Q1 2025 Novo Nordisk AS Earnings Call - London

May 8, 2025

So, good afternoon and welcome everyone. My name is Chibubut Hai, I'm from my quick analyst at Morgan Stanley . So, thanks for joining the overall first quarter.

Speaker Change: We are delighted to have with us the management team of NRN Nordisk. So, Lars Freger, Jörgensen, Karsten Mutsen, Martin Lange, and Mike Gustafs, thank you very much for joining us and so here without further ado, I will...

Speaker Change: Thank you very much. Thank you very much and thank you for hosting us today. Like we normally do, we'll go through a few sites relative and snappily to set the scene and then get into your questions.

Thibault Boutherin: Okay. Good afternoon and welcome everyone. My name is Thibault Boutherin. I am Pharma Equity Analyst at Morgan Stanley. Thanks for joining the Novo Q1 2025 event post results. We are delighted to have with us the management team of Novo Nordisk. Lars Fruergaard Jørgensen, Karsten Munk Knudsen, Martin Holst Lange, and Maziar Mike Doustdar. Thank you very much for joining us. Without further ado, I will hand it over to you, Lars.

Thibault Boutherin: Okay. Good afternoon and welcome everyone. My name is Thibault Boutherin. I am Pharma Equity Analyst at Morgan Stanley. Thanks for joining the Novo Q1 2025 event post results. We are delighted to have with us the management team of Novo Nordisk. Lars Fruergaard Jørgensen, Karsten Knudsen, Martin Lange, and Mike Doustdar. Thank you very much for joining us. Without further ado, I will hand it over to you, Lars.

Speaker Change: Of course, we'll be talking about the future that might turn out to be different and what we preach from here, so please be careful around that.

Speaker Change: This is the summary slides. I'll not cover it in much detail. We will through our few slides talk to commercial performance. We'll talk to the pipeline and our financial guidance for the year. So firstly on financial performance. We'll talk to the pipeline and our financial guidance for the year.

Lars Fruergaard Jørgensen: Yeah.

Thibault Boutherin: Thank you so much.

Lars Fruergaard Jørgensen: Thank you very much. Thank you for hosting us today. Like we normally do, we'll go through a few slides relative snappingly to set the scene and then get into your questions. Now, of course, we'll be talking about the future that might turn out to be different than what we preach from here, so please be careful around that. This is the summary slides. I'll not cover it in much detail. We will through our few slides, talk through commercial performance. We'll talk through the pipeline and our financial guidance for the year. Firstly, on financial performance, you have seen the reported 18% growth, will, you know, relatively equally contributing regions, US and international operations.

Speaker Change: You have seen the reported 18% growth, well, you know, relatively equally contributing regions, US and international relations, and it's, again, the Tier 1 fine size in diabetes and obesity that's driving the growth.

Thank you.

Speaker Change: We are proud that we are still an absolute volume leader. We have the slides just to on the line how we are scaling and with our big footprint in Mike's part of the world.

Speaker Change: We have close to two thirds of all patients on GIL-1-based treatments, and you know that we're investing significantly in keeping that, say, leadership position in terms of serving many more patients for the future. So scaling in manufacturing is happening and we're quite pleased with that. Thank you very much.

Lars Fruergaard Jørgensen: It's again, the GLP-1 franchise in diabetes and obesity that's driving the growth. We are proud that we are still an absolute volume leader. We have these slides just to underline how we are scaling and with our big footprint in Mike's part of the world, we have, you know, close to two-thirds of all patients on GLP-1-based treatments. You know that we're investing significantly in keeping that, let's say, leadership position in terms of serving many more patients for the future. Scaling in manufacturing is happening, and we're quite pleased with that. A key topic for this quarter has been the US development in scripts, and here the slide is. We have seen that we have gone flat in the scripts. That's something we take very seriously.

Speaker Change: A key topic for this quarter has been the U.S. development script and the field slide is.

Speaker Change: We have seen that we have gone flat in the scripts. That's something we take very seriously.

Speaker Change: It is impacted by how compounding has developed for the GOV to a small degree in the US to a degree where we now estimate that it is as big as our own business, more than a million patients.

Speaker Change: You have probably seen the announcements from this day that we have to drop short this list.

Speaker Change: We are building some partnerships with telehealth providers and we also will have some benefit from the decision by CVS in terms of focusing on the goal.

Lars Fruergaard Jørgensen: It is impacted by how compounding has developed for Wegovy to a small degree, Ozempic in the US to a degree where we now estimate that it is as big as our own business, more than a million patients. You have probably seen the announcements from this day that we're off the drug shortage list. Hence, it's now illegal to do compounding. We have started the NovoCare Pharmacy cash offering. We are building some partnerships with telehealth providers, and we also will have some benefit from the decision by CVS in terms of focusing on Wegovy. We are taking this very seriously, and we believe that, as we progress the year, compounding will be dramatically reduced.

Speaker Change: really only for individualized persons in rare cases that will be allowed and will work hard to make sure that it's limited to that.

Speaker Change: and we expect that will that should lead to an reflection point in the scripts in the coming second half of the year and I'm sure we'll get into this in more detail.

Speaker Change: With that, I'll hand over to Mike for some words on I.O. Thank you very much Lars.

Mike Gustaf: Lars showed you how the different regions and international operations have been doing almost all of them.

Speaker Change: with very good growth rates. He also mentioned that the growth is really in GOP1, diabetes GOP1 and obesity GOP1, so I've decided to use the slide on focusing on GOP1.

Lars Fruergaard Jørgensen: It's really only for individualized persons in rare cases that will be allowed, and we'll work hard to make sure that that is limited to that. We expect that will, that should lead to an inflection point in the scripts, in the coming second half of the year. I'm sure we'll get into this in more detail. With that, I'll hand over to Mike for some words on IO.

The 11% GOP1 diabetes growth at the company shows...

Speaker Change: 13% of it comes from international operations, and you can see the three products that we have, ozemic, rebellious, and victosa, and how they are basically delivering their growth rates in each of the four regions we have in international operations.

Maziar Mike Doustdar: Thanks very much, Lars. Lars showed you how the different regions and international operations have been doing, almost all of them with very good growth rates. He also mentioned that the growth is really in GLP-1, diabetes GLP-1 and obesity GLP-1. I've decided to use the slide on focusing on GLP-1. The 11% GLP-1 diabetes growth that the company showed, 13% of it comes from international operations. You can see the 3 products that we have, Ozempic, Rybelsus, and Victoza, and how they are basically delivering their growth rates in each of the 4 regions we have in international operations.

Mike Doustdar: Thanks very much, Lars. Lars showed you how the different regions and international operations have been doing, almost all of them with very good growth rates. He also mentioned that the growth is really in GLP-1, diabetes GLP-1 and obesity GLP-1. I've decided to use the slide on focusing on GLP-1. The 11% GLP-1 diabetes growth that the company showed, 13% of it comes from international operations. You can see the 3 products that we have, Ozempic, Rybelsus, and Victoza, and how they are basically delivering their growth rates in each of the 4 regions we have in international operations.

Speaker Change: On the other hand, he showed 65% growth rates for the company on obesity, GOP1, and a lie in share of that 137% of that, this quarter came from international operations on the back of two products

Speaker Change: Sachsander, which is slowly going out and the Govy, which is very quickly replacing and being launched across the market. We came into the year with close to 20 markets

Speaker Change: being having the govi. As of today, we are very close to 25 and we have plans, of course, roll out the govi in many more markets as we go and the growth rates speak for themselves.

Maziar Mike Doustdar: On the other hand, we showed 65% growth rates for the company on obesity GLP-1, and a lion's share of that, 137% of that this quarter came from international operations on the back of two products, Saxenda, which is slowly going out, and Wegovy, which is very quickly replacing and being launched across the markets. We came into the year with close to 20 markets having Wegovy. As of today, we are very close to 25, and we have plans to of course, roll out Wegovy in many more markets as we go, and the growth rates speak for themselves.

Mike Doustdar: On the other hand, we showed 65% growth rates for the company on obesity GLP-1, and a lion's share of that, 137% of that this quarter came from international operations on the back of two products, Saxenda, which is slowly going out, and Wegovy, which is very quickly replacing and being launched across the markets. We came into the year with close to 20 markets having Wegovy. As of today, we are very close to 25, and we have plans to of course, roll out Wegovy in many more markets as we go, and the growth rates speak for themselves.

Speaker Change: Thank you very much. So, as you all know, we've reported on redefined one that created a lot of attention and all this is also on redefined two in type two that we just as have reminded. We saw very, very strong weight loss in redefined 123% weight loss.

and Pebble.

Speaker Change: to that of we go, IE, we get a lot more weight on us but with the same safety and solid ability profile. Same thing in tattoo that needs.

Speaker Change: But it's also important to call out that we're taking some learnings from those plants, cheaply that they were too brief. We did not accrue the phone weight loss potential, we do believe that they lose maybe more weight loss potential for Kate Rezeman. [inaudible]

Martin Holst Lange: Thank you very much. Yeah. As you all know, we've reported on REDEFINE 1 that created a lot of attention, and obviously also on REDEFINE 2 in type 2 diabetes. Just as a reminder, we saw very, very strong weight loss in REDEFINE 1, 23% weight loss. Comparable to that of Wegovy. I.e., we get a lot more weight loss, but with the same safety and solubility profile. Same thing in type 2 diabetes. It's also important to call out that we're taking some learnings from those trials, chiefly that they were too brief. We did not accrue the full weight loss potential.

Martin Lange: Thank you very much. Yeah. As you all know, we've reported on REDEFINE 1 that created a lot of attention, and obviously also on REDEFINE 2 in type 2 diabetes. Just as a reminder, we saw very, very strong weight loss in REDEFINE 1, 23% weight loss. Comparable to that of Wegovy. I.e., we get a lot more weight loss, but with the same safety and solubility profile. Same thing in type 2 diabetes. It's also important to call out that we're taking some learnings from those trials, chiefly that they were too brief. We did not accrue the full weight loss potential.

Speaker Change: and therefore we've extended redefined for, and we've initiated, or will initiate in this quarter redefined 11, taking the learnings of doing along the track, but also focusing on how to breathe high-trade, if a saturation has been stopped. [inaudible]

Speaker Change: with that and with these initiatives we do believe that we will see the fuller weight loss potential of Keckler-Simmers and obviously given the duration of redefine free that is basically by design already built in.

Martin Holst Lange: We do believe that there is maybe more weight loss potential for CagriSema, and therefore, we've extended REDEFINE 4, and we have initiated or will initiate in this quarter REDEFINE 11, taking the learnings of doing a longer trial, but also focusing on how to re-titrate, if titration has been stopped. With that, with these initiatives, we do believe that we will see the fuller weight loss potential of CagriSema. Obviously, given the duration of REDEFINE 3, that is basically by design already built in. Very exciting still for us. We do see a lot of merit in obviously CagriSema, but also the broader Amylin biology. I'll come back to that. Both for emricitan, but also for cagrilintide and more of that, each with their different traits.

Martin Lange: We do believe that there is maybe more weight loss potential for CagriSema, and therefore, we've extended REDEFINE 4, and we have initiated or will initiate in this quarter REDEFINE 11, taking the learnings of doing a longer trial, but also focusing on how to re-titrate, if titration has been stopped. With that, with these initiatives, we do believe that we will see the fuller weight loss potential of CagriSema. Obviously, given the duration of REDEFINE 3, that is basically by design already built in. Very exciting still for us. We do see a lot of merit in obviously CagriSema, but also the broader Amylin biology. I'll come back to that. Both for emricitan, but also for cagrilintide and more of that, each with their different traits.

Speaker Change: Very exciting still for us, we do see a lot of merit in obviously Kekusema, but also the broader Emily and biology I'll come back to that, both Simon Cretzens, but also for Kekwillinside and more of that, each with their different traits.

