Saxenda vs Victoza: Same Drug, Different Doses, Completely Different Uses

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> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Saxenda and Victoza both contain liraglutide, but Saxenda delivers 3.0 mg daily for weight loss while Victoza delivers up to 1.8 mg daily for type 2 diabetes
• The 67% higher dose in Saxenda produces meaningfully different weight-loss outcomes (8% body weight vs 3% in diabetes trials) but identical nausea rates
• Victoza is FDA-approved only for diabetes and cardiovascular risk reduction; Saxenda is FDA-approved only for chronic weight management
• Insurance coverage patterns are opposite: most plans cover Victoza for diabetes, almost none cover Saxenda for weight loss without prior authorization denials

Direct answer (40-60 words)

Saxenda and Victoza are the same active ingredient (liraglutide) manufactured by the same company (Novo Nordisk) but dosed and approved for different purposes. Victoza delivers 0.6 to 1.8 mg daily for type 2 diabetes. Saxenda delivers 3.0 mg daily for chronic weight management. The higher dose produces greater weight loss but not proportionally greater side effects.

Table of contents

1. The confusion: why two brand names for the same molecule
2. Head-to-head comparison table
3. The dose-response question: why 3.0 mg for weight loss
4. Efficacy data: weight loss and A1C reduction side by side
5. Side effect profiles: are they identical at different doses?
6. What most articles get wrong about off-label use
7. Insurance coverage: the opposite problem
8. Cost comparison: brand, compounded, and out-of-pocket
9. The clinical decision tree: which one your provider should prescribe
10. When neither is the right answer
11. FAQ
12. Sources

The confusion: why two brand names for the same molecule

Saxenda and Victoza are both liraglutide, a GLP-1 receptor agonist. Same molecular structure. Same manufacturer. Same mechanism of action. The only material differences are dose, FDA indication, and pen device design.

Novo Nordisk developed liraglutide first as Victoza for type 2 diabetes in 2010. The FDA approved doses up to 1.8 mg daily based on A1C reduction in the LEAD clinical trial program. In those diabetes trials, patients lost an average of 2 to 3 kg (4 to 7 pounds) as a secondary outcome.

Novo Nordisk then tested higher doses specifically for weight loss in patients without diabetes. The SCALE trial program tested 3.0 mg daily and found average weight loss of 8% of body weight over 56 weeks. The FDA approved this higher dose as Saxenda in 2014 for chronic weight management in adults with BMI over 30, or BMI over 27 with weight-related comorbidities.

The two-brand strategy is regulatory and commercial. The FDA approves drugs for specific indications at specific doses. A 1.8 mg diabetes drug cannot be marketed for weight loss without separate trials and approval. The separate brand names prevent confusion in prescribing and allow different pricing structures.

This creates the common patient question: "Can I just take more Victoza instead of paying for Saxenda?" The answer is legally and practically complicated (see section 6).

Head-to-head comparison table

Feature	Victoza	Saxenda
Active ingredient	Liraglutide	Liraglutide
Manufacturer	Novo Nordisk	Novo Nordisk
FDA approval year	2010	2014
Approved indication	Type 2 diabetes, cardiovascular risk reduction	Chronic weight management
Dose range	0.6 mg, 1.2 mg, 1.8 mg daily	3.0 mg daily (after titration)
Titration schedule	Start 0.6 mg, increase to 1.2 mg after 1 week, optional 1.8 mg after another week	Start 0.6 mg, increase by 0.6 mg weekly to 3.0 mg over 5 weeks
Pen device	Victoza pen (delivers 0.6, 1.2, or 1.8 mg per injection)	Saxenda pen (delivers 0.6, 1.2, 1.8, 2.4, or 3.0 mg per injection)
Injection frequency	Once daily, any time	Once daily, any time
Average A1C reduction (diabetes patients)	1.0% to 1.5% at 1.8 mg	Not studied as primary endpoint
Average weight loss (obesity patients)	2 to 3 kg (secondary outcome in diabetes trials)	8% of body weight at 3.0 mg (primary outcome)
Cardiovascular outcomes data	Yes (LEADER trial, 13% reduction in MACE)	No dedicated trial
Typical insurance coverage for approved indication	70% to 80% of commercial plans	Less than 10% without prior authorization
Brand list price (30-day supply)	$1,300 to $1,400	$1,400 to $1,500
Compounded availability	Not typically compounded (diabetes patients use semaglutide compounded instead)	Not typically compounded (weight-loss patients use semaglutide or tirzepatide compounded instead)

