Q3 2025 Novo Nordisk A/S Earnings Call - London

November 6, 2025

Speaker #1: Right are marvelous . Well , welcome to the third quarter , 2025 Road show for Novo Nordisk . I'm Richard Foster , European farm analyst .

Richard Foster: Right. Marvelous. Well, welcome to the Q3 2025 roadshow for Novo Nordisk. I'm Richard Foster, European Farm Analyst. It's my great pleasure, and that's at JPMorgan, obviously. It's my great pleasure to welcome Carsten, Martin, and Ludwig from the Novo management team to our presentation. There's going to be a short intro presentation from Carsten and the team. We'll go into Q&A. Carsten?

Richard Foster: Welcome to the Q3 2025 roadshow for Novo Nordisk. I'm Richard Foster, European Farm Analyst. It's my great pleasure, and that's at JPMorgan, obviously. It's my great pleasure to welcome Carsten, Martin, and Ludwig from the Novo management team to our presentation. There's going to be a short intro presentation from Carsten and the team. We'll go into Q&A. Carsten?Thanks very much.

Speaker #1: It's my great pleasure. And that's at JP Morgan. Obviously, it's my great pleasure to welcome Carsten Martin and Ludvig from the Novo management team to our presentation.

Speaker #1: There's going to be a short intro presentation from Carsten and the team , and then we'll go into Q&A . Carsten , over to you .

Ludovic Helfgott: Thanks very much.

Speaker #1: Thanks very much. Okay.

Speaker #2: Thank you .

Speaker #3: Thank you , Richard , for hosting us . And to JP Morgan , also for hosting us . Welcome to the Nordisk Q3 London lunch Road show presentation .

Carsten: Thank you, Richard, for hosting us and to JPMorgan also for hosting us. Welcome to the Novo Nordisk Q3 London Launch Roadshow presentation. We've been looking forward to seeing you all. We'll kick it off by some 5, 10 minutes of presentation, then we go, as usual, onto Q&A. This meeting is being webcasted. Of course, you know, we have a global audience listening in. Forward-looking statements, as usual, predictions, comments around the future may pan out differently, as we all know. No changes in that respect. On our strategic aspirations as was covered also yesterday by the call, we're getting to the tail end of our strategic aspirations.

Karsten Munk Knudsen: Thank you, Richard, for hosting us and to JPMorgan also for hosting us. Welcome to the Novo Nordisk Q3 London Launch Roadshow presentation. We've been looking forward to seeing you all. We'll kick it off by some 5, 10 minutes of presentation, then we go, as usual, onto Q&A. This meeting is being webcasted. Of course, you know, we have a global audience listening in. Forward-looking statements, as usual, predictions, comments around the future may pan out differently, as we all know. No changes in that respect. On our strategic aspirations as was covered also yesterday by the call, we're getting to the tail end of our strategic aspirations.

Speaker #3: We've been looking forward to to seeing you all . We'll kick it off by by some 5 or 10 minutes of presentation . And then then we go , as usual on to Q&A .

Speaker #3: This meeting is being webcasted so , so of course , you know , we have a global audience . Listening in . Following statements as usual , predictions , comments around the future may pan out differently .

Speaker #3: As we all know . So no . No changes in that respect . On on our strategic aspirations as as was covered also yesterday by the call .

Speaker #3: We're getting to the tail end of our strategic aspirations . But so so we'll find a new framework coming into next year . But we're rolling through this year , end of this year with the with our current framework .

Carsten: We'll find a new framework come into next year, but we're rolling through this year, end of this year with our current framework. We delivered 15% top line growth for year-to-date numbers, 11% for the quarter, and continued strong momentum for our R&D pipeline build, including business development activities, as my colleagues will come back to in a minute. This is a strategy update, so I hand over to Ludo to kick that off.

Karsten Munk Knudsen: We'll find a new framework come into next year, but we're rolling through this year, end of this year with our current framework. We delivered 15% top line growth for year-to-date numbers, 11% for the quarter, and continued strong momentum for our R&D pipeline build, including business development activities, as my colleagues will come back to in a minute. This is a strategy update, so I hand over to Ludo to kick that off.

Speaker #3: So we're we delivered a 15% top line growth for for a year to date numbers , 11% for the quarter . And and continued strong momentum for our R&D pipeline built , including business development activities .

Speaker #3: As my colleagues will will come back to in in a minute . This is a strategy update . So I'll hand it over to Ludo to cheat that off .

Speaker #2: Absolutely .

Ludovic Helfgott: Absolutely. Essentially this is something that Mike shared. First of all, good morning. Thank you for having us. This is what actually Mike shared yesterday in our overall call, and this is actually aimed at explaining what is the variation, the change, the sharpening of our strategy that has happened over summer. We've been for years, of course, more than 100 years in diabetes, and I believe you can say we've actually created the overall obesity category. Alongside these metabolic diseases have some commonalities and convergencies with other comorbidities on the kidney side, on the cardiovascular side, on the MASH side. The point is that what we are doing in a bit different manner today than maybe what we used to be doing before, is that we want to treat patients with obesity and diabetes.

Speaker #3: So .

Speaker #4: Essentially this this this is something that Mike shared . First of all good morning . Thank you for having us . This is what actually Mike shared yesterday in our overall call .

Speaker #4: And this is actually is aimed at explaining what is the the variation , the change , the sharpening of our strategy that is that has happened over summer .

Speaker #4: We've been for years , of course , more than 100 years in diabetes , and we've I believe you can say we've actually created the overall obesity category .

Speaker #4: And alongside these metabolic diseases have some commonalities and convergences with other comorbidities on the kidney side , on the cardiovascular side , on the mesh side , the point is that what we are doing in a bit different manner today than maybe what we used to be doing before is that we want to treat patients with obesity and diabetes .

Speaker #4: So we're not treating diabetes and obesity, but patients with so what matters are the core diseases and their associated comorbidities in that sense.

Ludovic Helfgott: We're not treating diabetes and obesity, but patients with. What matters are the core disease and their associated comorbidities. In that sense, we want to make sure that whatever comorbidity we are looking at or investigating from a research and development perspective, there's a high overlap between the patients that have obesity and diabetes and these comorbidities. Which means that all these circles you can see here are reinforcing our patient base. If a disease is actually has an overlap of patient that is quite remote from obesity or diabetes patients, then we won't go for it. It's a superior focus. It's a sharpening of our strategy. I think it's more an evolution than a revolution, but it has the merits of helping us deepening furthermore in the core patient base that we're looking at, which are diabetes patients and obesity patients.

Speaker #4: We want to make sure that whatever comorbidity we are looking at or investigating from a research and development perspective, there's a high overlap between the patients that have obesity and diabetes.

Speaker #4: And this and this comorbidities , which means that all these circles , you can see here are reinforcing our patient base . But if a disease is actually has an overlap of patient that is quite remote from obesity or diabetes , patients , then we won't go for it .

Speaker #4: It's a superior focus. It's a sharpening of our strategy. I think it's more an evolution than a revolution. But it has the merits of helping us deepen.

Speaker #4: Furthermore , in the core patient base that we're looking at , which are diabetes patients and obesity patients . So again , if and only if these patients have a joint overlap with our core , we'll of course looking for the comorbidities .

Ludovic Helfgott: Again, if and only if these patients have a joint overlap with our core, we're of course, looking for the comorbidities. The best example is MASH. There's a huge overlap between the MASH patients and the obese patients. Logically, we want to invest both in R&D and in commercial into MASH. That explains why, by the way, we acquired the company, Akero, you might wanna talk about at a later stage. It's really a sharpening, a deepening, a strong belief that the future value is so big in this market, more than 2 billion patients, that there's enough to capture if we are really going deep into this patient situation. Of course, that as we always said, we're keeping the rare disease franchise with a clear focus on blood disorders and hematological disorders.

Speaker #4: And the best example is MASH. There's a huge overlap between the MASH patients and the obese patients. Logically, we want to invest both in R&D and in commercial into MASH.

Speaker #4: And that explains why , by the way , we acquired the company Akiro . You might want to talk about at a later stage .

Speaker #4: So it's really a sharpening , a deepening , a strong belief that the the future value is so big in these markets , more than 2 billion patients that is enough to capture if we're really going deep into this patient situation .

Speaker #4: And then , of course , as we always said , we're keeping the rare disease franchise with a clear focus on the blood disorders and renal disorders .

Speaker #4: Again , we did some BD on that , and we can talk about it , but it's a bit as we've always said , a company within a company okay .

Ludovic Helfgott: Again, with some BD on that, and we can talk about it, but it's a bit, as we've always said, a company within a company. Okay? A biotech within Novo Nordisk. This is true commercially. It's also true from an R&D perspective. Again, the focus will remain on the core therapy areas and prioritizing the unmet need comorbidities when there is a big overlap with the obese patients, the overweight patients, and the diabetic patients. There's enough space, we believe, to dive into these areas and to create an attractive growth for more than the next decade. Back to the results of the first nine months of the year. As you can see, very balanced growth rate from a geographic perspective.

Speaker #4: A biotech within a within a Novo Nordisk . This is true commercially . It's also true from an R&D perspective . So again , the focus will remain on the core therapy areas .

Speaker #4: And prioritizing the unmet need comorbidities when there is a big overlap with the obese patients , the overweight patients and the diabetic patients .

Speaker #4: And there's enough space , we believe , to to dive into these areas and to create an attractive growth for the more than the next decade , back to back to the results of the first nine months of the year .

Speaker #4: As you can see , very balanced growth rate from a from a geographic perspective . Overall , 15% growth . 15 in the US and 16 in IO with a cross with different profiles by regions .

Ludovic Helfgott: Overall, 15% growth, 15 in the US and 16 in IO with across with different profiles by regions. We can talk about it. From a therapeutic area perspective, it's a bit the same. We have again, 15% overall, 10% growth for the diabetes, more mature markets, and it's very true in the US with the high penetration of GLP-1 as we know, 10%, 10%. The insulin, 3%. The obesity care growth of 41%. 41% with a split of 83 in IO and 24 in the US. Rare disease, back to its normal production situation. We're growing 13% in a balanced manner between IO and the US.

Speaker #4: We can talk about it from a therapeutic area perspective . It's a bit the same . We have again , 15% overall , 10% growth for the diabetes .

Speaker #4: More mature market . And it's very true in the US with the high penetration of GLP one , as we know 10% , 10% , the insulin , 3% , the obesity care growth of 41% , 41% with a split of 83 .

Speaker #4: In IO and 24 in the U.S., and rare disease back to its normal production situation with growing 13% in a balanced manner between IO and the U.S.