Speaker Change: But the potential offering of Kekrasen is obviously unsurpassed witness. [inaudible]

Speaker Change: Comorbidity Benefits that we know, and at least I love from tomato side, IETV Benefits, soon to be liver benefits, maybe benefits on causes and functions, and obviously in diabetes space also kidney benefits.

Thank you. Bye.

Speaker Change: All the medical sites are something that we have been talking about for some. [inaudible]

Speaker Change: Time, obviously there's a lot of talk in the town about anything, or PLP1 analog.

Martin Holst Lange: The potential offering of CagriSema is obviously unsurpassed weight loss with a very strong safety and solubility profile, and with the comorbidity benefits that we know, and at least I love, from semaglutide, i.e. CV benefits, soon to be liver benefits, maybe benefits on cognitive function, and obviously in the diabetes space also kidney benefits. Also, semaglutide is something that we have been talking about for some time. Obviously, there's a lot of talk in the town about anything oral GLP-1 analog. Just to remind you, with oral semaglutide, we see with 25 mg for obesity, 17% weight loss. That is a really, really strong weight loss in this space with, again, a safety and solubility profile that is not only well known and acceptable to patients, but also established in a very, very large database.

Martin Lange: The potential offering of CagriSema is obviously unsurpassed weight loss with a very strong safety and solubility profile, and with the comorbidity benefits that we know, and at least I love, from semaglutide, i.e. CV benefits, soon to be liver benefits, maybe benefits on cognitive function, and obviously in the diabetes space also kidney benefits. Also, semaglutide is something that we have been talking about for some time. Obviously, there's a lot of talk in the town about anything oral GLP-1 analog. Just to remind you, with oral semaglutide, we see with 25 mg for obesity, 17% weight loss. That is a really, really strong weight loss in this space with, again, a safety and solubility profile that is not only well known and acceptable to patients, but also established in a very, very large database.

Speaker Change: Just remind you, with all the measures that we see with 25 mg for obesity, 70% weight loss.

Speaker Change: That is a really, really strong weight loss in this space. We'll, again, a safety and solar-painted profile that is not only well known and acceptable to patients but also established in a very, very large database.

In that we also have seen the biomearches for comorbidities. [inaudible]

Speaker Change: For example, Ways to Conference, for example, Doreng in Risk of Information, for example also Doreng in Blood Press and Nibbens.

Speaker Change: And that basically means that we have a regional aspiration of getting the benefits.

Speaker Change: from the select line, but maybe also the trance into the orthometric transfer piece in April . [inaudible]

Speaker Change: Again, a very strong offering with unsurpassed efficacy in the aerospace, being the first.

All TF1 for the treatment of obesity. [inaudible]

Martin Holst Lange: In that, we also have seen the comorbidity, sorry, biomarkers for comorbidities. For example, waist circumference, for example, lowering in risk of inflammation. For example, also lowering in blood pressure and lipids. That basically means that we have a reasonable aspiration of getting the benefits from the SELECT trial, but maybe also other trials into the oral semaglutide for obesity label. Again, a very strong offering with unsurpassed efficacy in the oral space, being the first oral GLP-1 for the treatment of obesity. Very well-established safety and tolerability profile, and potential for CV and other benefits in the label. I can speak a lot to this slide. The short message is we see progress across all our therapy areas in our phase 1 to 3, actually phase 4 pipelines.

Martin Lange: In that, we also have seen the comorbidity, sorry, biomarkers for comorbidities. For example, waist circumference, for example, lowering in risk of inflammation. For example, also lowering in blood pressure and lipids. That basically means that we have a reasonable aspiration of getting the benefits from the SELECT trial, but maybe also other trials into the oral semaglutide for obesity label. Again, a very strong offering with unsurpassed efficacy in the oral space, being the first oral GLP-1 for the treatment of obesity. Very well-established safety and tolerability profile, and potential for CV and other benefits in the label. I can speak a lot to this slide. The short message is we see progress across all our therapy areas in our phase 1 to 3, actually phase 4 pipelines.

Speaker Change: Very well if that is it, and for the very spoken, and potential for CV and other benefits in the network.

Thank you. Thank you.

Speaker Change: I can speak a lot to this line. The short messages we see progress across all our therapy areas.

In our phase 1, 2, 3, exit phase 4 pipeline.

Speaker Change: Indiabetes, Nubis, GN, Casabesla, in liver disease, in actually also kidney disease, but certainly also in viruses.

Speaker Change: Nord of important things happen and will happen for this duration of 2025.

Speaker Change: I think most interestingly for today is probably to dwell a little bit on our PC pipeline.

Speaker Change: We believe it to be strong and deep and very competitive.

Speaker Change: Building a pipeline that caters to different patient needs across the species spectrum. [inaudible]

Speaker Change: From our perspective, it's naive to think that obesity is one disease.

Many patients. [inaudible]

Martin Holst Lange: In diabetes, in obesity, in cardiovascular, in liver disease, in actually also kidney disease, but certainly also in rare disease. A lot of important things have and will happen, for the duration of 2025. I think most interestingly for today is probably to dwell a little bit on our obesity pipeline. We believe it to be strong and deep and very competitive. Building a pipeline that caters to different patient needs across the obesity spectrum. From our perspective, it's naive to think that obesity is one disease. Many patients with different patient needs. Just to give an example, if you have reasonably low BMI, let's say 30 to 35, no comorbidities, we are building cagrilintide currently taking that into phase 3 to cater to that.

Martin Lange: In diabetes, in obesity, in cardiovascular, in liver disease, in actually also kidney disease, but certainly also in rare disease. A lot of important things have and will happen, for the duration of 2025. I think most interestingly for today is probably to dwell a little bit on our obesity pipeline. We believe it to be strong and deep and very competitive. Building a pipeline that caters to different patient needs across the obesity spectrum. From our perspective, it's naive to think that obesity is one disease. Many patients with different patient needs. Just to give an example, if you have reasonably low BMI, let's say 30 to 35, no comorbidities, we are building cagrilintide currently taking that into phase 3 to cater to that.

with different patients. [inaudible]

Speaker Change: Just to give an example, if you have reasonably low BMI, let's say 30 to 35, no comorbidities [inaudible]

Speaker Change: We are building a grilling site currently taking that into phase three to cater to that.

Speaker Change: If you have a link for it, maybe it's a slightly bigger weight loss and focus on comorbidities, it's a big weight loss needs, it's going to be a cap of summer, it's going to be an increase, and it's going to be our current internal triagonist.

Speaker Change: But we've also just done an acquisition for an external triagonist being a Geo-to-1-2-2-G-R-T, and we've also acquired a small molecule with a non-increasing-based mode of action.

Speaker Change: So, India Beach is based, a lot of exciting stuff coming in, and obviously also our research pipeline that we are not just closing continuously feeding into that, not only looking at weight loss but also at quality of weight loss and comorbidity but also at quality of weight loss and comorbidity but also at quality of weight loss and comorbidity

Martin Holst Lange: If you have a need for, maybe a slightly bigger weight loss and focus on comorbidities, it's Wegovy. If you have bigger weight loss needs, it's gonna be CagriSema, it's gonna be amycretin, and it's gonna be our current internal trial candidates.

Martin Lange: If you have a need for, maybe a slightly bigger weight loss and focus on comorbidities, it's Wegovy. If you have bigger weight loss needs, it's gonna be CagriSema, it's gonna be amycretin, and it's gonna be our current internal trial candidates.

So with that over to you Karsten, thank you Martin. Thank you.

Speaker Change: Then we move to Outlook, so we're continuing an innovation based growth strategy, glaring HMS and growth in the first quarter on back-up significant growth in the preceding years and the guidance here that we updated here in the first...

Lars Fruergaard Jørgensen: We've also just done an acquisition for an external triagonist being a GLP-1 through current GIP. We've also acquired a small molecule with a non-incretin-based motivation. In the obesity space, a lot of exciting stuff coming in, and obviously also our research pipeline that we are not disclosing, continuously feeding into that, not only looking at weight loss but also at quality of weight loss and comorbidities. With that, over to you, Karsten.

Martin Lange: We've also just done an acquisition for an external triagonist being a GLP-1 through current GIP. We've also acquired a small molecule with a non-incretin-based motivation. In the obesity space, a lot of exciting stuff coming in, and obviously also our research pipeline that we are not disclosing, continuously feeding into that, not only looking at weight loss but also at quality of weight loss and comorbidities. With that, over to you, Karsten.

Speaker Change: In connection with the first quarter, is the sales growth now of between 13 and 21%. It's lower than three months ago, and that's really a function of this.

Speaker Change: Slower, start to the year, linked to especially compounding in the US impacting the Govy.

Speaker Change: and this outlook is also based on an acceleration of scripts in the US in the second half of the year based on a number of tactics we're deploying and I'm sure we'll come back to that in further detail during the session.

Karsten Munk Knudsen: Thank you, Martin. We move to outlook. We're continuing an innovation-based growth strategy, delivering 18% growth in Q1 on back of significant growth in the preceding years. The guidance here that we updated here in Q1 in connection with Q1 is a sales growth now of between 13% and 21%. It's lower than 3 months ago, and that's really a function of the slower starts of the year linked to especially compounding in the US impacting Wegovy. This outlook is also based on an acceleration of scripts in the US in the second half of the year, based on a number of tactics we're deploying.

Karsten Knudsen: Thank you, Martin. We move to outlook. We're continuing an innovation-based growth strategy, delivering 18% growth in Q1 on back of significant growth in the preceding years. The guidance here that we updated here in Q1 in connection with Q1 is a sales growth now of between 13% and 21%. It's lower than 3 months ago, and that's really a function of the slower starts of the year linked to especially compounding in the US impacting Wegovy. This outlook is also based on an acceleration of scripts in the US in the second half of the year, based on a number of tactics we're deploying.

Speaker Change: Operating profit, also lowered compared to three months ago, but it's important to note that the lowering of top line is partially being offset by...

Speaker Change: by Tyler Resource Education, so very diligent in terms of how we resource the company. Still driving growth, but of course gearing the company vis-à-vis the growth that we're seeing.

Speaker Change: 7.17, Trudeini's Corner, in three months ago to 6.56 now. This year we have full hedge on the US dollar, so on the net profit we have done that.

Karsten Munk Knudsen: Uh, and I'm sure we'll come back to that in, in further detail during the session. Operating profit, uh, uh, also lowered compared to three months ago, but it's important to note that the, that the lowering of top line is partially being offset by, by tighter resource allocation. Uh, so, so very diligent in terms of how we resource the company. Still driving growth, but of course, gearing the company vis-à-vis the, the growth that, that, that we're, that we're seeing. Currencies, uh, have, uh, have, have, have moved a-against the company with the US dollar, uh, being, being down from, uh, seven point one seven, uh, to Danish kroner, uh, in, uh, three months ago to, to six point, uh, five six, uh, now.

Karsten Knudsen: Uh, and I'm sure we'll come back to that in, in further detail during the session. Operating profit, uh, uh, also lowered compared to three months ago, but it's important to note that the, that the lowering of top line is partially being offset by, by tighter resource allocation. Uh, so, so very diligent in terms of how we resource the company. Still driving growth, but of course, gearing the company vis-à-vis the, the growth that, that, that we're, that we're seeing. Currencies, uh, have, uh, have, have, have moved a-against the company with the US dollar, uh, being, being down from, uh, seven point one seven, uh, to Danish kroner, uh, in, uh, three months ago to, to six point, uh, five six, uh, now.

Speaker Change: and that's what you see in net financials. And then finally, Castlow Down, compared to three months ago, still very cast-generative as a business and the reason we're lowering.

Speaker Change: is of course a function of the lower top line outlook and then the gearings in the U.S. Cross-to-Net model that further amplifies it on freecast though. So that's the outlook for 2025 continued growth.