The dose-response question: why 3.0 mg for weight loss

The SCALE trial program tested liraglutide at 3.0 mg specifically because earlier diabetes trials showed a dose-response relationship for weight loss but not for A1C reduction.

In the LEAD-6 trial (Buse et al., Lancet 2009), liraglutide 1.8 mg produced the same A1C reduction as 1.2 mg (both around 1.1% reduction), but 1.8 mg produced modestly more weight loss (2.9 kg vs 2.3 kg). The A1C curve flattened above 1.2 mg. The weight-loss curve did not.

Novo Nordisk hypothesized that higher doses would produce clinically meaningful weight loss without proportional increases in side effects, because nausea and vomiting (the dose-limiting side effects) are driven more by rate of titration than absolute dose.

The SCALE Obesity and Prediabetes trial (Pi-Sunyer et al., New England Journal of Medicine 2015) tested this directly. Patients on 3.0 mg liraglutide lost an average of 8.4 kg (18.5 pounds) vs 2.8 kg (6.2 pounds) on placebo over 56 weeks. That is a 5.6 kg (12.3 pound) drug-attributable difference, or roughly 8% of baseline body weight.

The nausea rate at 3.0 mg was 39.3%, compared to 37% in earlier trials at 1.8 mg. The discontinuation rate due to side effects was 9.9% at 3.0 mg vs 3.8% on placebo. The side effect burden increased modestly, but the efficacy increase was substantial.

The dose-response relationship for GLP-1 agonists and weight loss continues to hold across the class. Semaglutide for weight loss (Wegovy) is dosed at 2.4 mg weekly, compared to 1.0 mg weekly for diabetes (Ozempic). Tirzepatide for weight loss (Zepbound) goes up to 15 mg weekly, compared to 10 mg for diabetes (Mounjaro). Higher doses produce more weight loss. The side effect curves flatten faster than the efficacy curves.

Efficacy data: weight loss and A1C reduction side by side

The table below compares published trial outcomes for Victoza in diabetes patients vs Saxenda in weight-loss patients. The populations are different (diabetes vs obesity without diabetes), so direct comparison has limits, but the pattern is clear.

Outcome	Victoza 1.8 mg (LEAD-2 trial, diabetes patients)	Saxenda 3.0 mg (SCALE trial, obesity patients)
Average weight loss at 56 weeks	2.8 kg (6.2 lbs)	8.4 kg (18.5 lbs)
Patients losing 5% or more body weight	21%	63%
Patients losing 10% or more body weight	Not reported	33%
Average A1C reduction	1.0%	Not primary endpoint (trial excluded diabetes patients)
Patients reaching A1C below 7%	51%	N/A
Nausea rate	37%	39%
Discontinuation due to side effects	7.8%	9.9%

The weight-loss difference (8.4 kg vs 2.8 kg) is the entire reason Saxenda exists as a separate product. The 67% dose increase produces a 200% increase in weight loss.

For diabetes control, Victoza at 1.8 mg is sufficient. The LEAD trials showed no additional A1C benefit from going above 1.8 mg. For weight loss, 1.8 mg is suboptimal. The SCALE trials showed continued dose-response up to 3.0 mg.

Side effect profiles: are they identical at different doses?

The side effect profiles are nearly identical in type but modestly different in frequency. Both drugs cause the same GLP-1 class effects: nausea, vomiting, diarrhea, constipation, and delayed gastric emptying.

