Acquired podcast 的主持人 Ben Gilbert 和 David Rosenthal 深入探讨了诺和诺德（Novo Nordisk）引人入胜的历史，这家制药巨头是突破性的糖尿病和减肥药物 Ozempic（奥земпик）和 Wegovy（维格列汀）的幕后推手。他们追溯了该公司在 1921 年于加拿大多伦多的起源，当时发现了胰岛素——一种对 1 型糖尿病患者具有救命意义的疗法，以及随后 Frederick Banting 和他的同事提取胰岛素的过程。 奥古斯特·克罗格（August Krogh）是一位丹麦动物生物学家和诺贝尔奖获得者，他的妻子被诊断出患有糖尿病，他在其中扮演了关键角色。1922 年，他前往多伦多，学习了胰岛素的生产过程，并获得了将胰岛素引入斯堪的纳维亚半岛的权利。克罗格和他的妻子玛丽（一位医生）以及年轻的内分泌学家汉斯·克里斯蒂安·哈格多恩（Hans Christian Hagedorn）一起，开始在哥本哈根大学从动物胰腺中提取胰岛素。 1924 年，他们成立了 Nordisk Insulin 公司，该公司完全由一个非营利基金会拥有和控制，该基金会肩负着双重使命：生产胰岛素，并以成本价在斯堪的纳维亚半岛销售，以最大限度地提高胰岛素的可及性，并资助进一步的糖尿病研究。 叙述随着彼得森兄弟（Harold 和 Torvald）的故事发生了有趣的转折，他们是胰岛素项目的早期雇员，但被哈格多恩解雇了。他们创立了 Novo Insulin 公司，在接下来的 65 年里，该公司与 Nordisk 展开了激烈的竞争。Novo 迅速创新，推出了保质期更长的液体胰岛素，降低了 Nordisk 的价格，并推动了进一步的发展。 这种竞争精神推动了不懈的研发，从而产生了新的胰岛素产品和给药系统。Nordisk 开发了一种更长效的胰岛素，称为鱼精蛋白胰岛素（NPH），但拒绝将其授权给 Novo。Novo 绕过了专利，推出了自己的版本，引发了诉讼。 第二次世界大战标志着一个转折点。由于丹麦被纳粹占领，Novo 成为纳粹占领区欧洲的官方胰岛素供应商，大幅扩大了产量。另一方面，Nordisk 则因其与盟国的许可协议而遭受损失。战后，Novo 崛起成为一家拥有强大研发部门的主要制药公司。 在 1970 年代，Novo 的酶业务面临财务困难。他们与 Nordisk 接洽商议合并事宜，但遭到 Nordisk 首席执行官 Henry Brenham 的拒绝，后者看到了大规模生产 MC 胰岛素的机会。到 1980 年，Nordisk 的全球市场份额显著增加。 1980 年代带来了另一场革命：基因工程。Genentech 与 Eli Lilly 合作生产人胰岛素。虽然起初落后，但诺和诺德投资于基因工程，并为未来做好了准备。 诺和诺德最终于 1989 年与 Nordisk 合并。 主持人随后探讨了复杂的制药价值链。2004 年，管理层支持与 Serrano 达成出售协议，但该基金会阻止了合并，并专注于自身的发展。他们详细阐述了药品制造商、分销商、药房、药品福利管理机构 (PBM)、保险公司和雇主，强调了创建一个正常运作的自由市场所面临的挑战。 故事随后转向了科学家 Lotte Bjerre Knudsen 领导的 GLP-1 药物的开发。Semaglutide（索马鲁肽），存在于 Ozempic 和 Wegovy 中，可显著减轻体重，并为健康带来许多其他益处。它于 2018 年获批用于治疗糖尿病，并于 2021 年获批用于减肥，这使得诺和诺德成为制药行业的领导者。 讨论涵盖了 GLP-1 的市场，并讨论了胰岛素作为一项业务的现状。 最后，主持人评估了诺和诺德的优势，例如反定位、规模经济、转换成本、网络经济、垄断资源和品牌，并权衡了价值创造与价值获取，反思了其使命驱动型方法和独特的公司结构。

Acquired podcast hosts Ben Gilbert and David Rosenthal delve into the compelling history of Novo Nordisk, the pharmaceutical giant behind the groundbreaking diabetes and weight loss drugs Ozempic and Wegovy. They trace the company's roots back to 1921 Toronto, Canada, with the discovery of insulin, a life-saving treatment for Type 1 diabetes, and the subsequent extraction of insulin by Frederick Banting and his associates. August Krogh, a Danish animal biologist and Nobel laureate whose wife was diagnosed with diabetes, plays a pivotal role. He traveled to Toronto in 1922, learned the insulin production process, and secured the rights to bring insulin to Scandinavia. Krogh, along with his wife Marie, a physician, and Hans Christian Hagedorn, a young endocrinologist, began extracting insulin from animal pancreases at the University of Copenhagen. In 1924, they established Nordisk Insulin as an operating company fully owned and controlled by a nonprofit foundation with a dual mission: to produce insulin and sell it at cost in Scandinavia to maximize access and fund further diabetes research. The narrative takes an intriguing turn with the story of the Peterson brothers, Harold and Torvald, early employees of the insulin project who were fired by Hagedorn. They founded Novo Insulin, sparking an intense rivalry with Nordisk for the next 65 years. Novo quickly innovated with shelf-stable liquid insulin, undercutting Nordisk's prices and driving further advancements. The competitive spirit fueled relentless R&D, leading to new insulin products and delivery systems. Nordisk developed a longer-lasting insulin called protamine insulin (NPH), but refused to license it to Novo. Novo circumvented the patent and launched their own version, triggering lawsuits. World War II marked a turning point. With Denmark occupied by the Nazis, Novo became the official insulin provider for Nazi-occupied Europe, expanding production significantly. Nordisk, on the other hand, suffered due to its licensing agreements with Allied countries. After the war, Novo emerged as a major pharmaceutical company with a robust R&D division. In the 1970s, Novo faced financial difficulties with its enzyme business. Approaching Nordisk for a merger, it was rejected by Nordisk CEO Henry Brenham who saw an opportunity to aggressively scale the production of MC insulin. By 1980, Nordisk had significantly increased its global market share. The 1980s brought another revolution: genetic engineering. Genentech partnered with Eli Lilly to produce human insulin. Though, initially falling behind Novo Nordisk invests in genetic engineering, and is poised for the future. Novo Nordisk eventually comes to a merger with Nordisk in 1989. The hosts then explore the complex landscape of the pharmaceutical value chain. In 2004, management supported a deal to sell with Serrano, but the foundation blocks the merger and focuses on its own developments. They elaborate on drug manufacturers, distributors, pharmacies, pharmacy benefits managers (PBMs), insurance companies, and employers, highlighting the challenges in creating a functioning free market. The story then turns to the development of GLP-1 drugs led by scientist Lotte Bjerre Knudsen. Semaglutide, found in Ozempic and Wegovy, offers significant weight loss and numerous other benefits for the health. Approved for diabetes in 2018 and weight loss in 2021, it has propelled Novo Nordisk to the forefront of the pharmaceutical industry. The discussion covers the market for GLP-1s, and the state of insulin as a business is discussed. Finally, the hosts assess Novo Nordisk’s powers such as counter positioning, economies of scale, switching costs, network economies, cornered resources, and brand and weigh value creation versus value capture, reflecting on its mission-driven approach and unique corporate structure.