u/irishreally

Quick catch-up for anyone who bailed after the CagriSema selloff in February.

Novo has won on the pills, and it isn't close. Oral Wegovy just hit 3 million US scripts in 5 months, one of the fastest drug launches on record, and printed a new weekly high around 159k. Lilly's Foundayo is stuck near 20k a week. Even at the week 8 of each launch it was Novo ~73k vs Lilly ~17k, so this isn't just the head start. People prefer pills to injections, and first-mover advantage plus brand trust have done the rest.

Now look at the tape. $NVO trades on ~10x earnings, near a decade low. $LLY is on ~35-40x. You're paying a quarter of the multiple for the company actually winning the pill race, and you collect a ~4% dividend and a buyback while you wait.

Catalysts are lined up: H1 results on 5 August, then the CagriSema obesity FDA decision in Q4.

Lilly still leads the overall franchise on tirzepatide, and US pricing is a real headwind, so it's not a one-way bet. But at 10x, while winning the launch that's growing the whole market, a lot of bad news is already priced in. Also do not forget the pill is about to start selling in Europe, and orders are being taken. And Novo is well liked over here! DYOR.

Part 2 of 3. Part 1, the Starmer eulogy, is here: [https://www.reddit.com/r/LabourUK/s/lK6xHyx8ge\]

Yesterday I buried the Starmer project. Today I want to talk about why I'm allowing myself, cautiously, to hope again.

Andy Burnham walks into Westminster on Monday as the MP for Makerfield and, near enough, the next prime minister. He inherits a cold rented house. 14 years of austerity and meanness have stripped the place for parts. The rivers out the back run with sewage, the taps cough limescale and sometimes other stuff, and the utilities flogged off for a song now fail and bill you for the privilege of fixing what was already paid for but which went to dividends and consultancy fees.

Starmer was handed the keys two years ago, hired some of his old dodgy mates and asked them to repaint the hallway, as he didn't want to upset the NIMBYs. The family inside has stopped believing anyone will ever fix the boiler, and Reform is the neighbour leaning over the fence telling them it's hopeless: blame the people over there. So, the first 100 days can't be about easing in. They have to be about one big idea, told plainly: a New Deal for Britain. Roosevelt saw the opportunity and put his country to work, building things people could see and stand on. He also took the electoral mandate and changed things. That is the answer to Farage too.

Energy first, because Trump handed Andy the open goal. As Starmer fell, Trump jeered at him to "open North Sea oil". Andy's answer should be to laugh. The North Sea is roughly 90% spent, and production has fallen 77% since 1999. 'Drill, Baby, Drill' is not an answer. The real prize is energy independence built at home: a national programme to put solar, batteries, heat pumps and EV chargers on a million roofs, funded by green bonds and repaid by a levy that is always smaller than the saving, so the household is better off from day one. 26,000 jobs. A bite out of a £37bn energy trade deficit. That is a nationwide, industrial, patriotic answer to the cost of living, and it's exactly the kind of thing Reform can't argue with on the doorstep.

Then build, because Burnham is the King of the North, and he should govern like it. Restart HS2, and this time build it from Manchester down so the North finally gets its railway first instead of last, after a decade of being told to wait, only to watch the southern toffs under Sunak scrap the northern leg. And launch the biggest council house building programme in a generation, social homes people can actually afford, built from the ground up with solar and heat pumps so the rent and the energy bill both come down together. Reform tells working people that nobody builds for them anymore. Prove them wrong with bricks, jobs and tech.

And be honest about who is best at actually making this stuff. China builds the cheapest solar panels and the best electric cars on earth, and pretending otherwise just keeps Britain cold and stuck in traffic in a 15-year-old diesel. So let's open the doors. Invite the Chinese solar and car makers to build here, in our factories, with our workers, the way Nissan came to Sunderland a generation ago. Jobs and cheap kit, at the price that makes the whole New Deal add up. Trump will hate it. That's not a bad point.

