Q1 2022 Novo Nordisk A/S Earnings Presentation - London

Okay.

[music].

Richard Vosser: Welcome everyone to Novo's Q1 Roadshow. I'm Richard Vosser, JP Morgan.

Q1, right Joey and Richard Parkes at JP Morgan, Great pleasure to have the entire management.

Richard Vosser: It's a great pleasure to have the Novo management team here for this roadshow. Karsten CFO, Camilla Sylvest, Michael Nedelcovych, Marcus Schindler, Daniel Bohsen, Lars Joergensen, Marcus Hggblom, Andres Jensen, Douglas Langa, Laura Hindley, Andres Jensen, Camilla Sylvester, Andrzej Popkowski, Daniel Bohsen, Novo Nordisk, André Hennig, André Jorgensen, André Hennig, André Joergsen, and Martin Lange, Martin Parkhoi, Lars Joergsen, and Novo Nordisk, as Head of Development. So I'll hand over to Karsten for a few introductory remarks in the presentation. Thanks.

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It's called <unk>.

Goodbye.

So.

Exactly.

Lovely.

And.

Is head of our development.

Development, so I'll hand over to Carsten.

Or if you are in charge of your marks in the presentation. Thanks Kosta. Thank you.

Right.

Thank you to JP Morgan for hosting the slides presentation.

Karsten: Thank you, JP Morgan, for hosting this lunch. It's good to interact in person and I'd like to remind you that this launch session is being recorded so just for general use. So we have a great team here in London, and we released our results last week. So you could say it's not as fresh as we had anticipated. But the reason why we released our numbers, as I'm sure you're aware, but basically, you know, we have to follow the Danish regulations for listed companies in Denmark. And when you have identified material information, then you have to go really without any undue notice and report as fast as possible.

It's always good to transact in an in person and I'd like to remind you that our this launch cessnas.

It's being recorded so so just for general use.

We have a great team here in London, and ER, and we released our results and last week. So you could say, it's it's it's not as fresh eyes.

We had anticipated, but the reason why we released our numbers.

I'm sure you're aware, but there, but basically you know we have to follow the Danish regulations for listed companies said that in Denmark, and when you have identified material information then the then you have to go really.

Without any audio notice and report as fast as possible so that entails a lot of hard work for them.

Karsten: So that entails a lot of hard work from, you know, everybody in the organization and the board meeting, et cetera. So it's not something we take lightly. But the benefit for you is that then you have the weekend also to prepare for this long session.

Everybody in the organization and the board meeting et cetera.

So it's not something we take lightly but there but the benefit for you is that there then you had the weekend also to prepare for our farthest long session.

So.

Karsten: So. So the session for today is, I would say, reasonably snappy on the presentation. And then we have a good time for Q&A and perhaps also a bit of time afterwards in a breakout if you didn't manage to ask your question at the launch session. So I have to remind you about forward-looking statements. And we just saw this again, that predicting about the future can be hard, and real events might fall out differently. So that's how the world operates.

So this session for today is I'll say reasonably snappy on there on the presentation and then we have a good time for Q&A.

And perhaps also a bit of time afterwards.

And a breakout if if you didnt manage to ask you a question that at the lunch session.

So.

Yeah, I have to remind you about forward looking statements and put you just saw this again.

I'm thinking about the future can be hot and.

And the real events might fall out differently. So.

So that's.

How the world operates.

Karsten: And in terms of our strategic aspirations as a company, we launched the concept back in 19, and we updated a couple of them at our latest Capital Markets Day. So this is how we report to the market on an ongoing basis. And just to cover some of the key components, in terms of our purpose and sustainability, our ESG performance, we continue to drive performance both on CO2, which is of course not getting easier this year, because people have started to travel and product distribution is moving a notch more towards air distribution, linked to kind of our supply chain situation.

In terms of our.

The strategic aspirations as a company we launched a concept back 19, and we updated a couple of them at our latest capital market day. So.

So this is how we report to the market on our own.

Corn basis and adjust to cover some of the key confidence in.

In terms of our purpose and sustainability of our ESG performance and we continue to drive our performance both on tier two which is of course not getting easier. This year. This year because people have started to travel and product distribution is moving.

In our small towards there.

Yes.

At distribution are linked to the kind of our supply chain situation. So ed so still down compared to 19, but there, but not as much down as last year.

Karsten: So still down compared to 19, but not as much down as last year. And on our social responsibility piece, I think it's a great achievement by Martin and the development team that now we have a positive scientific opinion around our thermal insulin solution that basically enables our human insulin to be stored at below 30 degrees for a month, which is really a key feature in developing markets, so really something that can make a difference.

And on our social responsibility piece I think it's a great achievement by marching into the.

The development team that they're that now we havent positive scientific opinion a route.

Turning to the insolent solution that basically enables sir.

Our human insulins to be at to be start at below 30 degrees for four months, which is really a key feature in.

Yeah.

In developing markets. So so really something that can make a difference the reason for the European registration is that then we can reference that in all these countries way it would be more relevant where perhaps there's less access to electricity and so on.

Karsten: The reason for the European registration is that then we can reference that in all these countries where it would be more relevant, where perhaps there's less access to electricity and so on, and then finally diversity and inclusion also a key priority for the company to continue to progress on that.

And then finally, a diversity and inclusion are also a key priority for the company to continue to.

Progress on that on that.

On our pipeline, which Martin will come back to later.

Karsten: On our pipeline, which Martin will come back to later, after last year, where it was more of an investment year and trial execution year, now we're starting to see some really good trial readouts. You saw some at the Capital Markets Day between MyMate and ConcisionMap, and now you've seen onwards to the first phase three results, favorable phase three results with the once-weekly insulin. So we're really happy about that, as you'll hear later on.

After last year, where it's more of an investment year in trial execution year, notwithstanding to see something.

Really good trial Readouts you saw some at the Capstone RFA between my mate and could see some app.

Now you have seen on what's to the.

The first phase III results are favorable phase III results with a once weekly insulin. So we're really happy about that as you will hear later on and of course, the high dose of a setback in the U S marketplace.

Karsten: And of course, the high-dose Ozempic in the U.S. marketplace. Commercial, we keep performing against our aspirations or even ahead of those aspirations. Some of you will remember our initial obesity aspiration about doubling obesity. That's actually exactly what we did in the first quarter compared to the first quarter last year.

Commercial will keep performing.

Wednesday expirations are even ahead of those aspirations. Some of you remember our initial obesity aspiration about toppling obesity.

Exactly what we did in the first quarter.

Compared to the first quarter of last year. So it's a really fantastic traction on our visa franchise. These days.

Karsten: So really fantastic traction on our obesity franchise these days. And then all of it turning into a great sales growth of 18%. The strongest sales growth in relative terms in two decades of Novo Nordisk and the biggest absolute sales growth quarter over quarter ever in the history of Novo Nordisk. So really amazing performance in terms of commercial execution and turning it into financial results also at 18% operating profit growth. I'll come back to that in more detail.

And then all of it.

Turning into a great <unk>.

Sales growth of 18%.

Actually the the.

Our strongest sales growth in relative terms in two decades of off Nynorsk and the biggest absolute sales growth quarter over quarter ever in the history of known or so so really amazing performance say in terms of commercial execution and turning it into financial results also at 18% operating profit growth.

I'll come back to that in more details and then in terms of capital allocation.

Camilla Sylvest: And then in terms of capital allocation, we had very strong cash conversion in the first quarter and also allocation to shareholders at $20 billion, a lot of value allocated to shareholders in terms of both dividends and share buybacks. So with that, I'll hand it over to Camilla to cover our status on commercial execution. Yeah, thanks a lot, Karsten. Good morning, good afternoon, everyone, I should say here in London.

We had very strong cash conversion in the first quarter and also allocation to shareholders at 20 billion a lot of value allocated to shareholders in terms of both dividends and share buybacks.

So with that I'll hand, it over to Camilla.

Stan.

Status on commercial execution.

Thanks, a lot guys.

Hey, good morning, good afternoon, everyone I should say here in London.

Camilla Sylvest: You know our sales growth, 18% sales growth driven by a combination of a strong growth in international operations of 13% and North America operations growing 24%. We also see nice growth in each of the regions here, EMEA, China, and rest of world. So all units contributing to growth.

Today's call is 18% sales growth driven by a combination of.

Our strong growth in international operations of 13% and North America operations growing 24%.

We also see nice growth in each of the regions here EMEA, China and rest of world and so on units contributing to growth when we look at therapy area distribution Yossi.

Camilla Sylvest: When we look at therapy area distribution, you see the 18% is clearly driven by a growth in GLP-1, where we see continued growth in North America of 38% in our GLP-1 franchise of 60% in international operations. We see an insulin growth rate of minus 4%, driven by minus 15% in the U.S., but a slight increase of 1% in international operations. And then, as Karsten was alluding to, 107% growth in our obesity franchise, driven by 146% increase in North America operations and 63% in I.O.

Percent is clearly driven by a growth in DLP, one where we see continued growth in North America, 38% in Altice, one franchise of 60% in international operations.

And we see an insulin that growth.

Wade of minus 12% driven by minus 15% in the U S.

A slight increase of 1% and international operations, and then as Scott was alluding to 100%, 7% growth in our obesity franchise driven.

By 146% increase in North America operations and 63 in aisle and then we have a continued and thank you Sir.

Camilla Sylvest: And then we have a continued single-digit growth in our rare disease franchise. And if we then zoom in on two of the biggest growth areas, if we start with GLP-1, especially our Osempic franchise, you see here the four weeks rolling estimates of how prescriptions have really picked up in the beginning of this year on an NBRX level. On the right-hand side, you see the TRX level, a very steady performance, increasing the Osempic share of the total GLP-1 segment.

The growth in our rare disease franchise and if we then Lynn on the two of the biggest growth areas. If we start with TLC one.

Especially our thematic franchise you see here the four weeks voting estimates of how <unk> prescriptions have really picked up in the beginning of this year and in MPLX level.

On the right hand side, you'll see the Trs level.

A very steady performance, increasing with Sandeep Shah.

Of the total TTS segment. This short term increase is driven by additional focus from outside on PCC, but of course also on on more doctors prescribing with sandpaper see better pickup now and military segments also and of course that might potentially also be a halo effect with it.