And with that, we're ready to move to the Q&A.

Karsten Munk Knudsen: This year we get, we have full hedge on the US dollar, so on the net profit we hedge on that. That's what you see in net financials. Finally, cash flow down compared to 3 months ago, still very cash generative as a business. The reason we're lowering is of course, a function of the lower top line outlook, and then the gearing that is in the US gross to net model that further amplifies on free cash flow. That's the outlook for 2025 continued growth. With that, we're ready to move to Jacob and Q&A.

Karsten Knudsen: This year we get, we have full hedge on the US dollar, so on the net profit we hedge on that. That's what you see in net financials. Finally, cash flow down compared to 3 months ago, still very cash generative as a business. The reason we're lowering is of course, a function of the lower top line outlook, and then the gearing that is in the US gross to net model that further amplifies on free cash flow. That's the outlook for 2025 continued growth. With that, we're ready to move to Jacob and Q&A.

Thank you. Thank you.

Speaker Change: Thank you. Thank you, Karsten, thank you, team. That concludes the first part of the session and we'll move into the Q&A. We'll do one question for person, please. And we'll start with our host of today to go from Robert Danny.

Thank you. Thank you.

Thibaut Morgenstern: Thank you very much. So the question is on the serious agreement with the agreement is clear. So just if you could confirm if there is any timeline associated with the exclusivity and as such, if you picked in an improvement in the opt-in rate on this formulary with a regional guidance.

Thibaut Morgenstern: Thank you to Paul, I think it goes to you, Lars. Yeah, thank you. So we have a longstanding good relationship with CVS.

Lars Fruergaard Jørgensen: Perfect. Thank you, thank you, Karsten. Thank you, team. That concludes the first part of the session. We'll move into to Q&A. We'll do one question per person, please, and we'll start with our host today, Thibault from Morgan Stanley.

Jacob Rode: Perfect. Thank you, thank you, Karsten. Thank you, team. That concludes the first part of the session. We'll move into to Q&A. We'll do one question per person, please, and we'll start with our host today, Thibault from Morgan Stanley.

Lars Juergensen: And based on that, we have made an agreement with them that we will bring also our casual offering into the pharmacy chain, so really focused on giving more access.

Thibault Boutherin: Thank you very much. The question is on the CVS agreement, with agreement with CVS. Just if you could confirm if there is any timeline associated with the exclusivity, and also just if you baked in any improvement in the opt-in rates on this formulary within your guidance?

Lars Juergensen: We have not bid on an exclusive contract, so the rates we have provided you can assume that it's similar for co-preferred and exclusive access.

Karsten Munk Knudsen: Yep. Thank you, Thibault. I think it goes to you, Lars.

Jacob Rode: Yep. Thank you, Thibault. I think it goes to you, Lars.

Nevertheless, Sylvest has decided to go with the Gobi.

Lars Fruergaard Jørgensen: Yeah. Thank you. We have a longstanding, good relationship with CVS. Based on that, we have made an agreement with them that we will bring also our cash offering into the pharmacy chain. Really focused on giving more access. We have not bid on an exclusive contract, the rates we have provided, you can assume that it's similar for co-preferred and exclusive access. Nevertheless, CVS has decided to go with Wegovy, I think it's linked to obviously the profile of Wegovy, the real world experience in the weight loss it delivers, and also the additional benefits. I know personally that they're keenly interested in MASH. You have a big, say, overlap in patient populations when you look at MASH obesity.

Lars Juergensen: And I think it's linked to obviously the profile of the GOV, the real world experience in the weight loss of the delivers.

Lars Juergensen: and also the additional benefits and I know personally that they're keenly interested in Nash.

Lars Juergensen: and you have a big say overlap in patient populations when you look at mass obesity.

Lars Juergensen: So there's a real one with need. So it's actually a very, say, inexpensive way to get access to match cards assuming we get this on label in the second half.

Lars Juergensen: So it's a really good bill for them and for a pair, it works very well to focus on this product.

Lars Juergensen: So there are a lot of scares about, say, price competition, etc. And it's not going to be initiated because of exclusivity because we will not make that and our competitors will do that as well.

Lars Fruergaard Jørgensen: There's real unmet need. It's actually a very, very, say, inexpensive way to get access to MASH coverage, assuming we get this on form, on label in the second half. It's a really good deal for them and for payer, it works very well to focus on this product. A lot of scares about, say, price competition, et cetera. It's not going to be initiated because of exclusivity because we will not make that, and I doubt our competitor will do that as well. But we will see that in a managed way, pricing will come down over time, as we've seen in all other categories, and that is unlocking larger volumes. It still unlocks growth.

Lars Juergensen: But we will see that in a man's way, pricing will come down over time as we've seen in all the categories and that is unlocking larger volumes. So it still unlocks growth and I think that's a very good outlaw and a very good model for us.

Thank you.

Nicholas, Verkier, then we move to Emily.

Lars Juergensen: Hi, thanks, Emily Field from Parkways. Reading through the comments from yesterday's call, it does seem that you are and with the launch of Novo Care and that you're expecting for the cash pay portion of, we'll go each increase in the second half. However, we've obviously seen a lot of consumer focused companies worn about consumer softness in the US with the economic situation there. So, are you within your revised guidance range? Sorry.

Lars Fruergaard Jørgensen: I think that's a very good outlook and very good model for us. Thank you.

and Gareth Sinclair.

Karsten Munk Knudsen: Thank you, Lars. Very clear. We move to Emily.

Jacob Rode: Thank you, Lars. Very clear. We move to Emily.

Speaker Change: Thanks Emily, I think it goes to you, Karsten? Yeah, so as I also said at the call, estimating the cash channel for us linked to compounding until it helped agreement.

Emily Field: Hi. Thanks. I'm Emily Field from Barclays. You know, reading through the comments, from yesterday's call, it does seem that you are and with the launch of NovoCare, and that you're expecting sort of the cash pay portion of Wegovy to increase in the second half. However, you know, we've obviously seen a lot of consumer-focused companies warn about consumer softness in the US with the economic situation there. Are you in, you know, within your revised guidance range, are you anticipating any consumer softness, or if you could just provide context how you're thinking about, you know, what's will still be a relatively expensive out-of-pocket product?

Speaker Change: Stance on a number of assumptions. So the way we've been a number of assumptions and somewhat limited data quality. So that's what we build into our guidance. And the way we've done it is basically to triangulate from different aspects.

Speaker Change: One is the amount of people we currently estimate is on compounded product today, especially both compounded products.

[Company Representative] (Novo Nordisk): Thanks, Emily. I think I'll go to you, Karsten.

Jacob Rode: Thanks, Emily. I think I'll go to you, Karsten.

Speaker Change: How many were switched to branded and hence get into the cast channel?

Karsten Munk Knudsen: Yeah. As I also said at the call, estimating the cash channel for us linked to compounding and telehealth agreements stands on a number of assumptions. The way we've been-- A number of assumptions and somewhat limited data quality. That's what we build into our guidance. The way we've done it is basically triangulate from different aspects. One is the amount of people we currently estimate is on compounded product today, especially bulk compounded products, how many will switch to branded and hence, get into the cash channel as one element. Then whatever data we otherwise can see in terms of cash channels, penetration and telehealth impact.

Karsten Knudsen: Yeah. As I also said at the call, estimating the cash channel for us linked to compounding and telehealth agreements stands on a number of assumptions. The way we've been-- A number of assumptions and somewhat limited data quality. That's what we build into our guidance. The way we've done it is basically triangulate from different aspects. One is the amount of people we currently estimate is on compounded product today, especially bulk compounded products, how many will switch to branded and hence, get into the cash channel as one element. Then whatever data we otherwise can see in terms of cash channels, penetration and telehealth impact.Based on that, we've made an estimate on what is realistic in our view to put into our guidance on Wegovy cash channel throughout the, especially the second half of this year.

as one element. [inaudible]

Speaker Change: and then whatever data we otherwise can see in terms of cash channel penetration and and till the health impact. So based on that, we have made an estimate on what is realistic in our view to put into our guidance on on the Ruby cash channel throughout the year, especially the second half of this year.

Thank you, Karsten. Here we go to Sachin.

Sachin: Hi there. I wonder if you could just try and put some guardrails on what you mean for real launch for oral summer. And the reason I have to question this, you frame the oral segment of the market as a minority, so it is a real launch in that context which should be different from I guess the competitors commentary which is used.

Speaker Change: Paul Seigman, it's a lot bigger. So I'm just going to give you two potentials. One, the leave, discolour, some inventory, would you give any colour on that or B, any coin to relapse to consensus next year, which is three billion damage? Thanks.

Karsten Munk Knudsen: Based on that, we've made an estimate on what is realistic in our view to put into our guidance on Wegovy cash channel throughout the, especially the second half of this year.

Speaker Change: I can talk to the launch and maybe I'll just continue in and I don't think you're going to get in guidance on yourself, but...

[Company Representative] (Novo Nordisk): Thank you, Karsten. Can we go to Sachin?

Jacob Rode: Thank you, Karsten. Can we go to Sachin?

[Analyst]: Hi there. I wonder if you could just try and put some guardrails around what you mean for real launch for oral SEMA. The reason I ask the question is you frame the oral segment of the market as a minority. Is the real launch in that context, which should be different from, I guess, the competitor's commentary, which assumes oral segment's a lot bigger? I'm just gonna give you two potentials. One, that you've disclosed some inventory. Would you give any color on that, or, B, any commentary related to consensus next year, which is 3 billion DKK? Thanks.

[Analyst 1]: Hi there. I wonder if you could just try and put some guardrails around what you mean for real launch for oral SEMA. The reason I ask the question is you frame the oral segment of the market as a minority. Is the real launch in that context, which should be different from, I guess, the competitor's commentary, which assumes oral segment's a lot bigger? I'm just gonna give you two potentials. One, that you've disclosed some inventory. Would you give any color on that, or, B, any commentary related to consensus next year, which is 3 billion DKK? Thanks.

Speaker Change: Martin described the profile, so I think we have a winning, potentially winning profile in terms of efficacy.

Speaker Change: and in any new category you have to relate to safety and I think it's rare to have a launch where you have as much safety as you have on this.

Speaker Change: and not least when you have to go up against small molecules that clear in different ways than this product. So I think from the get-go, a very strong profile.

[Company Representative] (Novo Nordisk): Thank you, Sachin. I think it goes to you, Lars, and the real launch.

Jacob Rode: Thank you, Sachin. I think it goes to you, Lars, and the real launch.

Lars Fruergaard Jørgensen: I can talk to the launch and maybe others can chip in on. Well, I don't think you are going to get any guidance on sales. Martin described the profile. I think we have a winning, potential winning profile in terms of efficacy and in any new category you have to relate to safety. I think it's rare to have a launch where you have as much safety as you have on this, and not least when you have to go up against small molecules that clears in different ways than this product. I think from the get-go, a very, very strong profile. You also know we've been building API capacity, and we actually have a dedicated US supply chain for this.

So we have API North Carolina.

Typically when we install new capacities.

Speaker Change: It's defined for a certain certain output and then we optimize that over time. This is this optimization is going really well.

So on an out point of view, we are in cursed.

Speaker Change: And then, of course, we also have different formalization technology generations that also, you know, creates more say outputs.

Speaker Change: So when we say we can go into a full ounce, that means that we believe we have the products to be able to do that.

Speaker Change: We will not get into, say, sizing the all opportunity. We think there is going to be a large and technical segment.

Lars Fruergaard Jørgensen: We have API in North Carolina. Typically when we install new capacities, it's defined for a certain output, and then we optimize that over time. This optimization ego is going really well. On an out point of view, we are encouraged. Of course, we also have different formulation technology generations that also, you know, creates more, say, output. When we say we can go into a full launch, that means that we believe we have the products to be able to do that. We'll not get into, say, sizing the all opportunity. We think there is going to be a large and technical segment when we ask patients, physicians who are already on weekly injection therapy that is seen as very convenient.