Ludovic Helfgott: From an obesity perspective and the entire obesity medications, the market continues to expand in the US with a branded anti-obesity medicine and DRx continuing to grow as we discussed, and from a TRx as well. This is where I guess a lot of the discussions will be focused today. We continue to see this market has a huge growth reservoir for us. We're barely scratching the surface with only between, let's say, 3 and 4 million patients addressed today over the 100 million patients that this market is about. A strong expansion of the out-of-pocket, a strong expansion of the cash channel, moving from 4% to more than 10%, since only 9 months.

Speaker #4: From a obesity perspective and the entire obesity medications , the market continues to expand in the US with a branded anti-obesity medicine and VR continuing to grow up as we discussed , and from a chair as well .

Speaker #4: And this is where I guess a lot of the discussions will be focused today. We continue to see this market as a huge growth reservoir for us.

Speaker #4: We barely scratching the surface with only between , let's say , three and 4 million patients addressed today , over 100 million patients that this market is about a strong expansion of the out of pocket , a strong expansion of the cash channel moving from 4% to more than 10% , since only nine months .

Speaker #4: And that's what we have been working a lot on over the past couple of months, expanding the direct sales and the telehealth partnerships. Recently, we partnered with Costco as an example. We just launched Smash a couple of weeks ago and are continuing our investment in patient access.

Ludovic Helfgott: That's what we have been working a lot over the past couple of months, expanding the direct sales and the telehealth partnerships recently with Costco, as an example. Just launched MASH a couple of weeks ago and continued investment in patient access. We can clearly see that there are some frictions in the script delivery, and we are investing in making sure that the biggest and the widest number of patients can access the anti-obesity medicine. Last but not least, again, I'll be quite short because as you can realize this is still pretty much in discussions. You have here Metsera, which has been a company that we've been looking for for quite a while, and we've been in contact with them for quite a while.

Speaker #4: We can clearly see that there are some frictions in the scripts delivery , and we are investing in making sure that the biggest and widest number of patients can access the the entire medicine .

Speaker #4: Last but not least , and again , I'll be quite short because as you can realize , this is still pretty much in in in discussions you have here meztira , which has been a company that we've been looking for for quite a while , and we've been in contact with them for quite a while .

Speaker #4: We believe this company , from a portfolio perspective , has a very interesting and attractive set of products with an S , by the way , not just one , both in single usage and in combination .

Ludovic Helfgott: We believe this company, from a portfolio perspective, has a very interesting and attractive set of products with an S, by the way, not just one, both in single usage and in combination. They're very helpful because we fundamentally believe that the market obesity being huge, other immunopatients just in the US is also very fragmented with very different needs, behaviors, and categories of patients, but also way to address their obesity treatment directly, as we said, or through physicians. We believe that the best way to cater for all these different patient needs and patient types and differences, and comorbidities associated is to have a wide portfolio. We like a lot our portfolio. We believe that in order to be a leader in that space, we need even more products. We need even more products with different characteristics.

Speaker #4: And they're very helpful because we fundamentally believe that the market of obesity being huge , 100 million patients just in the US is also very fragmented with very different needs , behaviors , categories of patients , but also way to address their obesity treatment directly .

Speaker #4: As we said, or through physicians. And we believe that the best way to cater to all these different patient needs, patient types, and the differences and comorbidities associated is to have a wide portfolio.

Speaker #4: We like a lot our portfolio . We believe that in order to be a leader in that space , we need even more products .

Speaker #4: We need even more products with different characteristics, and that's why we believe Meztira complements well with our pipeline. It's not just the pipeline; it's also the capability of this company.

Ludovic Helfgott: That's why we believe Metsera complements well our pipeline. It's not just the pipeline, it's also the capability of this company. We've been knowing them for quite a while, and their ability to design extremely attractive molecule is certainly one of the reasons why we're so interested. Beyond, of course, the medicines and the assets that we of course kick rather in the next decade. That's very interesting for us. We can discuss that later on. This was the segue to our scientific discussions. That's when Martin comes on stage. Martin.

Speaker #4: We've been knowing them for quite , quite a while , and their ability to design extremely attractive molecule is certainly one of the reasons why we're so interested beyond , of course , the medicines and the assets that will of course kick rather in the next decade .

Speaker #4: So that's very , very interesting for us . We can discuss that later on . And this was the segue to our scientific discussions .

Speaker #4: And that's when Martin comes on stage. Martin.

Speaker #5: Thank you very much . Ludwig . So staying on on the concept of complementarity to our pipeline , addressing unmet need in serious chronic disease , we've done two acquisitions , one within mesh .

Martin: Thank you very much, Ludovic. Staying on the, on the concept of complementarity to our pipeline, addressing unmet need in serious chronic disease, we've done two acquisitions. One within MASH. As you know, we did have an internal asset, FGF21. We terminated that for, I would say, lack of superiority over what we already had in our pipeline. We do see a tremendous unmet need in F4. As you know, we just have semaglutide approved for treatment of MASH in the US for F2 and F3. F4 is basically a huge unmet need with no treatment available. Efruxifermin is the first, I would say, only treatment with true clinical value-adding data in F4.

Martin Holst Lange: Thank you very much, Ludovic. Staying on the, on the concept of complementarity to our pipeline, addressing unmet need in serious chronic disease, we've done two acquisitions. One within MASH. As you know, we did have an internal asset, FGF21. We terminated that for, I would say, lack of superiority over what we already had in our pipeline. We do see a tremendous unmet need in F4. As you know, we just have semaglutide approved for treatment of MASH in the US for F2 and F3. F4 is basically a huge unmet need with no treatment available. Efruxifermin is the first, I would say, only treatment with true clinical value-adding data in F4.

Speaker #5: As you know , we did have an internal asset , Fgf21 . We terminated that for for I would say a lack of superiority over what we already had in our pipeline .

Speaker #5: We do see a tremendous unmet need in NFL. As you know, we just have semaglutide approved for treatment of mesh in the US for F2 and F3.

Speaker #5: F4 is basically a huge unmet need with no treatment available. Efruxifermin is the first, I would say the only treatment with true clinical value-adding data in F4.

Speaker #5: You've seen the data substantial, both clinical and statistical reduction of fibrosis without worsening of mesh, and also a reduction in mesh without worsening of fibrosis.

Martin: You've seen the data substantial, both clinical but also statistical re-reduction of fibrosis without worsening of MASH, and also a reduction in MASH without worsening of fibrosis. These are very clinically relevant data in the F4 space, where again, the unmet need is huge and patients are dying from this condition. Also in the F2 and F3 space, we see very convincing and the potential for best-in-class data. Complementing our pipeline, this makes sense as an acquisition moving into the MASH space for patients living with diabetes, obesity, and MASH. Similarly, in the rare disease space, huge unmet need in the rare blood, rare kidney disorder. These are truly rare diseases.

Martin Holst Lange: You've seen the data substantial, both clinical but also statistical re-reduction of fibrosis without worsening of MASH, and also a reduction in MASH without worsening of fibrosis. These are very clinically relevant data in the F4 space, where again, the unmet need is huge and patients are dying from this condition. Also in the F2 and F3 space, we see very convincing and the potential for best-in-class data. Complementing our pipeline, this makes sense as an acquisition moving into the MASH space for patients living with diabetes, obesity, and MASH. Similarly, in the rare disease space, huge unmet need in the rare blood, rare kidney disorder. These are truly rare diseases.

Speaker #5: These are very clinically relevant data in the A for space where again , the unmet need is huge and patients are dying from this condition .

Speaker #5: But also in the F2 and F3 space , we see very , very convincing and the potential for best in class data . So complementing our pipeline , this makes sense .

Speaker #5: An acquisition moving into the mesh space for patients living with diabetes, obesity, and mesh. Similarly, in the rare disease space, there is a huge unmet need in the rare blood and rare kidney disorder; these are truly rare diseases.

Speaker #5: We've seen an opportunity to acquire a novel proposition in the complement system . Again complementing our pipeline and also allowing us to leverage our research , but also clinical as well as commercial expertise to create synergies across the pipeline and portfolio and look sort of at the broader internal pipeline .

Martin: We've seen an opportunity to acquire a novel proposition in the complement system, again complementing our pipeline and also allowing us to leverage our research, but also clinical as well as commercial expertise to create synergies across the pipeline and portfolio. Look sort of at the broader internal R&D pipeline. You've seen this before. We see a lot of progress, a lot of momentum across our therapy areas. I do wanna call out, obviously, in the space of obesity, we will soon see readout of CagriSema, phase 3 in type 2 diabetes. I will see, obviously more exploratory readout for in phase 2, also in type 2 diabetes. In the obesity space, we continue to generate value for semaglutide. Best in class oral data for obesity treatment based on a GLP-1 therapy with oral semaglutide.

Martin Holst Lange: We've seen an opportunity to acquire a novel proposition in the complement system, again complementing our pipeline and also allowing us to leverage our research, but also clinical as well as commercial expertise to create synergies across the pipeline and portfolio. Look sort of at the broader internal R&D pipeline. You've seen this before. We see a lot of progress, a lot of momentum across our therapy areas. I do wanna call out, obviously, in the space of obesity, we will soon see readout of CagriSema, phase 3 in type 2 diabetes. I will see, obviously more exploratory readout for in phase 2, also in type 2 diabetes. In the obesity space, we continue to generate value for semaglutide. Best in class oral data for obesity treatment based on a GLP-1 therapy with oral semaglutide.

Speaker #5: You've seen this before . We see a lot of progress , a lot of momentum across our therapy areas . I do want to call out , obviously , in the space of obesity , we will soon see readout of Cagrisema , a phase three in type two diabetes .

Speaker #5: And we'll see, obviously, more exploratory readouts like Incretin in Phase 2. Also, in type 2 diabetes in the obesity space, we continue to generate value for semaglutide.

Speaker #5: So, best-in-class oral data for obesity treatment based on a JP one therapy with oral semaglutide shows a 17% weight loss and has a well-known safety and tolerability profile. It is currently under regulatory review with the US FDA as we speak and has also been submitted to the European authorities.

Martin: 17% weight loss, well-known safety and tolerability profile, under regulatory review with US FDA as we speak, and submitted to the European authorities. 7.2 mg, same thing, 21% weight loss. The same safety and tolerability profile that we know from the lower doses of semaglutide. Filed for regulatory approval in Europe and soon to be also in US. We'll see readout of further CagriSema studies, specifically REDEFINE 4, over the next couple of months. We'll see initiation of cagrilintide, actually, that happened yesterday, phase 3 program. We will see initiation of the amycretin development program. Obviously, I would be very remiss if I did not mention regulatory submission of Mim8 in rare disease. I think with that, back to you guys.

