Q1 2021 Novo Nordisk A/S Earnings Call (London-Based Investors)

Hello, and welcome to the Q1 2021 Novo Nordisk a S earnings presentation.

Operator: And welcome to the Q1 2021 Novo Nordisk AS Earnings Presentation. Throughout the call, all participants will be in a listen-only mode, and afterwards there will be a question-answer session. Today, I'm pleased to present Karsten Munk. Please go ahead with your meeting.

Throughout the call all participants will be in a listen only mode and afterwards, there will be a question and answer session.

Today I'm pleased to present cost Munk Knudsen. Please go ahead with your meeting.

Thank you and welcome to the Q1 results meaningful off no. One orsk today with me I have to convince the investor head of commercial strategy and marching along our head of global development.

Karsten Munk Knudsen: Thank you, and welcome to the Q1 results meeting for Novo Nordisk. Today with me I have Camilla Sylvest, Head of Commercial Strategy, and Martin Lange, Head of Global Development. So before moving into our investor presentation, I'd just like to thank KU Operec and Goldman Sachs for organizing this London launch conference meeting. We have been looking forward to meeting you all in person, as we did a year ago, and hopefully, we'll be getting closer to meeting in person in the coming quarters.

So before moving into our Investor presentation.

Just like to thank God, because youre, correct and Goldman Sachs for orchestrating this.

London launched conference meeting, we had been looking forward to meeting you all in person says.

A year ago.

Hopefully it won't be getting closer to meeting in person.

In person in coming quarters.

So we will the process for this meeting is that we will do a quick.

Karsten Munk Knudsen: So the process for this meeting is that we'll do a quick review of our quarterly slide deck. It will last to the tune of 15 minutes, after which we will move on to a Q&A session.

Review of.

Our quarterly slide deck, and that's it to the tune of 15 minutes afterwards, we would be moving.

Moving on to our Q&A session.

Karsten Munk Knudsen: So, and as you know, then, statements we make around the future are inherently bound by uncertainty. The results can differ from what we indicate, either positively or negatively, but that's how it predicts around the future. In terms of our strategic aspirations for the first quarter, as you recall, this is how we portray the company and the strategy execution of the company. Then we continue to have very strong traction on our strategic aspirations, as we did last year but also here into the first quarter.

So and as you know and statements were made around the future I inherently bound by by uncertainty.

Resource can can differ from what we indicate our either positively or negatively.

How does a predicting around the future.

Yeah.

In terms of our strategic aspirations are for the first quarter as you'll recall. This is how we portray the company and and strategy execution of the company. Then we continue to have a very strong traction on our strategic aspirations as we did last year, but also here into the into the first quarter.

Karsten Munk Knudsen: So we continue to execute on our Defeat Diabetes social responsibility strategy through different activities here with the University of Toronto as well as the World Diabetes Foundation focusing on prevention and access. Furthermore, we are progressing on our environmental strategy, Circular for Zero, where we are aiming to become a circular company by 2030. We are progressing well, as we reported last year, on our CO2 emissions from manufacturing, getting to neutrality already there.

So we continue to execute on our defeat diabetes, social responsibility strategy through our different activities with the yeah with the University of Toronto as well as towards diabetes Foundation football focus focusing on prevention and axis.

Furthermore, we're progressing on our environmental strategy circle for zero and.

Well, we are aiming at a it's becoming a circle accompanied by 2030, we are progressing well as we reported last year on our.

C O two emissions from manufacturing are getting to a new.

New trash are already there and now we're focusing on additional areas and what you see yes. It there in terms of supply situations are now who have commitments are corresponding to 15% of our supply mission.

Karsten Munk Knudsen: Now we are focusing on additional areas, and what you see here is that, in terms of supply, CO2 emissions, now we have commitments corresponding to 15% of our supply emissions to be CO2 neutral in the time to come. In our pipeline innovation and therapeutic focus, we have received regulatory approval for SimPIC in China, which we see as a big opportunity in the years to come, providing better diabetes medications for patients in China.

To be sure to neutral.

In the time to come.

On the on our pipeline innovation and therapeutic focus we have received regulatory approval for <unk> in China, which she is a big opportunity in that yet to come and providing better diabetes medications for patients in China.

Karsten Munk Knudsen: On obesity, we have decided to initiate the clinical development of a high-dose version of oral semaglutide, a 50-milligram version that Martin will come back to. And in other serious chronic diseases, we have initiated the development of once-weekly semaglutide 2.4 in NAS, which Martin will also come back to.

On obesity, we have.

Decided to initiate the clinical development on a on a high dose version of awesome exercise the 50 milligram version.

Matson will come back to and are in the other shares.

Chronic diseases we.

We have initiated the development of a once weekly some exercise to point fall in index, which Martin will also come back to them.

Karsten Munk Knudsen: As to commercial execution, we are continuing to gain diabetes value markets here with 60 basis points. We are continuing to grow our obesity business, where, as you recall, we are aiming at more than doubling our sales by 2025 compared to 2019, so a lot of focus on growing our obesity business, and biofarm sales increased by 1% in the first quarter. So solid sales there also.

As to commercial execution, we are are continuing.

Continuing to gain diabetes benchmarks, yet here with the 60 basis points, we are continuing to grow our pizza business, whereas you'll recall, we are aiming at more than doubling.

All sales by 2025 compared to 2019, so a lot of focus on growth in our PC business and biopharm sales increasing by one percentage 0.0 by 1% in the first quarter. So so solid sales and that also.

Karsten Munk Knudsen: Financially, that yielded 7% sales growth and 3% operating profit growth, driven by both operating units and a clear step-up in growth from our business in North America, driven by U.S. margins continuing to be attractive and continuing to focus on productivity gains and, consequently, a free cash flow generation of almost $10 billion in the quarter and $16 billion return to shareholders between dividends and continued share buyback. When we look at our global sales growth and contribution split on our two main dimensions, then you see 7% growth, which when you adjust for stocking both last year and this year, then our underlying run rate on the top line is more representative around 9% driven by continued strong growth in IO around the double digits or even slightly above.

Financially that yields a 7% sales growth and 3% operating profit growth driven.

Driven by both operating units and and a clear step up in growth from our business in the in North America are driven by both the U S.

Yeah margins continuing to be attractive and continuing our focus on productivity gains and consequently, a free cash flow generation of almost 10 billion in the quarter and 16 billion returned to shareholders between dividends and continued share buybacks.

When we look at the at our global sales.

Sales growth and the contribution split on the on our two main dimension said, then you see a 7% growth, which when you adjust for stocking both the last year and this year than a underlying run rate on top line is more.

Ah represents of around 9%.

Driven by continued strong growth in an io are around the double digit or even slightly up off.

While we were looking at growth in North America at the 6% Mark and adjusted even slightly higher.

Karsten Munk Knudsen: While we were looking at growth in North America at the 6% mark and adjusted even slightly higher, compared to last year, this represents a good step up in North America, where we reported 3% consular exchange rate growth last year. As to therapy areas, then the key growth driver of the company is our GF1 business growing at 23%, being the main growth driver. You see solid growth both in North America as well as in IO.

Last year. This represents a good step up in North America.

The reported 3%.

At constant exchange rate growth last year.

As to our step therapy areas than the key growth driver for the company. This is our tier one business growing 23% being the main growth driver you see solid growth both in North America as well as an I O <unk>.

Karsten Munk Knudsen: Insulin is flat, so we continue to see solid growth in IO, while the insulin decline in the first quarter is 10% compared to around the 20% mark we looked at last year. Obesity I covered 9% split between Iowa and North America, and finally, biofarm 1% growth. With that, over to you, Camilla.

Insulin is is flat and so we continue to see.

Solid growth in Io why are they the insulin decline.

In the first quarter is 10% compared to around 20% marker, where we looked at last year.

Obeche I call it 9% split between the island, North America, and <unk>, and finally, biopharm and 1% growth.

That Oh, so you Camilla.

Camilla Sylvest: Yes, thank you, Karsten. On diabetes value market share, we continue to expand our leadership, and with the latest annual numbers, we have increased by 0.6 percentage points to 29.3 percentage points global diabetes value market share. This is primarily driven by an increase in market share from GLP-1 of close to 3%. And in insulin volume, we also increased our market share by approximately 0.6 percentage points. And altogether, that ends up with a diabetes value market share of 29.3%.

Yeah. Thank you Carsten on diabetes value market share, we continue to expand our leadership.

With the latest annual numbers, we have increased two six percentage points to 29.3 percentage point.

Diabetes value market share. This is primarily driven by an increase in market share from TLC, one of close to 3% and in insulin volume. We also increase our market share as opposed to Memphis, you'll find six percentage points and and all together that it's at the diabetes value market share.

It was 29, 3%.

And in the last 12 months, we have it as I just mentioned also increased our market share in the telephone he had for one segment, but also in the U S and here you see our total incident and our total tier one market share of $58 two on MPLX and Theyre just about 50 on the children scripts.

Camilla Sylvest: In the last 12 months, we have, as I just mentioned, also increased our market share in the total GLP-1 segment but also in the U.S. And here you see our total GLP-1 market share of 58.0 on NPRX and just about 50 on the total script. If you look at the next slide, you will see that Rebelsus continues to increase NBRX uptake. You can see here that there is a continued uptake that has been impacted by the reps in the field. And that means as soon as they are back in the field, we see an uptake back to the original trend. Rebelsus has now been launched in 15 countries.

And if you look at the next slide you will see and that we felt just continues to increase and MPLX uptake.

And you see here that there is a continued uptake that has been answered.

Impacted by the reps in the field and that means as soon as we're back in the field, we see an uptick back to the original trend and without risk has now been launched in 15 countries and there's an increasing preference and awareness amongst acp's.