Speaker Change: when we ask patient's decisions who are already on weekly injection therapy that is seen as very convenient, but we also know that there are many who prefer a tablet.

and the best old treatment. [inaudible]

Speaker Change: So, we feel really good about the opportunity we have in the ability to...

to launch and to apply the market.

Speaker Change: And then I think there will be interesting considerations about the go-to market model to use the known classical, say, contracting PVM insurance audio go with the channel we have built or do both.

Speaker Change: We will not disclose all the taxes around that, but I think it's really a great opportunity and I think we have all the elements from supply, commercial go to market channels to make that an exciting opportunity for us.

Lars Fruergaard Jørgensen: We also know that there are many who prefer a tablet-based oral treatment. We feel really good about the opportunity we have and the ability to launch and supply the market. Then I think there'll be interesting considerations about the go-to-market model to use the known classical, say, contracting, PBM insurance, or do you go with the channel we have built or to do both. We'll not disclose all the taxes around that, but I think it's really a great opportunity, and I think we have all the elements from supply, commercial go-to-market channels to make that an exciting opportunity for us. Thank you.

Thank you.

Speaker Change: Very good, nice that last thing, we have no rush up here.

Speaker Change: Thanks, just a question on duration of treatments on compounded drugs, and what data do you have on that, and Hansh, we think about that, and or should is there a better proxy XUS where you've gone out of pocket market, had we think about duration of treatment for those, those sub-sensifications?

Speaker Change: I go to you, Carter? Yeah, so again, not super good data on compounded, it's really market research with all the caveats on market research.

[Company Representative] (Novo Nordisk): Very good. Let's start last, then we have Naresh over here.

Jacob Rode: Very good. Let's start last, then we have Naresh over here.

Speaker Change: So, I would say that the indications we have is that the average day time is shorter than the seven months we've been talking to on begobie in the compounded segments.

[Analyst]: Thanks. Just a question on duration of treatments on compounded drugs. What data do you have on that, and how should we think about that? Is there a better proxy ex US where you've gone out-of-pocket market? How do we think about duration of treatment for those, that subset of patients?

[Analyst 2]: Thanks. Just a question on duration of treatments on compounded drugs. What data do you have on that, and how should we think about that? Is there a better proxy ex US where you've gone out-of-pocket market? How do we think about duration of treatment for those, that subset of patients?

Speaker Change: So that's the starting point. What I would say that's an average across all the different shapes and forms of compounded approaches. What we are also hearing is...

Speaker Change: When we have, you know, some of the different telehealth service providers that are selling compound today.

[Company Representative] (Novo Nordisk): That goes to you, Karsten.

Jacob Rode: That goes to you, Karsten.

Karsten Munk Knudsen: Yeah. Again, not super good data on compounded. It's really market research with all the caveats on market research. I would say that the indications we have is that the average stay time is shorter than the 7 months we've been talking to on Wegovy in the compounded segments. That's the starting point. What I would say that's an average across all, you know, all the different shapes and forms of compounded approaches. What we are also hearing is that when we have, you know, some of the different telehealth service providers that are selling compounded today, it's important to note that their business is to wrap a service around the product and a subscription model.

Karsten Knudsen: Yeah. Again, not super good data on compounded. It's really market research with all the caveats on market research. I would say that the indications we have is that the average stay time is shorter than the 7 months we've been talking to on Wegovy in the compounded segments. That's the starting point. What I would say that's an average across all, you know, all the different shapes and forms of compounded approaches. What we are also hearing is that when we have, you know, some of the different telehealth service providers that are selling compounded today, it's important to note that their business is to wrap a service around the product and a subscription model.

It's important to note that their business...

Speaker Change: is to wrap a service around the product and the subscription model.

So they have a lot of intent.

Speaker Change: to keep people on products and basically make a 12-year agreement, a 12-month agreement at a lower price point than a two-month agreement.

Speaker Change: So I think there are some opportunities in telehealth with the subscription model, both in terms of pricing, economy, but also the patient services and reminders of patients, so like here in the UK.

Speaker Change: We have a collaboration with E-Math, where they're like weekly notice cases around that you take care of, because of injection, etc.

So I think that service to patients.

Karsten Munk Knudsen: They have a lot of incentive to keep people on product and basically, you know, make a 12-month agreement at a lower price point than a 2-month agreement. I think there's some opportunity in telehealth with the subscription model, both in terms of, you know, pricing accordingly, but also the patient services and reminders to patients. Like here in the UK, we have a collaboration with EMIS, where there are, like, weekly notifications around did you take your Wegovy injection, et cetera.

Karsten Knudsen: They have a lot of incentive to keep people on product and basically, you know, make a 12-month agreement at a lower price point than a 2-month agreement. I think there's some opportunity in telehealth with the subscription model, both in terms of, you know, pricing accordingly, but also the patient services and reminders to patients. Like here in the UK, we have a collaboration with EMIS, where there are, like, weekly notifications around did you take your Wegovy injection, et cetera.I think that service to patients should help on stay time, and it goes hand in hand with the telehealth providers' incentives as well. I think that's as specific as we can be on it based on data.

Speaker Change: should help on stay time, and it goes hand in hand with the telehealth providers intensive as well. So I think that's as specific as we can be on it based on data.

Simon Baker: Very good, thanks. Then we move to Simon Baker, you in the front.

Thanks so much.

Speaker Change: A sort of big picture question, it becomes the crux of it, about the whole supply demand dynamic here, that last year this was clearly a supply constrained market. Is that still the case?

Speaker Change: It feels like, in the feedback we get from clients, this is more demand constrained.

Karsten Munk Knudsen: I think that service to patients should help on stay time, and it goes hand in hand with the telehealth providers' incentives as well. I think that's as specific as we can be on it based on data.

Speaker Change: But could that simply be that it is supply constraint which is the compounds of your market and that is going to go away?

[Company Representative] (Novo Nordisk): Very good. Thanks. We'll move to Simon Baker. You in the front.

Jacob Rode: Very good. Thanks. We'll move to Simon Baker. You in the front.

Speaker Change: They must be confident, you must be confident that you can supply all that they need because obviously an outage would not be helpful there. So just really give us a feel for how the market looks now because the trend from last year, the scripts, these movie parties are not absolutely clear, so it's really, really helpful.

Simon Baker: Thanks so much. A sort of bigger picture question, but it comes to the crux of it, about the whole supply demand dynamic here. That last year this was clearly a supply constrained market. Is that still the case? It feels like from the feedback we get from clients is this is more demand constrained, but could that simply be that it is supply constrained, it's just the compounds have been supplying half your market, and that's gonna go away. Thinking about both demand and your ability to increase supply, how does the CVS deal fit into that? I mean, presumably they must be confident, you must be confident that you can supply all that they need because obviously an outage would not be helpful there.

Lars Juergensen: May the go to your presence, or else you could build on if anything outwards? [inaudible]

Speaker Change: So in terms of supply demand, and then for those of you who read our quarterly announcements very carefully, then you'll see the wording around supply.

Speaker Change: has been and supply constraints has been torn down significantly and if you compare to just three months ago where we said that across markets and products with supply constraints, now we're talking about certain markets and certain products.

Simon Baker: Just really give us a feel for how the market looks now because the trend from last year, the scripts, these moving parts is not absolutely clear. Any insights will be really helpful.

Speaker Change: So that is just a clear signal that at a global scale the supply demand balance has changed significantly.

[Company Representative] (Novo Nordisk): It goes to you, Karsten as well, then Lars, you can build on if anything onwards.

Jacob Rode: It goes to you, Karsten as well, then Lars, you can build on if anything onwards.

Speaker Change: So I wouldn't say that we're totally out of constraints across all Mars and all parts but it's much, much better. You see that also as a function of significantly more big overlaunches in Iowa and more in the plan which is also baked into our guidance.

Karsten Munk Knudsen: Yeah. In terms of supply demand, for those of you who read our quarterly announcements very carefully, you'll see the wording around supply has been and supply constraint has been toned down significantly. If you compare to just 3 months ago where we said across markets and products with supply constraints, now we're talking about certain markets and certain products. That is just a clear signal that at a global scale, the supply demand balance has changed significantly. I wouldn't say that we're totally out of constraints across all markets and all products, but it's much, much better.

Karsten Knudsen: Yeah. In terms of supply demand, for those of you who read our quarterly announcements very carefully, you'll see the wording around supply has been and supply constraint has been toned down significantly. If you compare to just 3 months ago where we said across markets and products with supply constraints, now we're talking about certain markets and certain products. That is just a clear signal that at a global scale, the supply demand balance has changed significantly. I wouldn't say that we're totally out of constraints across all markets and all products, but it's much, much better.

Promotional efforts for Biko, Paul Sempick at a global scale.

So, that's kind of the macro picture. Thank you.

on supply demand.

In the U.S. we're fully supplied for our GF1 portfolio.

Speaker Change: So that high inventory and of course ready to service our applications vis-vis the CVS agreements.

Speaker Change: and clearly we don't want to get into a drug shortage situation again, neither VCVS or all similar launches come next year.

Karsten Munk Knudsen: You see that also as a function of significantly more Wegovy launches in IO and more in the plan, which is also baked into our guidance, promotional efforts for Ozempic at a global scale. That's kind of the macro picture on supply demand. In the US, we're fully supplied for our DF one portfolio. The high inventories, you know, and of course ready to service our obligations vis-a-vis the CVS agreements. Clearly we don't want to get into a drug shortage situation again, neither vis-a-vis CVS or similar launch come next year. That leads to the second part of your question. Is it then demand constraint?

Karsten Knudsen: You see that also as a function of significantly more Wegovy launches in IO and more in the plan, which is also baked into our guidance, promotional efforts for Ozempic at a global scale. That's kind of the macro picture on supply demand. In the US, we're fully supplied for our DF one portfolio. The high inventories, you know, and of course ready to service our obligations vis-a-vis the CVS agreements. Clearly we don't want to get into a drug shortage situation again, neither vis-a-vis CVS or similar launch come next year. That leads to the second part of your question. Is it then demand constraint?

Speaker Change: then that leads you to the second part of your question, is it then demand constraints?

Speaker Change: that the market has actually accelerated super nicely in terms of total volumes.

Speaker Change: At a global scale, if you take branded products, the Vietamart has more than doubled compared to a year ago, so I think that's a double the year before also.

Speaker Change: So the Mark expansion and demand, I would say, data proofs that we are penetrating on the mark that is expanding as it should.

Speaker Change: and in the US, if you take compounding and then say in obesity compounding is one-third of the market.

Karsten Munk Knudsen: That links into what we've been communicating this quarter that the market has actually accelerated super nicely in terms of total volumes. At a global scale, if you take branded products, the obesity market has more than doubled compared to a year ago. I think that's. And it doubled the year before also. The market demand expansion and demand I would say data proves that we are penetrating as or the market is expanding as it should. In the US if you take compounding and then say, you know, obesity compounding is 1/3 of the market, then you actually get to a really attractive market expansion also in the US.

Karsten Knudsen: That links into what we've been communicating this quarter that the market has actually accelerated super nicely in terms of total volumes. At a global scale, if you take branded products, the obesity market has more than doubled compared to a year ago. I think that's. And it doubled the year before also. The market demand expansion and demand I would say data proves that we are penetrating as or the market is expanding as it should. In the US if you take compounding and then say, you know, obesity compounding is 1/3 of the market, then you actually get to a really attractive market expansion also in the US.

Speaker Change: Then you actually get to a real attractive market expansion also in the US.

Speaker Change: Unfortunately for us, it's based on compound expanding it in the cast channel and that's why it's so important for us.

