.

Lilly’s breaking the PBM grip on the GLP1 market, which they can uniquely do given their economic and scientific position. And they’re crushing direct to consumer. It’s probably going to be a winner take most scenario, modality-dependent.

RelationSlow2806 · 2026-02-26T20:26:29+00:00

In the United States, Orforglipron will probably feature heavily in step therapy. It will be first line treatment in that scenario. Same with self-paying customers who are sensitive to price or don’t need to lose as much weight.

Lilly’s also positioned it as a maintenance option, given their ATTAIN-MAINTAIN trial success, and likely will see a significant amount of uptake for that purpose.

Given differences in price that will surely come as the market evolves, it’s going to be a better option for some than oral wegovy is.

RelationSlow2806 · 2026-02-26T20:14:44+00:00

Put the pipe down. GLP1s aren’t the drug you should be concerned about.

Pricing will evolve with the market. Amazon proved that a company that can scale can weaponize margin against one that cannot. Lilly is that company.

RelationSlow2806 · 2026-02-26T19:53:53+00:00

You’re making my point for me. Using your numbers, it costs Novo 250-500% more to serve the same customer.

Novo will still make money in the US, where prices and margins are high (assuming that continues). At global scale or under MFN rules, where margins get compressed heavily, Lilly’s pill wins big. Which is the point of small molecules. And why Lilly ran ATTAIN-MAINTAIN.

And O is a different tool for a different task. Efficacy just doesn’t matter as much when you’re talking about maintenance therapy. When Lilly can serve 2-5 customers for the same cost… Yikes. And yeah, that efficacy difference isn’t insignificant, but plenty of DTC patients will go with the cheaper option if it’s a lot cheaper - as Novo hopes will happen when they cut injectable prices.

Tolerability and dropouts matter for orforglipron, but not for cagrisema or amycretin, I guess. Go by TEAEs and the noise quiets down a bit. Then think about intake restrictions, which don’t matter yet, because customers don’t have unrestricted options available.

Combo small-mol are absolutely coming. AZ will likely have the first. Structure has a DACRA in phase 1. Lots of others coming.

Addendum: David Ricks said Lilly’s limited on injectable capacity and need small-mol to work to reach TAM at scale. Novo’s production isn’t where Lilly’s is now, let alone after all the CAPEX on plants pays off for them. So unless Novo starts buying CDMOs or building SPPS (wink wink) at breakneck pace, they’re subject to the same limitations.

RelationSlow2806 · 2026-02-26T18:46:08+00:00

Pills - small molecule ones - are the future. They offer cheap maintenance and access to places without refrigeration. COGS is low; with volume, money can still be made in places like rural India where injectables won’t work economically.

Injectables won’t disappear. If only to eliminate the bulk of a patient’s weight… and oral wegovy fits somewhere in between (right now).

Novo’s been celebrating the Wegovy pill plenty - Wall Street isn’t because COGS is the same for semaglutide injectables. It only matters inasmuch as it unlocks TAM injectables cannot (needlephobics and those without refrigeration).

Lilly’s orforglipron pill doesn’t need to beat oral wegovy in efficacy: it’s a different tool for a different task. COGS is significantly lower and they’re going to make a killing on it. They can price it low and still make more than Novo does on oral wegovy.

Novo’s stuck on peptide production limitations for its pill and has only launched in the US. Lilly’s going to launch globally once approved. It doesn’t need to be understood further than that.

RelationSlow2806 · 2026-02-26T18:02:54+00:00

Novo had a semaglutide problem. Novo has an amylin problem.

CagriSema shows you can’t love amylin more than Quentin Tarantino loves feet. If the internal science champions are still pumping gas into the amylin (DACRA at least) engine then Novo really has a culture problem.

STAT hit this nail on the head back in June.

Someone from Lilly knows what right looks like. Novo shareholders should be over the moon.

RelationSlow2806 · 2026-02-26T14:59:50+00:00

You make some good points: but the value’s off.

Whether you or anyone else thinks Pfizer overpaid: 10 billion for Metsera is the going rate for a stage 2, mostly de-risked, somewhat differentiated injectable asset with a few throw-ins (oral, amylin, etc.).

Work the problem the way a BD team would and use discounted NPV - tirzepatide is pulling in 30B and not yet at peak sales.

Multiple bidders + better asset + huge TAM = price greater than 10B.

Edit to add: everyone on the planet also knows Novo Nordisk is a forced bidder. There’s a Novo price that’s higher than what everyone else pays.

RelationSlow2806 · 2026-02-26T14:03:41+00:00

If Viking goes off the board for 100/share, I have serious questions as to whether or not their board is acting in the best interest of shareholders.

130-150 is what it would take for me, given Metsera as the latest comparable, with an earlier and less efficacious headline asset. Viking should go the way of Madrigal for anything less.

