<p>(本文作者為路透社 Breakingviews 專欄作家。文中觀點僅代表其個人立場。)</p><p>作者：Aimee Donnellan</p><p>都柏林，4 月 14 日（路透社 Breakingviews）——在上個月於哥本哈根舉行的諾和諾德公司（NOVOb.CO）年度股東大會上，首席執行官 Maziar Mike Doustdar 極力聚焦積極面。這家丹麥製藥公司的新型 Wegovy 減肥藥開局創紀錄，僅在兩個月內就開出超過 60 萬張處方。Doustdar 還成功讓該公司的療法比其主要競爭對手禮來公司（LLY.N）的口服版本更早上市，在這場近期主要由美國集團主導的激烈競爭中奪回了一些優勢。</p><p>然而，新一代肥胖藥物仍有一個未解之謎。它們尚未經歷近年來因突然流行而引發的嚴重消費支出放緩，因此當家庭預算收緊時，客户能在多大程度上堅持治療尚不清楚。至少可以説，伊朗戰爭後更為嚴峻的經濟形勢將使製藥商已經痛苦的降價戰進一步加劇。</p><p>禮來公司和諾和諾德公司是所謂 GLP-1 領域的巨頭，該領域涵蓋糖尿病和減肥藥物。根據 Visible Alpha 收集的分析師預測，僅這兩類藥物今年的收入就將超過 1000 億美元。同一估算顯示，到 2030 年這一數字將達到 1160 億美元，因為預計禮來和諾和諾德將推出除 Wegovy 和 Zepbound 等經典注射藥物之外的新劑型。一個關鍵焦點是各種口服藥片，諾和諾德的負責人上個月對此大加推崇。</p><p>然而，維持需求需要客户持續付費。這在製藥界是一個陌生的問題，因為購買者通常是醫院或醫生，資金最終由保險公司或衞生服務機構提供。然而，減肥藥已成為一種零售現象，越來越多的客户選擇 “自付費用”。價格可能相當高昂。據 Breakingviews 計算，在美國，每月處方的自付費用可能佔平均總收入的近五分之一，在英國則約為 10%。結果是，如果失業率飆升或消費支出下滑，需求可能會受到打擊。這種情況可能已近在眼前。油價上漲將侵蝕家庭預算，使其不太可能在其他商品和服務上揮霍。高盛分析師已將美國消費增長預測從戰前的 2% 大幅下調至 1.2%，指的是 2026 年第四季度與一年前相比。而且經濟本身已在走弱。2 月份，在海灣衝突爆發前，美國減少了 9.2 萬個就業崗位，失業率升至 4.4%。這可能是減肥藥面臨的首次真正壓力測試。早在 2022 年，當能源價格和利率同時上升時，GLP-1 運動仍處於早期階段，而美國消費者由於疫情期間的封鎖和刺激政策，擁有異常龐大的積蓄可供動用。核心問題在於減肥藥在家庭優先事項清單中的位置：它們是像寬帶合同、抵押貸款和醫療必需的治療那樣，客户在經濟衰退中通常會繼續支付？還是更像可自由支配的奢侈品或品牌食品，通常在困難時期首當其衝？換句話説：GLP-1 用户是否足夠珍視他們新的苗條身材，以至於即使需要削減其他開支也要繼續付費？從製藥商的角度來看，樂觀的觀點是，非處方減肥客户平均相對富裕。但也有證據表明，成本已是 GLP-1 藥物患者和用户面臨的重大挑戰。副作用和經濟障礙是停止治療的最常見原因。超過一半服用 GLP-1 藥物的人在一年內不再繼續使用。數據顯示，一旦自付費用超過 500 美元，停藥率急劇上升。患者也將越來越容易轉向更便宜的替代品。與其每月花費超過 1000 美元購買禮來公司的 Zepbound 處方，他們可以切換到更便宜的新型藥片，這些藥片具有相似的減重效果，每月成本低至 149 美元。與此同時，諾和諾德一直在削減其月度處方的成本，以奪回市場份額。但還有風險更大的選擇：繼續從網上藥店購買注射版仿製藥。價格可低於每月 130 美元，促使許多患者嘗試運氣，甚至在網上尋找危險且通常不受監管的版本。GLP-1 製造商也面臨長期問題。禮來和諾和諾德正在投入數十億美元用於研發，試圖改進現有產品。就諾和諾德而言，部分原因是為了避免在 2031 年 Ozempic 和 Wegovy 的關鍵成分在美國專利到期後出現收入大幅下滑。當藥物專利保護到期時，其價格通常會下跌約 80%。屆時，製造商需要五倍的患者數量才能獲得與之前相同的收入。將這些數字應用於 GLP-1 藥物，意味着大約 7500 萬美國人必須服用這些藥物才能保持收入穩定，這超過了美國 45 歲及以上人口的一半。