Core Insights - The article highlights the performance of pharmaceutical companies in the 2025 Fortune Global 500 list, with Merck, Novo Nordisk, and Johnson & Johnson being notable entries, showcasing the strength of the pharmaceutical sector [2][3]. Pharmaceutical Sector Performance - The total revenue of the 500 companies in the 2025 Fortune Global 500 list is approximately $41.7 trillion, accounting for one-third of global GDP, with a year-on-year increase of 1.8%. The total net profit is $2.98 trillion, showing a slight increase of 0.4% [2]. - The entry threshold for the list is $32.2 billion, which has slightly increased compared to the previous year [2]. - Among the top 50 most profitable companies, three are pharmaceutical firms: Merck, Novo Nordisk, and Johnson & Johnson. Notably, Merck and Novo Nordisk are making their debut on the list, while Novartis has dropped out [2]. Financial Performance of Key Companies - Merck reported a net profit of $17.117 billion, with a remarkable growth rate of 45.9% [3]. - Novo Nordisk achieved a net profit of $14.644 billion, reflecting a growth of 20.6% [3]. - Johnson & Johnson's net profit stands at $14.066 billion, indicating stable growth [3]. - Merck's revenue is significantly driven by its PD-1 cancer drug, Keytruda, which accounts for nearly one-third of its total revenue [3]. - Novo Nordisk's sales surged to $29.3 billion, a 38% increase, primarily due to its semaglutide product line, including Ozempic, Wegovy, and Rybelsus [3]. Novo Nordisk's Market Position and Challenges - Novo Nordisk's revenue for the 2024 fiscal year is reported at 290.4 billion Danish Krone (approximately $42.1 billion), with a net profit of 100.9 billion Danish Krone (approximately $14.64 billion), well above the entry threshold of $32.2 billion [5]. - The company boasts a profit margin of approximately 36%, placing it among the leaders in the global pharmaceutical industry [5]. - In terms of revenue ranking, Novo Nordisk is positioned within the top ten globally, following giants like Johnson & Johnson, Roche, Pfizer, and Merck [6]. Product Performance and Market Dynamics - The semaglutide product line is identified as the primary growth driver for Novo Nordisk, with total sales reaching $29.3 billion, contributing to over 25% growth in overall revenue [7]. - In Q1 2025, semaglutide sales hit $7.864 billion globally, surpassing Merck's Keytruda sales of $7.2 billion, temporarily making it the "king of drugs" [7]. Market Pressures and Strategic Adjustments - Novo Nordisk has revised its 2025 performance forecasts downward, with sales growth expectations adjusted from 13%-21% to 8%-14%, and operating profit expectations reduced from 16%-24% to 10%-16% [9]. - The downward revision is attributed to a slowdown in the U.S. market, increased competition from Eli Lilly's Mounjaro and Zepbound, and the widespread circulation of compounded GLP-1 drugs [9]. - Despite a 18% quarterly sales growth reported in Q2, the market reaction has been weak [10]. Leadership Changes and Strategic Focus - The company experienced a significant stock price drop of 21.8%-23% on July 29, resulting in a market value loss of over €6 billion, marking its largest single-day decline in history [11]. - In May, Novo Nordisk dismissed CEO Lars Fruergaard Jørgensen, appointing Maziar Mike Doustdar as the new CEO effective August 7, focusing on enhancing commercial execution and cost efficiency in the U.S. market [12]. - The company is also taking legal action against the proliferation of compounded drugs and is accelerating the establishment of official self-operated channels, such as NovoCare services, to address market chaos and improve the penetration of legitimate prescription channels [13]. Future Outlook - Novo Nordisk's strong performance in 2024, driven by its semaglutide product line, has positioned it among the most profitable pharmaceutical companies globally [14]. - However, the company faces significant challenges in the short term due to rising competition, declining market expectations, and regulatory issues related to compounded drugs [14]. - The new CEO Doustdar will need to navigate the pressures of reshaping the U.S. market while aiming to restore confidence through optimized execution and strengthened legitimate channels [14]. - If Novo Nordisk can successfully expand production capacity, control the circulation of counterfeit drugs, and maintain innovation in research and development, it is likely to solidify its leading position in the global pharmaceutical industry [15].

Core Viewpoint - The FDA has approved multiple indications for semaglutide (Ozempic, Wegovy, Rybelsus), particularly focusing on its use in children, elderly, and pregnant women [2]. Summary by Category Use in Children - Wegovy is approved for weight management in obese adults and children aged 12 and above. - Ozempic is indicated as an adjunct to diet and exercise to improve blood sugar control in adults with type 2 diabetes and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease [4]. - Wegovy, when combined with a low-calorie diet and increased physical activity, reduces the risk of major adverse cardiovascular events in adults with cardiovascular disease who are obese or overweight, and helps in weight loss and maintenance for obese or overweight adults and children aged 12 and above with at least one weight-related comorbidity [4]. Use in Pregnant Women - Semaglutide may cause harm to the fetus; it should be discontinued upon confirmation of pregnancy [6]. - Women and men of childbearing age should stop using semaglutide at least 2 months prior to planning pregnancy due to its long half-life [7]. - Breastfeeding is not recommended while using semaglutide [8]. Use in Elderly - No overall differences in safety or efficacy were found between Ozempic users aged 65 and older and younger patients, although some elderly individuals may be more sensitive [10]. - Wegovy reported more severe adverse reactions compared to younger adult patients [11]. - Rybelsus showed no overall differences in safety or efficacy between patients aged 65 and older and younger patients [12].