<p>(本文作者为路透社 Breakingviews 专栏作家。文中观点仅代表其个人立场。)</p><p>作者：Aimee Donnellan</p><p>都柏林，4 月 14 日（路透社 Breakingviews）——在上个月于哥本哈根举行的诺和诺德公司（NOVOb.CO）年度股东大会上，首席执行官 Maziar Mike Doustdar 极力聚焦积极面。这家丹麦制药公司的新型 Wegovy 减肥药开局创纪录，仅在两个月内就开出超过 60 万张处方。Doustdar 还成功让该公司的疗法比其主要竞争对手礼来公司（LLY.N）的口服版本更早上市，在这场近期主要由美国集团主导的激烈竞争中夺回了一些优势。</p><p>然而，新一代肥胖药物仍有一个未解之谜。它们尚未经历近年来因突然流行而引发的严重消费支出放缓，因此当家庭预算收紧时，客户能在多大程度上坚持治疗尚不清楚。至少可以说，伊朗战争后更为严峻的经济形势将使制药商已经痛苦的降价战进一步加剧。</p><p>礼来公司和诺和诺德公司是所谓 GLP-1 领域的巨头，该领域涵盖糖尿病和减肥药物。根据 Visible Alpha 收集的分析师预测，仅这两类药物今年的收入就将超过 1000 亿美元。同一估算显示，到 2030 年这一数字将达到 1160 亿美元，因为预计礼来和诺和诺德将推出除 Wegovy 和 Zepbound 等经典注射药物之外的新剂型。一个关键焦点是各种口服药片，诺和诺德的负责人上个月对此大加推崇。</p><p>然而，维持需求需要客户持续付费。这在制药界是一个陌生的问题，因为购买者通常是医院或医生，资金最终由保险公司或卫生服务机构提供。然而，减肥药已成为一种零售现象，越来越多的客户选择 “自付费用”。价格可能相当高昂。据 Breakingviews 计算，在美国，每月处方的自付费用可能占平均总收入的近五分之一，在英国则约为 10%。结果是，如果失业率飙升或消费支出下滑，需求可能会受到打击。这种情况可能已近在眼前。油价上涨将侵蚀家庭预算，使其不太可能在其他商品和服务上挥霍。高盛分析师已将美国消费增长预测从战前的 2% 大幅下调至 1.2%，指的是 2026 年第四季度与一年前相比。而且经济本身已在走弱。2 月份，在海湾冲突爆发前，美国减少了 9.2 万个就业岗位，失业率升至 4.4%。这可能是减肥药面临的首次真正压力测试。早在 2022 年，当能源价格和利率同时上升时，GLP-1 运动仍处于早期阶段，而美国消费者由于疫情期间的封锁和刺激政策，拥有异常庞大的积蓄可供动用。核心问题在于减肥药在家庭优先事项清单中的位置：它们是像宽带合同、抵押贷款和医疗必需的治疗那样，客户在经济衰退中通常会继续支付？还是更像可自由支配的奢侈品或品牌食品，通常在困难时期首当其冲？换句话说：GLP-1 用户是否足够珍视他们新的苗条身材，以至于即使需要削减其他开支也要继续付费？从制药商的角度来看，乐观的观点是，非处方减肥客户平均相对富裕。但也有证据表明，成本已是 GLP-1 药物患者和用户面临的重大挑战。副作用和经济障碍是停止治疗的最常见原因。超过一半服用 GLP-1 药物的人在一年内不再继续使用。数据显示，一旦自付费用超过 500 美元，停药率急剧上升。患者也将越来越容易转向更便宜的替代品。与其每月花费超过 1000 美元购买礼来公司的 Zepbound 处方，他们可以切换到更便宜的新型药片，这些药片具有相似的减重效果，每月成本低至 149 美元。与此同时，诺和诺德一直在削减其月度处方的成本，以夺回市场份额。但还有风险更大的选择：继续从网上药店购买注射版仿制药。价格可低于每月 130 美元，促使许多患者尝试运气，甚至在网上寻找危险且通常不受监管的版本。GLP-1 制造商也面临长期问题。礼来和诺和诺德正在投入数十亿美元用于研发，试图改进现有产品。就诺和诺德而言，部分原因是为了避免在 2031 年 Ozempic 和 Wegovy 的关键成分在美国专利到期后出现收入大幅下滑。当药物专利保护到期时，其价格通常会下跌约 80%。届时，制造商需要五倍的患者数量才能获得与之前相同的收入。将这些数字应用于 GLP-1 药物，意味着大约 7500 万美国人必须服用这些药物才能保持收入稳定，这超过了美国 45 岁及以上人口的一半。这似乎不太可能：去年年底，只有 12% 的美国人表示他们正在服用该药物。</p><p>尽管伊朗发生冲突，制药公司并未改变其公开的财务目标。但投资者可能已领先一步：礼来的股价在第一次海湾空袭前一天至上周五之间下跌了 11%，相比之下，标普 500 指数中的制药股下跌了 7%。从股东角度来看，囊中羞涩的用户是停止使用 GLP-1 药物还是仅仅找到更便宜的替代品并不重要。无论哪种情况，结果都是增长放缓。</p><p>礼来和诺和诺德的估值在近几个月持续下滑。礼来目前的交易价格仅为预期 12 个月市盈率的 26 倍，较 2024 年的近 60 倍峰值有所下降。与此同时，诺和诺德的市盈率倍数仅为 11，较 2024 年的 38 倍峰值大幅下降。这些跌幅主要归因于两家公司之间白热化的竞争，以及阿斯利康（AZN.L）、辉瑞（PFE.N）和罗氏（ROPC.S）等其他制药巨头即将进入市场的预期。短期内消费支出的冲击只会使问题更加复杂。请在 LinkedIn 上关注 Aimee Donnellan。</p><p>糖尿病和减肥市场收入快速增长</p><p><img src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/dwpkyjxgnpm/chart.png?x-oss-process=image/auto-orient,1/interlace,1/resize,w_1440,h_1440/quality,q_95/format,jpg" alt="" width="1420" height="860" original-src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/dwpkyjxgnpm/chart.png"/></p><p>价格战已重创 GLP-1 制造商的估值</p><p><img src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/znpnmjweevl/chart.png?x-oss-process=image/auto-orient,1/interlace,1/resize,w_1440,h_1440/quality,q_95/format,jpg" alt="" width="1420" height="834" original-src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/znpnmjweevl/chart.png"/></p><p>(编辑：Liam Proud；制作：Shrabani Chakraborty)</p>