Martin Holst Lange: 17% weight loss, well-known safety and tolerability profile, under regulatory review with US FDA as we speak, and submitted to the European authorities. 7.2 mg, same thing, 21% weight loss. The same safety and tolerability profile that we know from the lower doses of semaglutide. Filed for regulatory approval in Europe and soon to be also in US. We'll see readout of further CagriSema studies, specifically REDEFINE 4, over the next couple of months. We'll see initiation of cagrilintide, actually, that happened yesterday, phase 3 program. We will see initiation of the amycretin development program. Obviously, I would be very remiss if I did not mention regulatory submission of Mim8 in rare disease. I think with that, back to you guys.

Speaker #5: 7.2mg same thing 21% weight loss , the same safety and tolerability profile that we know from the lower doses of semaglutide for for for regulatory approval in Europe and soon to be also in US .

Speaker #5: We'll see readout of further studies specifically redefined for over the next couple of months . We'll see initiation of Cagrilintide . Actually , that happened yesterday .

Speaker #5: Phase three program . And we will see initiation of of the development program . And then obviously I would be very remiss if I did not mention regulatory submission of my mate .

Speaker #5: In rare disease, I think with that, back to you, guys.

Speaker #3: Yeah . Thank you Martin . Outlook for 2025 . Really reflects the script trends we've seen over the last few months . So , so he had the third quarter .

Carsten: Thank you, Martin. Outlook for 2025 really reflects the script trends we've seen over the last few months. Here at the Q3, we narrowed our top line guidance range by taking the top end down and narrowed around the low end of our guidance range. Now we're guiding top line between 8% and 11%, and then correspondingly adjusting our operating profit growth accordingly. FX slightly adverse, we updated that. No major changes there. Which is being offset in the net financials. Finally, you see our CapEx estimates coming down linked to changes to our CapEx program or some optimization there. A lower CapEx run rate this year.

Karsten Munk Knudsen: Thank you, Martin. Outlook for 2025 really reflects the script trends we've seen over the last few months. Here at the Q3, we narrowed our top line guidance range by taking the top end down and narrowed around the low end of our guidance range. Now we're guiding top line between 8% and 11%, and then correspondingly adjusting our operating profit growth accordingly. FX slightly adverse, we updated that. No major changes there. Which is being offset in the net financials. Finally, you see our CapEx estimates coming down linked to changes to our CapEx program or some optimization there. A lower CapEx run rate this year.

Speaker #3: We narrowed our top-line guidance range by taking the top end down and narrowing around the low end of our guidance range.

Speaker #3: So now we're guiding top-line growth between 8% and 11%. And then correspondingly adjusting our operating profit growth accordingly. FX is slightly adverse.

Speaker #3: So, we updated that; no major changes there. And which is being offset in net financials. And then finally, you see our CapEx estimates coming down linked to changes to our CapEx program.

Speaker #3: All some optimization there . So so a lower CapEx run rate this year . And we are looking into over the coming years that our CapEx run rate will be coming down as we gradually are finalising our our major CapEx initiatives , both on the API front as well as as on fill , finish .

Carsten: We are looking into, over the coming years that our CapEx run rate will be coming down as we gradually are finalizing our major CapEx initiatives, both on the API front as well as on fill finish. This concludes the presentation, and we're ready to move into Q&A. On one side note, I would say, the plan was for our CEO, Mike Duust to be here today. Unfortunately, he had other priorities for today. I'm sure he'll be back in connection with the full year. With that, per tradition, we'll have Jacob and investor relations control the crowd and Q&A. Over to you, Jacob.

Karsten Munk Knudsen: We are looking into, over the coming years that our CapEx run rate will be coming down as we gradually are finalizing our major CapEx initiatives, both on the API front as well as on fill finish. This concludes the presentation, and we're ready to move into Q&A. On one side note, I would say, the plan was for our CEO, Mike Duust to be here today. Unfortunately, he had other priorities for today. I'm sure he'll be back in connection with the full year. With that, per tradition, we'll have Jacob and investor relations control the crowd and Q&A. Over to you, Jacob.

Speaker #3: So this this concludes the presentation . And we're we're ready to move into into Q&A on on one side note , I would say the plan was for for our CEO Mike to be here today .

Speaker #3: Unfortunately he had other priorities for for today . So so you'll I'm sure he'll be back in connection with the with Full-year . So with that per tradition , we will have Jacob and Investor Relations control the control the crowd and Q&A .

Speaker #3: Over to you .

Speaker #6: I'll try . Thanks , Carsten . Let's do one question per institution and let's start with the host , Richard , please .

[Company Representative] (Novo Nordisk A S): I'll try. Thanks, Carsten. Let's do one question per institution, and let's start with the host, Richard Vosser, please.

Moderator: I'll try. Thanks, Carsten. Let's do one question per institution, and let's start with the host, Richard Vosser, please.

Speaker #1: Thanks. Maybe I'll start one with Martin. You mentioned the amycaretin data in terms of the type 2 diabetes trials. What do you expect to learn from those trials that you can take forward?

Richard Foster: Thanks. maybe I'll start one with Martin. You mentioned the amycretin data in terms of the type two diabetes trials. What do you expect to learn from those trials that you can take forward to think about the phase 3?

Speaker #1: To think about the phase three .

Speaker #5: Well , you've heard me say before , we'll not progress anything into phase three that we don't believe . Can be differentiated either .

Martin: You've heard me say before, we'll not progress anything into phase 3 that we don't believe can be differentiated either on efficacy, safety, convenience, to scalability. Obviously, you know that amycretin if on par efficacy, safety, it has a scalability upside. Obviously, it would be good to see also an upside, potential upside on efficacy, maybe also on tolerability. We also know that these priorities in type 2 diabetes patients are slightly more difficult to predict than it is in not type 2 diabetes, and therefore, we have to see a phase 2 study and the data set to fully speculate where would we take this and how will it be differentiated. Based on what I've seen so far, obviously, we have big aspirations, but I need to see the confirmation.

Karsten Munk Knudsen: You've heard me say before, we'll not progress anything into phase 3 that we don't believe can be differentiated either on efficacy, safety, convenience, to scalability. Obviously, you know that amycretin if on par efficacy, safety, it has a scalability upside. Obviously, it would be good to see also an upside, potential upside on efficacy, maybe also on tolerability. We also know that these priorities in type 2 diabetes patients are slightly more difficult to predict than it is in not type 2 diabetes, and therefore, we have to see a phase 2 study and the data set to fully speculate where would we take this and how will it be differentiated. Based on what I've seen so far, obviously, we have big aspirations, but I need to see the confirmation.

Speaker #5: On efficacy , safety , convenience , scalability . Obviously , you know that that amycretin if on par efficacy , safety , it has a scalability upside .

Speaker #5: But obviously it would be good to see also an upside potential upside on on efficacy . Maybe also on tolerability . We also know that that that these biologies in type two diabetes patients are slightly more difficult to predict than it is in non type two diabetes , and therefore we have to see phase two study and the data set to fully speculate where would we take this and how will it be differentiated based on what I've seen so far ?

Speaker #5: Obviously, we have big aspirations, but I need to see the confirmation.

Speaker #6: Right . Let's move on the left hand side to Sachin . Please .

[Company Representative] (Novo Nordisk A S): Right. Let's move on the left-hand side to Sachin, please.

Karsten Munk Knudsen: Right. Let's move on the left-hand side to Sachin, please.

Speaker #7: Thanks very much . Sachin Jain . From just one on Glp1 pricing . So we gave you price in the quarter . Year on year fell quite dramatic .

Sachin Jain: Thanks very much. Sachin Jain, Bank of America. Just one on GLP-1 pricing. Wegovy price in the quarter, year-on-year fell quite dramatically. It was about 20%. You not called out CVS. Was it something different, and how should we think about that into next year? The same question for just pricing trends on Ozempic, and obviously the question is X, whatever we may hear later today.

Speaker #7: It was about 20%. So was that you not calling out CVS? Was it something different? And how should we think about that as we move into next year?

Speaker #7: And the same question for just pricing trends on Ozempic. And obviously, the question is X, whatever we may hear later today.

Speaker #3: Yeah , I will I'll take that one . So so I assume you you asked about us pricing . So , so specifically for for Ozempic .

Carsten: Yeah, I will. I'll take that one. I assume you ask about US pricing. Specifically for Ozempic, there's really no change to what we've been saying all along. This is a big market which is maturing. We go for open access. We're looking at broadly unchanged access into next year. The price logic we've been seeing in the market for the past few years and what we've been guiding the markets is a net price year-over-year coming down some 10%, 15% or so, something like that. No changes to that commentary. As a general commentary, not a guide for next year. As to Wegovy and pricing trends, I would...

Karsten Munk Knudsen: Yeah, I will. I'll take that one. I assume you ask about US pricing. Specifically for Ozempic, there's really no change to what we've been saying all along. This is a big market which is maturing. We go for open access. We're looking at broadly unchanged access into next year. The price logic we've been seeing in the market for the past few years and what we've been guiding the markets is a net price year-over-year coming down some 10%, 15% or so, something like that. No changes to that commentary. As a general commentary, not a guide for next year. As to Wegovy and pricing trends, I would...

Speaker #3: There's really no change to what we've been saying all along. This is a big market which is maturing. We will go for open access.

Speaker #3: We're looking at broadly on change to access into into next year . And and the price logic . We've been seeing in the market for the past few years .

Speaker #3: And what we've been guiding the markets is a net price year on year , coming down from ten , 15% or something like that .

Speaker #3: So , so no changes to , to to that commentary . As a general commentary , not a guide for for next year as to wegovy and and pricing trends , I would you're correct when you do implied value per script .

Carsten: You're correct when you do implied value per script. Q3 is a step-down quarter-over-quarter. It's always, you know, dangerous to do quarterly net sales linked to, you know, all the uncertainties that goes into a value per script. I think it would be more appropriate to use a year-to-date value per script in terms of seeing where the Wegovy net price and the run rate of that into next year as at least one data point.

Karsten Munk Knudsen: You're correct when you do implied value per script. Q3 is a step-down quarter-over-quarter. It's always, you know, dangerous to do quarterly net sales linked to, you know, all the uncertainties that goes into a value per script. I think it would be more appropriate to use a year-to-date value per script in terms of seeing where the Wegovy net price and the run rate of that into next year as at least one data point.

Speaker #3: Q3 is a step down quarter over quarter . It's always , you know , a dangerous to to do quarterly net sales linked to all the uncertainties that goes into a value per script .

Speaker #3: So so I think it would be more appropriate to , to use a year to date value per script in terms of , of seeing where the wegovy net price and the run rate of that into next year as , as , as at least one data point .

Speaker #3: .

Speaker #6: Very good . Thank you . Let's stay on the second row with the with James .

[Company Representative] (Novo Nordisk A S): Very good. Thank you, Carsten. Let's stay on the second row with James.

Moderator: Very good. Thank you, Carsten. Let's stay on the second row with James.

Speaker #8: Great . Thank you very much . James . And Sachs I've got a question for Ludo on consumerization of the of the of the Salesforce .