Camilla Sylvest: The short-term increase is driven by additional focus from our side on DTC, but of course also on more doctors prescribing Osempic, we see better pickup now in lower-tier segments also. And of course, there might potentially also be a halo effect to the semaglutide molecule in general.

Some exercise molecule in general.

Camilla Sylvest: When we then look at Vigovi here, you see the uptake on the total Scripps, so TRX, and of course we have not been promoting Vigovi the last quarter in the U.S. Despite that, we now still see a continued uptake, but we have also 80% coverage now in the commercial segment. We are currently not promoting the three lowest doses. We don't want patients to be initiated if they cannot continue on the treatment.

When we then look at Diavik over here you see the.

Uptake on that.

Total Asquith so T Rx and then of course, we have not been promoting to go over the last for us in the last quarter in the U S.

Got that and we know we still see a continued uptake but.

We have also 80% coverage now in the commercial segment. We are currently not promoting <unk> with doses, we don't want patients to be initiated if they cannot continue on the treatment.

But we have now seen that our contract manufacturer.

Martin: But we have now seen that our contract manufacturer is initiating the commercial production, so we expect to be back in the market with supply in the second half of this year and making our product available again. So that's the plan for Vigovi in the U.S. and how we expect this to continue. And with that, I'll just hand it over to Martin to talk a little bit more about R&D. Thank you very much Camilla, this is going to be an exciting year in the R&D space, we'll have a lot of interesting readouts, obviously starting with the iCodec, but certainly also potentially we'll select later on in the year, if we get to do an interim analysis.

Initiating the commercial production so we expect to be.

Back in the market with supply in the second half of this year and in and making our product available again. So that's the plan for <unk> in the U S and how we expect this.

This to continue and with that I'll, just hand, it over to where margins will talk a little bit more about R&D, yes, thanks very much.

So this is going to be an exciting year in the R&D space will have a lot of interesting readouts, obviously, starting with the <unk>, but certainly also potentially with select later on.

The year, if we get to do an interim analysis.

Martin: But also we see very nice progress across all of our programs. We have, as you know, phase three programs ongoing in all of our therapy areas, which is an interesting place to be, especially when we see those reading out in the. Just want to call out two things in the diabetes space. First of all, obviously, as you know, we've got the 2.0 milligrams of magnetite approved in the U.S. for the treatment of type 2 diabetes.

But also we see very nice progress across all of our programs. We have as you know phase three programs ongoing in all of our therapy areas, which is an interesting place to be.

Especially when we see those reading out in the years to come.

Just wanted to call out two things in the diabetes space first of all obviously as you know we've got the two zero milligrams magnetite approved in the U S for the treatment of type two diabetes.

Martin: That is very, very exciting, also because you've seen the data, you've seen the results based on the publication. Now we have it into the label, very nicely describing the benefits of 2.0 mg versus 1.0 mg, namely more glycemic control, more weight loss, but no difference in the safety, tolerability profile between the two doses of Zymagnos, and also a very nice description of the cardiovascular benefits of semaglutide not, sort of distinguishing between one and two milligrams.

That is very very exciting also because you've seen the data you've seen the results based on the publication now we have it into the label.

Every nicely describing the benefits of to two milligram versus 1.0 milligram, maybe more glycemic control more weight loss.

But no difference in the safety Tolerability profile between the two doses of.

And also a.

Very nice description of the cardiovascular benefits of who may decide not.

Sort of distinguishing between one and two milligram, so a broad label, calling a good efficacy cardiovascular safety and good safety and Tolerability and Doug and his team are launching as we speak.

Martin: So a broad label calling out good efficacy, good cardiovascular safety, and good safety and tolerance, and Doug and his team are launching. We talked about the Onwards 2 program. This is truly, truly exciting.

We talked about the almost two program this is truly truly exciting.

Martin: From our perspective. I think you've seen the program, the ONWARDS program, it's six trials. It spans type 1, it spans type 2 diabetes, it's a global program. It even has one study, ONWARDS 5, that caters to payers, potential payer discussions. It's a real-world evidence study with the potential of demonstrating A1C superiority, exactly what payers are looking for. That would be a first.

From our perspective.

I think you've seen the program.

Whats program, it's six months.

It spans Taiwan, it's been type two diabetes is a global program.

It even has one starting on what's five that caters to peers potential discussions it's a real world evidence study with the potential of demonstrating a once these apparel exactly what payers are looking for that would be a first.

Martin: I think an insulin treatment having real-world evidence available at time of launch to cater to that discussion. And obviously, we're a bit excited. Onwards 2 was the first study to read out.

And insulin treatment, having real world evidence available at time of launch to cater to that discussion and obviously, we are pretty excited about them.

I want to once the first started to readout, we're still waiting for the next five quarters to read out.

Martin: We're still waiting for the next five studies to read out. And it was, in some aspects, the most difficult and therefore also the most interesting study that we had to look at, because the comparison was... Jeper, and Insulin Degle, Degle. And Degnodeg, as you know, really efficacious drug, but also probably the most hyper-safe insulin, basal insulin that we have out there. So going up against Trichyba in our first readout was...

It was in some aspects the most difficult and therefore also the most interesting stories that we had to luminaire because the comparison was incident placebo or instrumentation.

Thanks.

And David with that guys, you know really efficacious drug, but also probably the most hyper safe insulin basal insulins that we have out there so.

So going up against Tresiba in our first readout was obviously.

Patients were.

Martin: Patients were, your garden variety type 2 diabetes patients A1C at baseline between 7 and 10 all patients being treated with basal insulin at time of random, any base, Approximately 30% of patients came from Toshiba. The rest came from various other basal insulins, primarily insulin. Patients were randomized to either insulin agonist or insulin, really, really interesting. And obviously, you've seen the headline results, which were truly exciting.

<unk>.

Cotton varieties type two diabetes patients see a baseline between 700, all patients being treated with basal insulin at time of randomization.

Basically it.

Approximately 30% of patients came from Toshiba the rest came from various others.

Other basal insulins, primarily insulin logic.

Patients were randomized to either insulin.

Insulin.

Really really interesting.

Martin: This is a three to time study. That's the regulatory requirement from the FDA perspective. That means that for 100 years what we've seen when it comes to insulin development is non-inferiority on primary endpoint. You guys have commented and asked about that in recent years. Why don't you see superiority if you think this is a better endpoint? Basically because we had to do this, and probably also to an extent because there was maybe not that much to differentiate on other than the risk of, I would have a once weekly insulin with a super, super flat. Unstable Profile.

And obviously you've seen the headline results, which were truly exciting. This is a treat to target study that's the regulatory requirement from the FDA perspective.

It means that for 100 years, when we've seen when it comes to insulin.

Element.

Non inferiority on primary endpoint you guys have commented and asked about that.

In recent years why don't see severity. If you think this is a bit of insulin.

Basically because we had to do this three two times.

Probably also to an extent because.

There was maybe not that much to differentiate on other than that the risk of hypoglycemia.

We have a once weekly insulin with a super Super Flynn.

And I'll just remind you.

Martin: And just to remind you. Insulinicodec has a P2 trough over a week of 14% really, really stable, would be compared with 80%, 80% in, for example, Glartin and Nevermere, and 40% [inaudible] and that actually paints, even in a three to time setting into superiority on A1C. That's the first in 100 years we've never seen that, in this kind of story.

<unk> has a pizza trough over a week of 14% difference.

So really really stable.

To be compared with 80% 80%.

In Atlanta, and Denver, and 40% for placebo, so really flat and stable profile in.

And that actually pins out even in the <unk>.

Superiority on agency, that's a first in 100 years, we've never seen before.

And this kind of story and that is in and of itself quite encouraging obviously, making loss quite.

Martin: And that is, in and of itself, quite encouraging, obviously making us, quite optimistic of what comes next in the next five studies. But what is really also important is no difference in hypertension. I've heard some of you talk about there's a numerical difference in hypoglycemia, which is obviously true. You've seen the numbers, it was 0.25 and 0.75. Just to remind you again that in previous studies with basal insulin hyper rates have been, In the vicinity of 1.4 to 4 events per patient per year, here we're talking about less than one in both, Basically it means that a patient on insulin and ibuprofen has to wait 1.5 years before he or she gets a non-severe event.

Quite optimistic of what comes next in the next slides.

But what is really also important is no different and hyperglycemia I've heard some of you talk about as a numerical difference in hypoglycemia.

This is obviously true.

You've seen the numbers it was part two five and seven three.

Just to remind you again that in previous studies with basal insulins.

It had been.

In the vicinity of one full to fall events per patient per year.

Talking about less than one in both treatment arms.

Basically means that the patients on insulin either has to wait one five years before she gets in not so good.

Listen.

And when I'm talking about not severe we saw no severe events of hyperglycemia audience with a knife.

Martin: And when we talk about non-severe, we saw no severe events of hyperglycemia on insulin IV. We actually did see Sylvia Hypoglycemia with.., in this trial and therefore again speaking to the safety of, Another first is actually a significant improvement in quality of life, significant not only from a statistical perspective, but also from a clinical perspective, again, speaking to the benefits. So Camilla asked me, will we get the triad of efficacy, safety and convenience?

We exited C severe hypoglycemia with placebo in this trial and therefore again speaking to the safety of this compound.

The first is actually a significant improvement in quality of life.

Significant not only from a statistical perspective, but also from a clinical perspective against speaking to the benefits of this.

So it can be to ask me.

Will we get the triad of efficacy safety and convenience I think the answer is yes.

Martin: I think the answer is yes. There's even another off-site with Italy and Iconic and that's on the environment, going from seven to one injection. That obviously also have an impact on how much plastic, how much glass do we have to put into land. I think in 2022, that's not a trivial thing to have as an added benefit. Not in the bag yet, still waiting for the last five trials, but a very, very strong start.

There's even another upside with its really nice with it and that's only environment going from seven to one injection per week that obviously also have an impact on how much plastic how much land, we had put into landfills.

In 2022, and that's not a trivial thing to have.

As an added benefit.

So.

Not in the bag, yet still waiting for the last five to us, but a very very strong start five a day.

Thank you Martin.

Karsten: We are ahead of development, really happy with the insulin architect, so we'll get back much more on that in the quarters to come with the five additional trials. So looking at financials, you've all been through this as part of our release, but just recapping, 18% sales growth at constant exchange rate, take it into reported 24% sales growth, given the tailwind from especially the US dollar. So really significant sales growth on a big base. Cross-margin adjusted currency is reasonably flat.