Speaker Change: to get the cash channel built, both with Novo Care and partners in telehealth to service on the patient activation. So that's kind of the old supply-demand picture.

Speaker Change: Thank you, Carson. Let's do a bit differently, so are there any questions to either R&D or IO? James, smart man.

Thank you.

Thank you. Thank you.

Speaker Change: Thank you, James Krueger, thank you. My question for I.O. is on, we're going to be China, and I've got a quick one as I've cast in, but on we're going to be China is a very strong quarter. It's only the third quarter of the launch, but is this the start of a trend or should we expect it to be volatile on a quarter-three basis? Yes.

Karsten Munk Knudsen: Unfortunately, for us, it's based on compounders expanding in the cash channel. That's why it's so important for us to get the cash channel built both with NovoCare and partners in telehealth to service on the patient activation. That's kind of the old supply demand picture.

Karsten Knudsen: Unfortunately, for us, it's based on compounders expanding in the cash channel. That's why it's so important for us to get the cash channel built both with NovoCare and partners in telehealth to service on the patient activation. That's kind of the old supply demand picture.

Speaker Change: And do you have any other information about potential launch of semi-guitare generics?

[Company Representative] (Novo Nordisk): Thank you, Karsten. Let's do it a bit differently. Are there any questions to either R&D or IO? James, smart man.

Jacob Rode: Thank you, Karsten. Let's do it a bit differently. Are there any questions to either R&D or IO? James, smart man.

Speaker Change: China, Canada, Brazil, Mexico, those ones that are going there, and the quick other one for Karsten.

Speaker Change: Paul Semigluta, 25 milligram, the timing of the potential approval seems like it's six months. Have you used the PRB? Did you buy it? Is there an expense coming in the second quarter? [inaudible]

[Analyst]: Thank you. James

[Analyst 1]: Thank you. James

Speaker Change: So, on China and the Gobi, I would say we foresee a fantastic year throughout the upcoming three quarters. There's always in our part of the world, in China and emerging markets.

Speaker Change: Korpley fluctuations, it could be one quarter if it was better or worse, but I would say we have incredibly high ambition for China's big OV, not just this year, but beyond and

you should foresee.

Speaker Change: Good numbers coming out of that, in the context of LOE. [inaudible]

Speaker Change: and other players. They're to the best of my knowledge, five, six players right now that are trying to make some agglatine.

Karsten Munk Knudsen: On China and Wegovy, I would say we foresee a fantastic year throughout the upcoming 3 quarters. There's always in our part of the world in China and emerging markets, quarterly fluctuations. It could be one quarter is a little bit better or worse, but I would say we have incredibly high ambition for China's Wegovy, not just this year, but beyond. You should foresee good numbers coming out of that. In the context of LOEs and other players, there are, to the best of my knowledge, five, six players right now that are trying to make semaglutide for post LOE. We are watching them very seriously.

Karsten Knudsen: On China and Wegovy, I would say we foresee a fantastic year throughout the upcoming 3 quarters. There's always in our part of the world in China and emerging markets, quarterly fluctuations. It could be one quarter is a little bit better or worse, but I would say we have incredibly high ambition for China's Wegovy, not just this year, but beyond. You should foresee good numbers coming out of that. In the context of LOEs and other players, there are, to the best of my knowledge, five, six players right now that are trying to make semaglutide for post LOE. We are watching them very seriously.

for Post-LOE,

Speaker Change: And we are watching them very seriously, having said that, I would say that they would need to have a certain amount of volume.

Speaker Change: before they become a viable threat and there has to be a number of them also in the market that gives the government and everyone else confidence that collectively they will be able to again capture a large number of patients.

Speaker Change: Our success with Ozempich, historically, and now of course with Vigovia on the back of getting many, many more patients.

Month by month

Speaker Change: is one of our best tools we can we can we can have to protect the business for for.

Karsten Munk Knudsen: Having said that, I would say that they would need to have a certain amount of volume before they become a viable threat. There has to be a number of them also in the market that gives the government and everyone else confidence that collectively they will be able to again capture a large number of patients. Our success with Ozempic historically and now of course with Wegovy on the back of getting many more patients month by month.

Karsten Knudsen: Having said that, I would say that they would need to have a certain amount of volume before they become a viable threat. There has to be a number of them also in the market that gives the government and everyone else confidence that collectively they will be able to again capture a large number of patients. Our success with Ozempic historically and now of course with Wegovy on the back of getting many more patients month by month.

for for longer.

Speaker Change: Grand recognition I have spoken to that in the past should not be underestimated in place like China.

really cares about...

Speaker Change: Brandt, and the story we have been seeing that has helped us put many of our products that actually do not have patents in China, but we have leadership.

Speaker Change: and that gives us confidence and the hope going forward. And then of course, as we are ramping up...

So we all will be able to...

Maziar Mike Doustdar: Is one of our best tools we can have to protect the business for longer. Brand recognition, I've spoken to that in the past, should not be underestimated. A place like China really cares about brands and historically we have been seeing that has helped us put many of our products that actually do not have patents in China, but we have leadership and that gives us confidence and the hope going forward. Of course, as we are ramping up our economy of scale is at a very different level as many of these players. We also will be able to discuss with the government when the time comes on volumes and prices, perhaps in a position of strength compared to many other players.

Mike Doustdar: Is one of our best tools we can have to protect the business for longer. Brand recognition, I've spoken to that in the past, should not be underestimated. A place like China really cares about brands and historically we have been seeing that has helped us put many of our products that actually do not have patents in China, but we have leadership and that gives us confidence and the hope going forward. Of course, as we are ramping up our economy of scale is at a very different level as many of these players. We also will be able to discuss with the government when the time comes on volumes and prices, perhaps in a position of strength compared to many other players.

Speaker Change: Discussed with the government when the time comes on volumes and prices.

Speaker Change: and perhaps in a position of strength compared to many other players. So those are, I would say, what gives me confidence. And you also mentioned Mexico and some of the other players. I would say, to a large extent, the same thing, we just launched the Gobi in Mexico actually last month, going incredibly well. [inaudible]

Speaker Change: And Mexico was supposed to go LOE next year, 2026, and our legal and regulatory team have done a phenomenal job. And just more recently we have heard that that LOE is not postponed by an additional year, so we are very happy about that. So it gives us more time to follow on the bit of a strategy that we're doing in China. Thank you very much.

Speaker Change: Thank you, Mike, and abiding to the rule of one questioner first, and I'll take a liberty to move through, but just in the corner.

Maziar Mike Doustdar: Those are, I would say, what gives me confidence. You also mentioned Mexico and some of the other players. I would say to a large extent the same thing. We just launched Wegovy in Mexico actually last month, going incredibly well. Mexico was supposed to go LOE next year, 2026. Our legal and regulatory team have done a phenomenal job. Just more recently we have heard that that LOE is now postponed by an additional year. We are very happy about that. It gives us more time to follow on the bit of a strategy that we're doing in China.

Mike Doustdar: Those are, I would say, what gives me confidence. You also mentioned Mexico and some of the other players. I would say to a large extent the same thing. We just launched Wegovy in Mexico actually last month, going incredibly well. Mexico was supposed to go LOE next year, 2026. Our legal and regulatory team have done a phenomenal job. Just more recently we have heard that that LOE is now postponed by an additional year. We are very happy about that. It gives us more time to follow on the bit of a strategy that we're doing in China.

Thank you.

Can I do a question on a child's case? [inaudible]

Speaker Change: As a clarification on that 7.4 months of duration, is the mean different from median or mode that would really help to understand if you think so and early? The question is...

Speaker Change: If you indulge me with, you got about three million or so patients in the US on the Gowee Christ.

[Company Representative] (Novo Nordisk): Thank you, Mike. Abiding to the rule of one question per person, I'll take the liberty to move to Rajesh in the corner.

Jacob Rode: Thank you, Mike. Abiding to the rule of one question per person, I'll take the liberty to move to Rajesh in the corner.

Gowie, or all the brown fight across, including compunters. [inaudible]

Speaker Change: and the 90 million potentially of these patients, let's say a third of them have access with the access you have. We interior are scratching the surface of a very large market, right? Your penetration rates are quite low.

[Analyst]: Can I do a question and a clarification? A clarification on that 7.4 months of duration. Is the mean different from median or mode? That would really help to understand if things turn early. The question is, if you indulge me with, you've got about, say, you know, 3 million or so patients in the US on Wegovy, right? Not Wegovy, all the brands, right, across including compounders. The 90 million potentially obese patients, let's say a third of them have access with the access you have. We in theory are scratching the surface of a very large market, right? Your penetration rates are quite low. I'm quite puzzled you've had Lilly 2 quarters of destocking.

[Analyst 1]: Can I do a question and a clarification? A clarification on that 7.4 months of duration. Is the mean different from median or mode? That would really help to understand if things turn early. The question is, if you indulge me with, you've got about, say, you know, 3 million or so patients in the US on Wegovy, right? Not Wegovy, all the brands, right, across including compounders. The 90 million potentially obese patients, let's say a third of them have access with the access you have. We in theory are scratching the surface of a very large market, right? Your penetration rates are quite low. I'm quite puzzled you've had Lilly 2 quarters of destocking.

I'm quite proud of you've had Lily there. [inaudible]

Speaker Change: Two quarters of peace-talking, your growth got impaired by compounders in the first quarter when we are crashing the surface of a very large market. All the cell-side brokers like me have built their models proclaiming the market, 120, 132, I don't know, everyone has a big number. But...

Speaker Change: Does this make you stop in your tracks and ask the question, is there any other rate limiting step in realizing that market size?

Speaker Change: which might, because, Evan, if the market is that large, why compound is matter at the slow level of penetration? I'm unable to get my head around it, some very curious on how you would think about the problem.

[Analyst]: You, your growth got impaired by compounders in Q1 when we are scratching the surface of a very large market. All the sell side brokers, like me, have built their models proclaiming the market is 120, 150, 200. I don't know. Everyone has a big number. Does this make you stop in your tracks and ask the question, is there any other rate limiting step in realizing that market size? Because I mean, if the market is that large, why compounders matter at this low level of penetration? I'm unable to get my head around it. I'm very curious on how you would think about the problem.

[Analyst 1]: You, your growth got impaired by compounders in Q1 when we are scratching the surface of a very large market. All the sell side brokers, like me, have built their models proclaiming the market is 120, 150, 200. I don't know. Everyone has a big number. Does this make you stop in your tracks and ask the question, is there any other rate limiting step in realizing that market size? Because I mean, if the market is that large, why compounders matter at this low level of penetration? I'm unable to get my head around it. I'm very curious on how you would think about the problem.

Speaker Change: Thanks a lot for this, and Jill Buon, thanks for your attention to you, Lars. I think it's a great question. So I think it started with the classical margues structure with PVMs, insurance companies, and ultimately, you say, at large in

Speaker Change: And it started with, you know, opting in and relative easy access, course starts growing, and then a lot of friction is put in and becomes difficult to get access.

Speaker Change: So I think in totality the stack of players has not...

Speaker Change: Succeeded in actually unlocking the value of treating obesity because they take a tremendous health benefit, so there was data out recently from Aaron about when you do obesity treatment, there's a course, G1, but actually you start saving course in order from G2.

[Company Representative] (Novo Nordisk): Thanks, Rajesh. Your one penetration to you, Lars.

Jacob Rode: Thanks, Rajesh. Your one penetration to you, Lars.

Lars Fruergaard Jørgensen: I think it's a great question. I think it started with the classical market structure with PBMs, insurance companies, and ultimately, let's say at large, employers paying. It started with, you know, opting in and relatively easy access. Cost starts growing, and then a lot of friction is put in, and it becomes difficult to get access. I think in totality, the stack of players have not succeeded in actually unlocking the value of treating obesity because there is actually tremendous health benefits. There was data out recently from Evernorth about, you know, when you do obesity treatment, there's a cost year one, but actually you start saving costs already from year two. We haven't fully gotten to the perfect transaction model in untangling that.

