Happy pills: How Sweden and Denmark became rare bright spots for Europe’s pharma industry

Buoyed by sales of its groundbreaking obesity drugs, a Danish pharmaceutical company has recently become the second biggest business in Europe.

Novo Nordisk, based in the Bagsværd suburb of Copenhagen, might not have the same recognition as Lego or Ikea. But with 55,000 employees around the world — 23,000 of those in Denmark — and valued at around $375 billion on the stock market, it is the most visible representative of a sector that’s trending upward.

An industry report shows that, in Denmark, pharma sector exports more than doubled over the past decade, reaching €19 billion (a fifth of the country’s total exports). Swedish pharmaceutical exports also grew by two-thirds in that same period.

At a time when you can’t move in Brussels without bumping into billboards warning of the demise of European pharma, how are these two countries bucking the trend?

Playing nice

Pharma is a sector known for its hard-nosed bargaining and no-holds-barred defense of its intellectual property. But in Denmark and Sweden, growth has been propelled by a combination of government funding for research, a nurturing cluster of universities and hospitals, and the helping hand of bigger companies in the field.

Kasim Kutay, chief executive of Novo Holdings, the investment fund that holds the controlling stake in Novo Nordisk, said that a focus on “long-term returns” above immediate rewards to shareholders laid the groundwork for the company’s success. Novo Nordisk is unusual because it is controlled (through Novo Holdings) by the Novo Nordisk Foundation — a not-for-profit structure with philanthropic goals. The foundation model — also used by Lego and Carlsberg — meant that Novo Nordisk was never sold off to foreign buyers, even when a lot of money was put on the table.

“It’s a very powerful model,” said Kutay. “I would say it is one of the main reasons … why Denmark, as a country of five and a half million people, punches way above its weight.”

Part of the foundation’s mission is to ensure that the Nordics remain a vibrant scientific research hub, said Katay, and so the company’s success spills over to the wider life-science environment. Profits are reinvested through the foundation into research projects, such as a €300 million investment into a stem cell medicine research center and a €200 million investment into quantum computing for biology research.

Novo Holdings also has a “seed investment” arm, which provides early-stage funding to startups. While the rest of the company has to generate competitive “market-type returns” — the seed arm has specifically lower return targets, instead focusing on scientific impact. “It’s very, very active, and undoubtedly has made a big difference to the biopharma ecosystem,” said Katay.

But there’s also strong government support. Both Denmark and Sweden have dedicated life-science strategies and invest over 3 percent of their GDP in research and innovation, putting them among the top in the world for R&D investment on a per capita basis.

It’s paying off. Research produced by SwedenBIO, the industry group that represents biotechs in the Scandinavian country, shows a high number of early-stage biotechs in the country, which overall ranks fifth by number of medicines being researched in Europe, ahead of larger countries that also have an established presence in the sector, like the Netherlands and Italy.

The large majority of these, around 80 percent, are fledgling companies, with fewer than 10 employees, said Maja Neiman, science director for SwedenBIO. More than half are spin-offs from academic research institutes.

Neiman attributed the boom to Sweden’s entrepreneurial culture, which encourages innovation. “What we do share in the North is this culture of transparency, knowledge sharing, and very flat hierarchies,” she said.

From the ashes

The Nordics aren’t immune to loss. AstraZeneca was Sweden’s big pharmaceutical company, a rival to Novo Nordisk. But in 2013 it announced it was moving its research headquarters to Cambridge, in the U.K. (in theory the company remains Anglo-Swedish, but the former now takes precedence).

But after the move was announced, the Swedish government stepped in to make sure that the pharmaceutical ecosystem didn’t just disappear. The company’s sprawling former R&D headquarters, based in the town of Södertälje, near Stockholm, is now being reused to house start-ups. One of those is Anocca, which is developing advanced technology to modify the genetic code of immune cells to target tumors.

The company not only benefitted from AstraZeneca’s former plant, but also financial support to refurbish the location and a period of low rent, according to chief financial officer Jacob Michlewicz. 

And the notoriously high quality of life can help recruitment efforts — a notorious bottleneck in the industry. “Sweden is not a fantastic country if you want to earn as much money as an American CFO in Boston — we will never succeed in attracting that kind of people,” said Leif Johansson, outgoing chair of the board at AstraZeneca, speaking at an event organized by SwedenBIO last year. “But if you plan to have children, Sweden — as a young researcher … is a very fun and pleasant country to be in.”

Michlewicz estimated that 70 percent of hires are foreign. And he says Sweden’s strength as an IT hub (think Spotify) has also benefitted the company, which is employing a growing number of software developers, as the industry embraces automation and using powerful computers to crack difficult biological problems.

It’s clear that Sweden and Denmark are currently riding the pharma wave. But it’s one thing to create a biotechnology company, quite another to successfully develop a drug to the point you can launch it on the market — an enterprise that can cost a billion or more euros in research and investment and take 10 to 20 years. Anocca, for example, still hasn’t taken any of its experimental treatments out of the lab and into clinical testing (it plans to start in 2024).

And while 1,150 life science companies have set up shop in the awkwardly named Medicon Valley — an innovation hub spanning the Denmark-Sweden border — they’re at the middle of the table when it comes to the quality and number of cited papers, beaten by London, Zurich and Flanders in Europe. With this latest wave of new biotechs getting off the ground, that could change. But as any veteran biotech investor knows, plenty of much-hyped experimental drugs have turned out to be duds.