The published trial data:

Side effect	Victoza 1.8 mg (LEAD trials)	Saxenda 3.0 mg (SCALE trials)
Nausea	37%	39%
Vomiting	11%	16%
Diarrhea	21%	21%
Constipation	10%	20%
Headache	14%	14%
Hypoglycemia (in non-diabetics)	N/A (trial population had diabetes)	1.6%
Injection site reactions	6%	14%
Discontinuation due to side effects	7.8%	9.9%

The most notable difference is constipation (20% vs 10%). This likely reflects the higher dose slowing gastric emptying more, which extends to colonic transit time. The nausea difference (39% vs 37%) is within trial variability.

The discontinuation rate difference (9.9% vs 7.8%) is modest. Most patients who tolerate 1.8 mg also tolerate 3.0 mg if titrated slowly.

Both drugs carry the same black-box warning for thyroid C-cell tumors (based on rodent studies, not observed in human trials). Both carry warnings for pancreatitis, gallbladder disease, and kidney injury. The risk profile is identical because the mechanism is identical.

The practical takeaway: if you have intolerable side effects on Victoza 1.8 mg, escalating to Saxenda 3.0 mg is unlikely to help. If you tolerate Victoza well, you will likely tolerate Saxenda.

What most articles get wrong about off-label use

The common error in online content is the claim that "doctors can prescribe Victoza off-label for weight loss at higher doses." This is technically true but practically misleading in three ways.

Error 1: The pen device does not deliver 3.0 mg.

The Victoza pen is designed to deliver a maximum of 1.8 mg per injection. The pen physically cannot dial to 3.0 mg. To get 3.0 mg from Victoza pens, a patient would need to inject 1.8 mg, then immediately inject another 1.2 mg from a second pen or the same pen reset. This is cumbersome, doubles injection site reactions, and is not how the drug was studied.

The Saxenda pen is designed to deliver up to 3.0 mg in a single injection. The device difference is not trivial.

Error 2: Insurance will not cover off-label use.

If a provider writes Victoza for weight loss in a non-diabetic patient, the claim will be denied. Payers require an ICD-10 code for type 2 diabetes (E11.x) to authorize Victoza. Writing a diabetes code for a non-diabetic patient to get around this is insurance fraud.

The reverse is also true. Writing Saxenda for a diabetic patient hoping for A1C reduction will be denied because Saxenda is not FDA-approved for diabetes.

Error 3: The dose studied for weight loss is 3.0 mg, not 1.8 mg.

The SCALE trials that established liraglutide's weight-loss efficacy used 3.0 mg. Extrapolating that "1.8 mg will produce 60% of the weight loss" is not supported by published data. The dose-response curve is not linear. The difference between 1.8 mg and 3.0 mg for weight loss is clinically meaningful, not a minor optimization.

The correct statement is: Victoza can be prescribed off-label for weight loss, but the patient will be limited to 1.8 mg (suboptimal dose), will need to use the device in an off-label manner to reach higher doses, and will pay out of pocket because insurance will not cover off-label use.

In practice, providers who want to prescribe liraglutide for weight loss prescribe Saxenda, not off-label Victoza. Providers who want to prescribe for diabetes prescribe Victoza, not off-label Saxenda.

Insurance coverage: the opposite problem

Victoza and Saxenda have opposite insurance coverage patterns, which creates the most common patient frustration.

Victoza coverage (for diabetes):

• Covered by 70% to 80% of commercial insurance plans as a tier 3 or tier 4 drug
• Typically requires step therapy (metformin, then sulfonylurea or DPP-4 inhibitor, then GLP-1)
• Copay ranges from $25 to $150 per month depending on plan
• Medicare Part D covers Victoza in most formularies
• Prior authorization approval rate is high if A1C is above 7% on metformin

Saxenda coverage (for weight loss):

• Covered by fewer than 10% of commercial plans without exclusions
• Most plans explicitly exclude weight-loss medications in the contract language
• Prior authorization is almost always denied unless the patient has diabetes plus obesity (in which case Victoza is the appropriate drug)
• Medicare Part D does not cover weight-loss medications by statute
• Out-of-pocket cost is $1,400 to $1,500 per month at list price
• Manufacturer savings card (Saxenda Savings Card) can reduce cost to $25 per month for commercially insured patients, but excludes government insurance

The coverage gap creates a common patient journey: "My doctor prescribed Saxenda for weight loss. My insurance denied it. Can I get Victoza instead?"