Camilla Sylvest: And there is an increasing preference and awareness amongst HCPs. And we also continue to do direct-to-consumer advertising to support the uptake of Rebelsus, where now more than 80% of the new scripts are new to the GLP-1 class. Also, in Japan, we have launched reverses into the oil market, where that is 80% of the total diabetes market. And here, we have reached a market share of 0.5% of the modern oil anti-diabetic market so far. In I.O., we continue to see very solid diabetes sales growth across all regions. You see here the total I.O.

And we also continued to do direct to consumer advertising to support and they all take off with US as we're now more than 80% of the new scripts.

Mutual the TLC one class also in Japan, we have launched with else's into the air.

And all market and that is a 80% of the total diabetes market and here. We have reached the market, yes, your 0.5% of the modern oral anti diabetic end market so far.

In Iowa, we continue a very solid diabetes sales growth across all regions you see here total Io diabetes reported sales of 10% and in and.

Camilla Sylvest: diabetes reported sales of 10% and in geographical areas in India also growing, same with China and the rest of the world, significant double-digit growth. This also means that our share of growth in the total diabetes value market share in the I.O. is significantly above our market share. That is due to that increase of 1.4 percentage points in the last year. In obesity, we see Saksenda growing 9% in the first quarter. That is up against the 3% that we grew for a full year last year.

Geographical areas EMEA also growing staying with China and rest of world significant double digit growth. This also means that our shelf both in the total diabetes value market share in that value market in aisle is significantly above our market share and that is due to that increased M. C.

1.4 percentage points in the last year.

And in obesity, and we see success growing 9% in the first quarter that is up against the 3% that we grew it.

So full year nausea, and you see also send out having been impacted by COVID-19, but is now back on a positive trajectory.

Camilla Sylvest: You also see Saksenda having been impacted by COVID-19, but it is now back on a positive trajectory, and we continue to gain both value and volume market share. And in biofarm sales growth of 1%, primarily driven by North America, and unchanged sales in international operations, the rare blood disorder sales increased 2%, and then the rare endocrine disorder sales increased also by 2%. So with that, I would hand over to Martin

That's it and we continue to gain both value and volume market share in obesity.

And in Biopharma sales growth of it.

1%, primarily driven by North America.

And unchanged sales in international operations.

The way I've got this order sales increased 2% and then the rare endocrine too. So it does change the increase there also by 2%.

So and with that I would hand over to Martine die.

Martin Holst Lange: Thank you very much, Camilla. So looking broadly across the R&D activities, we are progressing our early stage pipelines but also our late stage pipelines across the therapy areas that we are now moving into. Diving into two aspects, the first being the initiation of our phase 3 trial for semaglutide 2.4 mg in NASH. This is building on the finalization of our phase 2 trial for which we have been granted breakthrough designation from the US FDA, allowing us, together with the now initiated phase three trial, to serve as the basis for a regulatory submission. The phase three trial is a fairly large...

Thank you very much Camilla.

So looking for audio Crosby onto your activities. We are progressing our early stage, but also our late stage pipeline across the therapy areas that we are now moving in.

Diving into two aspects the first being our initiation of a phase III trial. So she may even try to put four milligram.

Nish. This is building on the Finalization of our phase II trial for which we have been granted breakthrough.

<unk> from the U S FDA.

Allowing us together.

The now initiated a phase III trial to serve as the basis for a regulatory submission.

Phase three trial is a fairly large 1200 patient trials, where we look to randomize patients to either see medical side, all placebo based on on a background or both are unaffected on a standard of care.

Martin Holst Lange: We have about 1200 patient trials where we look to randomize patients to either semaglutide or placebo.

Martin Holst Lange: The trial will be conducted in two parts, part one being a 72-week trial looking for a binary histology endpoint, one being resolution of NASH with no worsening of fibrosis, and the other being improvement in liver fibrosis with no worsening of NASH. We will base the regulatory filing, as I said, on the combination of the phase two trial that has been reported, as well as part one of the phase three trial The trial, however, will be continued in part two, where we will be looking for 240 weeks of treatment and liver-related outcomes as the key endpoints. Next slide, please.

The trial will be conducted in two parts part one being a <unk>.

72 weeks.

Trial <unk>.

And for a binary histology endpoint, one P and resolution of Nash with no worsening of fibrosis.

Improvement in liver fibrosis with no worsening.

Worsening of Nish.

We will face the regulatory filing as I said on the combination of the phase III trials that has been reported as well as part one of the phase III trial. The trial, however will be a continued impact to where we will be looking for a 240 weeks of treatment.

And.

Dave or related outcomes as the key inputs.

Next slide please.

Also very exciting in in acknowledged.

Martin Holst Lange: Also, very exciting in acknowledging the tremendous unmet need still in obesity, also in terms of having an opportunity to broaden our palette of offerings going beyond injectables. We've decided to initiate a program to evaluate all semaglutide 50 milligram versus placebo in the obesity space, obviously looking at weight loss as the primary objective. The 650-patient study will, together with two other studies, serve as the entire program, thus building on the well-known safety and efficacy profile of semaglutide and allowing us to bridge to the data and the labels already established for semaglutide.

Acknowledgment of a tremendous unmet need still in obesity.

Also in terms of having an opportunity to broaden our pennant of offerings.

Beyond Injectables.

We've decided to in Q3 initiate.

A program too.

Evaluate also magnetite 50 milligram versus placebo. If you piece just base, obviously looking at weight loss is the primary endpoint.

The 650 patient study will together with two other studies service the entire program does building on the well known safety efficacy profile of tomato side.

English to bridge to the data and the labels already established four should make at a time.

Excellent.

So looking at the broader R&D milestones for 'twenty one.

Martin Holst Lange: So looking at the broader R&D milestones for 2021, as discussed, we are conducting both early and late stage activities across our therapy areas. Starting in Q1, as we have already mentioned, we submitted but also received a refusal to file for our 2.0 milligram semaglutide for the treatment of diabetes. The refusal to file was related to more data being requested on manufacturing, and we are currently working to resubmit the file during the course of Q2 of this year. Also, in Q1, we initiated, in acknowledgement of a tremendous unmet need in patients with heart failure and preserved ejection fraction. I started evaluating the effect of semaglutide 2.4 milligram in this space, aiming to show

As discussed.

We are conducting both early and late stage.

Activities across all therapy areas.

Starting in Q1 as already mentioned.

We submitted but also received a refusal to file for a 2.0 milligram ER.

<unk> for the treatment of diabetes.

Refusal to file was related to more data being requested on on manufacturing and.

We are currently working to resubmit the filed during the course of Q2 of this year.

Also in Q1, we initiated.

At $8 <unk> of a tremendous unmet need in patients with heart failure preserved ejection fraction as dawdy evaluating the effect of some magnitude 2.4 milligram in this space.

Aiming to show improved quality of life and improved activities.

Performance.

In these patients where no treatment currently exist.

Martin Holst Lange: [inaudible] In Q2, we are looking very much forward to receiving the US FDA decision on our obesity submission for 2.4 mg of semaglutide. We also, in Q2, aim to initiate, basically later this month, our phase three program for Alzheimer's, which also is evaluating semaglutide versus placebo in the treatment of mild cognitive impairment or early dementia. Moving to Q3, we expect to see a re-start of our early innovation in insulin therapy, but we also expect to initiate our cardiovascular outcomes trials to evaluate the newly acquired siltivecumab compound in the space of atherosclerosis combined with inflammation.

In Q2.

We are looking very much forward to receiving the U S. FDA decision on our Bcl two submission for two to four milligram of Sue magnetite.

We also in.

In Q2 aim to initiate.

Basically later this month, our phase III program for Alzheimer's disease.

Which which also is evaluating magnified versus placebo in the <unk>.

Treatment of mild cognitive impairment or early dementia.

Awesome.

Moving through Q3, we expect to see readout of our innovation in.

All early innovation in insulin.

Therapy, but we also expect to initiate our country.

Cardiovascular outcomes trials to evaluate the newly acquired since it seems you're baking that compound.

In the space of atherosclerosis.

Bandwidth with inflammation.

Moving to two two to the end of the year.

Martin Holst Lange: Moving to the end of the year, we expect to have an EU decision on the obesity semaglutide 2.4 milligram assessment, and we expect readout of our SOGROI data for growth hormone deficiency in the pediatric space.

Phase two to have a an EU decision on the UPC Shabak retired two four milligram.

Assessment.

We expect read off of readout of our.

Supplier data fault for growth hormone deficiency in the pediatric space and we also expect as per plan to see clinical readout of.

Karsten Munk Knudsen: And we also expect, as per plan, to see a clinical readout of the ongoing phase 1, phase 2 mind-made studies. This is a little bit complex because we will actually see readouts based on cohorts throughout the next quarters, but we will look at the final assessment in Q4 this year. With that, back to you, Karsten.

Ongoing phase one phase II studies. This is a little bit complex, because we will actually see read outs.

Based on cohorts throughout the next quarters, but we will get the final assessment in Q4. This.

This year.

With that back to you guys. Thank.

Karsten Munk Knudsen: Thank you, Martin. Now we have our P&L for the first three months, so 7% sales and 3% profit, as I covered before. Gross margin down by 130 basis points, of which 80 is related to currency and the majority of the remainder is impacted by amortizations of the MSphere acquisition we concluded in the fourth quarter of last year. Sales and distribution costs up 16% driven by a front-loading of GDC investments and general investments behind Rebelsys and the launch of that branch, whilst we continue to invest in research and development costs linked to the portfolio of projects Martin was just going through. All in all, a net profit growth of 6% and EPS growth of 8%. Next slide.