Head of development is really happy with with insulin <unk>.

So we will get back much more on that in the quarter.

To come up with the five additional trials.

We're looking at our financials, you've all been through this as part of our release.

Just recapping, 18% sales growth at constant exchange rates take it into reported 24% sales growth.

When the tailwind from especially the U S. Dollar so really significant sales growth on a big base.

Gross margin adjusted for currencies.

It would be flat.

And.

But of course, one thing worth noting is when you look at our employee count as we also have in our company.

Karsten: But of course, one thing worth noting is when you look at our employee count, as we also have in our company release, which is up 9% over the last year, the biggest single driver of that is actually an increase in manufacturing. So as we talked about scaling manufacturing, part of that is also scaling employees to all the classic of three shifts, seven days a week. In terms of sales and distribution cost, 18%, it's a classic.

Lease of which is up 9% over the last year.

The biggest single driver of that is actually an increase in mining and manufacturing so as we've talked about.

Scaling manufacturing part of that is also scaling it plays to all the classic Alpha.

Seven shifts.

We shipped 77 days a week.

In terms of distribution cost, 18%, it's a classic its investments in there do you have one diabetes as well as it will be tomorrow with development No news there.

Karsten: It's investments in DLT1 diabetes as well as obesity market development, no news there. And then R&D up 29% being, of course, impacted by our Dicerna acquisition and the run rate of Dicerna, which is actually also what you see in terms of the step up in other operating income compared to the first quarter last year. So net-net, Dicerna in the first quarter has a negative impact on our P&L to the tune of 2%.

And then R&D up 29% being of course impacted by buyout does for an acquisition in the run rate of.

After China, which is actually also what you see in terms of the step up in other operating income.

<unk> to our first quarter last year, so net net.

In the first quarter has a negative impact on our P&L through the June of 2% so adjusted for that.

Karsten: So just for that, as potentially some companies would do, then actually our operating profit growth would have been 20% excluding Dicerna. Apart from that, our R&D costs are really being driven by a focus to expand our pipeline and diversify, and a lot of investments going into both research and development, and from a therapeutic point of view, investing significantly in what we call other serious chronic diseases, so our cardiovascular franchise, as well as NASH and trials in that area, Alzheimer's. All in all, ATMs have an operating profit of 28% reported in reported terms.

Some companies will do then actually our operating profit growth would have been 20%.

Excluding it.

Sure.

Apart from that R&D costs are really being driven by our focus to expand our pipeline and diversify and a lot of investments going into both research and development and from a therapeutic point of view investing significantly in in what we call other serious chronic diseases. So our cardiovascular franchise, that's what I said.

Our snacks and trials in that area.

Timeless.

All in all agents that operating profit 28% reported.

In reported terms then we have the hedging going the other way that's how it is when you hit the U S tariff for 12 months, so very good hedging.

Karsten: Then we have the hedging going the other way. That's how it is when you hedge the US dollar for 12 months. So a very good hedging efficacy here in the beginning of the year and a net profit growth of 13%. That start, compared with the MBRX trajectory you saw with Camilla, led us to step up our outlook and raise our outlook significantly, I would say, from before 6 to 10 and now 10 to 14.

<unk>.

And in the beginning.

The year and the net profit growth of 13%.

That stock compared with the <unk> trajectory you saw with with Camilla led us to step up our outlook and raised our outlook.

Significantly I would say from it before six to 10 and now 10% to 14 and Youll see how it goes down throughout all our financial ratios. So so pretty much no no surprises there from top line all the way through to cash generation.

Karsten: And you see how it drills down throughout all our financial ratios. So pretty much no surprises there, from top line all the way through to cash generation and increased share buyback to now $24 billion. So that covers kind of the warm-up commentary.

And increased share buyback $2 24 billion.

So that covers kind of the Walmart commentary and.

Karsten: And now we move into Q&A. And I think we're a small audience, so let's do one maximum, two questions at a time. And then I'm sure we can ping around back and forth. So I'll just sit down. And then I'll give it to Richard to have the opening question as our host. Thanks Karsten.

Now we move into into Q&A, and I think were smaller audience. So so let's say, let's let's do one maximum two questions at a time and then I'm sure we can ping Pekka.

Richard Vosser: So maybe two then. Firstly on Camilla, you mentioned commercial, I think before the opt-in was sort of 40%. Could you give us an update on the opt-in level? and then secondly, on a Zempik two milligrams, you've highlighted, I think Doug highlighted on the conference, that it will be priced in line with other dices for diabetes. How do you manage that given the brand? and Closin, In Dozing. Lovie in terms of kind of...

Paying around back and forth.

So I'll just sit down and then.

Give it to.

Richard.

After the opening question as a host.

Thanks, Carsten so it may be too then.

Firstly on.

Camilla you mentioned commercial actually it's 80%.

I think before the optimum sort of 40% could you give us an update on the ELT level.

For.

Commercial employed.

And then secondly on two milligrams, you've highlighted I think Doug highlighted on the conference call.

That it will be priced inline with other dices that diabetes how.

Do you manage that given the brand.

Very close in the in in dosing.

Does that have any impact on.

<unk> capitalization.

Richard Vosser: Thanks Richard. So there's two for you Camilla, one on opt-ins and the other one for pricing of 2.0. Yeah, so Richard, we are approximately in a situation where we have 80% coverage across and then we have about half of the employers that opt in. So that means a 40% net coverage, so slightly more than what you recall from before. So it continues to improve, but it's a long list of employers that we are, of course, working with. But it does consistently, and on delivery on.

Yes.

Thanks, Richard So there's two <unk> one on <unk> and the other one for pricing of two point, though.

Yes, so Richard we are approximately in a situation, where we have 80% coverage.

And then we haven't.

So that means a 40% net conference or slightly more than what you recall from the call.

Safety continues to improve but is there a long list of employers and we of course are working with but what it.

It does.

<unk>.

And on delivery.

The messaging is very very important source of cost to stay completely.

Camilla Sylvest: Messaging is very, very important for us, of course, to stay completely true to what is the label. And we promote OCEMPIC in diabetes care. And right now, we don't promote the COVID in obesity care, but we will hopefully get back to that. But for us, it's extremely important to stay completely in line with that for good reasons, for business ethics reasons. Nevertheless, we do see a pick up in the scripts of OCEMPIC, as I just talked to, also because we are expanding our prescriber base. But of course, also because OCEMPIC is recognized for its triad of benefits, HbA1c lowering, strong weight loss, but also the significant cardiovascular risk reduction.

So what is the enable MD promote.

In diabetes care.

Right now we don't promote <unk>. Please proceed.

And hopefully get back to that but for us it's extremely important to state.

Completely in line with that.

For good reasons for business ethics and.

Nevertheless, we do see a pickup in.

In this space.

Okay. That's helpful.

And also because we are expanding our prescriber base.

Also because the same thing is recognized.

Benefits <unk> strong weight loss, but also the significant cardiovascular risk reduction so all of that.

Camilla Sylvest: So all of that, you know, with the increasing awareness, of course, builds more and more momentum for OCEMPIC. Thanks Camilla and just a bonus info on the coverage for in obesity as you would have seen then now we have a contract with the Department of Defense also so in addition of continuing to enroll more employers under commercial then of course we're also working with some of the public employers in terms of getting access whether it's under certain Medicaid plans or Department of Defense. So I think we have good progress all so very happy with that. Then I think we move to Wimmer.

<unk> awareness.

And more and more momentum.

Okay.

Thanks, Camilla and just.

Bonus inflow on the coverage.

In BC as you would've seen them.

And now we have a contract with the department of Defense also so so in addition of continuing to enroll more employers under commercial then of course, we are also working with some of the public our employees in terms of getting access whether it's under certain Medicaid plans or department of defense. So I think we have.

Good progress.

So very happy with that.

I think we moved two of them out.

Great. Thanks, Thank you very much.

Camilla Sylvest: Great, thank you very much. Can I just come back to Richard's question actually? I don't think high dose is quite at the same level as... But that's only 4.4 mg less than we're going, if the net price of Wagobi is similar to Saksen, that's a 30% premium on ozempic networks. I'm just curious, how did the pair discussion, because for 0.4 milligrams, that incremental dollar price is quite a lot. I'm just curious how you, you know, do you have a different rebate for the two milligram than the one milligram?

Can I come back to Rich's question actually.

So.

Was that the high dose is priced at the same level as at the one milligram.

But that's on the $12 four milligrams or less.

We'll go.

If the net prices will be similar to that.

A 50, well, 30% premium on Olympic net price.

No.

I'm just curious how did the payer discussions go.

Because we're not <unk> four milligram that incremental dollar price is quite a lot. So I'm just curious how you do did you have a different rebate for the two milligram and the one milligram. So that's the first question.

Camilla Sylvest: So that's the first question. So just following up on that. And then the second one, again, probably for Camilla, because you're the ones clearly doing really well. But if we think about the diabetes market long term, so the bookends are metformin and insulin and they're relatively stable at about 14 metformin. Slowly.

Richard.

And then the second one.

Again, obviously camilla.

Did you also want the fairly doing really well.

But if we think about the diabetes market long term so the bookends on that format and incident and Theyre relatively stable at about $14 4 million, 20% roughly coming down but slowly. So you have 40% of diabetes volumes the playful.

Camilla Sylvest: So you have 40% of diabetes volume to the plate. What is the peak penetration for GL? University, Jens Stoltenberg, Jens Stoltenberg, Jens Stoltenberg, Jens Stoltenberg, Jens, What does that mean for the rest of the world? Can Europe and the rest of the world get to that US level? Thanks, Emmanuel.

What is the peak penetration for <unk>.

In the U S.

Is it 25 30, how much do we need to leave for the SDLP to long term and then I guess tied to that.

What does that mean for the rest of the world can Europe and the rest of the world get to that level.

Thanks.

Karsten: I counted two and a half questions on that one, so thanks for pushing the limits. I think we'll let it pass this time around, then we'll get back at you at another time. So, Olympic 2.0 pricing, I'll give that a shot, and then Camilla, if you can talk to GF1 volume slash patient penetration, US slash rest of world. So, yes, on Olympic 2.0, it's diabetes pricing. That's what we see also from competition, and I think the way you should look at it is it's a flat pricing between 0.5, 1, and 2. So from a payer point of view, you buy the portfolio.