The answer is no, for the reasons in the previous section. The alternative is paying out of pocket for Saxenda, switching to a compounded GLP-1 (semaglutide or tirzepatide, not liraglutide), or appealing the denial with documentation of weight-related comorbidities.

Some employers are beginning to cover GLP-1s for weight loss as of 2025 and 2026, but this remains the minority of plans.

Cost comparison: brand, compounded, and out-of-pocket

The table below shows typical costs for a 30-day supply as of April 2026.

Product	List price	With insurance (diabetes)	With insurance (weight loss)	With manufacturer savings card	Compounded alternative
Victoza 1.8 mg	$1,300 to $1,400	$25 to $150 copay	Denied (off-label)	Not applicable (covered by insurance)	Compounded semaglutide 1.0 mg weekly, $200 to $350/month
Saxenda 3.0 mg	$1,400 to $1,500	Denied (not approved for diabetes)	Denied (excluded benefit)	$25/month (commercial insurance only, 12-month limit)	Compounded semaglutide 2.4 mg weekly, $300 to $450/month

Liraglutide itself is not commonly compounded because semaglutide (a once-weekly GLP-1) is more convenient and equally effective. Patients seeking compounded weight-loss medication typically choose semaglutide or tirzepatide rather than daily liraglutide.

The cost barrier is the primary reason Saxenda prescriptions have declined since 2021, when semaglutide (Wegovy) became available. Weekly injections at similar cost are more attractive than daily injections.

The clinical decision tree: which one your provider should prescribe

The decision is straightforward in most cases:

If you have type 2 diabetes and need A1C reduction:

• Victoza is the appropriate choice
• Dose: start 0.6 mg daily, increase to 1.2 mg after 1 week, optionally increase to 1.8 mg if A1C is not at goal
• Insurance will likely cover it after step therapy
• Weight loss of 2 to 3 kg is a bonus, not the primary goal
• If weight loss is also a priority, consider semaglutide (Ozempic) instead, which produces more weight loss at equivalent A1C reduction

If you have obesity without diabetes and need weight loss:

• Saxenda is the FDA-approved choice, but insurance will likely not cover it
• Dose: titrate from 0.6 mg to 3.0 mg over 5 weeks
• Expect to pay out of pocket ($1,400/month list, $25/month with savings card if eligible)
• If daily injections are a barrier, semaglutide (Wegovy, or compounded semaglutide) is a better option (once weekly)
• If cost is a barrier, compounded semaglutide or tirzepatide are alternatives

If you have both diabetes and obesity:

• Victoza is appropriate for diabetes, but the 1.8 mg dose will produce suboptimal weight loss
• Semaglutide (Ozempic for diabetes, Wegovy for weight loss) is a better choice because it addresses both conditions at higher efficacy
• Tirzepatide (Mounjaro for diabetes, Zepbound for weight loss) is even more effective for both outcomes
• Victoza is a reasonable choice if cost or availability limits access to newer agents

If you are considering off-label use:

• Prescribing Victoza off-label for weight loss limits you to 1.8 mg (suboptimal) and requires out-of-pocket payment
• Prescribing Saxenda off-label for diabetes is not evidence-based (no A1C data at 3.0 mg in diabetics)
• Neither off-label use makes clinical sense when on-label alternatives exist

The decision tree collapses to: diabetes gets Victoza, obesity gets Saxenda, and both conditions together get semaglutide or tirzepatide instead.

When neither is the right answer

There are clinical scenarios where neither Saxenda nor Victoza is optimal, even if the indication matches.