Thank you Martin.

Then we have a P&L for the first three months of a Simpson sales since sweeps and profit us Iqos before Crossmatching Eh Eh.

530 basis points of which is related to currency and the majority of the remainder is impacted by amortization stuff off the atmosphere acquisition.

Concluded in the fourth quarter of last year.

Central distribution costs up 16%.

Driven by a frontloading of DTC investments John investments behind Red rebel Sis.

And the launch of that brand launch we continue to invest.

In our research and development costs linked to the portfolio.

<unk> Matson was what's just going through.

Oh, no net profit growth of 6% and EPS growth off of.

8% next slide.

Karsten Munk Knudsen: We experienced a significant currency headwind in the first quarter and hedged that accordingly. So we had 1.8 in negative impact on currencies, of which we offset half by hedging gains as described in our company announcements. Our outlook for the year is on this slide, and we have not been all the way back in our history books, but I would say this quarter marks the first time in several years, many years, where we increased our guidance, not only on the floor, but the overall range, already here in the first quarter.

Okay.

We experienced a significant currency headwind.

It went in in the first quarter and and it hits that accordingly.

So one eight in a negative impact on conscious off which we offset half by by hedging gains as described in our company announcements next time.

Our outlook for the year.

We have on this slide and to.

And we've not been all the way back in our history books, but but I'd say this quarter marks the first time in several years, many years, where we increased our guidance.

Guidance are not on the floor, but the oil rates already here in the first quarter. So that is of course, a clear indication of our strong start of the year and.

Karsten Munk Knudsen: So that is, of course, a clear indication of a strong start to the year and a solid outlook for the remainder of the year. So now our sales growth outlook is 6% to 10% and our operating profit growth outlook is 5% to 9%. No changes to currencies or the tax rate. And then, as a consequence of the stronger business performance and slightly lower capex outlook, now we're looking at increasing our free cash flow outlook to now between 37 and 42 billion and, as a consequence, increasing our share buyback from 17 to 18 billion.

And a solid outlook for the remainder of the year. So in all of our sales growth outlook of 6% to 10% and operating profit growth outlook five to nine no changes to currency. So our tax rate and then as a consequence of the stronger business performance and slightly lower Capex outlook now we're looking at.

We are increasing our free cash flow outlook to between 37, and 42 billion and as a consequence, increasing our share buyback from 17 to 18 billion kroner.

Karsten Munk Knudsen: Next slide, please. So this marks our walkthrough of first quarter performance across the four dimensions of our strategic aspirations as well as our guidance for the full year, and we are now ready to move into Q&A, and please limit yourself to two questions per person. I believe we have the first question from K. U. R. Parekh.

Next slide please.

So this this marks a walk through of our first quarter performance across the four dimensions in our strategic aspirations as well as our guidance for the full year and.

We're now ready to move into Q&A and please please constraint yourself to two questions per person and.

I believe we have the first question from Matt you're correct.

Operator: Please go ahead, Kiro; your line is now open.

Please go ahead. Your line is now open.

K. Udpada: Thank you. This is K. Udpada from Goldman Sachs. Thanks, Karsten.

Thank you skewed product from Goldman Sachs. Thanks Carsten.

K. Udpada: Can I kick off the first question where you ended, which is on our kind of record, this is the first time since 2008 that you've raised guidance on the top end in the first quarter. And I know there was some discussion on the call yesterday, but would love to understand what the franchises are where you are doing better than you originally expected? Is it a kind of higher GLP-1 growth? Is it a kind of lower insulin kind of degradation in price? Is it slightly earlier pick-up of obesity trends? Is it better biopharmaceutical?

Can I pick up the first question, where you ended which is.

One hour kind of recall. This is the first time since 2008 that you've raised guidance on the top end in the fourth quarter.

And I know there was some discussion on the call yesterday, but would love to understand what are the franchises bed you are doing better than you originally expected.

Higher G. L. P. One growth is ignore what insulin kind of degradation in price is it.

Slightly only pick up of obesity trends is it better or Biopharma. If you can help us understand that on a franchise that would be great.

K. Udpada: If you can help us understand that on a franchise level, that would be great. And then, secondly, as we think about the longer term, when you provided your strategic aspirations to 2025, back in November 2019, most of us assumed or kind of concluded that that meant kind of 5-6% compounded revenue growth through that period. Your first year post that, so 2020, was 7% CER. And the midpoint of your guidance range today is 8% CER.

And then secondly, as we think about the longer term when you provided your strategic aspirations to 2025 back in November 2019.

Most of us assumed or kind of concluded that that kind of five 6% compounded revenue growth kind of through that period.

Your first your pause that's a 'twenty 'twenty was 7% CER and the midpoint of your guidance range today is 8% CER.

K. Udpada: So, kind of, can you help us understand when might be the right time for you to qualitatively or quantitatively re-address your strategic aspirations? Or does the growth profile kind of revert downwards post 2021, 22, which I kind of struggle to see?

So kind of can you help us understand when might be the right time for you to qualitatively or quantitatively address just strategic aspirations or does the growth profile kind of reward downwards post 2021 'twenty, two which I kind of struggle to see thank you.

K. Udpada: Thank you.

Yeah.

Karsten Munk Knudsen: Thank you for those two questions, Keyur, and I think I'll cover both of them and then my colleagues can jump in if relevant. So first of all, raising our outlook top-line for the first time in more than ten years is, of course, not something we do lightly, and we never kind of change our outlook lightly without a thorough evaluation. It's basically a function of two things.

Thank you for.

So those two questions.

And I think I'll cover both of them and then my colleagues can jump in yeah.

So so first of all there are raising our outlook.

The top line for the first time in more than 10 years.

It's of course, not something we do lightly and we never kind of changed our outlook likely.

Without a thorough evaluations.

What it's basically a function of two things first a very strong start to the year. So so the underlying 9% run rate in the first quarter and then secondly, the indications. We're looking also through April and the new to brand scripts, we're seeing in the pick up both in the obesity.

Karsten Munk Knudsen: First, a very strong start to the year, so the underlying 9% run rate in the first quarter. And then, secondly, the indication we're looking at through April and the new two brand scripts we're seeing and the pickup both in the obesity business and the rebels' business, indicating a solid trend for also going into the second quarter. And then finally, the risk level that we're looking at vis-à-vis the potential risks for the full year that we had when we consulted back in February, which could be COVID and healthcare reforms.

<unk> and the rebel CIS business, indicating.

Trends are also going into the second quarter.

And then finally the risk level is.

That we're looking at vis vis the potential risks for the full year that we had when we guided to.

In February.

That could be COVID-19 and health care reforms. So this is not the.

Karsten Munk Knudsen: So this is not only about one therapeutic category; this is actually a strengthening outlook across the four different categories. As to our 2025 strategic aspirations, there you recall that we moved away from having, you could say, one single target, focusing very much on operating profit growth into a broader communication base on the four quadrants and strategic aspirations, and our key focus point on the top line was to deliver solid sales growth as well as solid operating profit growth, and that remains unchanged.

When you're on one therapeutic category this is actually.

Strengthening outlook across the four different categories.

As to as to our 'twenty to 'twenty five strategic aspirations.

There, you'll recall that we moved away from from having a say a one single socket are focusing very much on operating profit growth into into a broader communication based on the fourth quadrant and strategic aspirations and to and our our key focus point on the top line.

Wants to deliver solid sales growth as well as solid operating profit growth.

And and that remains unchanged then you can save we are off to a very good start with grew 6% and 19, 7% in 'twenty and now with a midpoint of eight so so we are truly delivering according to to the growth outlook.

Karsten Munk Knudsen: Then you could say we are off to a very good start. We grew 6% in 19, 7 in 20, and now we have a midpoint of 8. So we are truly delivering according to the growth outlook. And what you should be looking at is whether we are trending on market shares, which is also the case. So at this point, we don't see any fundamental need for changing anything in our strategic aspirations, but we believe that we are very well on the way to deliver on what we have already put out. Thank you. Operator, next question.

So what you should be looking at is whether we are trending on market share social and which is also the case. So at this point, we don't see any fundamental need for changing anything in our strategic aspirations, but and all we believe that we are very well underway to deliver on what we already put out.

Thank you operator next question.

Operator: The next question comes from the line of Kerry Holford from Berenberg; please go ahead.

Next question comes from the line of Kerry Holford from Baird. Please go ahead.

Hi.

Kerry Holford: Hi, thank you for taking my questions. Firstly, on stocking, the question here about the stockpile that we saw in the first quarter of last year and the pandemic, which you cited was largely patient level stockpile has the majority of that now unwound through last year. And where does that now stand as we finish Q1 2021? So with those dynamics in mind, what is the average shelf life for the products that were stocked in early 2020?

Taking my questions.

So Ken a question about this.

Something that we saw in the second quarter last year kind of dynamic.

He's tied to see patient level okay.

And then the judge of that now unwanted when well see.

See last year.

And when is that next time.

Let me finish Q1 'twenty one.

Those dynamics in mind, what is the off the shelf stock.

They put up misspoke.

N T.

Kerry Holford: and how would that play into new orders from those patients? And then secondly, on a high dose or some other type. I understand the trial protocols will require 18 weeks of dose escalation to get to the highest dose, 50 megs, so given the discussion points we've had before around that, I'd just like to hear your thoughts on what makes you more confident now that such a similarly lengthy timeline will be acceptable for patients. Do you have any client concerns, etc.? Thank you.

And how would that play into it.

Just a nice patients.

And then secondly, just my take on it.

And at that time.

I'm just kind of a child pledged colleagues will require I think its 18 weeks.

Let's get to the highest taste.