這似乎不太可能：去年年底，只有 12% 的美國人表示他們正在服用該藥物。</p><p>儘管伊朗發生衝突，製藥公司並未改變其公開的財務目標。但投資者可能已領先一步：禮來的股價在第一次海灣空襲前一天至上週五之間下跌了 11%，相比之下，標普 500 指數中的製藥股下跌了 7%。從股東角度來看，囊中羞澀的用户是停止使用 GLP-1 藥物還是僅僅找到更便宜的替代品並不重要。無論哪種情況，結果都是增長放緩。</p><p>禮來和諾和諾德的估值在近幾個月持續下滑。禮來目前的交易價格僅為預期 12 個月市盈率的 26 倍，較 2024 年的近 60 倍峯值有所下降。與此同時，諾和諾德的市盈率倍數僅為 11，較 2024 年的 38 倍峯值大幅下降。這些跌幅主要歸因於兩家公司之間白熱化的競爭，以及阿斯利康（AZN.L）、輝瑞（PFE.N）和羅氏（ROPC.S）等其他製藥巨頭即將進入市場的預期。短期內消費支出的衝擊只會使問題更加複雜。請在 LinkedIn 上關注 Aimee Donnellan。</p><p>糖尿病和減肥市場收入快速增長</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>價格戰已重創 GLP-1 製造商的估值</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>(編輯：Liam Proud；製作：Shrabani Chakraborty)</p>

諾和諾德公司

<p>(The author is a Reuters Breakingviews columnist. The opinions expressed are her own.)</p>
<div class="lb-trans"><p>(本文作者為路透社 Breakingviews 專欄作家。文中觀點僅代表其個人立場。)</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）——在上個月於哥本哈根舉行的諾和諾德公司（NOVOb.CO）年度股東大會上，首席執行官 Maziar Mike Doustdar 極力聚焦積極面。這家丹麥製藥公司的新型 Wegovy 減肥藥開局創紀錄，僅在兩個月內就開出超過 60 萬張處方。Doustdar 還成功讓該公司的療法比其主要競爭對手禮來公司（LLY.N）的口服版本更早上市，在這場近期主要由美國集團主導的激烈競爭中奪回了一些優勢。</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，新一代肥胖藥物仍有一個未解之謎。它們尚未經歷近年來因突然流行而引發的嚴重消費支出放緩，因此當家庭預算收緊時，客户能在多大程度上堅持治療尚不清楚。至少可以説，伊朗戰爭後更為嚴峻的經濟形勢將使製藥商已經痛苦的降價戰進一步加劇。</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>禮來公司和諾和諾德公司是所謂 GLP-1 領域的巨頭，該領域涵蓋糖尿病和減肥藥物。根據 Visible Alpha 收集的分析師預測，僅這兩類藥物今年的收入就將超過 1000 億美元。同一估算顯示，到 2030 年這一數字將達到 1160 億美元，因為預計禮來和諾和諾德將推出除 Wegovy 和 Zepbound 等經典注射藥物之外的新劑型。一個關鍵焦點是各種口服藥片，諾和諾德的負責人上個月對此大加推崇。</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，維持需求需要客户持續付費。這在製藥界是一個陌生的問題，因為購買者通常是醫院或醫生，資金最終由保險公司或衞生服務機構提供。然而，減肥藥已成為一種零售現象，越來越多的客户選擇 “自付費用”。價格可能相當高昂。據 Breakingviews 計算，在美國，每月處方的自付費用可能佔平均總收入的近五分之一，在英國則約為 10%。結果是，如果失業率飆升或消費支出下滑，需求可能會受到打擊。這種情況可能已近在眼前。油價上漲將侵蝕家庭預算，使其不太可能在其他商品和服務上揮霍。