I counted just wanted to ask question.

On that one.

Pushing the limits.

I think we'll let it pass at this time round.

Then we'll get back with you at another time.

So it was simply to final pricing.

Give that a shot and then if you can talk to to give one volume.

Patient penetration in the U S.

Rest of World.

So, yes on simply to point, though.

Diabetes pricing.

That's what we see also from from competition and I think the way you should look at it is it's a flat pricing between the five one and two.

So from a payer point of view.

You buy the portfolio and actually a lot of patients I still only at the 0.5, so it's a flat price across part, but the blended volume so to say per patient is let's see how it all plays out, but but but will it be perhaps.

Karsten: And actually, a lot of patients are still only at the 0.5. So it's a flat price across, but the blended volume, so to say, per patient is, let's see how it all plays out, but will be perhaps less than one milligram, depending on the time horizon. So you have that, and then you have a different price point in obesity. So that's one key point to consider. And then the other key point is, of course, that having formularies in two different disease categories, so to say, then, of course, the formularies in terms of managing the formularies and the opt-ins or whatever step edits or whatever to get access to the medicines are different, and hence caters for differentiation from a payer point of view also in terms of how they manage their categories in terms of could even be coinsurance designs could be different between those categories. And we spoke about the opt-in also from on Richard's point of view. So the categories are being managed different by the payers also vis-a-vis their co-insurance. Camilla on DLT1 Penetration.

Less and less than one milligram, depending on the time horizon.

So you have that and then you have different price points in <unk>. So that's.

That's one key point.

And.

And then other key point is of course that.

Having.

Formulary into different disease categories. So to say then of course, the formularies in terms of managing formularies, and the opt ins or whatever step edits or whatever.

To get access to the medicines are different and hence caters for.

For differentiation from a payer point of view also in terms of how they manage their categories in terms of could even be co insurance designs could be different between those categories and we spoke about the opt in also from on Rich's point of view. So so the categories that are being managed differently by the pass also vis vis.

Their customers.

So camilo just one penetration.

Camilla Sylvest: Yes, so TLC1 penetration very depending on launches of new products and the efficacy that we see. So we now are in Europe and in the U.S. on a volume-based sort of 8 to 12% of the market, but we do see that it is significantly picking up. Of course, a lot of this is related to the continued benefits that we see, the cardiovascular risk protection, weight loss, and HbA1c loss. And just to give you an example from China where we've seen now reimbursement of Osempic, then we have seen the market size of TLC1 out of the total grow from 1% to now being closer to 7% or 8%, and that in a very short time frame.

Yes.

One penetration vary depending on the launches of new products and secrecy that we see.

<unk>.

And we now are in Europe , and in the U S. On a volume base sort of 8% to 12% of the of the market probably you will see that it is significantly picking up.

A lot of basis related to the continued benefits that we see the cardiovascular risk protection and waiting Allison H B.

And just to give you an example.

From China, where we have seen now reimbursement.

Thanks.

Then we have seen the market size.

One out of the total growth from 1% to now being closer to 7%, 8% and that in a very few a very short timeframe. So basically you should of course, you. If you look at the volume growth. We see that this segment is growing approximately 30% in volume roughly across most regions.

Camilla Sylvest: So basically, you should, of course, if you look at the volume growth, you see that this segment is growing approximately 30% in volume, roughly across most regions of Europe and U.S., and then you would see other segments of the market growing a lot less. So I think if you apply that dynamics, assuming that whenever there are new launches into the segment, then, of course, it keeps fueling the market growth rather than cannibalizing itself, then I guess you can try to understand how to do the math of what this could be. It's clear that the benefits of TLC1 are very, very strong when we just compare HbA1c and weight and also cardiovascular risk profile versus some of the other compounds in the market.

Thank you Ed and then.

Are there other segments of the market growing and not less so I think if you apply that dynamics, assuming that whenever there are new launches into the segment.

And then of course, it keeps fueling the market growth rather than cannibalizing yourself.

Then Dan.

And I guess are you can you can try to understand how to do the math of what it could be it's clear that the benefits of <unk>.

Very very strong and when we just come back.

<unk>.

And Wade and also cardiovascular risk profile versus some of the other compounds in the market.

Camilla Sylvest: So, I think that's the best way to look at it to try to understand what could this become. But there is also in guidelines now an increased focus on treating with GLP-1s right after metformin, so that's another support to this class. Great. Camilla, and I'm going to turn the peeper off. That's the guy with the knife tie, Mark.

And so I think that's the best way to look at it to try to understand what could this become but there is also an guidelines now an increased focus on trading with TLC one.

Slide estimate for me so that's another support to this class.

Thanks Camilla.

Keep it up.

Okay.

With a nice timeline.

Unknown Attendee: Thanks Peter, two questions, I'm going to, sorry to hark on about this, I'm going to expand on the questions from Rich and from Al, in a couple of years you're going to have a quite formidable competitor turning up where that whole GLP-1 pricing offset between obesity and diabetes is going to be gone and that's obviously, how should you or we be thinking about how you navigate that because all the responses you've made so far are all fair but that dynamic is going to change quite considerably in two years so I'd like you to discuss, And then secondly, I asked this this morning at the breakfast meeting, I mean, most of the industry has talked about, you know, responsible price increases, no more than inflation, but obviously now inflation is 78%. Is Novo going to eat it? Or do you think you've got the ability to put up your list price, Let's take a self from Matt.

Thanks pivotal city.

Two questions I'm going to sort of thoughtful about it is going to expand on the question from Richard <unk>.

A couple of years, you're going to have a quest formidable competitor, turning up where that whole GOP, one pricing offset between obesity and diabetes is going to be gone.

So.

How should we be thinking about how you navigate that because all the responses you've made so far off with that dynamic did change quite considerably in two years, so I'd like to discuss that.

Secondly on <unk>.

This morning at breakfast meeting I mean, most of the industry has talked about.

The price increases.

The inflation, but obviously now inflation is seven 8%.

No we're going to reach it or do you think you've got the ability to.

Put all your list price increases to protect yourself from inflation.

Yeah. So.

Unknown Attendee: Yeah, so Camilla, if you cover the first one, vis-a-vis, I think we explained clearly, you know, where we are today. So what could be the scenarios vis-a-vis Lilly? And what approach could they be pursuing?

[noise] community.

If you cover the first one vis vis <unk> I think we explained clearly where we are today. So so what could be the scenario vis vis daily and what what approach could they be pursuing and how would we think about the market dynamics on tier one pricing and then I'll cover inflation and how we try to.

Camilla Sylvest: And how would we think about the market dynamics on tier 1 pricing? And then I'll cover inflation and how we try to mitigate that. So.

Mitigate that.

So.

Camilla Sylvest: What we see now increasingly is that obesity is being reimbursed for tax center outside of the U.S. in an increasingly number of markets. And of course, when reimbursement happens, then prices are, of course, not the same as before reimbursement and out-of-pocket. And of course, in the same, to Karsten's point from before about the different channels in the U.S., by the time that you would expand into other channels, it could be Medicare, for example, over time if we get the TROIA resolutions in place, then, of course, it's likely that prices will converge towards each other.

While we see now increasingly is that that will be.

Please proceed is being reimbursed.

Flotek center outside of the.

The U S and in increasing the number of markets and of course, when the investment happens then prices of.

Of course, not the same as before reimbursement in out of pocket and of course in the same two classes points from before about the different channels in the U S. By the time that you would expand into other channels. It could be many Catholics and but over time, if we get the Troy resolutions in place then of course, it's likely that prices will converge towards each other so I think that's the dynamic.

Camilla Sylvest: So I think that's the dynamic that we are working towards to make sure that more and more patients can get access to obesity treatment. You know the numbers that just very few percentages are being treated despite a huge unmet need. So I think that's what we are pursuing. And I think that's what I should comment on, and actually not what Lili is more likely to do. You should check with them on that.

That we are working towards to make sure that more and more patients can get access to obesity treatment. You will know the numbers. That's just a very few percentages are being treated despite a huge unmet need. So I think that's what we're pursuing and then.

And I think Thats, what I should comment on and actually not what believes there are more likely to do and you said you should check with them on that but I do think that over time.

Camilla Sylvest: But I do think that over time, prices are likely to converge. But of course, this is offset by the volumes. A very, very big demand, as we have noticed, of course, also in the recent... Thanks Camilla, Of course, let's see what Lidl does. That's completely on their prerogative.

Prices are likely to converge, but of course this is offset by the volume and that there is.

A very very big demand as we have noticed of course also in the recent years.

Thanks Kim.

Of course, let's see what little dose that's completely on their prerogative and I think thats an outcome thing different scenarios also in terms of how they could go to market. So so we'll have to wait and see.

Karsten: And I think they've been out commenting, you know, different scenarios also in terms of how they could go to market. So we'll have to wait and see. On inflation and how to mitigate inflation, so the classic premise of inflation, we all see it, and the numbers, whether it's 7 or 10 percent in the U.S., et cetera. So running a company, then the starting point for, you know, mitigating inflation is, one, pass on the increased cost to your customers. You see that across many, many industries.

On inflation.

And how to mitigate and facing so so.

So the classic premise.

Faced and we all see it in the numbers, whether its seven or 8% in the U S et cetera, So running a company than the starting point for mitigating Invasiveness one pass on.

On the increased cost to our customers.

You see that across many many industries.

Karsten: Secondly, how do you fend off inflationary pressures from your suppliers? And if I take the last one first, then in terms of suppliers, then of course we get the pressures from our suppliers. We have a rather mature procurement setup.

Secondly, how do we send off inflationary pressures from.

From your suppliers.

If I take the last one first in terms of suppliers and of course, we are.

We get the pressures from from our suppliers.

We have a rather mature procurement set up so so in terms of being clear about.

Karsten: So in terms of being clear about the contractual settings we have in our contracts with our suppliers, some of these contracts just doesn't open for suppliers to increase prices, some there's a lag effect and some they can break the contracts or whatever. So I think we have a very mature setup there to minimize the immediate inflationary pressures, but clearly it is something that will happen. On the cost side, we mitigate that through efficiencies and resource allocation.