James Gordon: Great. Thank you very much. James Cruden, Goldman Sachs. I've got a question for Ludo on consumerization of the sales force. As you look at the prescription trends, it looks like it's 60/40 in the reimbursed channel, but maybe sort of 85, 15% in favor of bound in the consumer channel. How are you working to address this? What are the more recent learnings? It seems like that market is quite volatile and changes relatively quickly. How are you looking to bridge that gap to get more towards?

James Quigley: Great. Thank you very much. James Cruden, Goldman Sachs. I've got a question for Ludo on consumerization of the sales force. As you look at the prescription trends, it looks like it's 60/40 in the reimbursed channel, but maybe sort of 85, 15% in favor of bound in the consumer channel. How are you working to address this? What are the more recent learnings? It seems like that market is quite volatile and changes relatively quickly. How are you looking to bridge that gap to get more towards?

Speaker #8: So as you look at the prescription trends , it looks like it's 6040 . In the in the in the reimbursed channel . But maybe sort of 8,515% in favor of of Zepbound in the in the in the consumer channel .

Speaker #8: So how are you working to to to address this , what are the more recent learnings ? It seems like that market is quite volatile and changes relatively , relatively quickly .

Speaker #8: So how are we looking to bridge that gap to get more towards .

Speaker #4: The coffee machine? I have an opinion on that.

Martin: The coffee machine has an opinion on that.

Karsten Munk Knudsen: The coffee machine has an opinion on that.

Speaker #8: Exactly. Kicking off. So how do you plan to bridge that gap?

James Gordon: Exactly. It kicking off. How do you plan to bridge that gap?

James Quigley: Exactly. It kicking off. How do you plan to bridge that gap?

Speaker #4: Absolutely . So I think your you're you're right . I would on the volatility of that of that situation in the consumer market .

Martin: Absolutely. I think you're right on the volatility of that situation in the consumer market. A couple of things, if you don't mind, to step back. First of all, we only barely scratching the surface of this market.

Karsten Munk Knudsen: Absolutely. I think you're right on the volatility of that situation in the consumer market. A couple of things, if you don't mind, to step back. First of all, we only barely scratching the surface of this market.

Speaker #4: But a couple of things . If you don't mind to step back , first of all , we only barely scratching the surface of this market , including the consumer market .

Ludovic Helfgott: Including the consumerized market. We essentially, as I said, treating between 3 and 4 million patients, over 100 million patients. What's interesting when you are discussing, and we're doing a lot of this discussing with patients themselves or discussing with physicians or with online pharmacies, is that what is super important for these kind of patients are the price is one thing for sure. It's also the formats they're using, which grants them more or less flexibility in their behaviors of treatment. It's of course, the comorbidities they're looking after. If you make a long story short, you have 2 major kinds of comorbidities. You have those that are, we call them the feel and see, typically back pain, mental health, arthritis, sleep apnea.

Speaker #4: We essentially , as I said , treating between 3 and 4 million patients , over 100 million of patients . And what's interesting , when you are discussing and we're doing a lot of this discussing with patients themselves or discussing with with physicians or with online pharmacies , is that what is super important for this kind of patients ?

Speaker #4: Are the price is one thing for sure . It's also the the format that are using which grants them more or less flexibility in their behaviors of treatment .

Speaker #4: And it's of course , the comorbidities they're looking after . And if you make a long story short , you have two major kinds of comorbidities .

Speaker #4: You have those that are we call them the feel and see . Typically back pain , mental health , arthritis , sleep apnea .

Speaker #4: So the things that are really felt concretely by patients when you have the more invisible but equally , if not more dangerous comorbidities of cardiovascular and kidney comorbidities and the if you look at the typology of the patient that are going direct , you certainly have patients that are more sensitive to the first one than to the the former than to the latter .

Ludovic Helfgott: The things that are really felt concretely by patients when you have the more invisible, but equally, if not more dangerous comorbidities of cardiovascular and kidney comorbidities. If you look at the typology of the patients that are going direct, you certainly have patients that are more sensitive to the first one than to the former than to the latter. That's one. The second thing that we observe is that what is whilst increasingly the behaviors of these patients start to fragment and these groups of patients start to be different and different. There is still, at this stage, a strong importance of the perception of weight loss. Okay? That is slowly moving. It is moving very clearly with the physicians.

Speaker #4: That's one . The second thing that we observe is that what is whilst increasingly the behaviors of these patients start to fragment and these groups of patients start to be different and different , there is still at this stage , a strong importance of the perception of weight loss .

Speaker #4: Okay . And that is slowly moving . It is moving very clearly with the physicians . It is not moving at the same stage with the patients , which means that the reason why we are so much interested in the 7.2 , but also in the pill , is that actually these two elements on both formats give us the opportunity to talk about power again .

Ludovic Helfgott: It is not moving at the same stage with the patients, which means that the reason why we are so much interested in the 7.2, but also in the pill, is that actually these two elements on both formats give us the opportunity to talk about power again. We said different patient needs, the ability to talk more about power. It's also the ability to be more direct. Because one thing is the behavior of the patient themselves. Another one and what they're sensitive to, cardiovascular health or more immediate weight loss or back pain. It's also the way they're purchasing. When you look at this, you can clearly see that there is a real trend for direct to direct purchase. It's still a prescription.

Speaker #4: Now . So we said different patient needs , the ability to talk more about power . It's also the ability to be more direct .

Speaker #4: Because one thing is the behavior of the patient themselves . Another one is and what they are sensitive to cardiovascular health or more immediate weight loss or back pain , it's also the way they're purchasing .

Speaker #4: And when you look at this , you can clearly see that there is a real trend for direct to to direct purchase . It's still a prescription .

Speaker #4: There's still a physician on the other side of the screen , but it's a screen , not the the traditional physician . And in that sense , being direct is very important .

Ludovic Helfgott: There's still a physician on the other side of the screen, but it's a screen, not the traditional physician. In that sense, being direct is very important, and that's why we are multiplying our efforts with online pharmacies as well as with distributors like Costco. The building blocks are this one. Broader number of products to cater for more needs, including format, et cetera. Really more needs. The ability to understand equally the patients in their invisible needs as well as the visible, and a reinforcement of the power of our medicine. That's why 7.2 is important, and the pill is also equally important.

Speaker #4: And that's why we are multiplying our efforts with online pharmacies as well as with distributors like Costco. So the building blocks are this one broader number of products to cater for more needs, including formats, etc.

Speaker #4: . So really , more needs . The ability to understand equally the patients in their invisible needs as well as the visible and a reinforcement of the power of a medicine .

Speaker #4: That's why 7.2 is important and the pill is also equally important .

Speaker #6: Very good . Thanks . I saw James taking a lot of notes , so that's good . Let's go to to Simon .

[Company Representative] (Novo Nordisk A S): Very good. Thanks a lot, Ludo. I saw James taking a lot of notes, so that's good. Let's go to Simon.

Moderator: Very good. Thanks a lot, Ludo. I saw James taking a lot of notes, so that's good. Let's go to Simon.

Speaker #9: Thank you . Simon Beck from Rothschild and Co . Redburn . Really just continuing on on James's question but picking up on something Mike mentioned yesterday , which is the UK market .

Simon Baker: Thank you. Simon Baker from Rothschild & Co, Redburn, really just continuing on James' question, but picking up on something Mike mentioned yesterday, which is the UK market.

Speaker #9: Yeah , it's almost the same size as the US at the moment . What about 2.5 million people ? It's all , it's all consumer .

Ludovic Helfgott: Yeah.

Simon Baker: It's almost the same size as the US at the moment. We're about 2.5 million people. It's all consumer. What we've seen over the last year is we've moved from Mounjaro and Wegovy being the same price and Mounjaro having a 70% market share. You then cut price, Lilly's then raised price. I just wonder if you can give us an update on how the sort of dynamics of the share there and the relevance of that price volume dynamic to the US market. One other thing related to this, anecdotally, it feels like the stay time, the duration of therapy in the consumer channel is a lot longer than we were expecting. People aren't staying for 6 months. They're staying on it more long-term, albeit at lower doses. Any thoughts on how that's shaping-

Speaker #9: And what we've seen over the last year is we've moved from Mounjaro and Wegovy being the same price and Mounjaro having a 70% market share .

Speaker #9: You then cut price . Lilly's then raised price . I just wonder if you can give us an update on how the dynamics of the share there and the the relevance of that price volume dynamic to the US market .

Speaker #9: And one other thing related to this , anecdotally , it feels like the state time , the duration of therapy in the consumer channel is a lot longer than we were expecting .

Speaker #9: People aren't staying for six months . They're they're staying on it more more long term , albeit at lower doses . Any thoughts on how that shapes ?

Speaker #9: It feels like there's a whole chunk of volume that we weren't expecting . .

Ludovic Helfgott: Yeah.

Simon Baker: It feels like there's a whole chunk of volume that we weren't expecting.

Speaker #4: Two brilliant questions. I think on the first one, on the UK, that reflects, I think, underlines two things we've been saying.

Ludovic Helfgott: Two brilliant questions. I think on the first one on the UK, that reflects, I think underlines two things we've been saying. The first one is that, if you look right now from a preference share and, I think we're more or less neck and neck when it comes to preference share in the UK. It's very interesting because it means it's a market where we know it's a very price sensitive market, but in spite of that, the quality of our medicines and what we're doing with the medicines is actually being seen by the consumers and the physicians. That for me, reflects the fact that there is, let's say the dice are not cast on what exactly is the performance of good semaglutide versus the rest. That's the first thing.

Speaker #4: The first one is that . If you look right now from a preference share and and I think we more , more or less neck to neck when it comes to preference share in the UK .

Speaker #4: So it's very interesting because it means it's a market where we know it's a very price sensitive market . But in spite of that , the quality of our medicines and what we're doing with the medicines is actually being seen by , by the , the consumers and the physicians .

Speaker #4: So, that for me reflects the fact that there are, let's say, the dice are not cast on what exactly is the performance of goods and sides versus the rest.

Speaker #4: That's the first thing it illustrates price sensitivity . You're right . But if the market was just price sensitive , we wouldn't have the NBR we were having in the US , because if you look at the NBR , you can see the difference between vials and not vials .

Ludovic Helfgott: It illustrates price sensitivity, you're right, but if the market was just price sensitive, we wouldn't have the NBRX we're having in the US, because if you look at the NBRX, you can see the difference between vials and not vials. When you look at devices, we're actually again, head to head. It means that you have segments that are price sensitive, others that are less price sensitive. Back to the discussion of different preferences in the market. The second thing it actually reflects is the fact that each market in EU has its own special dynamic. I think that's what Mike said yesterday again. The competitive situation in EU will be market by market. In some markets, we will win. In some markets we are, there's more battles. We have markets where we can clearly register strong gains.