Thanks.

So given the discussion points the types of food.

Around that.

It takes.

Titration, Rick Clemmer for many cause appetite.

I'd just like to hear your thoughts on what makes you more confident now that's not to be a.

Thanks, he timeline.

Will be acceptable to patients do you have any cold screens concerned except a turnkey.

Karsten Munk Knudsen: Great. Thank you, Kerry, for those two questions. If I cover your stocking question, then, Martin, if you'll cover the oil-cement 50 milligram. So Kerry, as you allude to, in the first quarter last year, we had a stocking of 2 billion DKK, of which a big part was related to patient level stocking and the remainder on wholesaler. And wholesaler stocking pretty much flipped in the second quarter of last year, and hence the remainder was at patient level.

Great. Thank you carry for those two questions. If I cover the stocking question then a matching if you will cover the the oximetry 50 milligram. So so curious as you look to first quarter last year, where we had talking off of.

<unk>.

All of which are a big part was related to patient stocking.

And the remainder on wholesaler and wholesaler stocking a pretty much a flip in the second quarter of last year and hence the remainder was it was at patient level.

It's really hard to tease out the patient doesn't stocking. So that's not something we report it and track on an ongoing basis, you should anticipate to a question on shelf life that are that we have some minimum have two years of shelf life on the product set that we supply to them and to the markets.

Karsten Munk Knudsen: It's really hard to tease out patient level stocking, so that's not something we report and track on an ongoing basis. You should anticipate a question on shelf life that we have at least two years of shelf life on the products that we supply to the markets when we ship to wholesalers.

When we ship to wholesalers so on.

Karsten Munk Knudsen: So on that front, there could still be some destocking gradually during the latter part of 20 into 21, and perhaps even 22, but it's impossible to tease out what would be the destocking and if it will be consumed or not. Martin, then on all CMA 50 milligrams. Yeah, I think it's important to recall that already at seven and 14 milligrams, we are at pharmacologic active doses, so we are already experiencing both better glycemic control but also weight loss at those doses. So during a 16 week escalation, we actually see that patients adhere very nicely to this, and we see

On that front.

That could still be some destocking gradually during kind of the.

The latter part of 'twenty into 'twenty, one and perhaps even a 22, but it's impossible to to cheese out to.

What would be destocking, and if it'll be consumed a watch.

And then on cement.

So you mean 50 milligram yep.

Yes, I think it's important to recall that already it's at seven and 14 milligrams.

At pharmacology exit doses, so already accruing both better classroom of Controle, but also weight loss at that doses. So so during a 16 week escalation, we actually see that patients that she had very nicely to this end and we see that people.

Martin Holst Lange: in our ongoing high-dose diabetes trial appeared to be

Martin Holst Lange: The ABEDUS trial appeared to be accepting this dose escalation in good form. Great. Thank you, Martin. Next set of questions, please. Next question.

In our ongoing high dose diabetes trial appear to be accepting this dose escalation.

And in good form.

Yeah.

Great. Thank you Martin.

Next set of questions. Please.

Operator: The next question comes from the line of Peter Verduld from Citi. Please go ahead.

The next question comes from the line of Peter <unk> from Citi. Please go ahead.

Yeah.

Peter Verdult: Thank you. People at Old City, two questions. Karsten, just you and the Manningham team, I realize this has only happened overnight, but just how worried are you about the IP relating to the COVID vaccine spilling over to other essential medicines such as insulin and then just as a sort of part B to that.

Thank you.

<unk> Citi two questions.

You and the management team.

And so as that happens overnight, but just how worried are you about efforts.

Boyd IP related to COVID-19 vaccine.

Spilling over to other essential medicines.

You mentioned it and then just as a sort of puppy so pricing question.

Peter Verdult: This is a great long-term story here because of your portfolio. The current portfolio is mainly older drugs, so I know you are saying that you're just going to see what the proposals are.

China, we will not be.

These are great long term story here because of your portfolio.

But it makes the older drugs.

I know you will say, we're just going to see what the proposals all right.

Peter Verdult: This is one of the scenarios that you see, you know, sort of VP, BP, BP-esque.

One of the scenarios you see.

Yeah.

Yeah.

Okay.

Peter Verdult: you lose half your business in year one, and then you return to growth with strong volumes. Is that even plausible?

Business return to growth with strong volumes is that plausible.

Peter Verdult: in your view, and if not, why not? So that's a pricing question. And then more quickly for Martin on the pipe.

Do you view that adult vinyl.

So that's a pricing question and then we'll quickly tomorrow team.

The pipe.

Peter Verdult: Any timing update on SolSelect?

Any timing update also select Readouts signals, we're seeing from the program that's worth sharing.

Peter Verdult: , Peter Welford, Simon Baker, Emmanuel Papadakis, Eric Berrigaud, Benjamin Yeoh, Rajesh Kumar, Daniel Nodworski, Martin Lange, Louise Chen, Douglas Langa, Martin Jorgensen, Marcus Shevchenko, Andreas Fibig, Ludovic Helfgott, Martin Lange, Douglas Langa, Andreas Popkowski, Daniel Bohsen, Andreas Popkowski, Daniel Bohsen, Andreas Popkowski, Andreas Popkowski, and Martin Jorgensen,

Just to be clear those.

Demonstrates G.

Is that about initiating a patient.

Thank you.

Incentify stock would go up to two quick injection, where you're trying to match.

Because you have to make with.

Thank you.

Yeah.

Great. Thank you Peter.

That a handful of questions.

So if I start out on patents center in China in March and then if you cover so swollen select so so so pete on the AR on the patent issue in the U S.

Peter Verdult: To be clear, the STEMMA strategy is about initiating a pay

Peter Verdult: Thank you.

Karsten Munk Knudsen: Great. Thank you, Pete, for that handful of questions. So if I start out on patents and China and Martin, then if you cover Swole and Select. So, Pete, on the patent issue in the US, which emerged from COVID-19, actually, we do not believe that the existing patents are a barrier to the rollout of COVID-19. Then, as you know, for at least our older incidents, they are out of patent in the U.S., so that discussion is kind of totally, completely void.

First on the on COVID-19.

Then the actually we do not believe that the existing patents a barrier to the rollout of COVID-19.

COVID-19 on a global scale. So we don't think it would make a difference in terms of supply of COVID-19 vaccines for a number of reasons.

Then there is as you know for <unk> for at least all the instances they are out of patents in the U S. So that that discussion is kind of totally completely voids.

Karsten Munk Knudsen: And then, of course, it's important, as we all know, that this industry is based on a well-functioning patent system. That's why the industry at large, why we take huge risks and invest billions of kroner in developing highly risky projects to the benefit of patients and societies. So if that's not in place, of course, that will have very deep ramifications for society at large and patient outcomes. Then as to China and volume-based procurement, I think the key point here is that the Chinese government is working on a long-term plan, a 2030 plan, where they want to deliver improved healthcare for their population. And, of course, they want to do that in a way which is also affordable from a government point of view.

And then.

And then of course, it's important as we all know that the debt.

This industry is based on a well functioning patent system, that's why the industry at large, but why do we take huge risks and invest billions of corona. It developing a you know a highly risky projects.

Projects are to the benefit of patients and societies. So so if that's not in place of course that that will have you know a very deep ramifications for for society at large and patient outcomes.

And then as to as to China and volume based procurement I think the key point here is that the that the Chinese government that theyre working on a long term plan at 2030 plan, where they want to deliver.

Deliver improved health care for their population and of course they do.

They want to do that in a way, which is also affordable from a from a government point of view and so it's it's a long term plan in a fairly stable political setting and and that gives us of course predictable situations to work on and that's where we are part of that solution in terms of.

Karsten Munk Knudsen: And so it's a long-term plan in a fairly stable political setting. And that gives us, of course, a predictable situation to work under. And that's where we are part of that solution in terms of delivering new products to the Chinese healthcare market. So right now, we are investing in the market because we believe in the growth opportunity in the long run. So we're investing both behind Victoza and behind Traceeba and Rizotec. So for us, this is a growth story.

Delivering new products to the Chinese healthcare market.

So right now we are investing in the market because we believe in the growth opportunity in the long run. So we are investing both behind Victoza and Tresiba and rise to take so so far. So this is a growth story and yes, then it's another market that there will be tender based situations.

Karsten Munk Knudsen: And yes, as in other markets, there will be tender-based situations occurring over time, but this is basically older legacy products which are being exposed to competition. And our overall strategy is, of course, to pursue an innovation-based strategy for the benefit of patients and shareholders. So with that, Martin, over to Solan Select. Thank you very much. As you know, with any given outcome study, the timing sort of depends on, first, our ability to recruit patients, and second, the accrual of events, so basically the event rates.

Occurring over time.

But this is basically older legacy products, which are being exposed to competition.

Our all stretches of costs to pursue an innovation based strategy to achieve the benefits of a patient center and shareholders.

So with that much and also solar and select yep. Thank you very much.

As you know with any given the outcome study the timing sort of debating on first of all our ability to recruit and taken to the accrual of events. So basically the event rates.

I'm I'm, obviously super pleased to say that both shown analytics have finalized our recruitment as per plan during Q1 of this year.

Martin Holst Lange: I am super pleased to say that both Seoul and

Martin Holst Lange: People and Select have finalized their recruitment as per plan during Corona this year, not being delayed or significantly impacted by COVID-19. In terms of then moving forward, we're now basically dependent on the event rate.

Not in the delayed or significantly impacted by COVID-19.

In terms of them moving forward.

Basically dependent on the event rate.

We have it in.

Martin Holst Lange: Interpose the tripod assumptions and and so far, the assumptions

And to both try put assumptions and and and so far yes.