The contractual.

Settings, we have in our contracts with our suppliers.

Some of these contracts just doesn't open for.

Yeah.

For suppliers to increase prices, some that lag effect and some they can break the contracts or whatever so so I think we have a very mature.

Set up that two.

To minimize the immediate inflationary pressures, but clearly it is something.

That will happen.

On the cost side, we mitigate that through efficiencies and resource allocation and then win portion setting.

Karsten: And then we're in the fortunate setting that, as a rapidly growing business, we also have some margin leverage to work with. So we actually do have a number of levers to alleviate, http://si.united.org.au on the sales side. I think it's fair to say that in a number of markets, it's hard to kind of reopen contracts, especially in some, like, European markets. There we have negotiated a price point for our products, and hence it will be a very cumbersome, lengthy process, if at all possible, to open up, in some emerging markets, countries or IO markets, especially in hyperinflationary markets, there already exist mechanisms for basically changing our prices. That could be markets like Argentina and Turkey.

It's a rapidly growing business. We also have some margin leverage to work with so.

We actually do have a number of levers to alleviate.

Full year, partially the inflationary pressures, we face as a company.

And then the reminding you just.

I have to remind you of what mathematically of course, we are in a better setting than the than low margin industry. So being a high margin industry. Then of course just in relative terms.

Hits Us at 40 plus percent operating margin less.

And then the other players.

<unk> on the sales side.

I think it's fair to say that in a number of markets.

It's hard to kind of reopen contracts, especially in some European markets. There we have negotiated.

Our price point for all of our products and hence.

It will be a very cumbersome lengthy process if at all possible to open up in.

In some emerging markets countries, Ohio markets.

Especially in hybrid inflationary markets that already exist mechanisms for.

Basically changing our prices.

That could be markets, like Argentina, and Turkey, and so if you actually if you go to the appendix of our company announcements you can see how we how we adjust for hyperinflation in terms of our reporting in order not to overstate our constant exchange rate growth. So we exited backing out some of the.

Karsten: And so if you actually if you go to the appendix of our company announcement, you can see how we adjust for hyperinflation in terms of our reporting in order not to overstate our cost exchange rate growth. So we're actually backing out some of the hyperinflationary price increases in these markets. So there we do have mechanisms in place. In the U.S., and we are negotiating contracts for next year, as we speak, not concluded.

Hyper inflationary price increases.

In these markets so, but so there we do have mechanisms in place.

In the U S.

And we are negotiating contracts for next year as we speak not concluded.

Karsten: That's one out of many elements going into these negotiations between formulary positioning, competitive pressures, et cetera. And of course, inflation is one of the arguments there, as are many other aspects. So I think that's as clear as I can be on that. The volumes are very strong, so given the inflationary environment, does that slow down any pricing?

That's one out of many elements going into these negotiations between.

Formulary positioning competitive pressures.

Et cetera.

Of course inflation is one of the arguments there.

As many other aspects.

So I think that's as clear as I can be on that one.

Okay.

The volumes are very strong so given the inflationary environment does that slow down any pricing pressure that you might see an argument youll see all the volumes to your advantage.

Karsten: Bad as an argument, you obviously got the following to your advance. [inaudible] Yeah, so you would say the best way to fend off price decreases if you're in a US setting is that you're differentiated enough and you have the highest possible market share. Because then, of course, the harder it gets for payers and PBMs to throw you off a formulary. So clearly, on one hand side, when we show strong demand for our products, like the Olympic trajectory on volume and share, then, of course, the payers would be very cautious to remove from formulary because they will have a lot of their customers that will be unhappy if they cannot get the product that they wish for.

So.

Yes.

Yeah. So so you will see that the best way to fend off.

Price decreases if youre in the U S hitting us.

Is that you are differentiated enough and you have the highest possible market share. Because then of course the harder it gets for for payers and Pbms to throw you off formulary. So so so clearly when we.

On one hand side, when we show a strong demand for our products like <unk> like the Olympic trajectory on.

And on volume and share then of course, the payers would be very cautious to remove from formulary because they will have a lot of cost of their customers there'll be unhappy if they cannot get the product that they wished for so that's on one hand side of course on the other hand side when youre effectively a procurement organization.

Karsten: So that's on one hand side. Of course, on the other hand side, when you are effectively a procurement organization and you see a value bucket increasing rapidly, then, of course, you have to consider how to deal with that cost increase.

And you'll see a value pockets increasing rapidly.

And then of course, you have to consider how do we deal with that.

With that cost increase.

So that's kind of the balancing factors in that.

Karsten: So that's kind of the balancing factors. And that's, of course, their PBM job. And as we've said all along, our strategy is to grow the volumes and to maintain choice for patients. So ensure basically co-preferred formularies in the DH1 market in the US. I should know, I'm sure you've said, but the upgrade to the sales guidance, the growth, is that all, how much of that is volume? Peter Welford, Peter Welford, Peter Welford, I would say for all material purposes the upgrade in guidance is driven by increased ozempic volume. Thank you, Karsten. Two R&D questions. Thanks for joining us.

Of course that ppm job and as we've said all along.

Our strategy is to grow the volumes and to maintain choice for patients so ensure.

Sure.

Basically co preferred formulary in the tier one market in the U S.

Alright.

I should note I am sure you set for the steel prices sales guidance the growth is that all.

How much of that is volume.

This all volume versus price.

I would say for all mature purposes. The upgrade in guidance is driven by increased Olympic volumes.

Yes.

Mark.

Thank you Carsten.

Two R&D questions.

Perfect.

First one.

Karsten: I think most KOLs believe that the select trial is going to be successful. It's described as being a pivotal trial for the future of obesity medicine, so it's really important you get this right. So we're all sort of focused on Q3 in this potentially. We've had seabird studies, out early before and it sort of damages their potential when it comes to discussing with payers and governments and guidelines policymakers and things like that. So I'm thinking nominees are the treat as opposed to presenters here, particularly when it comes to the CV death and all cause mortality.

Most kols believe that the sector is going to be successful.

And is described as being a sort of a pivotal trial for the future of obesity medicines. So really important you got this right.

We're also focused on Q3 of this potential interim.

We.

Both studies reading out early before.

The damages.

That potential when it comes to discussing with payers and governments guideline policymakers and things like that so I'm thinking company to treat as opposed to percentages there, particularly when it comes to CV death, and all cause mortality.

Martin: So I guess, you know, if we say roughly 26 months into the trial, you know, 4.5% event rate at that point, 17% benefit, that's not a massive number to need to treat if you stop early. So can you help us understand what the stopping criteria are that ensures that you do not lose the power of this potential study? I mean, you know, a lot of KOLs are thinking you should do a primary prevention study and just wait and see what happens, but it's really important you get this one right, and the second one is really quite simple for iCadet.

So I guess, if we say roughly 26 months since the trial.

5% event rate.

To that point, 17% benefit it's not a massive number needed to treat.

So can you help us understand what the stopping criteria.

The insurers.

Lose the power of this potential study.

Kols I think you should do a private venture study and just wait and see what happens, but it's really important you get this one right. That's the first question and the second one is really quite simple.

Sure.

Ikea.

Martin: In the real world, we see severe hypos, which I think most people feel there will be some. How do you treat a severe hypo with IQDAT relative to obviously a normal insulin given that you're going to have, as you said, I mean insulin level, , , , , , , , , Great. Thanks, Mark. Let's talk for you, Martin.

In the real World, we see severe hypo switch I think most people feel there will be some.

How do you treat a severe hypo.

Relative to oxy.

<unk> then given that you're going to have as you said I mean that will be.

Be pretty stable.

214 weeks I presume you have to stay in hospital you have to stay on some medical care for longest I'm just interested in that.

Martin: Select stopping rules and the pros and cons of doing an interim with the stakeholders. And secondly, on ICODEC, how do we treat severe hypos in a real-world setting? So, actually, I like that you call it a simple question. The answer is going to be a little bit nerdy and a little bit complex.

Thanks Mark.

Two for your margin.

<unk> stopping rules in the pros and cons of.

In the interim.

The stakeholders and secondly on iconic hardware.

How do we treat severe hypos.

In a real world setting.

So actually I like that recorded a simple question.

There's going to be a little bit nerdy melter complex I think it is a super good question. It's obviously something that we'll be looking at in all practical purposes. When you do an RCT.

Martin: I think it's a super good question. It's obviously something that we've been looking at for practical purposes when you do an RCT, will be missed, have not seen this issue. We look obviously at prolonged hypoglycemia, we haven't seen, We also look at what's called repeat hypoglycemia. So that would be several events of hypoglycemia within a day where the patient, may be able to to to to Basically, they're way out of hypoglycemia, but then when the food is gone, they go back.

With $26 52 weeks or however, long you do it.

Real World because you send the patient home.

Theyre basically stopped with that potential problem issues.

Issues, we haven't seen it.

And we have exposed at this.

Point in time past asthma patients.

On what's program.

We've not seen this issue we look obviously at prolonged hypoglycemia, we haven't seen it.

We also look at what some call repeat hypoglycaemia, so that would be several events of hyperglycemia within a day.

Are the patients.

Maybe able to two to two.

Basically their way out of hypoglycemia, but then when the food is gone they go back.

Haven't seen it.

Martin: We haven't seen, I mean the flat and stable profile in and of itself protects a little bit. But the other thing is, and that's the nerdy part, and I apologize to my colleagues for that one. Not to the rest of you, you have to hear it and you have to learn it.

There's a I mean, the flat and stable profile in another self protect us a little bit from that but.

But the other thing is and that's that's the annuity part and I apologize to my colleagues for that one.

Martin: Camilla already knows it, so she can also say it. But the way that ivodex protraction works is that it binds to albumin. And that basically means that that level of albumin, All others being equal. The albumin and the insulin receptor.

Now to the audience.

Not just read your answer here.

Yes.

Okay can build already knows that.

So she's she can also.

But the way that IDEXX protection works is that it binds to <unk>.

And that basically means that that level of albumin.

All others being equal.

The albumin and the insulin receptor compete Paul aggregate.

Martin: And as you also know, if the insulin receptor is being occupied by insulin, it's being internalized into the cells, so therefore it cannot bind. That basically means that if you have not sufficient insulin receptors, iQTEC will simply be stuck on the alveoli. And that actually, in a nutshell, create... At least in theory, a very nice buffer. The other thing I actually, and I probably shouldn't, but I take a little bit of comfort in is that in the almost two-pronged...