Speaker #4: And when you look at devices, we actually, again, head to head, it means that you have segments that are price sensitive, others that are less price sensitive.

Speaker #4: Back to the discussion of different preferences in the market . The second thing is actually reflects is the fact that each market in IO has its own special dynamic .

Speaker #4: And I think that's what Mike said yesterday . Again , the the the competitive , the competitive situation in IO will be market by market in some markets .

Speaker #4: We will win in some markets we are there's more battles . We have markets where we can clearly register strong strong gains . In case of Australia , as an example , the UK recently other markets are a bit more difficult based on the structure of this market .

Ludovic Helfgott: Case of Australia as an example, the UK recently, other markets are a bit more difficult based on the structure of this market. Things have to be seen market by market, very importantly.

Speaker #4: So, things have to be seen market by market. Very importantly.

Speaker #6: Very good . Thanks . I think , for the second question on time . We'll come back afterwards . We'll come one more round .

[Company Representative] (Novo Nordisk A S): Very good. Thanks, Ludo. I think for the second question, stay time, we'll come back after-

Moderator: Very good. Thanks, Ludo. I think for the second question, stay time, we'll come back after-

Ludovic Helfgott: We'll come back.

[Company Representative] (Novo Nordisk A S): One more round. Let's go to Naresh.

Karsten Munk Knudsen: One more round. Let's go to Naresh.

Speaker #6: So let's go to Naresh .

Speaker #10: Thanks for taking my question . It's Naresh Chauhan from Intron Health . Can you just help us to think through 26 revenue growth ?

Naresh Chauhan: Thanks for taking my question. It's Naresh Chauhan from Intron Health. Can you just help us to think through 2026 revenue growth, please? Obviously we can see the Wegovy volumes as they are. Access is broadly flat. Pricing is obviously likely to be down. You've got the Medicaid removals, which are, we think, about a high single-digit volume impact, and then whatever competition you want to bake in from MorphoSys. With Ozempic, clearly, sequentially, we're in decline in the US, and ex-US you've got the LOEs. What are we missing? Where is the revenue growth coming from next year, please?

Speaker #10: Please ? Obviously , we can see the Wegovy volumes as they are access is broadly flat . Pricing is obviously likely to be down , and then you've got the Medicaid removals , which are we thinks about a high single digit volume impact .

Speaker #10: And then whatever competition you want to bake in from ortho. And then with the ZenBook, clearly the sequentially we're in decline in the U.S. and ex-U.S.

Speaker #10: You've got the lows . So as we what are we missing . Where is the revenue growth coming from next year ? Please .

Speaker #3: Yeah . Again , as I said yesterday , I'm not guiding for for 26 at this point in time . I think as , as a company we are guiding for for this year .

Carsten: Yeah. Again, as I said yesterday, I'm not guiding for 2026 at this point in time. I think as a company, we're guiding for this year, and we're actually rather elaborate around the trends impacting our business. Then we point to the market around the key one-offs that the market has to take into account into next year. I think I really don't have a lot more to add beyond saying, of course, the Wegovy pill launch, you know, pending regulatory approval is a key opportunity for the company starting hopefully beginning of next year.

Karsten Munk Knudsen: Yeah. Again, as I said yesterday, I'm not guiding for 2026 at this point in time. I think as a company, we're guiding for this year, and we're actually rather elaborate around the trends impacting our business. Then we point to the market around the key one-offs that the market has to take into account into next year. I think I really don't have a lot more to add beyond saying, of course, the Wegovy pill launch, you know, pending regulatory approval is a key opportunity for the company starting hopefully beginning of next year.

Speaker #3: And we're actually rather elaborate around the trends impacting our business . And then we point to the market around the key one offs that the market has to take into account in next year .

Speaker #3: So so I think I really don't have , have have a lot more and more to add beyond saying , of course , all the pill launched , you know , pending regulatory approval is is a key opportunity for for the company starting hopefully beginning of of next year .

Speaker #3: My mate approval , I think will will be , you know , in the second half of the year and hence have have lower impact .

Carsten: Mim8 approval, I think, will be, you know, in the second half of the year and hence have lower impact, but will also be a good, you know, future revenue growth driver for the company. CagriSema we're getting ready for submission. Again, perhaps it's not until next year it impacts top line growth. Then the following year it should start to take off. Then Loulou mentioned the ziltivekimab also where we're, you know, getting the first data next year. Hopefully they'll be competitive. Again, not next year, but in the following years.

Karsten Munk Knudsen: Mim8 approval, I think, will be, you know, in the second half of the year and hence have lower impact, but will also be a good, you know, future revenue growth driver for the company. CagriSema we're getting ready for submission. Again, perhaps it's not until next year it impacts top line growth. Then the following year it should start to take off. Then Loulou mentioned the ziltivekimab also where we're, you know, getting the first data next year. Hopefully they'll be competitive. Again, not next year, but in the following years.

Speaker #3: But we'll also be good , you know , future revenue growth driver for for the company and Cagrisema . We're getting ready for submission .

Speaker #3: So again perhaps it's not into next year . It impacts top line growth . But but then then the following year it should it should start to take off .

Speaker #3: And then Ludo mentioned . But also where we're you know , getting the first data next year hopefully there will be competitive . So again not not next year but but in the following years .

Speaker #3: So so so I think we have we have really nice pipeline progress and optionality and and that's really what it's going to going to drive a top line in perhaps not so much next year .

Carsten: I think we have really nice pipeline progress and optionality, and that's really what is gonna drive top line in perhaps not so much next year all of it, but in the coming years.

Karsten Munk Knudsen: I think we have really nice pipeline progress and optionality, and that's really what is gonna drive top line in perhaps not so much next year all of it, but in the coming years.

Speaker #3: All of it. But, in the coming years.

Speaker #6: Naresh thank you . Let's move to Harry .

Naresh Chauhan: Thank you, Naresh. Thank you, Carsten. Let's move to Harry.

Moderator: Thank you, Naresh. Thank you, Carsten. Let's move to Harry.

Speaker #10: Brilliant . Thank you . It's Harry Sefton .

Harry Stebbings: Brilliant. Thank you. It's Harry Stebbings from UBS. I'm gonna try one on Metsera. What if the FTC comes back and says no? Just like you to go through some of the scenarios there, because you've quite publicly endorsed this portfolio as being differentiated, clearly you don't want this to end up in the hands of some competitors. Just want to get your thoughts on what if the FTC-

Speaker #11: From UBS . I'm going to try one on Meztira . So what if the FTC comes back and says no , just like you to go through through some of the scenarios there because you've you've quite publicly endorsed this portfolio as being differentiated .

Speaker #11: So clearly you don't want this to end up in the hands of some competitors . So just want to get your thoughts on what if the FTC comes back and asks whether you want to divest any of your own assets ?

Ludovic Helfgott: Absolutely.

Harry Stebbings: comes back and asks.

Ludovic Helfgott: Absolutely.

Harry Stebbings: Whether you want to divest.

Ludovic Helfgott: Absolutely.

Harry Stebbings: Any of your own assets.

Speaker #4: So let me take a step back on your question . One we strongly believe that the market is really big is competitive . So we've gone into , of course , into this this operation with with clear thoughts in mind and clear ideas and of course , and we've been a also with strong advice .

Ludovic Helfgott: Let me take a step back on your question. One, we strongly believe that the market is really big, is competitive. We've gone into, of course, into this operation with clear thoughts in mind and clear ideas and of course, and we've been also with strong advice. We would never have done such a thing if we didn't believe that there was a very solid chance of this being cleared. Okay. However, things are what they are, and by definition, the FTC has the right to review any deal. It's perfectly okay, and we're ready to discuss the merits of the acquisition. You have two different views. Ultimately, it comes down to the merit of the portfolio. Either we explore this portfolio industrially, i.e.

Speaker #4: So we would never have done such a thing if we didn't believe that there was a very solid chance of this being cleared .

Speaker #4: Okay . However , things are what they are . And by definition , the FTC has the right to review any deal , so it's perfectly okay .

Speaker #4: And we're ready and we're ready to discuss the merits of the acquisition . You have two different views . Ultimately , it comes down to the merit of the portfolio .

Speaker #4: Either we we exploit this portfolio industrially , i.e. we own the portfolio . It's been validated by the FTC and we integrate the portfolios or we are the shareholders and important shareholders of a very successful company .

Ludovic Helfgott: We own the portfolio, it's been validated by the FTC, and we integrate the portfolios or we are the shareholders, and important shareholders of a very successful company. Again, all depends on the data ultimately. That has been the discussion and the thing all around. Given our belief in the quality of the portfolio and the capabilities, products with an edge, and combinations was also early. Either it's for us from an industrial perspective, we operate it, or we are the shareholders of a very attractive portfolio. That's ultimately boiling down to the quality of the assets we're seeing here.

Speaker #4: Again , all depends on the data ultimately , and that has been the discussion . And the thing all around , given our belief in the quality of the portfolio and the capabilities products with an S combinations was also early .

Speaker #4: Whether it's for us in from an industrial perspective, we operate it or we are the shareholders of a very attractive portfolio. So that's ultimately boiling down to the quality of the assets we're seeing here.

Speaker #6: Wonderful . Thanks a lot . I saw him from Ben next to Harry .

Naresh Chauhan: Wonderful. Thanks a lot, Loulou. I saw a hand from Ben next to Harry.

Moderator: Wonderful. Thanks a lot, Loulou. I saw a hand from Ben next to Harry.

Speaker #8: Brilliant . Thank you . Ben Jackson Jefferies . Martin , one for you on evoke . Plus , if I may , I think it was originally designed to include 20% of patients with significant small vessel pathology .

Benjamin Jackson: Brilliant. Thank you. Benjamin Jackson, Jefferies. Martin, one for you on PIONEER PLUS, if I may. I think it was originally designed to include 20% of patients with significant small vessel pathology, but that protocol got changed, if I'm right. It's not necessarily anything new, but I saw that it was updated in the slide, so I thought I'd just bring it up quickly. Do you have any color behind why this happened? Was this something to do with recruitment or a change in thinking of the biology or commercial aspirations in that, in that subgroup? Should we take that as synonymous with the vascular dimension that some executives are talking about?

Speaker #8: But that protocol got changed . If I'm right , it's not necessarily anything new , but a saw that it was updated in the slides , so I thought I'd just bring it up quickly , do you have any color behind why this happened ?

Speaker #8: Was this something to do with recruitment or a change in thinking of the biology or commercial aspirations in that , in that subgroup ?

Speaker #8: And should we take that as synonymous with the vascular dimension that some of executives are talking about ? And then following on from that , is there enough patients within that group that you have initially ended up recruiting to see a potential signal in there ?