Speaker Change: So, when we build a cast model, it's of course right now serving.

Inuit your patience with telehealth. [inaudible]

Speaker Change: But it's also built in the opportunity to act engaged with large payers, so if you take a payer...

That Health,

Speaker Change: Lads, Novo and Louise, you are self-insured, if you have long tenure among you and Louise, you will be accumulating all the cost from the comorbidities associated with obesity.

Speaker Change: You get the lower work attendance from those who are sick, so actually there's a very robust financials in actually helping them understand their own data and how do you actually go about it?

Speaker Change: You can say, in European health care systems, you have a lot of experience in how do you sanction rational?

Lars Fruergaard Jørgensen: When we build a cash model, it, of course, right now is serving individual patients with telehealth, but it's also building the opportunity to actually engage with large payers. If you take a payer that has a large number of employees, you are self-insured. If you have long tenure among your employees, you'll be accumulating all the cost from the comorbidities associated with obesity. You get the lower work attendance from those who are sick. Actually, there's a very robust financials in actually helping them understand their own data and how to actually go about it. You can say in European healthcare systems, you have a lot of experience in how do you sanction rational use of medicines based on health technologies.

Speaker Change: Ranks and rational use of medicine based on health technologies, but in the US it's like I have a right to access and there's no discrimination so far. I'm not advocating for discrimination, but we need to understand the individual patient needs and what's the value of doing that and I think this will be coming. Thank you very much.

Speaker Change: as more models are built. And that will also put pressure on the existing, say, chain in actually coming up with that solution to pay us.

Speaker Change: So I think this will happen over the relative short term and I think we'll see that will unlock a lot and then you'll have the cash channels so more channels have been opened up and the access will increase.

Lars Fruergaard Jørgensen: In the US it's like I have a right to access and there's no discrimination so far. I'm not advocating for discrimination, but we need to understand individual patient needs and what's the value of doing that. I think this will be coming as more models are built, and that will also put pressure on the existing, say, chain in actually coming up with that solution to payers. I think this will happen over the relative short term. I think we'll see that will unlock a lot. Then you'll have the cash channels. More channels being opened up and access will increase.

Speaker Change: Anything to add, Karsten? Yeah, just building on Lars' comments, because clearly obesity is our top priority, because we...

Karsten Knudsen: We have a super strong portfolio and a very significant on-met need on a global basis, so this is a D-key, or a D-pigot of tunes for the company.

Karsten Knudsen: So when we look at rate limiting factors, and we can have that discussion for all markets including China, where I was just a few weeks ago, but in the US you can look at it as the initially the rate limiting factor was supply.

Karsten Knudsen: Then as I said before, we've moved out of supply as a rate limiting factor. Then the next step is, how is the system a rate limiting factor? And when you look at the overall healthcare system, then in terms of prescribers,

[Company Representative] (Novo Nordisk): Anything to add, Karsten?

Jacob Rode: Anything to add, Karsten?

Maziar Mike Doustdar: Yeah, just building on Lars's comments because clearly obesity is our top priority because we have a super strong portfolio and very significant unmet need on a global basis. This is the key or the biggest growth opportunity for the company. When we look at rate limiting factors, and we can have that discussion for all markets, including China, where I was just a few weeks ago. In the US you can look at it as initially the rate limiting factor was supply.

Mike Doustdar: Yeah, just building on Lars's comments because clearly obesity is our top priority because we have a super strong portfolio and very significant unmet need on a global basis. This is the key or the biggest growth opportunity for the company. When we look at rate limiting factors, and we can have that discussion for all markets, including China, where I was just a few weeks ago. In the US you can look at it as initially the rate limiting factor was supply.

Karsten Knudsen: Today we have around 80,000 GPs that are prescribing begoblin Lewis.

Karsten Knudsen: And if you compare that to the number of scripts, then there's significant more capacity in the system. So it's not the healthcare system in terms of prescribers and scripts and fulfillment that's a rate limiting factor.

Karsten Knudsen: Then you say, what is in the rate limiting factor? And there I'll say in terms of capacity in the system, financial capacity in the system, then of course there's, there's, there's,

Karsten Munk Knudsen: As I said before, we've moved out of supply as a rate limiting factor. The next step is, how is the system a rate limiting factor? When you look at the oral healthcare system, then in terms of prescribers, today we have around 80,000 GPs that are prescribing Wegovy in the US. If you compare that to the number of scripts, then there's significant more capacity in the system. It's not the healthcare system in terms of prescribers and scripts and fulfillment that's a rate limiting factor. Well, what is then the rate limiting factor?

Karsten Knudsen: As I said before, we've moved out of supply as a rate limiting factor. The next step is, how is the system a rate limiting factor? When you look at the oral healthcare system, then in terms of prescribers, today we have around 80,000 GPs that are prescribing Wegovy in the US. If you compare that to the number of scripts, then there's significant more capacity in the system. It's not the healthcare system in terms of prescribers and scripts and fulfillment that's a rate limiting factor. Well, what is then the rate limiting factor?

Karsten Knudsen: Things has to fit together in the financial capacity, and that's why Lars is talking about access and pairs manning that, manning that in the appropriate way.

Karsten Knudsen: And that's why the cash channel is so important that we build that because that's also part of building capacity in the oil system because that moves it out in the out of public setting and the Himalayas pressure on insurance companies.

and then the last piece is some patient activation.

Karsten Munk Knudsen: There I would say in terms of capacity in the system, financial capacity in the system, then of course there's things has to fit together in the financial capacity, and that's why Lars is talking about access and payers managing that in the appropriate way. That's why the cash channel is so important that we built that because that's also part of building capacity in the oral system because that moves it out in the out-of-pocket setting and hence less pressure on insurance companies. Then the last piece is on patient activation. Because obesity is a different type of patient activation compared to other disease areas. Again, their telehealth providers play a different role than in other disease areas.

Karsten Knudsen: So because of these two, it's a different type of patient activation compared to other disease areas. And again that really helped provide us play a different role than in other disease areas. So that's how we're looking about the rate limiting factors across the different pieces of the system. So that's how we're looking about the rate limiting factors across the different pieces of the system.

Karsten Knudsen: There I would say in terms of capacity in the system, financial capacity in the system, then of course there's things has to fit together in the financial capacity, and that's why Lars is talking about access and payers managing that in the appropriate way. That's why the cash channel is so important that we built that because that's also part of building capacity in the oral system because that moves it out in the out-of-pocket setting and hence less pressure on insurance companies. Then the last piece is on patient activation. Because obesity is a different type of patient activation compared to other disease areas. Again, their telehealth providers play a different role than in other disease areas.

and many more.

Speaker Change: Thank you, Karsten, thank you, Lars, let's move to Peter Verdult

Speaker Change: Thank you, Pete, but I'll be in peace. Just one question for Karsten, rather than asking you to comment on every deal you sign or comment every permutation that President Trump might not enact, can we comment it for a different angle, which is when we follow you around the world in the last few years.

Speaker Change: The messaging has been looked 10% to 15% price mix, headwinds are on the portfolio in the US, it's a good proxy for us to use. Does that still stand or any, I know you're not going to quantify and say what it is now but does that still stand or should we just be assuming a step up going forward, given everything's going on. Thanks.

Karsten Munk Knudsen: That's how we're looking about the rate limiting factors across the different pieces of the system.

Karsten Knudsen: That's how we're looking about the rate limiting factors across the different pieces of the system.

[Company Representative] (Novo Nordisk): Thank you, Karsten. Thank you, Lars. Let's move to Peter Verdult.

Jacob Rode: Thank you, Karsten. Thank you, Lars. Let's move to Peter Verdult.

Speaker Change: Thanks, Pete, for that question. I'd say for the 10-15% is an olympic or diabetes comment and there are no changes to that one.

Peter Verdult: Thanks, Peter Verdult, BNP. Just one question for Karsten. Rather than asking you to comment on every deal you sign or comment every permutation that President Trump might or might not enact, can we come at it from a different angle? Which is, when we followed you around the world in the last few years, the messaging has been 10% to 15% price mix headwinds on the portfolio in the US is a good proxy to, for us to use. Does that still stand? I know you're not going to quantify and say what it is now, but does that still stand, or should we just be assuming a step up going forward given everything that's going on? Thanks.

Speaker Change: Of course it's forward-looking so now we are in R.A. and we're in the middle of the process so we don't know how that works out but based on what we know today that still stands.

Speaker Change: A lot of the administration and the communication there in terms of different healthcare impacts we've been commenting on tariffs but in terms of pricing, the main focus is on government channels whether it's Medicare, Medicaid or even BA.

Karsten Munk Knudsen: Thanks, Peter Verdult, for that question. I'd say for the 10% to 15% is an Ozempic or diabetes comment, and there are no changes to that one. Of course, it's forward-looking, we are in Inflation Reduction Act, and we're in the middle of the process, we don't know how that works out. Based on what we know today, that still stands. Multiple permutations from there. I would say it's important to note that a lot of the administration and the communication there in terms of different healthcare impacts, we've been commenting on tariffs.

Karsten Knudsen: Thanks, Peter Verdult, for that question. I'd say for the 10% to 15% is an Ozempic or diabetes comment, and there are no changes to that one. Of course, it's forward-looking, we are in Inflation Reduction Act, and we're in the middle of the process, we don't know how that works out. Based on what we know today, that still stands. Multiple permutations from there. I would say it's important to note that a lot of the administration and the communication there in terms of different healthcare impacts, we've been commenting on tariffs.

Speaker Change: and for the Covid that we've been discussing a lot today, the Covid is not present in Medicare and Hans has much less exposure to different pricing mechanisms introduced by the administration than other disease categories.

Perfect, thank you, Karsten, let's move to DeGrabbins. Let's move to DeGrabbins.

Thank you for watching!

Speaker Change: Thanks, David Evans from Kepler, so just going back, sorry, to the question on access and what's holding back, I mean...

Karsten Munk Knudsen: In terms of pricing, the main focus is on government channels, whether it's Medicare, Medicaid, or even VA. For Wegovy that we've been discussing a lot today, Wegovy is not present in Medicare and hence has much less exposure to different pricing mechanisms introduced by the administration than other disease categories.

Karsten Knudsen: In terms of pricing, the main focus is on government channels, whether it's Medicare, Medicaid, or even VA. For Wegovy that we've been discussing a lot today, Wegovy is not present in Medicare and hence has much less exposure to different pricing mechanisms introduced by the administration than other disease categories.

Speaker Change: There are roughly half a U.S. overweight patients do normally have insurance coverage, but what is actually making some of those go to the compounding channel? What actual steps are, I assume that the insurance company is just making it really difficult for these patients to actually get on the brand, even if they normally have coverage. [inaudible]

Speaker Change: Could you just talk us through, I mean, what are they doing? Is it just a delay for the patients to get on drug? Are they motivated to go to compounded products because it's quicker or easier? Or if you just give us a little more detail on that, thanks.

[Company Representative] (Novo Nordisk): Perfect. Thank you, Karsten. Let's move to David Evans.

Jacob Rode: Perfect. Thank you, Karsten. Let's move to David Evans.

David Evans: Thanks. David Evans from Kepler Cheuvreux. Just going back, sorry, to the question on access and what's holding back demand. I mean, there are roughly half of US overweight patients do normally have insurance coverage, but what is actually making some of those, you know, go to the compounding channel? You know, I mean, I assume it's the insurance companies just making it really, really difficult for these patients to actually get on the brand, even if they normally have coverage. Could you just talk us through, I mean, what are they doing? Is it just a delay for the patients to get on drug? Are they motivated to go to compounding products 'cause it's quicker or easier or? If you could just give us a little more detail on that. Thanks.

Thank you.