Then reconnect a country that spent a decade pulling up the drawbridge. Sign an immediate free-trade and free-movement deal with Canada, a like-minded democracy that would have us tomorrow, and give our young people back the right to live and work across the Atlantic, the way a whole generation just lost the right to do in Europe. And Europe, here's where I'd be generous, because it's the right thing to do. Give the job to Starmer. The one cause he clearly believes in is Europe; he was already steering the UK-EU summit on 22 July as his parting legacy. Make him the Rejoin Negotiator. It's the dignified second act and indicates cautious continuity to Europe. It puts a serious figure on the one brief he actually cares about. Let the careful lawyer do the careful, patient work of charting the road back.

And the team has to change too. Rachel Reeves is a busted flush; the bond markets will twitch at any change, but they'll twitch anyway, and you cannot relaunch a government with the architect of austerity-lite still holding the red box. A new chancellor and a cabinet that looks like a fresh start because it is one.

But the deepest change is the one that costs nothing. Andy already knows how to talk to people. He should be on Reddit, on TikTok, on Instagram, selling the New Deal directly, taking the questions, and setting the weather himself instead of letting the Mail and the BBC set it for him. That's the whole point. The right won the last decade because it spoke directly and through its bots, while Labour briefed lobby journalists. Go over their heads. Come straight to us.

A New Deal, built in public and sold in public. I'm u/irishreally, and I've been disappointed before. But for the first time in two years I think it might be worth getting my hopes up. Don't waste it, Andy.

Part 3, on who actually pays for all this, comes next.

We argue endlessly about boat people. Almost nobody mentions the other lot: the ones who never need a boat, because they arrive by plane with the good luggage.

It's a pattern once you start noticing it. The leaders who build their whole authority on how corrupt and hostile the West is, who warn their own populations that the West is out to destroy them, keep quietly sending their own families to go and live there.

Take Iran. At home the regime jails protesters and enforces the morality laws; abroad, thousands of its officials' relatives are reckoned to be settled comfortably across North America and Europe, a fair few of them lecturing at Western universities. There's a protest chant for exactly this, and it cuts deeper than any sanctions list: their child is in the West, our child is in prison.

North Korea goes further still, because there it isn't even a relative, it's the man at the top. Kim Jong Un, who keeps an entire country sealed and hungry behind a closed border, spent his own teens at school near Bern under a false name, basketball-obsessed and dressed in Western brands. His sister, now the regime's most aggressive anti-Western voice, was schooled in the same Swiss city, ballet lessons and all. They took the West for themselves, then shut the door behind them.

And this isn't only about the West's declared enemies, which is the part I think should bother people most. During the recent war the Israeli prime minister's adult son was reportedly living in a Miami apartment under state-funded protection, while men his own age were pulled off their jobs and sent to the front. The people most certain a cause is worth dying for have a curious talent for keeping their own families well clear of the dying.

So I keep landing on the same question. If a cause is righteous enough to demand real sacrifice, even death, from ordinary people, why is it never quite righteous enough for the ruler's own children? And if the West really is the enemy these men describe, why is it the one place they make sure their own families end up safe and free?

Here's the part our own leaders could fix tomorrow, if they wanted to. The West is where it all gets laundered: not just the money, though there's plenty of that, but the families themselves. We educate their children and sell them the property and ask remarkably few questions while we do it. And don't pretend they're too hard to find. We have built AI that can read a million records before lunch. Why not point it at this? Let it trace the scions and the shell companies sitting on their London flats, then shut the door. If a man's cause is too precious to risk his own children on, it is not precious enough to earn his family a Western passport and a comfortable exit. You cannot freeze the regime with one hand and wave its families through the VIP lane with the other.

Real figures only, nothing made up. Not advice, and I'm still buying ...

NVO is still down around 47% from its high, and everyone here seems to have decided semaglutide is finished.

Novo presented its CagriSema diabetes trials at the ADA conference on 7 June, all published in The Lancet the same day. In the largest study, a head-to-head in over 2,700 patients, CagriSema beat Novo's own semaglutide on both blood sugar and weight loss. People keep pointing to the CagriSema "failure" from February, but that was an obesity study against Lilly's drug. This was diabetes, against the current gold standard, and it won. The stock barely reacted, which tells you how sour the mood is.

Meanwhile the Wegovy pill has passed 3 million prescriptions since it launched in January, the fastest GLP-1 launch the US has ever seen. Growth has cooled a bit now Lilly's in the ring, but that's a lead to defend, not a collapse. And the higher doses people move onto over time are worth more per patient.