Benjamin Jackson: Following on from that, is there enough patients within that group that you have initially, ended up recruiting to see a potential signal in there and explore that, should you wish in the future?

Speaker #8: And explore that should you , should you wish in the future ?

Speaker #5: Absolutely . So , so one step back . Actually starting where you ended the original dialogue with the authorities was by far the most prevalent form of dementia is Alzheimer's disease .

Carsten: Absolutely. One step back, actually starting where you ended the original dialogue with the authorities was by far the most prevalent form of dementia is Alzheimer's disease. The vascular component, given GLP-1 biology, made sense also to evaluate. From a patient volume perspective, we agreed to be looking for signal rather than statistical significance. That's why across the two studies, the vast majority of patients had the Alzheimer's pathology. A little bit reflecting that it has turned out to be easier to identify and recruit patients with Alzheimer's pathology versus a very clear vascular pathology, in part because there are overlaps. A great number of patients with vascular pathology also have elements of Alzheimer's pathology. That's basically the reflection.

Karsten Munk Knudsen: Absolutely. One step back, actually starting where you ended the original dialogue with the authorities was by far the most prevalent form of dementia is Alzheimer's disease. The vascular component, given GLP-1 biology, made sense also to evaluate. From a patient volume perspective, we agreed to be looking for signal rather than statistical significance. That's why across the two studies, the vast majority of patients had the Alzheimer's pathology. A little bit reflecting that it has turned out to be easier to identify and recruit patients with Alzheimer's pathology versus a very clear vascular pathology, in part because there are overlaps. A great number of patients with vascular pathology also have elements of Alzheimer's pathology. That's basically the reflection.

Speaker #5: The vascular component . Given GLP one biology made sense also to evaluate but from a . Patient volume perspective , we agreed to be looking for signal rather than statistical significance .

Speaker #5: And that's why the across the two studies , the vast majority of patients had the Alzheimer's pathology . And a little bit reflecting that it has turned out to be easier to identify and recruit patients with Alzheimer's pathology versus a very clear vascular pathology , in part because there are overlaps .

Speaker #5: So a great number of patients with vascular pathology also have elements of of Alzheimer's . Pathology . So that's basically the reflection . Now that we're on that subject , obviously this is a true unmet need .

Carsten: Now that we are on that subject, obviously this is a true unmet need and I'm very proud that we are doing this, but we still have to call out. It's very high risk. It is a very volatile space to doing clinical development.

Karsten Munk Knudsen: Now that we are on that subject, obviously this is a true unmet need and I'm very proud that we are doing this, but we still have to call out. It's very high risk. It is a very volatile space to doing clinical development.

Speaker #5: And I'm very proud that we are doing this. But we still had to call out. It's very, very high risk.

Speaker #5: It is a very volatile space for doing clinical development.

Speaker #6: Thank you Martin . Let's move to Pete in the back . On characteristically .

[Company Representative] (Novo Nordisk A S): Thank you, Martin. Let's move to Pete in the back, uncharacteristically.

Moderator: Thank you, Martin. Let's move to Pete in the back, uncharacteristically.

Speaker #12: Yeah . Thanks , Pete . BNP just one for Carsten . Just are you sensing any change in the political appetite in the US to help you with your quest to deal with Compounders ?

[Analyst] (LBNP): Yes. Thanks, Jacob. Pete with LBNP. Just one for Carsten. Just, are you sensing any change in the political appetite in the US to help you with your quest to, you know, deal with compounders? Is there any change in that environment, that you can sense politically? Thank you.

Peter Verdult: Yes. Thanks, Jacob. Pete with LBNP. Just one for Carsten. Just, are you sensing any change in the political appetite in the US to help you with your quest to, you know, deal with compounders? Is there any change in that environment, that you can sense politically? Thank you.

Speaker #12: Is there any change in that environment that you can sense politically ? Thank you .

Speaker #3: Yeah , we're over the last number of quarters . We've been talking about compounding . And of course , our starting point as a company is , is clearly patient safety in the US , compounding is sourced from a wide variety of different sources which are not FDA approved .

Carsten: Over the last number of quarters, we've been talking about compounding and of course, our starting point as a company is clearly patient safety. In the US, compounding is sourced from a wide variety of different sources, which are not FDA approved. Of course that leads to a higher risk level compared to FDA-approved manufacturing facilities and products. That's a starting point. Of course it's a concern on our side vis-à-vis patents and the investments we do in bringing products to market and the commercial impacts this has to our business. As a company, we perform a number of lawsuits and litigations vis-à-vis this segment.

Karsten Munk Knudsen: Over the last number of quarters, we've been talking about compounding and of course, our starting point as a company is clearly patient safety. In the US, compounding is sourced from a wide variety of different sources, which are not FDA approved. Of course that leads to a higher risk level compared to FDA-approved manufacturing facilities and products. That's a starting point. Of course it's a concern on our side vis-à-vis patents and the investments we do in bringing products to market and the commercial impacts this has to our business. As a company, we perform a number of lawsuits and litigations vis-à-vis this segment.

Speaker #3: So of course , that that leads to a higher risk level compared to FDA approved manufacturing facilities . And products . So , so that's a starting point .

Speaker #3: Then , of course , it's a concern on our side vis a vis patents . And the investments we do in in bringing products to market .

Speaker #3: And the commercial impacts this has to our business as a company , we perform a number of lawsuits and litigations vis a vis this .

Speaker #3: This segment . But I would say the the main change would rely on , on the US administration and the health authorities in the US and the associated regulations , specifically compounding and clarity around can it truly be that that more than 1 million patients .

Carsten: I would say the main change would rely on the US administration and the health authorities in the US and the associated regulations vis-à-vis compounding and clarity around can it truly be that more than 1 million patients qualify as being personalized compounding. Specifically to your question, can I be hopeful around changes in that environment? That's forward-looking questions on politics, and healthcare reforms are always a little bit tricky. I am hopeful. There are no guarantees in a space like this. It's an agenda that we're actively pushing. Exactly how and when, et cetera, remains to be seen.

Karsten Munk Knudsen: I would say the main change would rely on the US administration and the health authorities in the US and the associated regulations vis-à-vis compounding and clarity around can it truly be that more than 1 million patients qualify as being personalized compounding. Specifically to your question, can I be hopeful around changes in that environment? That's forward-looking questions on politics, and healthcare reforms are always a little bit tricky. I am hopeful. There are no guarantees in a space like this. It's an agenda that we're actively pushing. Exactly how and when, et cetera, remains to be seen.

Speaker #3: Qualify as being personalized , compounding and so specifically to to your question , can I be hopeful around changes in that environment that's forward looking questions on politics and and and healthcare reforms are always a little bit tricky .

Speaker #3: I am I am hopeful , but but there are no guarantees in a space like this . So so it's an agenda that we're actively pushing exactly how and when , etc.

Speaker #3: remains to be seen .

Speaker #6: Thanks , Carlton . Let's move here to to Evan in the middle .

[Company Representative] (Novo Nordisk A S): Thanks, Carsten. Let's move here to Evan in the middle.

Moderator: Thanks, Carsten. Let's move here to Evan in the middle.

Speaker #10: Hello , Evan .

Speaker #13: Seagram from BMO Capital Markets . So in your slide , you say that the meztira acquisition complies with all applicable law you had overnight .

Evan Seigerman: Hello. Evan Seigerman from BMO Capital Markets. In your slide, you say that the Metsera acquisition complies with all applicable law, yet overnight Bloomberg reported that the FTC said that the bid may violate the procedural provisions of the HSR Pre-Merger Notification Act. Can you just square that for me, how you believe that you are complying with law when the FTC is saying that it may violate?

Speaker #13: Bloomberg reported that the FTC said that the bid may violate the procedural provisions of the HSR pre-merger Notification act . Can you just square that for me ?

Speaker #13: How you believe that you are complying with law ? When the FTC is saying that it may violate .

Speaker #3: Well , so so in short , we while I don't want to go into the details around the process for , for for obvious reasons , then then as a company , you know , it part of what we call the known risk that we adhere to all laws and regulations in any jurisdiction that , that , that that we operate and that includes , of course , when we perform a activities like M&A type activity , in this case , we had , you know , done our homework in terms of the requirements vis a vis FTC in a scenario like like this , with the expert external advisors .

Carsten: Well, in short, we, while I don't want to go into the details around the process for obvious reasons, then as a company, you know, it's part of what we call The Novo Nordisk Way that we adhere to all laws and regulations in any jurisdiction that we operate. That includes, of course, when we perform activities like M&A type activity. In this case, we had, you know, done our homework in terms of the requirements vis-à-vis FTC in a scenario like this with the expert external advisors. We do believe that it fulfills the requirement by FTC.

Karsten Munk Knudsen: Well, in short, we, while I don't want to go into the details around the process for obvious reasons, then as a company, you know, it's part of what we call The Novo Nordisk Way that we adhere to all laws and regulations in any jurisdiction that we operate. That includes, of course, when we perform activities like M&A type activity. In this case, we had, you know, done our homework in terms of the requirements vis-à-vis FTC in a scenario like this with the expert external advisors. We do believe that it fulfills the requirement by FTC.

Speaker #3: And and we do believe that that it fulfills the requirement by , by FTC . And as I said before , it was part of our due diligence as it was with the Catalan transaction .

Carsten: As Lulu said before, it was part of our due diligence, as it was with the Catalent transaction, not too long ago, where we assessed from an antitrust perspective, like we assess patent, CMC, clinical data, we assess antitrust and the likelihood of closing as part of our due diligence. That was exactly the same with the chair.

Karsten Munk Knudsen: As Lulu said before, it was part of our due diligence, as it was with the Catalent transaction, not too long ago, where we assessed from an antitrust perspective, like we assess patent, CMC, clinical data, we assess antitrust and the likelihood of closing as part of our due diligence. That was exactly the same with the chair.

Speaker #3: Not too long ago , where we assessed from an antitrust perspective , like we assess patents , CMC clinic clinical data , we assess antitrust and and and the likelihood of closing as part of our diligence .

Speaker #3: And that's exactly the same we did here .

Speaker #6: Good . Thanks . Thanks . Let's go to Thibault , also here in the middle . Thank you very much .

[Company Representative] (Novo Nordisk A S): Good. Thanks, Evan. Thanks, Carsten. Let's go to Thibault, also here in the middle.

Moderator: Good. Thanks, Evan. Thanks, Carsten. Let's go to Thibault, also here in the middle.

[Analyst] (Morgan Stanley): Thank you very much. Thibault with Morgan Stanley. Just a question on the GLP-1 in China. Ozempic and Wegovy saw this quarter. I think for Ozempic there was some wholesaler destocking, but Wegovy seems underlying. We are going to see semaglutide generics entering the market next year, obviously Mounjaro competition ramping up. Should we just assume that Ozempic and Wegovy may not really build in China based on this current trend and the headwinds coming?