Karsten Knudsen: Cut, do you want to go over that one? Yeah, I think you've been there. The simple question to that is, and it pretty much links to a behavioral theory that people move to the places with least friction. And here simplicity and ease of access, that has really been a play for compounders and to the health.

Thank you for watching!

Speaker Change: Lange, I can just have a picture that if you have a disease like obesity where say half of your population or more have that condition.

Speaker Change: Just intellectually it does make sense to cover that patient's insurance. [inaudible]

[Company Representative] (Novo Nordisk): Karsten, do you wanna go over that one?

Jacob Rode: Karsten, do you wanna go over that one?

Karsten Munk Knudsen: Yeah.

Karsten Knudsen: Yeah.

[Company Representative] (Novo Nordisk): Lars, since you've been-

Jacob Rode: Lars, since you've been-

Karsten Munk Knudsen: The simple question to that is, and it pretty much links to a behavioral theory that people move to the places with least friction. Here, simplicity and ease of access, that has really been a play for compounders and telehealth.

Karsten Knudsen: The simple question to that is, and it pretty much links to a behavioral theory that people move to the places with least friction. Here, simplicity and ease of access, that has really been a play for compounders and telehealth.

Speaker Change: Jensen Jensen is something about treating the few and having the many say contribute to it. So I think we need to get to a different state where we actually look at very large populations need to have treatment. And how do you get to get the model to work? Okay.

Speaker Change: You know, accordingly, and the current model is not designed to accommodate obesity, so just thought on insurance and obesity.

[Company Representative] (Novo Nordisk): Lars?

Jacob Rode: Lars?

Lars Fruergaard Jørgensen: I can just add a perspective that if you have a disease like obesity where, say, half of your population or more have that condition, just intellectually, it doesn't make sense to cover that based on insurance because insurance is something about treating the few and having the many, say, contribute to it. I think we need to get to a different state where we actually look at very large populations need to have treatment and how do you get to get the model to work, you know, accordingly. The current model is not designed to accommodate obesity. Just, you know, a thought on insurance and obesity.

Lars Juergensen: Nicholas, let's try with either I.O. or R&D again. Thank you.

Good take in R&D 1.

Speaker Change: Martin, give us something on the co-formulation progress, Kegri Soma, and it's important to scaling up supply for that asset, since you seem to have mentioned supply fee times in recent. Thank you.

Lars Juergensen: Updates and then media follow-on, the importance of redefine for and re-imagined for and your confidence in sharing superiority on weight loss in the former H.P. on simulator.

Thank you.

[Company Representative] (Novo Nordisk): Thank you, Lars. Let's try with either IO or R&D again. Manuel?

Jacob Rode: Thank you, Lars. Let's try with either IO or R&D again. Manuel?

[Analyst]: I'm taking R&D 1. Martin, give us an update on the co-formulation progress of CagriSema and its importance to scaling up supply for that asset, since you seem to have mentioned supply a few times in recent updates. Then maybe a follow on the importance of REDEFINE 4 and REIMAGINE 4, and your confidence on showing superiority on weight loss in the former HPO and seeing the latter. Thank you.

[Analyst 1]: I'm taking R&D 1. Martin, give us an update on the co-formulation progress of CagriSema and its importance to scaling up supply for that asset, since you seem to have mentioned supply a few times in recent updates. Then maybe a follow on the importance of REDEFINE 4 and REIMAGINE 4, and your confidence on showing superiority on weight loss in the former HPO and seeing the latter. Thank you.

Our base case and that's our plan.

Lars Juergensen: on re-defined fall and re-imagined fall, as you know, started design to test fall.

Martin Holst Lange: On co-formulation, ongoing studies, obviously having to show equivalence to both on the pharmacokinetics, but also on the clinical equivalence. I have no insight into the results. For us, it's an exploratory measure that will obviously add to our flexibility in the supply chain if we succeed. But we're currently aiming to scale the dual-chamber device to be able to cater to a full CagriSema launch. That's our base case and that's our plan. On REDEFINE 4 and REIMAGINE 4, as you know, study is designed to test for non-inferiority first and then superiority. Again, a base case and an upside. In the wake of REDEFINE 1, we do believe that the biology speaks to it.

Martin Lange: On co-formulation, ongoing studies, obviously having to show equivalence to both on the pharmacokinetics, but also on the clinical equivalence. I have no insight into the results. For us, it's an exploratory measure that will obviously add to our flexibility in the supply chain if we succeed. But we're currently aiming to scale the dual-chamber device to be able to cater to a full CagriSema launch. That's our base case and that's our plan. On REDEFINE 4 and REIMAGINE 4, as you know, study is designed to test for non-inferiority first and then superiority. Again, a base case and an upside. In the wake of REDEFINE 1, we do believe that the biology speaks to it.

Lars Juergensen: Nor Inferiorge, first and then Superiorge, so again the base case on an upside and in the wake of redefine one, we do believe that the biology speaks to it. The question is whether it's-

Lars Juergensen: The extension of, for example, Redefine 4 has been timely to really accrue the full weight loss. That remains to be seen. So I'm fairly confident on the non-inferoity and we'll have to see on the super-rooted.

Lars Juergensen: I think if we really want to look at the full weight loss potential of Kakros Hema, we have to wait for a dedicated prospect to start it like a redefining 11, which will be ready at time of launch.

Lars Juergensen: Thank you Martin, and then we move to Harry from UBS. Thank you.

Thank you.

Martin Holst Lange: The question is whether it's the extension of, for example, REDEFINE 4 has been timely to really accrue the full weight loss. That remains to be seen. I'm fairly confident on the non-inferiority, and we'll have to see on the superiority. I think if we really want to look at the full weight loss potential of CagriSema, we have to wait for a dedicated prospective study like REDEFINE 11, which will be ready at time of launch.

Martin Lange: The question is whether it's the extension of, for example, REDEFINE 4 has been timely to really accrue the full weight loss. That remains to be seen. I'm fairly confident on the non-inferiority, and we'll have to see on the superiority. I think if we really want to look at the full weight loss potential of CagriSema, we have to wait for a dedicated prospective study like REDEFINE 11, which will be ready at time of launch.

Harry: Brilliant, thank you very much. Maybe one on IO. So previously you talked about the fact that you have two different brands for some advertising as a potential advantage in IO to access the cash pay.

Harry: Channels, Forward Govy, Verses, Lily Justin and Jaro. Just wants to get an update there as to whether you're seeing the benefits of specifically targeting cash pay channels where Lily might not be able to, if they've got one product that has to be reimbursed and therefore only.

[Company Representative] (Novo Nordisk): Thank you, Martin. We move to Harry from UBS.

Jacob Rode: Thank you, Martin. We move to Harry from UBS.

Rimbus, diabetes, or obesity, thank you.

Harry: Yeah, so definitely we see a huge advantage on having gone for the two brand strategy in international operations. We have around six million patients on Ausempik today in I.O. and we have 1.1 million on the GOV.

Harry: Brilliant. Thank you very much. Maybe one on IO. Previously, you talked about the fact that you have two different brands for semaglutide as a potential advantage in IO to access the cash pay channel for Wegovy versus Lilly just with Mounjaro. Just once again, an update there as to whether you're seeing the benefits of specifically targeting cash pay channels where Lilly might not be able to if they've got one product that has to be reimbursed and therefore only reimbursed for diabetes or obesity. Thank you.

[Analyst] (UBS): Brilliant. Thank you very much. Maybe one on IO. Previously, you talked about the fact that you have two different brands for semaglutide as a potential advantage in IO to access the cash pay channel for Wegovy versus Lilly just with Mounjaro. Just once again, an update there as to whether you're seeing the benefits of specifically targeting cash pay channels where Lilly might not be able to if they've got one product that has to be reimbursed and therefore only reimbursed for diabetes or obesity. Thank you.

7 million patients,

Harry: It would be very, very difficult and of course, Louise Lumbers are. [inaudible]

Harry: and much much smaller than that. To have done that with a single brand, as you can see, Lily was not and has not been able to get reimbursement in the diabetes area to accommodate those patients. And for us as a company that takes diabetes incredibly serious. Thank you very much.

Maziar Mike Doustdar: Yeah. Definitely we see a huge advantage on having gone for the two-brand strategy in international operations. We have around 6 million patients on Ozempic today in IO, and we have 1.1 million on Wegovy. 7 million patients. It would be very difficult, and of course, Lilly's numbers are much smaller than that, to have done that with a single brand. As you can see, Lilly was not and has not been able to get reimbursement in the diabetes area to accommodate, you know, those patients. For us, as a company that takes diabetes incredibly serious, we wanted to make sure that we are there not just for the obesity patients, but also for diabetics one.

Mike Doustdar: Yeah. Definitely we see a huge advantage on having gone for the two-brand strategy in international operations. We have around 6 million patients on Ozempic today in IO, and we have 1.1 million on Wegovy. 7 million patients. It would be very difficult, and of course, Lilly's numbers are much smaller than that, to have done that with a single brand. As you can see, Lilly was not and has not been able to get reimbursement in the diabetes area to accommodate, you know, those patients. For us, as a company that takes diabetes incredibly serious, we wanted to make sure that we are there not just for the obesity patients, but also for diabetics one.

Harry: We wanted to make sure that we are there not just for the obesity and patients, but also for diabetics ones. So our strategy has fit off.

Harry: and the purpose that we have with both diabetes and obesity very, very well.

Harry: And I would say you also see that of course that has because one product is reimbursed often and the other one is not has been allowing us to play with the pricing in a way that would have not been possible of course if it was all under a single brand so the answer is yes.

Thank you, Mike.

Emily again?

Speaker Change: Hi, Emily Field from Barclays last note, R&D question, just for Martin, you know, for the monotherapy code, Berlin Tide, a trial that you're studying later this year, if you could get some sauce on just how many doses you're thinking of exploring and how far it's beyond

Maziar Mike Doustdar: Our strategy has fit us and the purpose that we have with both diabetes and obesity very, very well. I would say, you also see that, of course, that has because one product is reimbursed often and the other one is not, has been allowing us to play with the pricing in a way that would have not been possible, of course, if it was all under a single brand. The answer is yes.

Mike Doustdar: Our strategy has fit us and the purpose that we have with both diabetes and obesity very, very well. I would say, you also see that, of course, that has because one product is reimbursed often and the other one is not, has been allowing us to play with the pricing in a way that would have not been possible, of course, if it was all under a single brand. The answer is yes.

3.4 you may go.

Higher Josephs than the 2.4.

Speaker Change: And in that setting, we didn't see a lot of added weight loss. So 2.4 appears to be the optimal dose.

[Company Representative] (Novo Nordisk): Thank you, Mike. Emily again.

Jacob Rode: Thank you, Mike. Emily again.

Speaker Change: does mean there will not test an additional dose level in face-free, really looking towards maximize in the weight loss.

Martin Holst Lange: Hi, Emily Field from Barclays. I have another R&D question just for Martin. You know, for the monotherapy cagrilintide trial that you're starting later this year, if you could give some thoughts on just how many doses you're thinking of exploring and how far beyond 2.4 you may go. It's a really good question. As you know, we've already done and reported on phase two for cagrilintide, where we tested higher doses than the 2.4. In that setting, we didn't see a lot of added weight loss. 2.4 appeared to be the optimal dose. Doesn't mean that we'll not test an additional dose level in phase three, really looking towards maximizing the weight loss.

Martin Lange: Hi, Emily Field from Barclays. I have another R&D question just for Martin. You know, for the monotherapy cagrilintide trial that you're starting later this year, if you could give some thoughts on just how many doses you're thinking of exploring and how far beyond 2.4 you may go. It's a really good question. As you know, we've already done and reported on phase two for cagrilintide, where we tested higher doses than the 2.4. In that setting, we didn't see a lot of added weight loss. 2.4 appeared to be the optimal dose. Doesn't mean that we'll not test an additional dose level in phase three, really looking towards maximizing the weight loss.