诺和诺德公司

<p>(The author is a Reuters Breakingviews columnist. The opinions expressed are her own.)</p>
<div class="lb-trans"><p>(本文作者为路透社 Breakingviews 专栏作家。文中观点仅代表其个人立场。)</p></div><p>By Aimee Donnellan</p>
<div class="lb-trans"><p>作者：Aimee Donnellan</p></div><p>DUBLIN, April 14 (Reuters Breakingviews) - At Novo Nordisk’s (NOVOb.CO) annual shareholder meeting in Copenhagen last month, CEO Maziar Mike Doustdar was keen to focus on the positives. The Danish drugmaker’s new Wegovy weight-loss pill is off to a record start, with more than 600,000 prescriptions issued in just two months. Doustdar also managed to get the company’s remedy to market before larger rival Eli Lilly’s (LLY.N) oral version, claiming back some ground in a heated rivalry that has largely favoured the American group of late.</p>
<div class="lb-trans"><p>都柏林，4 月 14 日（路透社 Breakingviews）——在上个月于哥本哈根举行的诺和诺德公司（NOVOb.CO）年度股东大会上，首席执行官 Maziar Mike Doustdar 极力聚焦积极面。这家丹麦制药公司的新型 Wegovy 减肥药开局创纪录，仅在两个月内就开出超过 60 万张处方。Doustdar 还成功让该公司的疗法比其主要竞争对手礼来公司（LLY.N）的口服版本更早上市，在这场近期主要由美国集团主导的激烈竞争中夺回了一些优势。</p></div><p>Yet there’s an unanswered question hanging over the new generation of obesity drugs. They haven’t lived through a serious slowdown in consumer spending since exploding in popularity in recent years, meaning it’s not clear to what extent customers will stick with the treatments when household budgets get tight. At the very least, tougher economic times after the Iran war would intensify an already painful price war for the drugmakers.</p>
<div class="lb-trans"><p>然而，新一代肥胖药物仍有一个未解之谜。它们尚未经历近年来因突然流行而引发的严重消费支出放缓，因此当家庭预算收紧时，客户能在多大程度上坚持治疗尚不清楚。至少可以说，伊朗战争后更为严峻的经济形势将使制药商已经痛苦的降价战进一步加剧。</p></div><p>Eli Lilly and Novo Nordisk are the titans of the so-called GLP-1 world, which includes both diabetes and weight-loss drugs. They’re on track to generate over $100 billion in revenue this year from treatments in those two categories alone, per analysts’ forecasts gathered by Visible Alpha. That number will hit $116 billion by 2030, according to the same estimate, as Eli Lilly and Novo Nordisk are expected to launch new forms of the treatments beyond the classic injectable drugs like Wegovy and Zepbound. One key focus is the range of oral pills, which Novo’s boss trumpeted last month.</p>