Martin Holst Lange: The results seem to hold more or less true, and therefore, we expect the Solar Intellect complete as previously discussed. In terms of readouts, we don't look into efficacy or safety readouts. We obviously have a DMC to monitor both trials. But we do look into whether patients stay in the trial and stay on treatment, and there those numbers look good and comforting. Also speaking, obviously to an acceptance of all To your second question, we are developing high doses of oral semaglutides to, from an efficacy, but obviously also from a safety perspective, match the higher doses of subcutaneous semaglutides.

She makes you more or less true.

And therefore, we expect our children selection to two two.

Compete as previously discussed in terms of Readouts, we don't look at true efficacy safety Readouts, we obviously have the ability to monitor.

This drives what we do look into two obviously if patients stay in the trial and stay on treatment and those numbers are.

Look look good encompassing ultra speaking, obviously true true and acceptance of an offering.

To your second question.

We are developing the high doses.

All of a sudden magnetite through from it if efficacy, but obviously also from a safety perspective, Mitch are the higher doses of subcutaneous to make the time.

Martin Holst Lange: Thank you, excellent. Thank you, Pete. Thank you, Martin. Next set of questions.

Excellent. Thank you Pete Thank you Martin.

Next set of questions.

Operator: The next question comes from the line of Peter Welford from Jeffreys. Please go ahead.

The next question comes from the line of Peter Welford from Jefferies. Please go ahead.

Peter Welford: Oh, hi, thanks for taking my questions. I'll just restrict myself to just first...

Oh, hi, thanks for taking my questions.

Firstly, just with regards to your comments on the underlying growth I think you commented that the underlying rate was around 9% because it was a 5% delta to the 14% ex the COVID-19 stocking I Wonder if you could just outline for us to break down that 5% if possible I think you mentioned that the does that but it was obviously a part of it but if you could give.

Peter Welford: just with regard to your comments on the underlying growth. I think you commented that the underlying rate was around 9% because there was a 5% delta to the 14% X for COVID stocking. I wonder if you could just outline for us or break down that 5%, if possible. I think you mentioned that the Zempik was obviously a part of it, but if you could give us

Any sort of split that 5% it would be very helpful. And then just curious when we think about Zen pick. The did you. How are you guys full blown Chi should we think again will there be any need for any additional holes for formulation to thoughts or would it be based on existing cartridges formulations and.

Peter Welford: [inaudible]

And how should we think about that with regards to positioning will it be very much does intensification for existing patients.

Peter Welford: , Peter Welford, Simon Baker, Emmanuel Papadakis, Eric Berrigaud, Emmanuel Papadakis, Harry

I also think there's an opportunity to grab some market share from competitors.

Peter Welford: , Peter Welford, Simon Baker, Emmanuel Papadakis, Eric Berrigaud, Benjamin Yeoh, Rajesh Kumar

It's not new for us.

And then second question just with regards to the 50 make whole rule Sandler again, just help us think about how we should handicap that study can you just talk a little bit about PK based on sort of all absorption and what you know about west.

Peter Welford: [inaudible]

Peter Welford: Thank you.

Oral 50 make sense versus injectable formulation.

Karsten Munk Knudsen: Thank you for that set of questions. So if I start out explaining the underlying 9% and then Camilla if you talk about the high dose and the 50 mg positioning versus the injectable semaglutide 2.4. So on the 9% and the 5% adjustment related to the current year, I think the way you've accounted for shipment and tender timing, then we are looking at an IR growth just a notch higher than 10%, and then the remainder of the 5% is related to U.S. wholesaler stocking, which I would say to the tune of half or so is related to the Olympic 3 milligram pen presentation being launched. Then, Camilla, how do we position the samaricocyte high dose vis-à-vis current treatment for diabetes? Yes,

The Zip Pak.

And how we should therefore think about essentially where we could get to in that study again. Thank you.

Thank you.

That's a set of questions. So so if I start out.

Explaining the underlying nine 9% and then can be life, if you talk to the high dose and.

And the 50 milligram positioning versus say the injectable somatostatin to control. So it so on the on the 9% and 5% adjustment related to current year I think the way you should think about it is that that io growth of 9%.

When we adjust for stock.

Sorry for shipment in two tender timing then we're looking at as an iron.

And just a notch higher than 10% and then the remainder of our.

Of the 5% is related to U S wholesaler stocking of which.

I'll say to the tune of half or so is related to two or.

<unk> three milligram presentation being being launched.

Then.

Camilla, how do we position some exercise hydro's.

The country consumed after having just yet so and we know from our clinical trials from Lasalle take that eight out of 10 patients can't get in glucose control and with a weight loss and so what the way we are thinking of at high doses that that a few patients that overtime.

Camilla Sylvest: Yes, so we know from our clinical trials in Mozambique that 8 out of 10 patients can get into good glucose control with weight loss. So the way we are thinking of high doses is that there are a few patients that, over time, due to the progressive nature of diabetes, would need a higher dose and potentially could benefit from that. So that's how we basically see that patients can stay on DLP-1 for a longer time and with that keep the benefits in terms of glucose control and also blood sugar control, and with Mozambique, we also have a proven cardiovascular profile. So this is how we see the benefits of high dose.

The progressive nature of the diabetes.

It wasn't and need a higher dose potentially it can benefit from that so that's why that's how we basically see that patients can stay on a P. O P. One for a long time and with that keep the benefits and intense of glucose control and also blood sugar control and data centers. We also have a proven.

Cardiovascular.

Profile, so and this is how we see the benefits of a high dose.

Camilla Sylvest: Then you also had a question on 50 mg positioning in oral obesity versus injectable 2.4. Here it's important to mention that we know today that approximately only a quarter of the primary care physicians that are approached by patients with obesity are referring those to specialists. And that means that there is a big potential for those primary care physicians to treat people with obesity, but some of them are also reluctant to treat them with an injectable therapy.

Then you had a question also on the 50 milligram positioning and so or obesity versus injectable too painful. He is important to mention that we know today that approximate the only.

A quarter of the primary care physicians that are post with the patients with obesity are referring dose, especially and some of them.

And that means that there is a big potential for dose the primary care physicians to themselves treat people with obesity, but some of those are also reluctant to treat with an injectable therapy. So the way, we think about our hydro spot ethylene potentially the same.

Camilla Sylvest: So the way we think about a high-dose product with potentially the same efficacy as 2.4 is that there is a bigger group of physicians that will be able to treat obesity at the first instance where they meet the patients. So this is a way for us to make sure that we can tap into a bigger group of physicians.

Because he asked too painful is that there is a speaker group of physicians that we'll be able to treat obesity at the first instance, where they meet the patients. So this is a way for us to make sure that we can as having Topeka proof of it.

And with that make sure that we can.

Martin Holst Lange: Thank you, Camilla. Sorry, if you think about the PK, sorry, can you help us put 50 MIG oral in perspective from a sort of clinical perspective? How should we think about 50 MIG in terms of the PK versus the injectable formulation of adempic? Absolutely not. It's basically the same thing. We're looking at high doses of subagglutide, both oral and subcutaneous, as we did when we had to compare osembic and repulsive.

It provides and the benefits of sumac decide to even more people with living with obesity.

Thank you Camilla alright. Thank you Pete if you think about the PK sorry can you help us.

Make oral.

For the purposes of.

Clinical perspective, how should we think about 50 make in terms of the PK buses.

Taxable formulation does that bake.

Absolutely and it's basically the same thing.

We're looking at looking at the higher doses of sabbatical try both oral and subcutaneous as we did when we were we had to compare with sandvik and rebels so from a regulatory perspective.

Martin Holst Lange: So from a regulatory perspective, of course, we, you're absolutely right, there's a little more variability. The confidence interval for the oral formulation is a little broader, but given everything we've seen so far also for the 50 milligram, the confidence interval and obviously is making 50 milligram comparable to approximately 2.0 to 2.4 milligram of subcutaneous.

Of course, we.

You're absolutely right, there's a little more variability the confidence interval for the oral formulation is.

It's a little broader.

But but but given.

Everything.

We have seen so far also for the 50 milligram.

The confidence interval and obviously the mean.

Is making 50 milligram comparable to approximately 2.0 to 2.4 milligram of subcutaneous.

Martin Holst Lange: Thank you, Martin. Thank you, Pete. Next set of questions.

Yeah.

Thank you Martin Thank you Pete next set of questions.

Operator: The next question comes from the line of Simon Mather from ExampBNP. Please go ahead.

The next question comes from the line of sight from Exane BNP. Please go ahead.

Simon Baker: Thank you, everybody. Just a couple of questions and a follow-up on the 50 milligram oral center. Just obviously, a strong start to the year. Maybe we can touch on ribelsis a bit.

Thank you everybody.

Just a couple of questions and as a.

A follow up on the 50 milligram.

Or just.

Obviously, a strong start to year, maybe you can touch a bit on the rebel CIS I appreciate yesterday discussed the stocking that we got in Q4 and also the rebate reversal, which you know lots of Q4. So therefore Q1, probably wasn't as weak.

Simon Baker: I appreciate yesterday you discussed the stockpile that we had in Q4 and also the rebate reversal which flattered Q4 so, therefore, Q1 probably wasn't as weak as maybe it was perceived yesterday. But could you maybe just talk about your levels of confidence for the remainder of the year? Appreciate this third launch of this product. You've had DTC now going for quite some time. Just wondered if you could maybe share some real world compliance data and whether we can finally put to bed this whole concept that patients wouldn't like the drug because they have to wait until they can eat.

Maybe it was perceived yesterday, but could you maybe just talk to your levels of confidence for the remainder of the year. I. Appreciate is the launch of this product.