Thibault Boutherin: Thank you very much. Thibault with Morgan Stanley. Just a question on the GLP-1 in China. Ozempic and Wegovy saw this quarter. I think for Ozempic there was some wholesaler destocking, but Wegovy seems underlying. We are going to see semaglutide generics entering the market next year, obviously Mounjaro competition ramping up. Should we just assume that Ozempic and Wegovy may not really build in China based on this current trend and the headwinds coming?

Speaker #14: Thibault . Just a question on the GLP one in China . Ozempic and Wegovy this quarter , I think for Ozempic , there was some more stocking , but Wegovy seems underlying .

Speaker #14: We are going to see some generics entering the market next year. Obviously, Mounjaro competition is ramping up. So, should we just assume that Ozempic and Wegovy may not really build in China based on this current trend?

Speaker #14: And and the headwinds coming ?

Speaker #15: I can take it .

Ludovic Helfgott: I can take it. I don't think you should assume that. I think the reason why the Chinese market is slow to start is more based on the local regulations of the Chinese market. A big part of the demanded market is driven by direct to patients' demand. In China, from a regulatory perspective, you cannot do it with the obesity products. You can do it with the diabetes, not the obesity products. There is intense dialogue at this stage in China to make sure that we can open the market and make sure that patients can benefit. It's a regulatory limitation. It has nothing really to do with the potential of the market.

Ludovic Helfgott: I can take it. I don't think you should assume that. I think the reason why the Chinese market is slow to start is more based on the local regulations of the Chinese market. A big part of the demanded market is driven by direct to patients' dezmand. In China, from a regulatory perspective, you cannot do it with the obesity products. You can do it with the diabetes, not the obesity products. There is intense dialogue at this stage in China to make sure that we can open the market and make sure that patients can benefit. It's a regulatory limitation. It has nothing really to do with the potential of the market.

Speaker #4: I don't think I don't think you should assume that . I think the reason why the Chinese market is slow to start is more based on the local regulations of the Chinese market .

Speaker #4: A lot a big part of the demand is market is driven by direct to to patients demand . And in China , from a regulatory perspective , you cannot do it with the obesity products .

Speaker #4: You can do it with a diabetes not the obesity products . So there is intense dialogue at this stage in China to make sure that we can open the market and make sure that patients can benefit .

Speaker #4: But it's a regulatory limitation. It has nothing really to do with the potential of the market.

Speaker #3: And then then just building on Lulu's comment , which was related to the obesity market in the diabetes market , where we are on the national list with the with Ozempic and and we we have a very competitive market here in China , as you see in our reportings .

Carsten: Then just building on Lulu's comment, which was related to the obesity market. In the diabetes market, we are on the national list with Ozempic. We have a very competitive market share in China, as you see in our reportings. Truly, there are some budgetary constraints in the major hospitals that limits the amount of Ozempic utilization.

Karsten Munk Knudsen: Then just building on Lulu's comment, which was related to the obesity market. In the diabetes market, we are on the national list with Ozempic. We have a very competitive market share in China, as you see in our reportings. Truly, there are some budgetary constraints in the major hospitals that limits the amount of Ozempic utilization.

Speaker #3: So , so , so truly , there are some budgetary constraints in , in the major hospitals that , that limits the the amount of , of ozempic utilization and and of course , we have some , some local commercial plans for , you know , how how to continue to expand ozempic into the marketplace , both online like in obesity , but also into , you know , some of the outer hospitals , the second and third year .

Carsten: Of course, we have some local commercial plans for, you know, how to continue to expand Ozempic into the marketplace, both online, like in obesity, but also into, you know, some of the outer hospitals, the segment third-tier hospitals, because all penetration of GLP-1 in China, in diabetes as well as obesity, is very low compared to most other markets.

Karsten Munk Knudsen: Of course, we have some local commercial plans for, you know, how to continue to expand Ozempic into the marketplace, both online, like in obesity, but also into, you know, some of the outer hospitals, the segment third-tier hospitals, because all penetration of GLP-1 in China, in diabetes as well as obesity, is very low compared to most other markets.

Speaker #3: Hospitals , because all penetration of GLP one in China in diabetes as well as obesity is very low compared to most other markets .

Speaker #6: Thank you . That's clear . Let's move to to Jihan and then move to carry afterwards .

[Company Representative] (Novo Nordisk A S): Thank you, Lulu. Thanks, Carsten. Let's move to Yee-han, and then we'll move to Carrie afterwards.

Moderator: Thank you, Lulu. Thanks, Carsten. Let's move to Yee-han, and then we'll move to Carrie afterwards.

Speaker #16: Hi . Thanks for taking our question . Yihan Lee from Barclays . So just have a question on the radio . So like a lot of happened overnight , I think I'm just like curious in terms of sorry .

Emily Li: Hi. Thanks for taking our question. Emily Li from Barclays. Just have a question on the MASH Radue. Like a lot of happened overnight, I think I'm just, like, curious in terms of. Sorry. In terms of the valuation, did you have, like, several pipelines and just like, could you please elaborate how you value its pipelines separately, for example, like NNC0097 versus NNC0369-0233 versus the early ORLs, and also which part of the portfolio is the most strategically attractive to Novo? Thank you very much.

Speaker #16: So in terms of the valuation . So they did have like several pipelines and just like could you please elaborate how you value this pipeline separately , for example , like 097 versus 233 versus the early orals .

Speaker #16: And also which part of the portfolio is the most strategically attractive to novel ? Thank you very much .

Speaker #15: Okay .

Ludovic Helfgott: Okay. Of course, the valuation is part of our discussions, and we can't disclose that, but very clearly the whole portfolio is interesting. I would say not just the individual assets, but the combination of assets as well. As well as the early year, as well as the early ones. They all equally contribute to the valuation and the ability to really be able to answer the wide untapped demand in the market. It's the whole portfolio that is interesting.

Speaker #4: So of course , the valuation is part of our discussions . And we can't disclose that . But very clearly the whole portfolio is interesting .

Speaker #4: And I would say not just the individual assets , but the combination of assets as well as well as the as well as the early as well as the early ones .

Speaker #4: So they're they're all equally contribute to the valuation and the ability to really be able to answer the wide untapped demand in the market .

Speaker #4: It's the whole portfolio that is interesting.

Speaker #6: Thank you . Lulu . Let's get the microphone to Carrie , please .

[Company Representative] (Novo Nordisk A S): Thank you, Ludo. Let's get the microphone to Carrie, please.

Moderator: Thank you, Ludo. Let's get the microphone to Carrie, please.

Speaker #17: Thank you . Carrie Holford , Berenberg . My question is on whose Olympic . So based on your market data , your internal data , is there any residual headwinds in the US in terms of volume growth from off label , historical off label use in obesity ?

Kerry Holford: Thank you. Kerry Holford, Berenberg. My question is on Ozempic. Based on your market data, your internal data, is there any residual headwinds in the US in terms of volume growth from off-label, historical off-label use in obesity, or is that now flushed through? You mentioned the higher penetration now in diabetes within the US, clearly more significant competition now, from Lilly building. Are we now in a scenario where Ozempic is ex growth in the US, or do you see ways and means of rebuilding that?

Speaker #17: Or is that now flushed through . And you mentioned the higher penetration . Now in diabetes within the US . Clearly more significant competition .

Speaker #17: Now from Lilly building . Are we now in a scenario where is X growth in the US or do you see ways and means of rebuilding that ?

Speaker #6: Is perhaps a broader question on ozempic dynamics in the US ?

[Company Representative] (Novo Nordisk A S): Yes. perhaps a broader question on current Ozempic dynamics in the US.

Karsten Munk Knudsen: Yes. perhaps a broader question on current Ozempic dynamics in the US.

Speaker #3: Yeah , so so Ozempic and GLP one . Dynamics in the US . If you look at Ozempic scripts currently totaling around , call it 660,000 or so per week , according to Iqvia .

Carsten: Yeah. Ozempic and GLP-1 dynamics in the US. If you look at the Ozempic scripts currently totaling around, call it 660,000 or so per week, according to IQVIA, and look at the trend line of the volume growth over the last period, it has been slightly declining. You know, like a few percent, measured in volume. Then you say, What are the key drivers behind it? I would say it's a combination of the competition entering into the marketplace, and all segments slow down.

Karsten Munk Knudsen: Yeah. Ozempic and GLP-1 dynamics in the US. If you look at the Ozempic scripts currently totaling around, call it 660,000 or so per week, according to IQVIA, and look at the trend line of the volume growth over the last period, it has been slightly declining. You know, like a few percent, measured in volume. Then you say, What are the key drivers behind it? I would say it's a combination of the competition entering into the marketplace, and all segments slow down.

Speaker #3: And and look at the trend line of of of the volume growth over the last period . It has been slightly declining . You know , like a few percent measured in , volume and , and then then you say , what are the key drivers behind it ?

Speaker #3: And I would say it's a combination of competition , entering into the marketplace and all segment slowdown . So now now the GLP one diabetes market in the US is growing to the tune of call it 12% or so in in volume linked to linked to the oral penetration and diabetes .

Carsten: Now, the GLP-1 diabetes market in the US is growing to the tune of, call it, 12% or so in volume, linked to the old penetration in diabetes. If you adjust for double counting, then out of, you know, the treated diabetes patients around close to a third is now on a GLP-1 in the US. We see that continuing to go up, so it's not like we believe it has reached the ceiling because the broad labels for GLP-1s and especially for Ozempic yields that there should be more penetration to go for. I think it's natural as we've seen historically also.

Karsten Munk Knudsen: Now, the GLP-1 diabetes market in the US is growing to the tune of, call it, 12% or so in volume, linked to the old penetration in diabetes. If you adjust for double counting, then out of, you know, the treated diabetes patients around close to a third is now on a GLP-1 in the US. We see that continuing to go up, so it's not like we believe it has reached the ceiling because the broad labels for GLP-1s and especially for Ozempic yields that there should be more penetration to go for. I think it's natural as we've seen historically also.

Speaker #3: So so if you adjust for for double counting then then out of you know , the treated diabetes patients around close to a third is is now on a GLP one in the US .

Speaker #3: We see that continuing to go up . So it's not like like we believe it has reached the ceiling because the broad labels for for GLP one and especially for Ozempic yields that that there should be more penetration to , to go for .

Speaker #3: But I think it's natural , as we've seen historically , also you see these long product cycles and and then we're building on additional indications .

Carsten: You see these long product cycles and then we're building on additional indications and then we compete, you know, as much as we can with the label we have for Ozempic. I think the real volume opportunity for Ozempic going forward is clearly outside the US where penetration is much lower.