And as you also know.

The insulin visit is being occupied by insulin, it's being internalized into the cell. So therefore, it cannot find anymore.

That basically means that if you have not sufficient insulin receptors.

Simply be stuck on the albumin and that actually in a nutshell screen to create.

At least in theory, a very nice buffer.

To prevent hypoglycemia.

Other thing.

And I, probably shouldnt, but I'd take a little bit comfort. It is that you're almost two program.

Since it was a switch study we had to build the.

Martin: Since it was a switch study, we had to load the patients with iCodec to secure that they got up to a sufficient plasma concentration. And that basically meant that they had to start the first treatment the first week, with a 150% of expected insulin dose rather than. We had eight patients who inadvertently stayed on 150% for longer than one week. And that basically means that they were in fact overdosed and they did not experience.

Patients with <unk> to secure that they got up to a sufficient plasma concentration.

And that basically meant that they had to start the first treatment the first week.

With a 150% of expected insulin dose rather than a 100.

And we had eight patients who inadvertently stayed on.

150%.

For longer than one week.

That basically means that.

In fact.

Overdose and they did not experienced severe hypoglycemia.

Martin: I think even though that was obviously a mistake and we need to really optimize in the marketplace our communication around how to do that switch. It actually speaks to the safety and the robustness of the i-Codec molecule that I mean, even in that space, you don't, So, I mean, I should never say never, but what we've seen so far, it looks really, really good, and it... That was a long question, it was simple.

I think even though that that was obviously a mistake and we need to really optimize in the marketplace, our communication around how to do that.

It actually speaks to the safety and the robustness of the I would say that I mean EBIT.

In that space.

Introducing.

So.

I should never say never.

What we've seen so far it looks really really good and it looks really say it was a long question to a simple answer.

Martin: And on the other one, I'm not really prepared to go into numbers and details. But but you all know that we sample size the main part of the select trial for 17% differential on efficacy on MACE on the primary, If we do an interim analysis, our instructions to the GMC that the independent body that looks at the data is Jensen Jensen, Peter Welford, Peter Welford, Peter Welford, whatever sort of happens while closing down the trial as to be a sufficient differential.

On the other one.

I'm not really prepared to go into numbers in details, but you. All know that was emphasized the main part of this electronics for 17% differential on efficacy on based on the primary endpoint.

If we do an interim analysis, our instructions to the <unk> that the independent bodies.

It looks at the data.

It is.

Debt that debt.

Ever.

Sort of happens while closing down the trial.

Sufficient differential.

To secure that.

Martin: I would like to assure that the approximately 100 percent, sorry 100 events that would be accrued while we close down the trial cannot change that. Eritinemics, and the.., and that basically also means that if you do an infimum... The differential that will. Orbeen, Nick Sess, Osam, [inaudible] and not in a triple amount, it will be sort of.

Approximately 100%.

Sorry, 100 events that will be accrued while we close down the front.

What change.

The dynamics and the conclusion of the fund.

And that basically if you also mean that if you do an interim.

The differential that will be.

In excess of 17%.

And not in the trivial amount it will be sort of in excess of 17% I don't want to give the number.

Martin: Jensen, but that also means that that would be highly statistically will obviously be clinically relevant. I think Camilla, if we just see on the good side of 17 percent, she will be happy from a commercial and that also means that for some of the secondary endpoints that are also of clinical relevance and probably also of both regulatory and payer interest and they would, with some likelihood also be, or at the very least be going in the right direction. Thank you, Martin.

But that also means that that will be highly statistically significant.

It will obviously be clinically relevant I think camilla.

C.

On the good side of 17% and she will be happy from a commercial perspective.

And that also means that for some of the secondary endpoint that I'll also of clinical relevance and probably also both regulatory and payer interest.

They would with some likelihood also be statistically significant or at the very least be.

Going in the right direction.

Okay. Thank you Jonathan.

Martin: Then we'll move down the line to a few. Hi, I've got a lot of questions, I'm going to keep it to two and then come back, if possible, but Camilla, given what we know of Onwards 2, Martin, no to your point, it's not yet in the bag, you've still got five studies to come, bye. What would be, a good or a bad outcome relative to market shares of the basal insulin market for Microtech in three, four, five years, and secondly... You kind of give us a long list of reasons why Ozempic's been really strong.

We move down the lines of you.

Hi.

Lots of question I'll keep it to two and then come back possibly.

Camilla given what we know of on what's to come.

As Marty noted your point, it's not getting the boggy would still qualify studies to come but.

What would be.

Good.

Bad outcome relative to market shares.

The basal insulin market for Quebec increased four five years' time.

Secondly.

You kind of give us a long list of reasons why <unk> been really strong and I think all of those make perfectly logical plan.

Martin: I think all of those make perfectly logical sense, but the one you did not mention was potential use of ozempic whilst there is weaker resupply curve. Some wondering if that is the are you saying that's not what you are believing and consequently when VW does come back to the market in the second half of the year. You're not expecting to see any sequential decline in Ozempic U.S. volume over the first quarter, or should we be assuming that you will have some... Unknown Speaker, Unknown Speaker, Unknown Speaker, Thanks, Keyur, for those two questions.

But the one you did not mentioned was potential use of them Big Wild studies, because we supply can screen. So I'm wondering if that is the are you seeing that's not what you are believing and consequently, even weaker b does come back to the market in the second half of the year.

We're not expecting to see any sequential decline in <unk> volume over the fourth quarter, what should we be assuming that you will have some.

Flow through into because we can therefore, the sequential decline on Mozambique.

Thanks.

For those two questions I'm actually looking forward to hear the answers on that.

Camilla Sylvest: I'm actually looking forward to hear the answers on both. So what I could acknowledge here will make us satisfied, Camilla, in the basal segment. And if you can predict OCEMPIC and VREX levels for the next couple of years, I would also be really happy on that one. Thanks a lot, Keyur. You just turned this into my budget meeting. I really appreciate it.

And so.

Well, what I could take mortgage that would make us.

Satisfied.

In the basal segment.

And if you can predict with <unk> levels for the next couple of years.

Also be really happy.

Thanks, a lot.

Hi, Barton.

Camilla Sylvest: So I have a guy here next to me taking notes that will follow up forever on the answers. Marketshare and ICODIG, we talked about earlier, we have 37% share in value and 33% in volume in the Basel segment. And of course, this is significantly lower than what we've seen in other segments, the premix segment, for example, or even the fast acting segment. So having a superior offering on HbA1c that gives you no more hypose, but equivalent on hypose, a very, very low weight. And you really have to wait for a long time to see any hypose based on what Martin explained. And also a quality of life that is significantly better.

So I have a guy had X I mean, taking notes.

On the answers.

No.

Magazine.

We talked about earlier, we have.

37% churn in value and third <unk> volume in the basic segment.

And of course, this is significantly lower than what we've seen in other segments. The premix segment for example, or even the fact that think segment, so having a superior offering on <unk> that gives you.

No more hypos, but equivalent on hydro is a very very low rate.

<unk>.

You really have to wait for a long time to see any hypos based on what Martin explained and also.

Quality of life any significantly better. This is of course very very important and taking all of that together has a potential to of course transform the way we look at basically answering so I would hope that we can make significant inroads into the basis segment.

Camilla Sylvest: This is, of course, very, very important. And taking all of that together has the potential to, of course, transform the way we look at basal insulin. So I would hope that we can make a significant inroad into the basal segment. And probably we should just see the rest of the onward trials before we get closer to what could a good aspiration level be. But I do think that we need to be able to make something really good out of this for the sake of the many people that are truly concerned about hypose, but are also struggling with trying to understand how they should, you know, remember their doses on an everyday basis. We know more of them forget to take their daily insulin injections.

And probably we should just see the rest of the onward trials before we get to closer to what a good aspiration level.

But I do think that we need to be able to make something really good out of this for the sake of so many people that are truly concerned about hypos, but are also shopping with trying to understand how they should remember that doses on an everyday basis, we know more than forget to take their daily insulin injection. So I also fascinated fall into the mall.

Camilla Sylvest: So I also personally look forward to the more real life, the results of the trial where we leave patients more alone for a year's time to see what that looks like. Because, of course, compliance with a once weekly is likely to be higher, everything else. So I know I don't give you the market share answer, but at least we have potential. Majority market shares.

Life.

The results of the trials I believe patients more alone.

Yes time to see.

What that looks like because of cost compliance with a once weekly is likely to be higher everything else equal. So I know you don't give you the market your answer but at least one potential.

Camilla Sylvest: We can always discuss whether we discuss the absolute or relative, but that we can come back to. So I think that's enough for now until we've seen the rest of the onward trials. I appreciate the support from the room here, mainly to Karl and I. I'm taking notes. Then on OCEMPIC, actually we did discuss, you know, we have seen more prescribers from lower tier segments prescribing, and we also understand the relevance of GLP-1, the very strong OCEMPIC performance in terms of approximately 80% getting in good control, we know from our clinical trials. So a really, really great number of benefits, and that, of course, drives our continuous performance with OCEMPIC. I also spoke a little bit to the halo effect.

Majority of the market share majority market share.

Can always discuss discuss the absolute or relative Buddy.

We can come back to them.

So I think that's enough for now until we've seen the rest of the on with China.

I appreciate the thoughts from the room here.

Yeah.

Right.

Taking notes.

Yes.

And then on an authentic actually I did.

We did discuss we haven't seem all prescribers from military segments prescribing and we also understand.

Relevance of TLC one.

The very strong and.

With that it takes for farmers in terms of approximately 80% getting in.

Good control, we know from our clinical trials and celebrate a really quite a number of benefits and that of course drives our continuous performance with assembly and I also spoke a little bit to the Halo effect, that's probably an increased understanding of what this molecule can do.

Camilla Sylvest: There's probably an increased understanding of what this molecule can do to macrotype. And, of course, we cannot rule out that some people have, are living with diabetes thinking if I can, that they heard about what can this product do in terms of weight loss, and then they're interested in that. We don't have, I don't have any evidence to suggest that it's all, you know, off-label use or that it is. But I think it's very, very important for us to promote Ostempreg for diabetes care and Vigovi for obesity care, so. I think I will leave it with that part.

