As discussions on National Health Insurance reimbursement for Ozempic (semaglutide), a diabetes treatment by Novo Nordisk, accelerate, attention has been garnered to the company's sales and marketing strategy in Korea.

Novo Nordisk has stated that the company has not finalized a co-promotion partnership with a domestic company in Korea. Yet, the possibility remains open, particularly after signing a co-promotion deal for the same-ingredient obesity treatment, Wegovy, with Chong Kun Dang.

According to the pharmaceutical industry, Novo Nordisk Korea has decided to begin supplying Ozempic (semaglutide) to the Korean market on a non-reimbursed basis, starting on September 25, despite ongoing negotiations for National Health Insurance reimbursement.

Ozempic, approved in Korea in April 2022, is a long-acting, once-weekly GLP-1 injectable indicated as an adjunct to diet and exercise, either alone or in combination with other diabetes treatments, for adults with insufficiently controlled Type 2 diabetes.

Novo Nordisk previously applied for the reimbursement of Ozempic in 2023 but withdrew its application during the final stage of negotiations with the National Health Insurance Service (NHIS) over drug prices.

Analysis suggests that uncertainties in domestic product supply have complicated the negotiation process over expected usage volume and prevented reimbursement, ultimately resulting in the failure to obtain reimbursement.

Novo Nordisk's decision to initiate non-reimbursed supply now is likely interpreted as a sign of high expectations for a successful reimbursement listing.

Novo Nordisk Korea is reportedly preparing to resubmit its reimbursement application to the Health Insurance Review & Assessment Service (HIRA). The company is awaiting deliberation by the Drug Reimbursement Evaluation Committee (DREC) in the near future.

An anonymous professor of endocrinology at a major hospital in Seoul said, "Compared to the case in 2023, expectations for Ozempic's reimbursement listing are high," and added, "Although I can't confirm if it will succeed, I understand they proposed a reasonable price, and based on the collective opinion of the pharmaceutical industry and academic societies, I see a high possibility of success."

In 2023, the Korean Diabetes Association and the Korean Endocrine Society recommended to the DREC that Ozempic, as a long-acting GLP-1 receptor agonist, should be granted the scope of reimbursement coverage comparable to Trulicity, a drug in the same class that has been subject to a clinical comparative study.

The DREC gave conditional approval for reimbursement appropriateness, subject to the condition that the company accepts a price below the evaluated amount. And, Novo Nordisk accepted this condition. Although the DREC approval and negotiation with the NHIS remain, there is speculation that Ozempic's reimbursement price will be set similarly to, or slightly higher than, that of Trulicity.

As discussions for Ozempic's reimbursement are imminent, the potential for a co-promotion partnership with a Korean pharmaceutical company is also drawing attention.

Indeed, on September 18, Novo Nordisk signed a co-promotion agreement for the obesity treatment Wegovy with Chong Kun Dang. Through this agreement, the two companies will jointly conduct sales and marketing for Wegovy, targeting hospitals and clinics starting October 1.

Novo Nordisk stated that it will maintain the same distribution approach for Ozempic as it did during the initial phase of Wegovy's launch.

A Novo Nordisk official said, "We plan to distribute Ozempic through Zuellig Pharma in Korea, similar to Wegovy's case," and confirmed that "nothing has been decided regarding co-promotion or additional sales partnerships."

However, the pharmaceutical industry predicts that Novo Nordisk will use the same distribution network to stabilize the initial market entry of Ozempic quickly and will discuss the possibility of co-promotion in detail after reimbursement is secured.

This is because of a competing treatment, Lilly's Mounjaro (tirzepatide). Lilly is also pursuing reimbursement for Mounjaro's diabetes indication, and discussions about a potential co-promotion partnership are ongoing.

The pharmaceutical industry generally believes that Novo Nordisk will pursue a co-promotion strategy for Ozempic, similar to the one used for Wegovy, to focus on the drug's expansion potential.

A Novo Nordisk Korea official said, "The priority access of Ozempic is a result of our strong commitment and patient-centric efforts to provide it to Korean patients with Type 2 diabetes and healthcare professionals as quickly as possible," and added, "Simultaneous with the supply commencement, we are closely consulting with regulatory authorities to secure National Health Insurance approval for Ozempic to improve patient access to treatment."