<div class="lb-trans"><p>礼来公司和诺和诺德公司是所谓 GLP-1 领域的巨头，该领域涵盖糖尿病和减肥药物。根据 Visible Alpha 收集的分析师预测，仅这两类药物今年的收入就将超过 1000 亿美元。同一估算显示，到 2030 年这一数字将达到 1160 亿美元，因为预计礼来和诺和诺德将推出除 Wegovy 和 Zepbound 等经典注射药物之外的新剂型。一个关键焦点是各种口服药片，诺和诺德的负责人上个月对此大加推崇。</p></div><p>Yet sustaining demand requires that customers keep forking out. It’s an unfamiliar problem in the pharmaceutical world, where the buyers are often doctors or hospitals, with the money ultimately provided by insurance companies or health services. Weight-loss drugs, however, have also become a retail phenomenon, with customers increasingly paying “out of pocket”. The prices can be steep. Out-of-pocket costs for a monthly prescription can consume nearly a fifth of the average gross income in the U.S. and around 10% in the UK, according to Breakingviews calculations. The upshot is that demand could conceivably face a hit if unemployment spikes or consumer spending dips. That scenario may now be on the horizon. Rising oil prices will dent household budgets, making them less likely to splash out on other goods and services. Goldman Sachs analysts have slashed their forecast for U.S. consumption growth to 1.2% from 2% before the war, referring to the fourth quarter of 2026 compared with a year earlier. And the economy was already weakening. In February, before the Gulf conflict, the U.S. shed 92,000 jobs and unemployment rose to 4.4%. It might be the first real stress test for weight-loss drugs. Back in 2022, when energy prices and interest also rose, the GLP-1 movement was still young, and U.S. consumers had unusually large pent-up savings to draw on as a result of pandemic-era lockdowns and stimulus. The central question is where weight-loss drugs sit on the list of household priorities: are they like broadband contracts, mortgage payments and medically necessary treatments, which customers tend to keep paying in a recession? Or are they more like discretionary luxuries or brand-name groceries, which usually suffer when times get tough? Put another way: do GLP-1 users prize their new, slimmer figures enough to keep paying up, even if that means cutting spending elsewhere? The optimistic view, from the perspective of the drugmakers, is that over-the-counter weight-loss customers are relatively affluent on average. Yet there’s evidence that cost is already a big challenge for patients and users of GLP-1 drugs. Side effects and financial barriers are the most common reasons for discontinuation of treatment. Over half of people who take GLP-1 medications are no longer taking them within a year. Data shows