Speaker Change: Boy, I think already going back to what I spoke to before, having an asset that gives a 12, 13, 14 percent weight loss with a certain solubility profile will fit very nicely into the portfolio that we are building so that we can cater to the full need of the patients.

Speaker Change: I'm recognizing with him for two more questions. It was the first one.

Speaker Change: Hi there. Can I take another question or a question? I'll give you two a very important of it. So, do you have any ideas to walk the censorship of the hundred million?

Dressful patients in the US go forward.

Speaker Change: Novo Care Price, and where do you sit on potentially coming back to Surinja and Viral, Chief of Strategy, which doesn't have read through to reverse channels?

Martin Holst Lange: I think already, going back to what I spoke to before, having an asset that gives a 12%, 13%, 14% weight loss with a certain solubility profile will fit very nicely into the portfolio that we are building so that we can cater to the full needs of the patients.

Martin Lange: I think already, going back to what I spoke to before, having an asset that gives a 12%, 13%, 14% weight loss with a certain solubility profile will fit very nicely into the portfolio that we are building so that we can cater to the full needs of the patients.

Speaker Change: and I might just say one on Andy from Martin, you talked about oral non-ingleton GLB1.

Speaker Change: Does that preclude a later stage BD asset in oral that could be an XUS asset given to all of the summer's predominantly folks in the US?

[Company Representative] (Novo Nordisk): Thank you, Martin. We have time for two more questions. I think Nathan was the first one.

Jacob Rode: Thank you, Martin. We have time for two more questions. I think Nathan was the first one.

Question on Katz's channel. Do you wear a costume?

[Analyst]: Hi there. Can I take another question on the cash channel, given you talked about the importance of it. Do you have any idea as to what percentage of the 100 million addressable patients in the US can afford your NovoCare price? Where do you sit on potentially, you know, coming back to a syringe and vial cheaper strategy, which doesn't have read-through to reimburse channels? I might just take one R&D for Martin. You talked about oral non-incretin-based GLP-1. Does that preclude a later stage BD asset in oral that could be an ex-US asset, given oral semaglutide predominantly focused on the US? Thanks.

[Analyst 1]: Hi there. Can I take another question on the cash channel, given you talked about the importance of it. Do you have any idea as to what percentage of the 100 million addressable patients in the US can afford your NovoCare price? Where do you sit on potentially, you know, coming back to a syringe and vial cheaper strategy, which doesn't have read-through to reimburse channels? I might just take one R&D for Martin. You talked about oral non-incretin-based GLP-1. Does that preclude a later stage BD asset in oral that could be an ex-US asset, given oral semaglutide predominantly focused on the US? Thanks.

Speaker Change: Yeah, so, so the starting point is where are we today in terms of the cash channel and as we've said we just begun so we're in the low single digits with the noble care as she up our total scripts.

Speaker Change: If you look at competition, based on the market data we see there in the high teams of cash out of total.

Speaker Change: So that speaks to the potential in what we are today in the cast channel. And so,

Speaker Change: So, as a forward-looking statement, I do believe that the cast channel has the potential to constitute a very significant share of the total market, so approaching the 50% are even more in the medium to long-term.

[Company Representative] (Novo Nordisk): Question on cash channel to you, Karsten?

Jacob Rode: Question on cash channel to you, Karsten?

Martin Holst Lange: Yeah. So, the starting point is where are we today in terms of the cash channel? As we've said, we've just begun, so we're in the low single digits with the NovoCare as share of our total scripts. If we look at competition, they're based on the market data we see they're in the high teens of cash out of total. So, that speaks to the potential in where we are today in the cash channel. So, as a forward-looking statement, I do believe that the cash channel has the potential to constitute a very significant share of the total market, so approaching the 50% or even more in the medium to long term.

Martin Lange: Yeah. So, the starting point is where are we today in terms of the cash channel? As we've said, we've just begun, so we're in the low single digits with the NovoCare as share of our total scripts. If we look at competition, they're based on the market data we see they're in the high teens of cash out of total. So, that speaks to the potential in where we are today in the cash channel. So, as a forward-looking statement, I do believe that the cash channel has the potential to constitute a very significant share of the total market, so approaching the 50% or even more in the medium to long term.

Speaker Change: Exactly what price point that will end up being, that's of course something we'll be looking at as we mature the channel and penetrate our other channels. So all we do believe that the cash channel is a key channel for the market.

Speaker Change: Price sensitivity, I don't want to come too detailed on today in terms of how many can access the affordable $4.99 out of the $100 million or $110 million with obesity but based on the numbers I just gave, there will be a very nice potential already with the $4.99

Sorry? Sorry.

Martin Holst Lange: Exactly what price point that will end up being, that's of course something we'll be looking at as we mature the channel and penetrate other channels. All we do believe that the cash channel is a key channel for the markets.

Martin Lange: Exactly what price point that will end up being, that's of course something we'll be looking at as we mature the channel and penetrate other channels. All we do believe that the cash channel is a key channel for the markets.

Speaker Change: Jones and Wilde, sorry, of course we're looking at different product presentation options as we announced today, not that it's a cash play necessarily, but we submitted the Flex Starts PDFs to 90 to the FJ.

Lars Fruergaard Jørgensen: Price sensitivity, I don't want to comment too detailed on today in terms of how many can access the afford the $499 out of the 100 million, 110 million with obesity. Based on the numbers I just gave, there will be a very nice potential already with the $499. Sorry? As a while, sorry. Of course, we're looking at different product presentation options, as we announced today, not that it's a cash play necessarily, but we submitted the FlexTouch PDS 290 to the FDA. Hopefully we'll have an approval for that for Wegovy this year.

Speaker Change: So hopefully we will have an approval for that for we go with this here and of course we are also evaluating other product presentations.

Speaker Change: for the U.S. and globally as from Novo Nord, simply to give them the as Lars was talking to the size of the market, one billion people with obesity globally, this market will be served in different segments whether it's

Speaker Change: It's Cagulian type, all injectables, but then of course there will also be different product presentations to penetrate the market in different countries, the seven price points.

Karsten Knudsen: Thank you, Carson, and let's move for the final question, which is Simon Baker? One question for person, so we move to Simon Baker?

Lars Fruergaard Jørgensen: Of course, we are also evaluating other product presentations for the US and globally as we move forward. Simply given the, as Lars was talking to the size of the market, the 1 billion people with obesity globally, this market will be served in different segments, whether it's cagrilintide, oral, or injectables. Then of course there will also be different product presentations to penetrate the market in different countries, et cetera, and price points.

Simon Baker: I was going to sneak, I was going to sneak a second one, but that's me tell, so I won't. I'm not.

Just going back to the impact of the compounders. [inaudible]

Simon Baker: They've had a surprisingly significant impact from a standing star operating in the shadows.

Simon Baker: I'm just wondering if this changed your view on what happens at the end of the curve in 32, in terms of the ability of, do I say proper generic manufacturers to supply the market?

[Company Representative] (Novo Nordisk): Thank you, Karsten. Let's move for the final question, which is Simon Baker. One question per person, so we move to Simon Baker.

Jacob Rode: Thank you, Karsten. Let's move for the final question, which is Simon Baker. One question per person, so we move to Simon Baker.

Simon Baker: Because these competitors, one works for the numbers out, they've managed to source 25 kilos or so, with smag size for more than those where.

Simon Baker: Thank you. I was gonna sneak a second one, that's me told, so I won't. Just going back to the impact of the compounders. They've had a surprisingly significant impact from a standing start operating in the shadows. I'm just wondering, has this changed your view on what happens at the end of the curve in 32 in terms of the ability of, dare I say, proper generic manufacturers to supply the market? These compounders, if one works the numbers out, they've managed to source 25 kilos or so of semaglutide from Lord knows where. How has their performance now changed your view, if at all, of what the proper players can do at loss of exclusivity? Thank you.

Simon Baker: How has there performance now changed your view if at all of what the proper players can do at lots of exclusivity? Thank you.

I think Simon Lars will give it to you. No, but I think you need to consider a level playing field. [inaudible]

Simon Baker: We, when we build, for instance, an API facility, we spend half the time constructing it and the rest of the time validating it and build the quality around it to document that it's precisely the same product that comes out every time that's what was in the file. And when we test the currently compounded products out in the market.

Simon Baker: Those contain a lot of impurities, some of the even contain banned substances that are banned for used in drugs.

Simon Baker: and we have seen safety incidents being reported, even death linked to it. [inaudible]

[Company Representative] (Novo Nordisk): Thanks, Simon. Lars, I'll give it to you.

Jacob Rode: Thanks, Simon. Lars, I'll give it to you.

Simon Baker: So, if you asked these companies to comply with ordinary G&P rules, there would be SIPs supply.

Lars Fruergaard Jørgensen: I think you need to consider a level playing field, and we, when we build, for instance, an API facility, we spend half the time constructing and the rest of the time validating it and build the quality around it to document that it's precisely the same product that comes out every time as what was in the file. When we test the currently compounded products out in the market, those contain a lot of impurities. Some of them even contain banned substances that are banned for use in drugs. We have seen safety incidents being reported, even deaths linked to it. If you asked these companies to comply with ordinary GMP rules, there would be zip supply. Just to put it into perspective.

Simon Baker: So just to put it in perspective. So you can do a lot of, say, tricks short-term, but you have to be able to withstand the scrutiny of FJ and inspections, not only of the AI, but also to finish. And we have a number of cases where, you know,

Simon Baker: Quite serious, inspection reports have been filed, and even FBI closing down facilities. So, you have to factor in what is needed to be reliable, high quality supply.

Lars Juergensen: Thank you, Lars, thank you Simon. Before giving it to you, I'd like to thank Remarks, the big thank you for Korte Tötter, and for all the good questions. So, Lars, finally Remarks to you. Thank you, Arab. So, thank you all for coming. We acknowledge that it's been a turbulent period. And I hope it comes across that we have, I think, a relatively clear feel for what we need to execute on in terms of what we need to do.

Lars Fruergaard Jørgensen: You can do a lot of, say, tricks short term, but you have to be able to withstand the scrutiny of FDA and inspections, not only of the API, but also pill finish. We have a number of cases where, you know, quite serious, inspection reports has been, you know, filed and even FDA, sorry, FBI closing down facilities. You have to factor in what is needed to be a reliable high quality supply.

Lars Juergensen: Continuous Skating Capacity, Executing the Trials, Coming Back, Strongable, Kakya Semmer, and I think a leadership opportunity in the all GF1, BST, category, and then the commercial efforts that needed both to make sure that's preference for our products. [inaudible]

[Company Representative] (Novo Nordisk): Perfect. Thank you, Lars. Thank you, Simon. Before giving it to you, Lars, for final remarks, a big thank you for the turn up and for all the good questions. Lars, final remarks from you.

Jacob Rode: Perfect. Thank you, Lars. Thank you, Simon. Before giving it to you, Lars, for final remarks, a big thank you for the turn up and for all the good questions. Lars, final remarks from you.

Lars Fruergaard Jørgensen: Yeah. Thank you, Arup. Thank you all for coming. We acknowledge that it's been a, you know, turbulent period. And I hope it comes across that we have, I think a relative clear feel for what we need to execute on in terms of continuously scaling capacity, executing the trials, coming back strongly with CagriSema, and I think a leadership opportunity in the oral GLP-1 obesity category. Then the commercial efforts that's needed both to make sure there's preference for our products and what is needed to close down compounding to really sustain an attractive growth profile and bring innovation to patients around the world. On that, we are quite optimistic and clear on what we have to do. Thank you very much.

Lars Juergensen: Quite optimistic and clear on what we have to do so thank you very much.

Q1 2025 Novo Nordisk AS Earnings Call - London

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