高盛分析師已將美國消費增長預測從戰前的 2% 大幅下調至 1.2%，指的是 2026 年第四季度與一年前相比。而且經濟本身已在走弱。2 月份，在海灣衝突爆發前，美國減少了 9.2 萬個就業崗位，失業率升至 4.4%。這可能是減肥藥面臨的首次真正壓力測試。早在 2022 年，當能源價格和利率同時上升時，GLP-1 運動仍處於早期階段，而美國消費者由於疫情期間的封鎖和刺激政策，擁有異常龐大的積蓄可供動用。核心問題在於減肥藥在家庭優先事項清單中的位置：它們是像寬帶合同、抵押貸款和醫療必需的治療那樣，客户在經濟衰退中通常會繼續支付？還是更像可自由支配的奢侈品或品牌食品，通常在困難時期首當其衝？換句話説：GLP-1 用户是否足夠珍視他們新的苗條身材，以至於即使需要削減其他開支也要繼續付費？從製藥商的角度來看，樂觀的觀點是，非處方減肥客户平均相對富裕。但也有證據表明，成本已是 GLP-1 藥物患者和用户面臨的重大挑戰。副作用和經濟障礙是停止治療的最常見原因。超過一半服用 GLP-1 藥物的人在一年內不再繼續使用。數據顯示，一旦自付費用超過 500 美元，停藥率急劇上升。患者也將越來越容易轉向更便宜的替代品。與其每月花費超過 1000 美元購買禮來公司的 Zepbound 處方，他們可以切換到更便宜的新型藥片，這些藥片具有相似的減重效果，每月成本低至 149 美元。與此同時，諾和諾德一直在削減其月度處方的成本，以奪回市場份額。但還有風險更大的選擇：繼續從網上藥店購買注射版仿製藥。價格可低於每月 130 美元，促使許多患者嘗試運氣，甚至在網上尋找危險且通常不受監管的版本。GLP-1 製造商也面臨長期問題。禮來和諾和諾德正在投入數十億美元用於研發，試圖改進現有產品。就諾和諾德而言，部分原因是為了避免在 2031 年 Ozempic 和 Wegovy 的關鍵成分在美國專利到期後出現收入大幅下滑。當藥物專利保護到期時，其價格通常會下跌約 80%。屆時，製造商需要五倍的患者數量才能獲得與之前相同的收入。將這些數字應用於 GLP-1 藥物，意味着大約 7500 萬美國人必須服用這些藥物才能保持收入穩定，這超過了美國 45 歲及以上人口的一半。這似乎不太可能：去年年底，只有 12% 的美國人表示他們正在服用該藥物。</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>儘管伊朗發生衝突，製藥公司並未改變其公開的財務目標。但投資者可能已領先一步：禮來的股價在第一次海灣空襲前一天至上週五之間下跌了 11%，相比之下，標普 500 指數中的製藥股下跌了 7%。從股東角度來看，囊中羞澀的用户是停止使用 GLP-1 藥物還是僅僅找到更便宜的替代品並不重要。無論哪種情況，結果都是增長放緩。</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>禮來和諾和諾德的估值在近幾個月持續下滑。禮來目前的交易價格僅為預期 12 個月市盈率的 26 倍，較 2024 年的近 60 倍峯值有所下降。與此同時，諾和諾德的市盈率倍數僅為 11，較 2024 年的 38 倍峯值大幅下降。這些跌幅主要歸因於兩家公司之間白熱化的競爭，以及阿斯利康（AZN.L）、輝瑞（PFE.N）和羅氏（ROPC.S）等其他製藥巨頭即將進入市場的預期。短期內消費支出的衝擊只會使問題更加複雜。請在 LinkedIn 上關注 Aimee Donnellan。</p></div><p>Revenue is growing quickly in the diabetes and weight loss market</p>
<div class="lb-trans"><p>糖尿病和減肥市場收入快速增長</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>價格戰已重創 GLP-1 製造商的估值</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>(編輯：Liam Proud；製作：Shrabani Chakraborty)</p></div>

BREAKINGVIEWS-減肥藥面臨首次經濟壓力測試