Sure.

And of course, we cannot rule out that some people have.

Living with diabetes thinking.

I can.

That they heard about what can this product too in terms of weight loss and then they're interested in that we don't have I don't have any evidence to suggest that that is all.

Off label use all of that it is.

I think is very very important for us to promote a template for diabetes care.

<unk>.

So.

I will leave it with the with that pad and then.

Camilla Sylvest: And then, would we then later on see a decline in OCEMPIC? That's of course part of what one has to consider. Would there be a, whenever we are fully supported on Vigovi, would there be some people who have, even living with diabetes, that have easier access to Vigovi this way than OCEMPIC?

It would be then later on and see a decline in <unk>.

It's part of what one has to consider would that be whenever we have fully supported our nickel. We would there be some people who have been living with diabetes that has easier access to <unk> this way that authentic.

That's still to be seen but the scenarios of course, we tried to cater following the guidance that we had given you.

Karsten: Amen. Yeah, and just adding to this one, you know, forecasting NBRX is pretty much really, really complicated. And it's even more complicated to forecast the conversion from NBRX to TRX, just to make it even worse. But what we saw last year was kind of interesting.

And just adding to this one.

Forecasting and Brexit is pretty much.

Really complicated and it's even more complicated to forecast the conversion from indirect to direct.

Just to make it even worse, but what we saw last year was kind of interesting when you looked at <unk> and the mid last year that was also.

Karsten: When you looked at NBRX in the mid last year, there was also, you remember, the step up in NBRX linked to potential halo effects, et cetera. And we saw a step up, and then we saw the curve continuing from the step up. So I'm not saying, you know, we'll see the same now, but you don't find these very simple direct correlations, at least based on historical data. I think it's Sachin and then we move the other way.

But the step up in the <unk>.

A link to potential halo effects et cetera, but we saw a step up and then we saw the curve continuing from the step up.

So I'm not saying.

We'll see the same now but it's you don't you don't find these very simple direct correlations.

At least based on historical data.

I think as such and then we moved the other way.

Unknown Attendee: Thank you. I might just make a follow-up on the IGADEC hypos to Mark's question. So, I remember at the time of Treceva, there was a lot of debate around various hypo definitions. My question is fairly straightforward. In answer to the question, you talk about no severe, no repeat, no prolonged, but you clearly had an excess of clinically relevant, whatever it was, less than three minimals. Adi, no, a lot more about... University of Waterloo, And a real-life tattoo for what level of age? And a real-life tattoo for what level of age?

I want to take a follow up on deck hypos not specialty.

Members with Summit's received but there was a lot of debate around various sleeper destinations my questions fairly straightforward.

Answer to the question you spoke about nice via their repeat no prolonged but you've clearly had an excess of clinically relevant whenever it was less than three minimum.

<unk>.

Why that.

Okay.

All three metrics.

You bet.

Thanks.

Yeah.

The second question is if you could spend a little bit more.

Onwards volume.

What conversations you've had with payers.

As you know more about the molecule.

What are your expectations in the railroad.

<unk> led the way we see them.

Unknown Attendee: Can you get hypo-superiority? That's all I can answer, one very quick one on semicagri. Having seen to zepatite, would you consider a semicagri zepatite?

Can you get height superiority.

And Thats a one very quick one on semi category, having seen to <unk> would you consider the rest of them in Calgary satisfied head to head.

To this day.

Unknown Attendee: Thanks, Etienne. Three questions. So you beat them also.

Thanks Sachin.

Three questions. So.

<unk> also.

So one.

Martin: So one. Martin, I think you called it a hypo-nerdiness, kind of in second effect question, then almost five, you know, how did, why did you design that based on the pair dialogue, and then Sima Khakri versus Mr. Sepetain? We'll start from the beginning. So on the hyperglycemia, again, I think it's important to call out when we see a numerical difference at a very low level, I don't want to belittle the difference, but it's sort of comparing one to two, and then say you have a doubling in risk.

Martin I think you called a hypo nerdiness.

Kind of second effect question.

Then almost $5.

Why did it was decided that based on the payer dialogue and then the semi cap business.

Yes.

So we start from the beginning.

So the hypoglycemia again, I think it's important to call out when we see a numerical difference.

At a very low level.

I don't want to belittle the.

The difference, but its sort of comparing one to two and then say youll have adopting in risk.

Martin: This is also why there is no statistically significant difference. It's basically a function of really, really few events. And another way of looking at this is... You may have seen the number of or the proportion of patients reaching an A1C below 70. If you do that proportion, I think it's around 40, 40 something, versus 20 something.

This is also why there is no statistically significant difference, it's basically a function of really read a few events.

Another way of looking at this is.

You may have seen that.

The number of or the proportion of patients reaching.

In a world cheap low seven.

If you do that proportion I think.

It's around 40 40 something.

Versus 20, something and the interesting thing is if you didn't make the analysis, reaching even see below 7% without hypoglycemia.

Martin: And the interesting thing is, if you then make the analysis reaching A1C below seven without hypoglycemia, is the same numbers. Again, speaking to the very low rate of hypoglycemia, so absolutely a difference. // But on a level where it's difficult to say, if this is clinically relevant, I don't think it is. When we don't compare to Tursipa, I mean next study reading out will be ORN1 versus Glargen, and we know that there is a different hypo risk associated with that comparison. I think you'll see some maybe slightly different results.

It's the same numbers motive.

Again speaking to the very low rates of hypoglycemia, so absolutely a a difference.

But at a level, where it's difficult to say if this clinically relevant.

I don't think it is you'll also see.

When we don't compared to placebo I mean next study reading out will be on March one versus Florida, and we know that there is.

Different hypo.

The risk associated with that comparison.

You will see some subset so may be slightly different results and if we can repeat that.

Martin: And if we can repeat what we've seen so far. I think both, not only we, but also our future customers will... This was the same...

Uh huh.

I think both not only.

But also our future customers will say this is this is to save money.

Martin: Almost five, we basically... I think, at the very least, Camilla and I probably also, Karsten, have shared the frustration that we, from a regulatory perspective, we were forced to do it three times, and that means going for A1C parity, from the Pampas Bay. They don't really care.

Almost five.

We basically.

I think that this can be done and I, probably also share the frustration that we from.

Regulatory perspective, we were forced to treat to target that.

It means going for agency.

Parity.

From a payer perspective.

Martin: We saw that with placebo. We came with what we think was very nice hyperglycemia data, and they said, well, we can't pay for that. We would like to see it with, We wanted to change that outlook for Agrotech, so we had a dialogue with some US payers, some European authorities, the Chinese authorities. We, we asked them what are you doing? And very clearly, you had to demonstrate A1C superiority. We know now, also based on Normals 2, that is a potential, also in Normals 5, and they very clearly stated we want to see real world. The problem in doing three to target is that in our RCTs we can get, More than 50% of the patients to a certain target. And in real life, that does.

They don't really care, we saw that with placebo, who came with what we think was very nice hyperglycemia data appears it well we can't people that we would like to see.

It won't be different.

We wanted to change that outlook for <unk>. So we had a dialogue.

Some some USPI is some European endorses the Chinese authorities.

We asked them what are you looking for.

Clearly you had to demonstrate aon's esports.

Now also based on almost through that as a potential also known was flat.

And they very clearly stated we want to see real world data.

The problem into entry to target is that in our cities we can get.

More than 50% of the patients to a certain target.

And in real life.

Hold true.

Martin: Group, and therefore they wanted to see what happens with, I have never been able to do that, but with the advent of digital tools, monitoring, collecting data on remote, advising on internet. Tournette, and others. That basically allowed us to virtually give the patient the app on an iPhone, the insulin, a monitoring device for glycemic control, and then saying goodbye, we will see you in a year. Obviously, we do have some visits, but I think it's more of the same. They haven't.

And therefore, they wanted to see what happens with real life.

Never been able to do that but with the advent of digital tools monitoring collecting data on remote advising on insulin titration to Nf L.

That basically allows us to virtually get the patient the app.

On an iPhone.

The insulin and monitoring device for a placebo control.

And then saying Goodbye, we will see Ya.

Obviously, we do have some visits but I think it's four visit in the year.

Okay.

Uh huh.

Yes.

Martin: Historically, we have been looking somewhere between 0.2 and 0.4, depending on who you are talking about, and then again in a 26-week study versus Tresibas. Statistically Significant 0.22, that's a very nice place to start because it could give us the aspiration of going maybe beyond that in our mode 1. And the final question was, can you tell us about the head-to-head with the Serpentine? Sitting next to Camilla, I feel very confident that if the data that we see so far will catch up. Andrzej Popkowski, all the way through phase three.

They haven't historically, we have been booking somewhere between two and four depending on who you're talking to.

I think again in the 26 week study versus placebo to see statistically significant points with two that's a very nice place to start because it could give us the aspiration of growing maybe beyond that.

One five.

And then final question was.

Okay.

Okay.

The hit rate with this every time.

Sitting next to Camilla I feel very confident that if the data that we see so far.

Uh huh.

Martin: I don't think I wouldn't mind doing a head-to-head because as you've also heard me say before... I do think that CACUSEMA will hold its own on efficacy, we have very high aspirations for that, and on the safety and solubility side, so far we've seen something that is not additive but actually just the sum of what is symmetric, and that means that Cagri Sima holds the potential for being competitive on both avenues. Obviously, I would like to see the data before I commit, but if it holds true, then we are all in. Great. Thank you, Martin. Thank you, Septon.

All the way through phase III.

I don't think I wouldn't mind doing a head to head.

As you've also heard me say before.

I do think that <unk> will hold its own on efficacy.

We have very high aspirations for that.

And on the safety and Tolerability side, so far we've seen something that is not additive, but actually just the sum of what is making side.

That means that <unk>.

Holds the potential for being competitive on both efficacy and safety.

Obviously, I would like to see the data before I commit but.

If it holds true that we own it.

Karsten: We have time for two more questions. So I'll say it's two persons and one shot each, and Joe, you are the first one. Okay, can I ask a more thought experiment?

Great. Thank you Martin Thank you sets and we have time for two more questions.

It's two persons in one shot each.

And Joe you are the first one.