abandonment rises sharply once out-of-pocket costs exceed $500. Patients will find it increasingly easy to trade down to cheaper alternatives, too. Instead of splurging over $1,000 a month on a prescription for Eli Lilly’s Zepbound they could switch to the cheaper new pill forms, which have similar weight-loss outcomes and can cost as little as $149 a month. Meanwhile, Novo Nordisk has been slashing the cost of its monthly prescriptions in a bid to win back market share. But there’s also the riskier option of continuing to buy injectable copycat drugs from online pharmacies. Prices can be less than $130 a month, prompting many patients to try their luck or even seek out dangerous and often unregulated versions on the internet. The GLP-1 makers have longer-term problems, too. Eli Lilly and Novo Nordisk are spending billions of dollars on research and development, trying to improve their current offerings. In Novo’s case, this is partly to avert a dramatic loss of revenue once the key ingredient in Ozempic and Wegovy comes off patent in the U.S. in 2031. When a drug’s patent protection expires, its price typically drops by around 80%. At that point, a manufacturer would need five times as many patients to earn the same revenue as before. Apply those numbers to GLP-1 drugs, and the implication is that roughly 75 million Americans would have to take them to keep revenue steady, which is more than half of the U.S. population aged 45 or over. That seems implausible: late last year, only 12% of Americans reported that they were taking the medication.</p>
<div class="lb-trans"><p>然而，维持需求需要客户持续付费。这在制药界是一个陌生的问题，因为购买者通常是医院或医生，资金最终由保险公司或卫生服务机构提供。然而，减肥药已成为一种零售现象，越来越多的客户选择 “自付费用”。价格可能相当高昂。据 Breakingviews 计算，在美国，每月处方的自付费用可能占平均总收入的近五分之一，在英国则约为 10%。结果是，如果失业率飙升或消费支出下滑，需求可能会受到打击。这种情况可能已近在眼前。油价上涨将侵蚀家庭预算，使其不太可能在其他商品和服务上挥霍。高盛分析师已将美国消费增长预测从战前的 2% 大幅下调至 1.2%，指的是 2026 年第四季度与一年前相比。而且经济本身已在走弱。2 月份，在海湾冲突爆发前，美国减少了 9.2 万个就业岗位，失业率升至 4.4%。这可能是减肥药面临的首次真正压力测试。早在 2022 年，当能源价格和利率同时上升时，GLP-1 运动仍处于早期阶段，而美国消费者由于疫情期间的封锁和刺激政策，拥有异常庞大的积蓄可供动用。核心问题在于减肥药在家庭优先事项清单中的位置：它们是像宽带合同、抵押贷款和医疗必需的治疗那样，客户在经济衰退中通常会继续支付？还是更像可自由支配的奢侈品或品牌食品，通常在困难时期首当其冲？换句话说：GLP-1 用户是否足够珍视他们新的苗条身材，以至于即使需要削减其他开支也要继续付费？从制药商的角度来看，乐观的观点是，非处方减肥客户平均相对富裕。但也有证据表明，成本已是 GLP-1 药物患者和用户面临的重大挑战。副作用和经济障碍是停止治疗的最常见原因。超过一半服用 GLP-1 药物的人在一年内不再继续使用。数据显示，一旦自付费用超过 500 美元，停药率急剧上升。患者也将越来越容易转向更便宜的替代品。与其每月花费超过 1000 美元购买礼来公司的 Zepbound 处方，他们可以切换到更便宜的新型药片，这些药片具有相似的减重效果，每月成本低至 149 美元。与此同时，诺和诺德一直在削减其月度处方的成本，以夺回市场份额。但还有风险更大的选择：继续从网上药店购买注射版仿制药。价格可低于每月 130 美元，促使许多患者尝试运气，甚至在网上寻找危险且通常不受监管的版本。GLP-1 制造商也面临长期问题。礼来和诺和诺德正在投入数十亿美元用于研发，试图改进现有产品。