A few other things the gloom skips over. Novo actually raised its guidance at Q1, the first upgrade in over a year. There's a big buyback running. The new CEO is stripping out cost and pointing R&D back at what Novo does best. And the stock sits on a P/E around 10, against a ten-year average closer to 27. You're paying a wreckage price for a business that's still growing.

People keep telling me Lilly's pill is cheaper to make, as it is a simple molecule versus Novo's fiddly peptide. Maybe so, but who cares? These drugs sell for hundreds a month, so a few cents either way on manufacturing means nothing. And the simplicity isn't the edge people think it is. Something that simple is easy to copy, easy to fake, and it'll go generic the moment the patents lapse. Novo's peptide is a real pain to make, which is half the reason supply has been so tight for years, and it's also why a rival can't just knock it off. The hard part is the moat.

Next things to watch are the half-year results on 5 August and the CagriSema obesity decision from the FDA, due before year end. Do your own homework, but I think the panic has gone too far.

Novo Nordisk's Wegovy pill (oral semaglutide, launched 5 January) hit roughly 100,000 prescriptions in its first month and crossed 1 million patients inside three months. Novo just reported 2 million+ cumulative prescriptions. They called it the strongest GLP-1 volume launch ever and raised guidance off the back of it.

Eli Lilly's Foundayo (orforglipron, launched 6 April) had around 20,000 patients by the end of its first month, per the Q1 earnings call. Novo did that in a single week.

The efficacy gap is real too. The Wegovy pill delivered 16.6% mean weight loss at 64 weeks. Foundayo delivered 12.4% at 72 weeks. Less weight loss, more time.

So on Lilly's Q1 earnings call (30 April), you'd expect some pointed questions about why the pill launch is tracking so far behind the competitor that beat them to market by three months. Instead, analysts described it as "encouraging early days".

In total, Lilly announced four acquisitions in Q1 2026 alone (Orna, Centessa, Kelonia, Ajax), with approximately $12 billion in pending deal payments. Those are enormous advisory mandates. The banks covering Lilly as equity analysts are the same banks competing for M&A fees from Lilly as a client.

Incentives matter. When your M&A desk is earning eight-figure fees from a company, it takes a particular kind of analyst to look the management in the eye and say: "Your pill launched at a fraction of your competitor's pace, with lower efficacy. Walk us through why this isn't a problem."

If Novo had launched a pill at one-fifth of Lilly's pace, it would be framed as a crisis. For Lilly, it's "encouraging".

Disclosure up front: long $NVO, not advice

WeightWatchers historically had a brutal retention problem: members who weren't losing weight quit. The programme is grim if the scales aren't moving. That capped the LTV of every member they acquired and was a structural drag on the business for years.

GLP-1s change the maths fundamentally. With Wegovy or Foundayo through Med+, almost everyone in the programme actually loses weight. The non-responder cohort that used to drive churn shrinks dramatically. Retention curves transform.

The market seems to be treating $NVO vs $LLY as a zero-sum fight for share. I think the more interesting frame is that the GLP-1 + WW ecosystem creates compounding retention for all three names. Lilly added Foundayo to Med+ on 9 April, days after Novo's subscription deal launched. WW is multi-vendor by design. Both drugs can win.

Why I'm long Novo specifically rather than just owning the category:

1. Pill efficacy gap: ~14% mean weight loss for Wegovy pill vs ~8-9% for Foundayo in trials. For treatment-naive patients choosing oral, that's clinically meaningful. If I'm going to spend the money to lose weight, I want the best reduction for my £/$

2. Cardiovascular outcome data on-label. Lilly has nothing equivalent for Foundayo. The typical Wegovy candidate is BMI 30+, often with hypertension or existing heart disease. Cardiologists like it.

3. Lilly's injectable lead (60% share vs Novo 39%) is real, but the oral category is open territory. Novo had a 3-month launch head start and the stronger label.

What's already priced in: Novo guided for declining sales and profit in 2026 amid pricing pressure. That's why NVO is at $44, not $80.

What I don't think is priced in: the WW retention transformation drives a multi-year tailwind for both injectable and oral GLP-1 pull-through, on top of headline script data.

Q1 reports Wednesday pre-open. ±7% implied move. Happy to be told what I'm missing.