Unknown Attendee: If sales growth continues closer to the level that you've seen in one queue than you expect it to go back to because all sorts of, you know, fantastic things happen, the halo effect, At what level of sales growth do you think we should be? Market, and you can easily reinvest and everybody still is. There must be some point at which there's a diminishing return, you know, you haven't got... All the ideas that you need to spend that much money in R&D. Camilla has a lot for all of the TTC. I think the government might just have to interdict you.

Okay can I ask more thought experiment if sales growth continues closer to the level that you've seen in <unk> and you expect it to go back to you because all sorts of fronts.

These things happen the Halo effect and all the rest of it.

What level of sales growth do you think we should actually see margin leverage come through because at the moment you have the luxury of stronger sales and you've got it.

And you can easily reinvest.

It is very happy with that.

Must be some point, which is a diminishing return.

<unk>.

The idea is that you need to spend that much money in R&D and Camilla.

All of the September .

Labour government might just have to interdict here of course, we will have lots of ideas on.

Karsten: Of course, we will have lots of ideas in R&D on how to spend money. The huge amount of money that you get if you continue to have... Jensen, Transcript by Rev.com Page of Jensen, Leverage coming through. And I'm going to sneak in just a very...

Spend money well.

The huge amounts of money yet continue to have.

15% topline growth for any extended period of time. So can you just help us think about that level, where we should think about leverage coming through.

Reinvestment.

Just to sneak in just a very quick second one.

Just wondering whether.

Unknown Attendee: Transcripts provided by Transcription Outsourcing, LLC. Have you seen any evidence of people not staying on OZMP? which would speak to perhaps some of them being there in obesity or are we seeing much longer stays? Thanks, Joe.

You've highlighted in the past, but stay time is significantly less <unk> than it is on diabetes have you seen any evidence of people not staying on Aries uptake.

Which would speak to perhaps some of them being that BCP or always see Nigel at the same time.

Sure.

Karsten: Two relevant questions. As you know also from our strategic aspirations, then we have clearly communicated, even though that it's not necessarily translating into all spreadsheets in London and other good cities, that we're working with a stable margin outlook in the medium term for the company. So our clear base plan is also at higher growth rates is really to be investing mainly in R&D. Right now, you should also bear in mind that, you know, as we spoke about the inflationary pressures, we also have to have some work to do there. We believe we can do it, but that's also a reality. So clearly, I don't want to invest in R&D unless I believe it has an attractive return. But that would be the key premise.

Thanks, Joe two relevant questions as you know from our strategic aspirations.

We have clearly communicated even though that it's not necessarily translating into all spreadsheets in London and other good country.

Cities that we have.

We're working with a stable margin outlook in the medium term for the company. So so clear based plan is also at higher growth rates.

It's really to be investing mainly in R&D right. Now you should also bear in mind that the.

As we spoke about the inflationary pressures.

Also have to have some work to do there we believe we can do it but.

But that's that's also a reality so.

Clearly I don't want to invest in R&D on this I believe it has a attractive return, but that would be the key premise.

Karsten: And I think we've shown our financial discipline over and over again. You shouldn't be modeling with upside on operating margin, you should be working on also investing in the long term, and stay tuned, we don't have any data, Camilla. Tract. We don't have any evidence of any. It's too early.

I think we've shown our financial discipline on Oregon. So.

You shouldnt be modeling with the upside on operating margin.

Would be working on us investing in the long term.

And state time, we don't have any data coming out okay. That's right. We don't have any evidence of any changes in your statement.

Right, it's too early so.

Camilla Sylvest: So be happy a year down the road. Pete, last set of questions. I promised the two very quick ones. So just coming back to the Weger v Azempic debate for a minute, just in terms of high dose, can you just remind us, is it generally true that the higher dose GLP-1 to 2 migs, is that more commonly needed for larger obese type 2 diabetics? I guess I'm thinking, is there any correlation between dose of GLP-1 needed versus, and equally, what proportion of obesity Weger v patients on your initial data did have type 2 diabetes? If you can give us, And then can I just ask a quick one just on the way to the production.

Half year year down the road.

Last set of questions.

I hope, it's a two very quick ones just coming back to the way can be adapted.

For a minute.

Hi, guys can you just reminded.

Is it generally true that the higher dose <unk> is that more commonly needed for larger obese type two diabetics I guess is there any correlation between dose of <unk> needed and equally what proportion of <unk> patients from your initial data did have type two diabetes.

If you could give us that.

And then can I just ask a quick one just on the legacy production you say you want to make sure you got enough stocks before you opened the gate if you like given what's happened.

Unknown Attendee: You say you want to make sure you've got enough stocks before you open the gates, if you like, given what's happened. Can you give us some sort of idea, what sort of... Transcripts provided by Transcription Outsourcing, LLC.

Can you give us some sort of idea whats.

Trs so what's especially.

Because we have no idea of the rates of production.

Catalyst one.

What are you assuming in terms of that before you do could you give us any idea of what you're receiving in terms of the demand before you do that say this isn't a inventory we're opening up to at least give us some sort of idea of the timeframe you're thinking about.

Karsten: Yeah, so if I just take the inventory build first, and the way we do it in terms of sizing inventories, Pete, is we work with a number of scenarios, because it is clearly super volatile what we're looking into, based on our historic experiences. So we base the sizing of inventories as a combination of different scenarios, and then we furthermore combine it with our launch tactics, which you should expect to be probably more gradual than a big bang out of the gate. So it's impossible to give you one point estimate without for sure being completely wrong.

Yeah. So so if I just take the inventory build first and the way we do it in terms of sizing and choice.

Peters, we've worked with a number of scenarios because it is clearly super volatile.

We're looking into.

Based on our historic experiences so we.

We based the sizing of England Charles is a combination of different scenarios and then we Furthermore, combine it with the with our launch tactics, which you should expect to be probably more gradual than a big Bang out of the gate. So it's impossible to give you one one point estimate without for sure be completely wrong, but.

Karsten: But you have the historic trends, both on TRX gradient uptake, as well as NBRX. So it's also how many new starts should we expect, and certainly a little bit longer, but, You know, the big question is, of course, to what extent do physicians have patient inventory, so to say, patients waiting for the product. So that's a big uncertainty, and that's what we're careful how to manage.

You have you have to historic trends.

Both on the <unk> gradient uptake as well as <unk>. So it's also how many new starts should we expect and certainly a little bit longer but.

The Big question is of course to what extent.

<unk>.

Patient inventory, so to say patients waiting for the product. So that's the big uncertainty and that's what we're careful how to manage so in reality. It is not only <unk>. It's also patient stocking.

Martin: So in reality, it's not only a TRX measure, it's also a patient stocking-type assessment that we're making. And we just want to make sure that it turns into a more controlled approach this time around, then Martin on the 2.4 patient profiles and in terms of need of those. So, if we start with those parts, I think you've seen a differential in terms of the, Those requirements for glycemic control versus weight. So you reach a plateau for glycemic control, for example, on some amplotide, when you reach those 2.0 milligram approximately, that would just gotten approved, you can't get much out on glycemic control moving beyond 2.0 milligram.

Type of assessment that we're making and we just want to make sure that that.

That it turns into a more controlled.

Our approach at this time round.

Then Martin on.

On the same at $2 four per patient.

Profiles.

In terms of need of it.

Doses.

So.

If we start with the dose those but I think you've seen it.

<unk> in terms of the.

Those requirements for glycemic control.

So.

You reach a plateau for placebo control for example on some appetite when you reach those $2 two milligram approximated that we've just gotten approved you can't get much out on placebo control moving beyond what's your military on body weight loss, we haven't seen that plateau, yet and that also means that I mean first of all this is difference between one.

Martin: On body weight loss, we haven't seen the plateau yet. And that also means that, I mean, first of all, you see a difference between 1.0 and 1.2 in terms of body weight loss, but you also see moving beyond 2.0, for example, towards 2.4 milligram, a further body weight loss. And this is a little bit in opposition to maybe what also we saw last, where there was actually a plateauing looking at the triseptide data that appeared to have sort of reached something between the 10 and 15 milligram in terms of body weight lowering. We haven't seen that for semaglutide like, well, semaglutide.

Sure and what point too in terms of body weight loss, but you also see moving beyond two months you for example wants to put two four milligram.

The body weight loss and this is a little bit in opposition to maybe what also we sold last week.

There was actually a plateauing.

It did.

The symptom data that appeared to have sort of reached something between the 10 and 15 milligram in terms of body weight loss, we haven't seen that policymakers.

Most of the maintenance budget. So we actually Havent established full <unk> 90 for the weight loss products.

Martin: So we actually haven't established the full ED90 for the weight loss, on the clinical side. All patients that we've investigated with magnetite 2.4 milligram have been not diabetics. I think in the real world, I don't know if we have data yet on patients on Rigoe being how many also have diabetes.

Yeah.

The clinical side.

<unk> patients that we've investigated with two four milligram.

Not diabetics I think in the.

Well I don't know if we have data yet on patients on <unk>.

Ultra.

Peter.

In the data.

Martin: So far, I mean, the vast majority of what we have on, we go in 2.4 milligrams, man-sized. Thank you, Martin, and thanks for joining this Novo Nordisk Q1 launch meeting, and thanks to Richard and J.P. Morgan for hosting it. I would just like, by closing out with a comment that we'll be at ADA and we'll be hosting a sell-side event at ADA in the U.S. in early June, so I hope to see you all.

So so far I mean, the vast majority of what we have when we go to.

Two four milligrams met side, it's not diabetics.

Martin: We'll probably do both some type of a sell-side, nice sell-side dinner, and then we'll have an investor event with Martin and a couple of his colleagues from R&D, so we hope to see you there, hopefully with more data also out of R&D, but who knows? So thank you, and have a great rest of the day. Andrzej Vosser, Peter Welford, Peter Welford, Peter Welford, Peter Welford,

Alright, Thank you Martin.

Thanks for joining on this.

<unk> Q1 launch meeting and thanks, Richard JP Morgan for hosting it.

I would just liked by closing out with the comment that we'll be at Ada and will.

The hosting of sell side event at <unk> in the USA in early June So I hope to see all the way.

We'll probably do both.

That type of a sell side a nice sales at dinner and then we'll have an investor event with a match and then a couple of friends colleagues from from R&D. So we hope to see you there hopefully with more data also for out of R&D.

Who knows.

So thank you and having a great rest of the day.

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