DTC now going for quite some time.

Just wondering if you could maybe share some real world compliance and whether we can finally put to bed. This whole concept the patients wouldn't licensed drug because they have to wait until they're getting on with.

Simon Baker: And with all of this, therefore, your confidence of achieving current consensus estimates of 6.6 billion corona for this year would be would be helpful. Secondly, just a follow up to yesterday, one of the questions. Can you 100% rule out that the refusal to file

All of this stuff for your confidence of achieving current consensus estimates of $6 6 billion for this year would be.

It would be it would be helpful and secondly.

Secondly, just a follow up to yesterday one of the questions.

Can you, 100% rule out, but the refusal to file some at 2.0 has absolutely no bearing whatsoever on.

Simon Baker: for

Simon Baker: , Peter Welford, Simon Baker, Emmanuel Papadakis, Eric Berrigaud, Emmanuel Papadakis, Mark Purcell, Daniel Bowers, Harry Sephton, Lars Jorgensen, Michael Novod, Thomas Bowers, Harry Sephton, Lars Joergensen, Martin Lange, Ludovic Helfgott, Lars Jorgensen, Daniel Bohsen, Andres Jen Thank you, Simon. I lost count of the number of questions. So hopefully, we will capture them all. But the first one for you, Camilla, on Rebelsys and what makes us confident that we have such a great product and launch trajectory. Then Martin's refusal to file 2.0 versus 2.4. And then the outcome of the 50 mg dose and the spillover opportunities vis-à-vis Alzheimer's. So, Camilla, if you start off.

2.4, obviously the producers for June I'm, just wondering if you can help us understand why it would have no bearing if they're manufactured in different facilities, author and the same and therefore, just help us a bit more comfort on that would be helpful. And then just a final one on the 50 milligram dose I guess put simpler.

Weight loss.

Tunnel modeling suggests that you could achieve with a 50 milligram dose.

And to that point clearly your injectable summer programs and our role in two four milligram dose.

Just wondering if there's maybe a change in your stance with respect to all set up for outside mirrors I think youre going to report. So you can make dose why not go for a 50 milligram dose okay.

Yeah.

Great. Thank you and thank you Simon.

Kind of the number of questions. So hopefully we will capture capture them all but the first one.

For you Camilla on Roberto Center, and and what makes us confident that our debt.

We have such a great product.

Launch trajectory than March and a refusal to file.

At two point over 2.4.

And then the.

Outcome off the 50 milligram dose and the spin.

Hello.

Yes.

So if you start off.

Karsten Munk Knudsen: Yes, so we remain very confident in the rebalances because, despite two lockdowns, we now see that prescription volumes have increased approximately 20% from Q4 to Q1. And we also see market share steadily increasing. So, despite the ups and downs on NBRX, we see a very strong and steady TRX trend. And this is, of course, based on the fact that both the number of prescribers and the number of scripts per prescriber are also steadily increasing.

Yeah. So we remain very confident in everything else is because despite two lockdowns. We now see that prescription volumes have increased approximately 20% from Q4 to Q1, and we also see market share steadily increasing so despite the ups and downs in MPLX, we see a very strong and steady trend.

And this is of course based on the fact that those are the number of prescribers and empty and number of scripts per prescriber base also steadily increasing and eh.

Karsten Munk Knudsen: And now that we have reps back in the field in the US, we see that we are back on a very strong trajectory with that. We also can confirm that the positioning, meaning that 80% of the scripts are coming from outside TLP-1, continues in the same way as we have communicated before. And now with real-world evidence, we are also able to see that the data look good. We haven't published it yet, but we expect to be able to do that soon. So, all in all, we remain very confident in Rebelsus, and we continue to track on a very good trajectory despite the lockdown.

And now we wouldn't be here, perhaps back in the field and USB C.

And we are back to a very strong trajectory on that.

We also can confirm that.

The positioning and meaning that the 80% of the scripts are coming from outside of tier one that continues the same way as we have communicated before.

So.

And now with real World evidence. We are also able to see that those data look good we haven't published yet, but we expect to be able to do that so all in all we remain very confident in every vouchers and in N V. I am continue to track on a very good trajectory. Despite the lockdowns.

Perfect. Thank you familiar in the Marcellus shale.

Camilla Sylvest: Thank you, Camilla, and the Martin Audio team. So, thank you very much. First on the refusal to file, I can't go too much into an ongoing regulatory review, but obviously, the 2.0 milligram for diabetes versus the 2.4 milligram for obesity are two independent files, and we have no indication that the data requested from 2.0 milligram for diabetes would spill over or impact.

Thank you very much so first on the refusal to file I can't go too much into an uncle and regulatory review, but but but obviously the two zero milligrams for diabetes.

Versus the two four milligram full pieces here to independent files.

And we have no indication that that.

The data requested from two zero.

Milligram in diabetes.

Martin Holst Lange: Director, 2.4 Milligram Assessment in Obesity at this point, on Alzheimer's disease. This was

What impact the two four milligram assessment in obesity at this point.

On the Alzheimers disease. This was specifically discussed.

Martin Holst Lange: and Peter Welford, from an efficacy perspective but also from a safety perspective, if every data point that we have at this point has been generated with diabetes.

Well from an efficacy, but also from a safety perspective, if every data point that we have at this point.

Has been generated with diabetes doses show, the what would be comparable to seven and 14 milligram doses.

Martin Holst Lange: The following are the latest doses, so what would be comparable to 7 and 14 mg of ribelsis? These have proven to be

He's a proven to be very efficacious and establishing the proof of concept.

Martin Holst Lange: Very effective in establishing the proof of concept, and at the same time, very clear advice from the neurologists that have guided us in this that in a fragile population, being careful not to induce too high of a weight loss, and obviously, going to the higher doses, higher weight loss would be expected. So on the balance of efficacy versus safety, we do believe, together with the regulatory authorities, that the diabetes level 7-14 mg dose is the correct one. Sorry about the weight loss. Apologies, yeah, for

And at the same time very clear advice from from the <unk>.

Colleges that have guided us in this that in a fragile population.

Being careful not inducing too high of a weightless and obviously go into the higher doses.

The higher weight loss would be.

Expected, so underpayments of efficacy versus safe.

Safety.

We do believe together with the regulatory authorities that that that the diabetes level 714 milligram dose.

Other correct to choose.

Okay.

Yes, sorry, the Whitehorse apologies here.

For the 15 milligram expected weight loss with a system that you expected. The wait list for the 50 milligram will be comparable to the weight loss that we have observed for 2.4 milligram of subcutaneous medicine.

Martin Holst Lange: of Subcutaneous Magnesite.

Martin Holst Lange: Thank you, Sam.

Martin Holst Lange: Thank you, Simon. Thank you, Martin.

Karsten Munk Knudsen: And we've been talking a lot about trends, and I think if we could change the trend in terms of questions back to two questions per person, then I think we can allow more to get to. So next set of questions, please.

Thank you Sam thank.

Thank you Simon Thank you Martin.

And we've been talking a lot about trends.

And I think if we could change the trend in terms of questions.

Two questions.

Per person than I think we cannot allow more time to get to so next set of questions. Please.

Operator: The next question comes from the line of Naresh Chouhan from Intron Health. Please go ahead.

The next question comes from the line of John.

Please go ahead.

Hi, there.

Naresh Chouhan: Hi there, thanks for taking my questions.

For taking my questions.

Just on.

Naresh Chouhan: Just on the GLP-1 market shares, please. On slide 7, you show a drop-off in market share for the total Novo Nordisk GLP-1 franchise, which seems to have been lost to Trlicity. So, two questions on this. One, can you help us understand what's caused that? And two, more importantly, does this signal a more competitive pricing environment amongst the more efficacious GLP-1s?

The GOP on market shares. Please on slide seven you show a drop off in market share.

For the title Novo Nordisk GOP, one franchise, which seems to have been lost to Felicity.

Two questions on this one can you help us understand what's caused that in too.

More broadly does this signal a more competitive pricing environment amongst the Morris of cases GOP ones. Obviously was seen at the lower end, but we haven't seen that between is that they can truly ste.

Naresh Chouhan: We've seen it at the lower end, but we haven't seen that between.

Naresh Chouhan: Uzbek and Trilisi, and obviously with the upcoming launch of Tezepatide and the 3.0 maker, just a sense of what's happening with pricing would be really helpful in the US. Thank you. Great. Camilla, do you have two more market shares between Osempic and Tuliste?

And obviously with the upcoming launch it is episodic.

Zero.

Sense of what's happening on pricing would be really helpful. In the U S. Thank you.

Okay.

Do you have drawn martius between simply can't are interesting.

Camilla Sylvest: Yeah, so at the beginning of the year, we saw Trulicity launching their high dose, and you see a small increase in their NBRX share at the beginning of the year. But most recently, you see that gap narrowing a bit again.

So at the beginning of the year results release, if you know what I'm seeing that high dose and you see a small increase in that empiric sure in the beginning of the year, but most recently you'll see also that are capped.

Gap and narrowing a bit again and what's important for US is the continued class growth is around 20% in the market and that means that there.

Camilla Sylvest: What's important for us is that class growth is around 20% in the market, and that means that there is, you can say, continued innovation in this segment that also means that the fact that today only around 8% of people are being treated with GLP-1 is likely to increase when this market is expanded by more than one company in the area. What is important for us is, therefore, that we continue to innovate in this segment.

There is.

You can say our continued innovation in this segment that also means that the.

The fact that today only around 8% of people are being treated with <unk> and <unk>.

Likely to increase when we when this market is expanded by by more than one and you can take company in the area.