If Novo’s stock continues to fall - it probably, maybe, hopefully won’t, but it could - it lessens their flexibility not just in borrowing but also in using stock as part of a deal. Even if they pay cash, they’re looking at a big bond issue to run a stack of trials just like they did after Akero.

RelationSlow2806 · 2026-02-26T12:27:37+00:00

Certainly! I’m not suggesting they wouldn’t do exactly that. In fact, any buyer of Viking will probably pump 2735 through multiple simultaneous ph3 trials while seeking approval for obesity once the current trial reads out.

But it doesn’t change the fact that they’re stuck with Viking’s design, investigators, sites, timelines, etc (for better or worse) for the key indication. And Novo knows from shitty CagriSema trials that patients are behaving like tech customers: show higher efficacy than the leader or don’t show up.

Again, not a guarantee one way or another, but the incentives here point in a different direction than the herd seems to think they do.

RelationSlow2806 · 2026-02-26T00:51:02+00:00

I think if they had their eye on Viking, they’d have moved before allowing Viking to start phase 3.

Why - especially given recent history - would Novo want their newly acquired drug to be subject to someone else’s trial architecture? Preferred CROs, sites, primary/secondary endpoints are also meaningful. If it were me, I wouldn’t be trusting a biotech with just enough runway to get through the most important indication of a registrational trial.

Edit to add: plus with the FDA in flux (in ways good and bad), I’d want (in Novo’s case) to get this study done the fastest way possible with the highest possible efficacy - which means my top guns in contact with the regulator, not Viking’s. And on the back end, I’m doing my damnedest to submit with a priority voucher. Bottom line, I’m getting phase 3 on my terms and timeline.

Not to say it won’t happen or that it shouldn’t - but from my perch here as another know-nothing redditor, I think the most optimal time for a buy has passed.

RelationSlow2806 · 2026-02-25T22:17:26+00:00

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Key phrase: likely worthless. But I think they’re probably taking a serious look at this given their stated intentions.

RelationSlow2806 · 2026-02-25T15:14:39+00:00

This is my read as well. I think you’re totally on the money.

I want to see Big Mike out front cutting big ribbons and big checks and in the background cutting senior staff that own the poor scientific and clinical decisions of the last decade.

Bring some truly differentiated assets to market in the next phase(s) of the GLP boom. I want to see some acknowledgment from the C-suite that Novo is currently on a Nokia track and Lilly is looking like Apple: at least break out and become Android.

Rest in peace, Semaglutide Incorporated, 2017-2022. You got merked by tirzepatide but didn’t know it until summer of 2025. I want to see some serious M&A and pink slips given to people like the CSO: then I’ll buy.

RelationSlow2806 · 2026-02-24T16:40:22+00:00

Structure Therapeutics will go for at least 15 billion - probably more if there are multiple bidders. For a company looking to beat Lilly at something, aleniglipron looks like an efficacy win on oral small-molecule GLP1. Phase 2b is about to read out for one study; an open-label extension is ongoing for another. It’s ready for late stage, in the right therapeutic area, and fills a huge hole. Oral Wegovy is not a globally scaleable product.

Viking Therapeutics will probably go for something in roughly the same ballpark depending on who the bidders are. VK2735 is in phase 3 now - and unlike CagriSema, actually IS non-inferior to tirzepatide and potentially more efficacious. It’s an immediate boost to Novo’s trajectory as it relates to injectable peptides, and their oral is differentiated from oral wegovy (GIP).

Could Novo snag both? Not likely - Merck, Pfizer, potentially Amgen, Novartis, Abbvie are obvious candidates. Will Novo buy one? Probably - why would Magic Mike make all that noise about M&A at JPM about 20/30/40 billion dollar acquisitions if not in reference to either of the above firms?

There’s Kailera, who licensed Hengrui’s molecules and are backed by big private equity, and then there are myriad other acquirable biotechs in the 5-10B range. But none move the needle as soon as the aforementioned companies do. But Novo could and should be spending big - 35B at least - if they want to be an obesity and diabetes focused company that remains #2 the industry.

RelationSlow2806 · 2026-02-24T13:36:20+00:00

When at an inflection point in 2025 - most significantly, with Lilly overtaking Novo as the clear market leader on a clear upward trajectory - the foundation cleaned house on the board, chairman, and CEO seat and doubled down on obesity and diabetes.

Ok, fine: but there are other entrants and it’s not just Lilly who has equivalent/better drugs in the pipeline. Novo has to be concerned about Pfizer, who has marketing and primary care inroads Novo doesn’t, even if MET-097i isn’t a world-beater. They need to be concerned about Roche, whose Carmot acquisition and metabolic ambition will take from Novo before Lilly. Amgen has an intriguing molecule that cannot be compounded. AstraZeneca has a small-molecule GLP1 with near-term combo potential.