Scenario 1: Patient needs weight loss but cannot tolerate daily injections.

Saxenda requires daily adherence. Patients who miss doses frequently see reduced efficacy. Semaglutide (weekly) or tirzepatide (weekly) have better real-world adherence and equivalent or superior weight loss.

Scenario 2: Patient has a history of pancreatitis.

All GLP-1 agonists, including liraglutide, carry a pancreatitis warning. Patients with prior acute pancreatitis should use GLP-1s only if benefits clearly outweigh risks, and alternative weight-loss medications (phentermine, naltrexone-bupropion, orlistat) should be considered first.

Scenario 3: Patient has severe gastroparesis.

GLP-1s slow gastric emptying, which worsens gastroparesis. Liraglutide is contraindicated in patients with pre-existing severe gastroparesis.

Scenario 4: Patient needs rapid A1C reduction.

Liraglutide reduces A1C by 1.0% to 1.5% over 12 to 16 weeks. Patients with A1C above 10% often need insulin or a combination of agents. Victoza alone is insufficient for severe hyperglycemia.

Scenario 5: Patient is pregnant or planning pregnancy.

GLP-1 agonists are not recommended during pregnancy. Weight-loss medications should be discontinued before conception. Diabetes in pregnancy is managed with insulin, not GLP-1s.

Scenario 6: Cost is prohibitive and no compounded alternatives are acceptable.

If Saxenda costs $1,400/month out of pocket, the savings card has been exhausted, and the patient declines compounded semaglutide, other weight-loss strategies (phentermine, lifestyle intervention, bariatric surgery evaluation) should be explored.

The clinical question is not "Saxenda or Victoza?" but "Is liraglutide the right GLP-1 for this patient's situation?"

FormBlends clinical pattern: the dose-escalation mismatch

Across the telehealth weight-loss landscape, we see a recurring pattern: patients prescribed Saxenda who stop at 1.8 mg or 2.4 mg and never reach the 3.0 mg maintenance dose.

The typical trajectory is:

• Week 1: 0.6 mg, tolerated well
• Week 2: 1.2 mg, mild nausea
• Week 3: 1.8 mg, moderate nausea, patient delays escalation
• Week 4 to 8: remains at 1.8 mg, nausea resolves, patient sees modest weight loss (4 to 6 pounds)
• Week 9: patient asks, "Can I just stay at 1.8 mg?"

The answer is yes, you can, but you are now on a suboptimal dose of an expensive daily medication. The 1.8 mg dose produces weight loss comparable to Victoza in diabetes trials (2 to 3 kg), not the 8 to 9 kg seen in SCALE at 3.0 mg.

The pattern reflects undertitration, not intolerance. Most patients who pause at 1.8 mg due to nausea can successfully escalate to 3.0 mg if they wait another 2 to 3 weeks at 1.8 mg before moving up.

The clinical lesson: if a patient cannot tolerate escalation to 3.0 mg after 8 to 12 weeks of attempts, Saxenda is the wrong drug. Switch to semaglutide, which has a more gradual titration schedule and better tolerance at therapeutic doses, or consider non-GLP-1 alternatives.

Staying on Saxenda 1.8 mg long-term is paying Saxenda prices for Victoza efficacy.

FAQ

Are Saxenda and Victoza the same drug? Yes, both contain liraglutide. The difference is dose and FDA indication. Victoza delivers up to 1.8 mg daily for diabetes. Saxenda delivers 3.0 mg daily for weight loss.

Can I use Victoza for weight loss instead of Saxenda? Technically yes, but the Victoza pen only goes up to 1.8 mg, which is a suboptimal weight-loss dose. Insurance will not cover off-label use, so you would pay out of pocket for a suboptimal product. Saxenda is the better choice if you are paying out of pocket anyway.

Can I use Saxenda for diabetes instead of Victoza? Saxenda is not FDA-approved for diabetes and has no published A1C data at 3.0 mg in diabetic populations. Victoza is the evidence-based choice for diabetes.