就诺和诺德而言，部分原因是为了避免在 2031 年 Ozempic 和 Wegovy 的关键成分在美国专利到期后出现收入大幅下滑。当药物专利保护到期时，其价格通常会下跌约 80%。届时，制造商需要五倍的患者数量才能获得与之前相同的收入。将这些数字应用于 GLP-1 药物，意味着大约 7500 万美国人必须服用这些药物才能保持收入稳定，这超过了美国 45 岁及以上人口的一半。这似乎不太可能：去年年底，只有 12% 的美国人表示他们正在服用该药物。</p></div><p>The drugmakers have not changed their public financial targets amid the conflict in Iran. But investors may be ahead of the issue: Eli Lilly’s shares dropped 11% between the day before the first Gulf strikes and last Friday, which compares with a 7% fall for pharmaceutical stocks in the S&amp;P 500 Index. From a shareholder’s perspective, it doesn’t matter so much whether cash-strapped users stop taking GLP-1s or simply find cheaper alternatives. The takeaway in either case is slower growth.</p>
<div class="lb-trans"><p>尽管伊朗发生冲突，制药公司并未改变其公开的财务目标。但投资者可能已领先一步：礼来的股价在第一次海湾空袭前一天至上周五之间下跌了 11%，相比之下，标普 500 指数中的制药股下跌了 7%。从股东角度来看，囊中羞涩的用户是停止使用 GLP-1 药物还是仅仅找到更便宜的替代品并不重要。无论哪种情况，结果都是增长放缓。</p></div><p>The valuations of both Eli Lilly and Novo Nordisk have been declining in recent months. Eli Lilly now trades at just 26 times its expected 12-month forward earnings, down from a peak of nearly 60 times in 2024. Meanwhile, Novo Nordisk is only trading at a multiple of 11, down from a peak of 38 times in 2024. These declines are largely due to the red-hot competition between the two companies and the prospect that other pharmaceutical giants like AstraZeneca (AZN.L) , Pfizer (PFE.N) and Roche (ROPC.S) will soon gatecrash the market. A near-term hit to consumer spending only compounds the problem. Follow Aimee Donnellan on LinkedIn.</p>
<div class="lb-trans"><p>礼来和诺和诺德的估值在近几个月持续下滑。礼来目前的交易价格仅为预期 12 个月市盈率的 26 倍，较 2024 年的近 60 倍峰值有所下降。与此同时，诺和诺德的市盈率倍数仅为 11，较 2024 年的 38 倍峰值大幅下降。这些跌幅主要归因于两家公司之间白热化的竞争，以及阿斯利康（AZN.L）、辉瑞（PFE.N）和罗氏（ROPC.S）等其他制药巨头即将进入市场的预期。短期内消费支出的冲击只会使问题更加复杂。请在 LinkedIn 上关注 Aimee Donnellan。</p></div><p>Revenue is growing quickly in the diabetes and weight loss market</p>
<div class="lb-trans"><p>糖尿病和减肥市场收入快速增长</p></div><p><img src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/dwpkyjxgnpm/chart.png" alt="" original-src="https://www.reuters.com/graphics/BRV-BRV/dwpkyjxgnpm/chart.png"/></p>
<p>Price wars have already hit GLP-1 makers’ valuations</p>
<div class="lb-trans"><p>价格战已重创 GLP-1 制造商的估值</p></div><p><img src="https://imageproxy.pbkrs.com/https://www.reuters.com/graphics/BRV-BRV/znpnmjweevl/chart.png" alt="" original-src="https://www.reuters.com/graphics/BRV-BRV/znpnmjweevl/chart.png"/></p>
<p>(Editing by Liam Proud; Production by Shrabani Chakraborty)</p>
<div class="lb-trans"><p>(编辑：Liam Proud；制作：Shrabani Chakraborty)</p></div>

BREAKINGVIEWS-减肥药面临首次经济压力测试