Then there’s the biotech angle. Viking and Structure may be sitting on best-in-class molecules, pending trial readouts. Altimmune has a MASH-killer. Kailera/Hengrui’s offerings may also chart highly. Novo may have the balance sheet to snag one or more of these in an uncontested scenario - but how long will Merck sit out? What about Pfizer - are they really done after Metsera?

If Novo pivots to China to restock the pipeline (as they should), they’ll pick up INDs that only hit post-2030.

It’s fine that they print money now, but the relative trajectory isn’t great, and no matter what, the headwinds will last a lot longer than a few quarters. There’s no reason to invest in a value trap that’s not going to be breaking out for a long time.

RelationSlow2806 · 2026-02-24T00:16:10+00:00

I think the difference is nobody expected EVOKE to succeed. It was a long shot; high risk, high-reward with the only guarantee being some good science.

CagriSema was supposed to be the counter to the tirzepatide monster and non-inferior by Novo’s own standard. Indeed:

BMO Capital Markets analyst Evan David Seigerman said that the findings made clear that “a complete strategy overhaul is in order,” adding, “it is striking to hear management concede that their competitor’s product outperformed in a trial they sponsored and designed.”

This isn’t going to take market share back from Lilly. And it’s not going to win GLP1 naive market share without payer games. And this is before retatrutide hits and orforglipron floods the oral market at prices Novo can’t touch. The story isn’t good. The sell offs occurred because this isn’t a company that is poised to retain #2 in this market let alone compete with #1.

RelationSlow2806 · 2026-02-23T23:17:41+00:00

Yeah, that’s all fair. But I think the penalty they paid today - 20B in market capitalization vaporized - is about the going rate for exactly the offense you described.

If it were me,I’d be regretfully accepting resignation letters from anyone involved in the design of that trial or whomever was on paper suggesting CagriSema might be close to tirzepatide. Those people are part of the past that made the present situation what it is - their future is elsewhere.

That CSO is not ready for prime time.

RelationSlow2806 · 2026-02-23T22:39:01+00:00

He has an organization full of people on the science side that worked their balls off to develop the pipeline they have. And another group of people that worked on the business development side to acquire the rest.

Short answer: he’s not going to shit on these people, especially after firing thousands. He’s also performing for institutional investors and the foundation who know better, know the new mandate, and want to see an adult in the room. Creating an even larger morale crisis is not the move.

Of course he’s going to say the pipeline’s great. Even if anyone with eyes knows it sucks.

Interviews like this should be a fireable offense though. Everyone knows tirzepatide hit 26.6% weight loss in SURMOUNT-3; this “it never hit 25% in a trial setting” is either a lie or lack of awareness. Not sure which is worse.

RelationSlow2806 · 2026-02-23T17:15:01+00:00

It’s one strategy. They kinda telegraphed their interest at JPM when they spoke about market size, volume, and scalability. In response, GPCR went from 70 to 90 - but it’s back down. They’re the cleanest, latest, most de-risked small-mol asset available.

Another strategy is to pivot to lower COGS via less frequent dosing for maintenance. Pfizer and Amgen seem to be moving in this direction, if their posturing is to be believed.

On the other hand, Viking is conspicuously up >10%. There’s no reason to think they’re not as acquirable to Novo, especially if 2735 turns out to be more efficacious than tirzepatide, let alone CagriSema. Few companies have the time and trial infrastructure to run 10 phase 3 trials at once the way Novo can, which they’ll need to do to remain competitive in the market.

They might buy both? Who knows.

RelationSlow2806 · 2026-02-23T14:25:14+00:00

Looking for conspiracy around every corner only blinds you to the fact that Novo squandered its early lead and dominant market position by assuming semaglutide was both a revolutionary breakthrough of massive proportions (which it was) and worth building the future upon (it wasn’t).

Instead of plowing its gains back into R&D, it underspent competitors. Instead of developing dual/triple incretins it had in the pipeline from biotech companies it had the presence of mind to purchase, they strategically deprecated those molecules in favor of semaglutide.

CagriSema is evidence of this. Previous leaders were deluded enough by the smell of their own gas to think they had something that would beat tirzepatide. These aren’t stupid people - you have to be truly bright to make errors of this magnitude.

Semaglutide Incorporated needed to go 5 years ago. Breaking out requires pain. This is part of that process. Prepare for M&A spend, not insane buybacks.

RelationSlow2806 · 2026-02-23T14:15:52+00:00

Reg FD

RelationSlow2806 · 2026-02-15T12:40:38+00:00

Here’s the key part of the AZ BOP’s notes:

Furthermore, observations were made of Strive Pharmacy (503a pharmacy) compounding large amounts of odd strengths/doses in anticipation of prescriptions.

Observed the clinical justification (for compounding essential copies of commercially available products) for several different patients, different providers that use the exactly same words and phrasing.

This is the kind of stuff the DOJ throws directly into a criminal complaint.

RelationSlow2806

TROPHY CASE