What is important for US is therefore that'd be continue to innovate in the segment and of course suite of S&P. We see a continued a high share of growth in the class eight an M 80 basis.

Camilla Sylvest: And of course, with OCEMPIC, we see a continued high share of growth in the class on an MAT basis. So this, of course, is important for us, and we are also planning to launch a high dose later on, as we discussed earlier in this call. So that's primarily what's around the market shares in the GLP-1 segment in the U.S. Thank you.

So this of course is important for us and we are also planning for launching a high dose later on as we discussed earlier on in this call.

That's but that's primarily what is the what's around and the market shares in the tier one segment in the U S.

Thank you Camilla and as to pricing.

Karsten Munk Knudsen: Thank you, Camilla. And as to pricing, in reality, there is nothing new to report. We have a high degree of market access, more than 90%, and when you look at the volume value spread, which has been a favorite, then it's similar to what we saw last year. So there are no changes in dynamics.

In Red So nothing new to report with a high degree of market access more and more than 90% and when you look at the volume value spread which has been kind of favorite and it's it's.

Similar to what we saw last year, so no changes in dynamics.

Operator: The next question comes from the line of Michael Lurkson from UBS. Please go ahead.

Next question please.

Next question comes from the line of Michael Weinstein from UBS. Please go ahead.

Michael Leuchten: Oh, thank you. Two questions, please. One, Karsten, just going back to...

Thank you two questions. Please one cost and just going back to the.

Michael Leuchten: The dynamics around the guidance increase this time of the year. Thank you for the moving parts.

The dynamics around the guidance increase this time of the year. Thank.

Thank you for the for the moving parts.

Michael Leuchten: But you haven't narrowed the corridor; it remains wider than it normally is. If you had more confidence around healthcare reform and COVID dynamics, why did you not narrow it? So that's question number one. And then question number two for Martin, just going back to the heart failure trials that you started, just interested in your thoughts around timing here. There are incremental data points in the near future around other modalities in heart failure with preserved ejection fraction. You're kicking off trials now, which maybe had you waited a little bit longer might have given you a little bit more.

But you Havent narrowed the corridor remains wider than it normally is since you have had more confidence around health care reform.

And COVID-19 dynamic why do you get up narrow it.

So that's question number one.

Question number two four for Martin.

Going back to the heart failure trial that you started just interested in your thoughts around timing here there are incremental data points in the near term future around other modalities in heart failure with preserved ejection fraction.

Trials now.

Which maybe you had to wait a little longer might have given you a little bit more insight into this patient population, but yesterday pointed out we don't really have another treatment option. So wondered if you could talk a little bit about the decision to launch now as opposed to maybe wait for another few data points.

Michael Leuchten: I think that the program might have given you a little bit more insight into this patient population. Yesterday, we pointed out that we don't really have a lot of treatment options. So I wondered if you could talk a little bit about the decision to launch now as opposed to maybe waiting for another few data points.

Karsten Munk Knudsen: Great. Thank you, Michael. So I'll take the first on guidance, and Martin will take the heart failure question. So Michael, I think it's a classic discussion about the breadth of the ranges. When we evaluated it, then basically, what we looked at was, again, the strong Q1 performance and the risk picture for the year, which indicated that the midpoint of our range would be higher. So that's what made us increase both the floor and the top range of the guidance range.

Great. Thank you Michael So I'll take the first one on guidance in March and it took the sort of your question. So Michael I think it's it's a classic discussion on the breadth of the ranges when.

When we evaluate it and then basically what we looked at was again the strong Q1 performance and the risk picture for the remainder of the year and and.

And which indicated that the midpoint of our range.

It would be high so that that's what made us increase both the floor and to end the top range of the guidance range. So so this was.

Karsten Munk Knudsen: So this was a clear reflection of a stronger performing business and also a lower risk level. You can always kind of theorize around the breadth of the range, but fundamentally it's stronger online performance and lower risk that led us to this guidance, which is, in reality, not unusually broad if you compare it to some other companies in the sector.

A clear reflection of our stronger performing business and also lower risk level. Then you can always kind of a.

Regicide surround the breadth of the range, but fundamentally it's it's stronger underlying performance and lower risks that that led us to this guidance, which is in reis not unusually projects compared to some other companies in the sector.

So so much in on a on a.

Martin Holst Lange: Absolutely, so as you also mentioned,

Absolutely. So as you also mentioned hip if is usually underserved population as we speak.

Martin Holst Lange: So as you also mentioned, HFPF is a hugely underserved population as we speak, more than 20 million, 25 million patients suffering from this, 80% of them are also suffering from obesity and it has been shown that weight loss can improve the functionality of the patients so to speak, improve their everyday activity, improve quality of life, improve their stamina and obviously moving into the obesity space hopefully soon, launching 2.4 mg of semaglutide, it makes sense for us to explore broader how we can help also in obesity related comorbidities, HFPF being one, but obviously we are also looking at peripheral Thank you, Michael. Thank you, Martin. Then the next set of questions.

More than 20 million 25 million patients suffering from this.

80% of them are also suffering from obesity and it has been shown that weight loss can improve.

The functionality of the patient so to speak.

Improved.

Everyday activity improve quality of life.

Their stamina.

And obviously moving into two pieces.

She space hopefully soon launching two four milligram.

It makes sense for us to explore broader how we can help also.

PCT related Comorbidities have been won but obviously.

Sure.

Peripheral artery disease, we're looking at auto arthritis, and we're looking at it broadly speaking in this electrified and cardiovascular disease.

Martin Holst Lange: The next question comes from the line by Vimala Kapadia from Bernstein. Please go ahead. Oh, great. Thank you very much.

Thank you Michael Thank you Martin.

And our next set of questions.

Next question comes from the line of.

Operator: Well great, thank you very much for taking my questions, I won't multiply them, from Bernstein. Can you come back to China, please? And what are you thinking about the GRP-1 outlook in the country? So how far can the cost actually go? Should we be thinking about a penetration level that's similar to the US over the long term in terms of total diabetes volume? So is there a structural reason why, in the longer term, it could be lower than US levels? And then, just tied to that, how do you think about growth in China more broadly versus the rest of the world moving forward? Is it actually accretive or dilutive to the region?

From Bernstein. Please go ahead.

Oh, great. Thank you very much for taking my questions.

Somebody doesn't come back to the China. Please on how youre thinking about the.

The <unk> outlook.

In the country. So how far can the costs actually go should we be thinking about a penetration level that is similar to the U S. Over the long term in terms of total diabetes volume. So is there a structural reason why why.

The longer term.

It could be it could be lower than in the U S levels and just tied to that how do you think about the growth in China more broadly versus the rest of IL moving forward is it actually is accretive.

Diluted to our to the region and then my second question is just a bigger picture question on on semi glu tied and you're clearly investing quite heavily in the molecule across various metabolic indications. So I'm. Just curious how you think about the concentration risk longer term you reformulate. The order a second assume IP will be extended but how are you.

Vimala Kapadia: And then my second question is just a bigger picture question on semi-glutide, and you're clearly investing quite heavily in the molecule across various metabolic indications. I'm just curious how you think about the concentration risk longer term. You're reformulating the oral product, so I can assume IP will be extended, but how do you think about the injectable product longer term? What is the company doing to ensure that IP risk is moderated longer term given you're investing quite heavily?

Think about the injectable product longer term what is the company doing to ensure that IP risk. It is moderated longer term given you're investing quite heavily thank you.

Vimala Kapadia: Thank you.

Karsten Munk Knudsen: So on the first one, the GLP-1 opportunity in China, I'll hand it to you, Camilla, and then R&D strategy and concentration risk, I think that's a key one for you, Martin, it's the core R&D strategy. So Camilla, the GLP-1 opportunity in China.

So yeah. So on the first one.

The tier one opportunity in China.

Hunter you Camilla in and then the R&D strategy and concentration risk I think that's a that's a key one for Ya marching at its core R&D strategy. So so can we just went up Chongqing China.

Yes, so in China, we are only just embarking on the tier one opportunity as we are basically at the 1% of the total diabetes market as you know in the U S and in Europe BMO to around.

Camilla Sylvest: Yes, so in China, we are only just embarking on the GLP-1 opportunity as we are basically at 1% of the total diabetes market. As you know, in the US and in Europe, we are more to around 10% of the total market. So it means that in China, there is no difference in terms of unmet need.

10 ish percent and.

Of the children market. So it means that in China. There is no difference in terms of unmet need on the contrary many people in China, who would also potentially benefit from a tier one treatment. However in terms of regulatory approvals, we only had victoza approved.

Camilla Sylvest: On the contrary, many people in China would also potentially benefit from a GLP-1 treatment. However, in terms of regulatory approval, we only had Victoza approved not that many years ago, and for a number of years, it was unreimbursed. Now we are in a different situation with having Victoza reimbursed, and we see growth this quarter to the tune of close to at least above 85% in that segment, so primarily driven only by Victoza.

Not that many years ago and for for a number of years it was unreal.

Now we are in a different situation with having the Tulsa reimbursed and we see a growth.

This quarter to the tune of close to or at least above 85% and in that segment, So and primarily driven only by the tusa and now last month, we had <unk> approved in China. So as.

Camilla Sylvest: And now, last month, we had Osempic approved in China. So whereas, of course, we would need to go through the usual processes in China with bidding, reimbursement, and so on, there is still a very big unmet need and opportunity to get to the level of where we are in Europe and in the US on GLP-1 in China.

Well as of course, we would need to go through the usual processes in China, repeating and reimbursement and so on that's still a very big unmet need and opportunity to get to the level of where we are in the Europe and in the U S.

Andrea if you want in China.