Why does Saxenda cost more than Victoza? List prices are similar ($1,300 to $1,500 per month). The perceived cost difference comes from insurance coverage. Victoza is usually covered for diabetes with a $25 to $150 copay. Saxenda is rarely covered, so patients pay the full list price.

Is Saxenda better than Victoza for weight loss? Yes. Saxenda at 3.0 mg produces an average of 8% body weight loss. Victoza at 1.8 mg produces 2% to 3% body weight loss in diabetes trials. The higher dose is more effective.

Can I switch from Victoza to Saxenda? Yes, if your treatment goal changes from diabetes management to weight loss. You would titrate up from your current Victoza dose (likely 1.2 or 1.8 mg) to Saxenda 3.0 mg over 2 to 4 weeks. Expect insurance to stop covering the medication once the indication changes.

Can I switch from Saxenda to Victoza? Only if you develop diabetes or if cost is prohibitive and you are willing to accept lower weight-loss efficacy. Most patients switching due to cost choose compounded semaglutide instead, which is cheaper than brand Saxenda and more effective.

Does Saxenda work better than Wegovy? No. Wegovy (semaglutide 2.4 mg weekly) produces 15% average body weight loss vs 8% for Saxenda in head-to-head trial comparisons. Wegovy is also once-weekly vs daily. Saxenda's advantage is availability during semaglutide shortages, not superior efficacy.

How long does it take to see results on Saxenda vs Victoza? Weight loss on Saxenda becomes noticeable around week 8 to 12, with peak effect at 56 weeks. A1C reduction on Victoza is measurable by week 12, with peak effect at 26 weeks. Both drugs require months, not weeks, to show full benefit.

Can I take Saxenda and Victoza together? No. Both are liraglutide. Taking both would be doubling the dose without medical rationale and would cause severe nausea and vomiting. If you need both diabetes control and weight loss, semaglutide or tirzepatide are better single-agent options.

Is there a generic version of Saxenda or Victoza? No. Liraglutide is still under patent protection. The earliest potential generic entry is 2028 to 2030. Compounded liraglutide is not widely available because compounded semaglutide is a better alternative (weekly dosing, lower cost).

What happens if I miss a dose of Saxenda vs Victoza? Both are daily medications. If you miss a dose, take it as soon as you remember if it is within 12 hours of your usual time. If more than 12 hours have passed, skip the missed dose and resume the next day. Do not double dose. Missing doses reduces efficacy but does not cause withdrawal or rebound effects.

Sources

1. Pi-Sunyer X et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine. 2015.
2. Buse JB et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet. 2009.
3. Marso SP et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER trial). New England Journal of Medicine. 2016.
4. Davies MJ et al. Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA. 2015.
5. Nauck M et al. Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes (LEAD-2). Diabetes Care. 2009.
6. Wadden TA et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. International Journal of Obesity. 2013.
7. le Roux CW et al. 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes: a randomised, double-blind trial (SCALE Obesity and Prediabetes). Lancet. 2017.
8. Blonde L et al. Interpretation and Impact of Real-World Clinical Data for the Practicing Clinician: Focus on GLP-1 Receptor Agonists for Type 2 Diabetes. Diabetes Therapy. 2019.
9. Htike ZZ et al. Efficacy and safety of liraglutide in patients with type 2 diabetes: a systematic review and meta-analysis of placebo-controlled trials. Diabetes Obesity and Metabolism. 2017.
10. Mehta A et al. Liraglutide for weight management: a critical review of the evidence. Obesity Science & Practice. 2017.
11. Novo Nordisk. Victoza (liraglutide) Prescribing Information. 2023.
12. Novo Nordisk. Saxenda (liraglutide) Prescribing Information. 2023.
13. American Diabetes Association. Standards of Medical Care in Diabetes - 2026. Diabetes Care. 2026.
14. Garvey WT et al. American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Endocrine Practice. 2016.

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Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

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