Mike Doustdar 0.9 3 ideas

"The pill has been the centerpiece of growth for us... We today have 246,000 people on the pill... Our pill and its clinical trial has shown 16.6% weight loss. Our competitors pill has 12.4% weight loss." While Novo lags in injectable efficacy currently, they have a distinct "moat" in the oral market. The pill opens a massive Total Addressable Market (TAM) of needle-phobic patients that the competitor (Lilly) cannot serve as effectively due to lower efficacy and higher discontinuation rates (10.4% vs 3.6%). Additionally, the upcoming 7.2mg injectable dose will match the competitor's 21% weight loss, neutralizing the main disadvantage. Long NVO as a volume play. The pricing pressure is a known short-term headwind, but the oral platform provides a durable competitive advantage in 2026. Medicare volume uptake is slower than expected; pricing headwinds compress margins more than volume expands them.

"We sued hims and hers obviously over their compounded semaglutide... We really don't understand why it continued. And I certainly don't understand why it's still here. When the prices of the original product and the knockoff version has become very, very similar." The regulatory arbitrage trade for compounding pharmacies is ending. Novo asserts the "shortage" (the legal basis for compounding) is over. With the DOJ and FDA signaling support, and aggressive litigation (120+ cases), HIMS faces an existential threat to its high-margin compounded GLP-1 business line. Short/Avoid HIMS. The business model relies on a loophole that is actively being closed by the IP holders and regulators. Litigation drags on for years allowing HIMS to continue operating; another supply shortage re-opens the compounding window.

"Our competitor was able better than us to explain about their higher efficacy when it comes to magnitude of weight loss... Our competitor has 15mg of GLP-1 in their product, and that gives them 2,021% weight loss [vs NVO's 15-16%]." Novo's CEO admits Lilly currently has the superior injectable product regarding the metric patients care about most: weight loss percentage. This explains Lilly's 60% market share vs Novo's 40%. Until Novo's higher dosage (7.2mg) or CagriSema launches, Lilly retains the "best in class" injectable status. Watch. Lilly remains the efficacy leader in injectables, but faces stiff competition in the oral form factor. Novo's new high-dose products erode Lilly's efficacy advantage.