Camilla Sylvest: Great. Thank you, Camilla and Martin on concentration risk. Yeah. So, so, as you say, we're investing in the semaglutide molecule, maximizing the value, both for the patients but, obviously, also the broader value of the semaglutide molecule. We are cognizant of the pattern life. And obviously, we're looking into

Thank you Camilla and marching on concentration risk.

So so so obviously as we say we are investing in D. C Metro type molecule maximizing the value both.

Both for the patients, but obviously also.

Broader value of this should make the type of monitoring we are cognizant of the.

Yeah.

All of the patent life and obviously.

Karsten Munk Knudsen: , Peter Welford, Simon Baker, Emmanuel Papadakis, Eric Berrigaud, Daniel Bowers, Harry Sephton, Lars Jorgensen, Michael Novod, Thomas Bowers, Harry Sephton, Martin Lange, Douglas Langa, Lars Joergensen, Matthew Weston, Daniel Bohsen, Andres Hggblom, Andreas Hggblom, Stephen Atkins, Matthew Weston, Novo Nordisk, Stephen Atkins, Daniel Bohsen, Andres Hggblom, Andreas Hggblom, Andreas Hggblom, Andreas Hggblom, Andreas Hggblom, the importance of China, and I would say when I look at our P&L here in the first quarter, and you saw the 60% spend increase on S&D, part of that I said was rebalances, but another part is investment in China and growth in our innovative product portfolio, be that Victosa, Rizodec, Traceeba. And then what we don't have in the Chinese market at this point is both our obesity franchise, its rebalances, and we are kind of relatively speaking underutilized on our biofarm portfolio, where we're also investing quite a bit these days.

Looking into our pipeline now that that moves beyond magnified.

Both within diabetes obesity, but also broadly in all this.

These areas securing there that we are in a good place also for front from an IP perspective.

Following the runoff of the sumac what's happened.

Thank you Martin and <unk> and then to go to.

The second piece of your commercial question vis vis the importance of China, and I would say when I look at our P&L in the first quarter than the than the and you saw the six incentive spend increase.

The S&P part of that I said was the rebels as but another part of this investment in China and growth in <unk>.

If their product portfolio B b that victoza right should take Tresiba.

And.

What we don't have in China in the Chinese market at this point is both our obesity franchise.

It's rebel Sis and and we are kind of relatively speaking.

Under utilized.

Utilized on our biopharm portfolio.

Sure.

Investing quite a bit these days. So so China is a key growth driver for the company for many years to come as to the relative gross growth versus Io.

Karsten Munk Knudsen: So China is a key growth driver for the company for many years to come. As to the relative growth versus IO, we're not guiding down to specific regions, but as you see, this quarter, China is actually accretive to growth for IO. Thank you. Next set of questions.

We're not guiding down to a specific regions, but as you see.

This quarter actually China is accretive to growth for file.

Thank you the next set of questions.

Next question comes from the line of Richard Vasa from J P. Morgan. Please go ahead.

Operator: The next question comes from the line of Richard Wasser from J.P. Morgan. Please go ahead.

Thanks for taking my questions just going on other regions.

Richard Vosser: Thanks for taking my question. So just going on other regions for ASEMPIC and RIBELSIS in international operations, how do you balance the launch of the two brands over the next few years? Perhaps you could talk about the geographic expansion opportunities you have with those, the opportunities to increase penetration in a similar way to what you talked about in China. So maybe you could talk about the dynamics there and how you think about those dynamics and whether that's a good corollary for VBP for other insulins in China. Thanks very much.

Right.

That's an operation how do you balance the the.

The launch of the two brands over the next few years, perhaps you could talk about the geographic expansion opportunities you have with those.

Opportunities to increase penetration in a similar way too you talked about that in China. It seemed like a very strong start for a second because I know there was some maybe.

Tender timings or shipment timings, but it seems it jumps out so you talk about the price there and then secondly, coming back to GDP in China.

Richard Vosser: Thank you, Richard. So, Camilla, if you would talk about kind of the global rollout of Rebelsis and Ocempic and how we think about that in the rest of the world and the opportunity there, and perhaps also a little bit of color on it, because you had experience of human insulin in China while you were there, so just kind of the competitive pressure and how we dealt with the local manufacturers and the competitive pricing already in human.

Yeah human in Spain has been competing on the ADL score for a number of years with local players.

And I think it's been.

Sort of relatively flat and stable at that time, So maybe you could talk about the dynamics there.

And how you think about those dynamics and whether that's a good.

Corollary or.

So as EVP for other incidents in China, Thanks, very much.

Thank you Richard.

So so camilla.

Camilla Sylvest: Thank you. So, basically, the dynamics in terms of the balance of the brands, Rebelsis and OCEMPIC, are quite similar across the world. It basically means that in most countries of the world, two-thirds of the potential is in the oil segment. So with our launch of Rebelsis, we are entering that segment for a primary care physician audience also that traditionally has preferred an oil compound. So of course, in some markets, this opportunity is extraordinarily big, like in Japan, which I believe you were referring to. And in Japan, 80% of the potential is basically in the oil segment. Here, also, primary care physicians have traditionally not prescribed injectables.

We will talk to to kind of the global rollout of rebel incentives and pick and how we think about that in restaurant and the opportunity there.

And perhaps also a little bit of color from it because you had experience on human insulin in China, while the value of that so so just to kind of the competitive pressure in that and how we dealt with it.

With the local manufacturers and the competitive pricing already in human insulin.

Yep. Thank you.

So basically the dynamics.

Terms of the balance of the friendship with answers I understand quite similar across the world and it basically means that in most countries have to work through so I took a potentially sandy segment. So we our launch of rebel since we are entering into.

Into that segment to a primary care physician audience also that traditionally have prefer an oral compound. So of course in some markets. This opportunity is extraordinary peak like in Japan that I believe you were referring to.

And in Japan, 80% of the potential is basically in the oil segment.

And also a primary cancer patients have traditionally not prescribed injectables. So we have not engaged with dose in the past. That's why we have teamed up with a partner in Japan and his team to help us promote but in other countries. There is a.

Camilla Sylvest: So we have not engaged with those in the past. That's why we've teamed up with a partner in Japan, MST, to help us promote. But in other countries, like in the US, there is more of a habit of primary care physicians also prescribing injectables, and that's where we have had a bigger tradition of getting engaged with those. So depending a little bit on the exact size of the segments per market, we position ourselves with those in the oil segment clearly and, of course, authentically in the injectable segment.

Like in the U S. There is.

And more of a habit of primary care physicians and also prescribing injectables and where we have had as big a tradition of getting engaged with dose so it depending a little bit on the exact size of the segments per market, we do precision with houses into all segments, clearly and it and of course in authentic Indian Jacob.

Segment so.

Camilla Sylvest: So in terms of resources and so on, we also try to allocate resources in a competitive way across both segments so that we can compete. When it comes to increasing our penetration geographically, we are basically rolling out Belsus and Osempic in most countries. It takes, you know, a little while, but we are progressing. And with Belsus, we are now in 17 countries, and with Osempic, we are in 58 countries now. So that's progressing quite fast.

In terms of resources and so on we also try to resolve it in a competitive way across both segments. So that we can compete in both.

And when it comes to and increasing our penetration geographically, we are basically rolling out to your spouses and authentic.

In most countries it takes a little while but we are progressing and we stayed with US and we are now in 17 countries and we do the same thing.

88 countries by now so and so.

So that's progressing.

Quite fast.

Camilla Sylvest: Then when it comes to China and human insulin, it's clear that there are a number of providers in the Chinese market for human insulin. There has traditionally been quite fierce competition in that segment. And of course, we try to understand exactly what is driving the dynamics and also how we should compete. But, as Karsten just said, we are primarily focused on upgrading to new and innovative medication in China. But there can be, of course, areas and lower tier segments where it's mainly human insulin that is reimbursed in some parts of China. And here, of course, we look into that particular local opportunity. But in general, we are focused on innovation and upgrading the market for new and better treatments.

Then when it comes to China, and human insulin, it's clear that there are a number of the providers in the Chinese market.

With human insulin that's traditionally been a.

Quite a fierce competition in that segment and of course, we try to understand exactly what's the what's driving the dynamics and also how we should compete but as costs. As you said and we are primarily focused on upgrading to new and innovative medication in China, but they can be of course areas and go what's your segments where.

It's mainly human insulin that is to reinvest in some in some parts of China and he of course, we look into that particular local opportunity, but in general we are focused on innovation and upgrading the markets through new and better treatments.

Karsten Munk Knudsen: Thank you, Camilla. Thank you, Richard. Unfortunately, this was the last question we had time for today.

Thank you Camilla Thank you Richard.

This was unfortunate the last question we have time for today. So thank you for the interest in Novo Nordisk and sending out Q1.

Karsten Munk Knudsen: So thank you for your interest in Novo Nordisk and for attending our Q1 results meeting. As you saw, we're delivering on our strategic aspirations in all four quadrants and delivered a particularly strong first quarter with adjusted 9% sales growth and, as a consequence, increased our full year guidance outlook for the first time in more than 10 years. So I am looking forward to seeing you or connecting with you in the next quarter in August. Thank you. Bye-bye.

Results meeting.

As you saw it and we're delivering on our strategic aspirations on the on all four quadrants enter and delivered a particularly strong first quarter with adjusted 9% sales growth and that's a consequence increased our full year guidance outlook for the first time in more than 10 years. So we're looking forward to see you.

Connect with you in the next quarter in August Thank you Bye bye.

Operator: This concludes our conference call. Thank you all for attending. You may now disconnect your lines.

This concludes our conference call. Thank you all for attending you may now disconnect your lines.

unknown: [inaudible]

Okay.

Yeah.