Karsten Munk Knudsen: You see these long product cycles and then we're building on additional indications and then we compete, you know, as much as we can with the label we have for Ozempic. I think the real volume opportunity for Ozempic going forward is clearly outside the US where penetration is much lower.

Speaker #3: And then we then then we compete . You know , as much as we can with the , with the , with the label .

Speaker #3: We have for , for Ozempic . But I think the , the real volume opportunity for going forward is clearly outside the US , where penetration is , is much lower .

Speaker #6: Thanks , Carson . Let's go back to Richard Russell on the first row .

[Company Representative] (Novo Nordisk A S): Thanks, Carsten. Let's go back to Richard Rosser in the first row.

Moderator: Thanks, Carsten. Let's go back to Richard Rosser in the first row.

Speaker #1: Hi , Richard . JP Morgan , you mentioned 3 to 4 million patients treated with GLP one in the US in the obesity market .

Richard Foster: Hi. Richard Vosser, JPMorgan. Ludovic, you mentioned 3 to 4 million patients treated with GLP-1s in the US in the obesity market. Have you done any work on return of patients? Just thinking about, you know, how many patients have been treated in GLP-1 since the start of the obesity market and, you know, whether we're getting returns or patients are just dropping off and never coming back.

Speaker #1: Have you done any work on return of patients just thinking about , you know , how many patients have been treated in GLP one since the start of of the obesity market ?

Speaker #1: And, you know, whether we're getting returns or patients are just dropping off and never coming back.

Speaker #15: Yeah. So I think.

Ludovic Helfgott: Yeah. I think back to the discussions, we're seeing very different patterns of patients, but you can clearly see that the average duration is just an average. It's far more dispersed than what we see. You have patients that are just there for a couple of months. You have patients that already are integrating the fact that it's good for their cardiovascular health to be treated with the GLP-1. These patients are closer to the year. The average per se doesn't mean much. It means even less than any kind of treatment we've been seeing, back to your question earlier on.

Speaker #4: Back to the discussions, we're seeing very different patterns of patients. But we can clearly see that the average duration is just an average.

Speaker #4: It's far more dispersed than what we see . You have patients that are just there for a couple of months . You have patients that already are integrating the fact that it's good for your cardiovascular health to be treated with GLP one , and these patients are closer to the year .

Speaker #4: So the average per se doesn't mean much . It means even less than any kind of treatment . We've been seeing . Back to your question earlier on and what we are increasingly interested in is understand how you can , without portfolio , help the patients manage their treatment , not with one single medicine , but with many , many scenes switching from oral to injectable , from high dose to low dose , from cagrilintide to something else .

Ludovic Helfgott: What we are increasingly interested in is understand how you can with our portfolio help the patients manage their treatment, not with one single medicine, but with many medicines, switching from oral to injectable, from high dose to low dose, from cagrilintide to something else. We have really have a portfolio approach, which will be helpful for us to maintain patients and help them on the long run rather than the short run. Don't look at the average. Look at the dispersion.

Speaker #4: So we have really have a portfolio approach which will be helpful for us to maintain patients and help them on the long run , rather than the short run .

Speaker #4: Don't look at the average , look at the dispersion .

Speaker #6: Thank you . For your time for for a few more , let's go to Sachin .

[Company Representative] (Novo Nordisk A S): Thank you. Ludvig, we have time for a few more. Let's go to Sachin.

Moderator: Thank you. Ludvig, we have time for a few more. Let's go to Sachin.

Speaker #7: Sachin Jain bank of America . Can I take one on Mash ? So I just want to understand where you are on the cadence of launch from your perspective .

Sachin Jain: Sachin, JPMorgan. Can I take one on MASH? I just want to understand where you are on the cadence of launch from your perspective. Approval was a number of months ago. You then launched a sales force. You were talking about access. The CVS deal was supposed to be for MASH, and yet we don't seem to have seen anything. Just to understand your level of optimism and what the unlock from here remains to be given it feels like we've seen not a lot so far, which is, I guess, a little bit surprising.

Speaker #7: So, approval was a number of months ago. You then launched a sales force. You were talking about access; the CVS deal was supposed to be for Mash.

Speaker #7: And yet we don't seem to have seen anything . So just to understand your level of optimism and what the unlock from here remains to be given , it feels like we've seen not a lot so far , which is , I guess a little bit surprising .

Speaker #4: So on the on the on Mash , I think it's really early days and the data we have is really we have a few weeks of data right now .

Ludovic Helfgott: On the MASH, I think it's really early days, and the data we have is really, we have a few weeks of data right now. We can clearly see that there's a good response on MASH from the physicians with whom we are talking, and maybe some of you will be at the SLD at the end of this week, and we can then maybe address that at a later stage. There's good response on semaglutide. I think there is a good response on the endos. We need to continue our work with the GPs referring to the eps, to the hepatologist. It's a growth that is really in its infancy, excuse me.

Speaker #4: We can clearly see that there's a good response on Mash from the physicians with whom we are . We are talking and maybe some of you will be at the at the end of this week , and we can then maybe address that at a later stage .

Speaker #4: There's good response on semaglutide . I think there is a good response on the on the Endos . We need to continue our work with the GPS , referring to the to the apps , to the Hepatologist .

Speaker #4: It's a it's a it's a it's a growth that is really at in its infancy . Excuse me . We also seeing that we have and we are looking at the same frictions from the reimbursement in the world of Mash as the friction we observing undercoverage on the in the world of a and we are equally busy trying to remove these frictions .

Ludovic Helfgott: We're also seeing that we have and we are looking at the same frictions from the reimbursement in the world of MASH as the friction we're observing under coverage in the world of obesity. We are equally busy trying to remove these frictions. Early days, we know a bit more at a later stage, but the first feedback we're from physicians is actually quite promising and they're very sensitive to the quality of the F2, F3 reduction or in steatosis and as well as the safety profile. Last but not least, what's super important to understand for the F2, F3 is that the main cause of morbidity and death is actually cardiovascular disease. The hepatic failures arrive in when you're F4.

Speaker #4: So early days we know a bit more at a later stage , but the first feedback we have from physicians is actually quite promising and very and they're very sensitive to the the quality of the f2-f3 reduction in , in steatosis and as well as the safety profile .

Speaker #4: Last but not least, what's super important to understand for the F2-F3 is that the main cause of morbidity and death is actually cardiovascular disease.

Speaker #4: The hepatic failures arise in F4 in the F2 , F3 , there's an over proportionate number of patients suffering from cardiovascular disease . And this is where again , semaglutide can prove very helpful for these patients versus the other treatments .

Ludovic Helfgott: In the F2, F3, there's an overproportionate number of patients suffering from cardiovascular disease. This is where, again, semaglutide can prove very helpful for these patients versus the other treatments. This is what our medical affairs are being also discussing as we speak.

Speaker #4: And this is what our medical affairs are being also discussing as we speak .

Speaker #6: Thanks . Let's move to Evan and David Evans afterwards .

[Company Representative] (Novo Nordisk A S): Thanks, Bruno. Let's move to Evan and then David Evans afterwards.

Moderator: Thanks, Bruno. Let's move to Evan and then David Evans afterwards.

Speaker #13: Hi Evan . And BMO Capital Markets . So thinking about the potential oral market with Wegovy and a pill or 25 milligram oral Sema , you know , without giving away the secrets , how are you going to commercialize that against the competition from Lilly ?

Evan Seigerman: Hi. Evan Seigerman in BMO Capital Markets. Thinking about the potential oral market with Wegovy and a pill or 25 mg oral sema, you know, without giving all away the secrets, how are you going to commercialize that against the competition from Lilly?

Speaker #15: Okay, back again. Yeah, absolutely.

Ludovic Helfgott: Okay. Back again.

[Company Representative] (Novo Nordisk A S): That's good. That's good, yeah.

Karsten Munk Knudsen: That's good. That's good, yeah.

Speaker #4: Absolutely. So, I think what's super interesting about that market is that we are increasingly convinced that the oral market constitutes, in itself, a significant part of the market.

Ludovic Helfgott: Absolutely. Absolutely. I think what's super interesting with that market is that we are increasingly convinced that the market, the oral market constitutes in itself a significant part of the market. We've been talking about 25, 35, between 25, 35% in the end game. That is really the first thing. The second thing is that we're coming to the market with a product that is actually quite interesting because for the first time, on an oral, you don't have to trade between efficacy and tolerability. Superior in efficacy, we believe, to any competition, superior also in tolerability, and we've just seen data again and again and again coming on the other forms of oral GLP-1. You're coming here with a drug that doesn't force you to compromise between efficacy and tolerability. It's quite unique.

Speaker #4: We've been talking about . 2535 between 2,535% . And in the end game . So that is really the first thing . The second thing is that we're coming to the market with a product that is actually quite interesting because for the first time on an oral , you don't have to trade between efficacy and tolerability superior in efficacy , we believe , to any competition .

Speaker #4: Superior . Also , interoperability . And we've just seen data again and again and again coming on the on the other forms of oral glp1 .

Speaker #4: So you're coming here with a drug that doesn't force you to compromise between efficacy and tolerability . And it's quite unique . It's the first time ever it's happening .

Ludovic Helfgott: It's the first time ever it's happening. In the case of the diabetes, it was not the case. The benefits are actually quite interesting. Last but not least, the whole arsenal that our US colleagues are preparing right now from a channel of distribution across all channels available, the ability to work on all the typical levers of a promotion as well as the more individual level of promotion is really pushed full throttle. You have a full throttle package across the traditional and less traditional channels. You have a product profile that is, for the first time, not having to trade off between efficacy and tolerability. You have a significant part of the market. Three ingredients why we believe it can really make a difference. Not even forgetting what I just earlier...

Speaker #4: In the case of diabetes , it was not the case . So the benefits are actually quite interesting . Last but not least , the whole arsenal that our US colleagues are preparing right now from a channel of distribution across all channels available .

Speaker #4: The ability to work on all . The typical levers of of promotion , as well as the more individualized of promotion , is really push full throttle .

Speaker #4: So you have a full throttle package across the traditional and less traditional channels . You have a product profile that is , for the first time , not having to trade off between efficacy and and , and that's and you have a significant part of the market .

Speaker #4: Three ingredients why we believe it can really make a difference . Not even forgetting what I just earlier alluded to , which is the ability to put that oral in the widest portfolio , and having people potentially going from injectable to oral or vice versa , depending on what they want .

Ludovic Helfgott: has alluded to, which is the ability to put that oral in the widest portfolio, and having people potentially going from injectable to oral or vice versa, depending on what they want.

Speaker #6: Good. Let's move to David Evans, and afterwards we'll take whoever has a question for Martin on R&D.

[Company Representative] (Novo Nordisk A S): Good. Let's move to David Evans. Afterwards, we'll take whoever has a question for Martin on R&D.

Moderator: Good. Let's move to David Evans. Afterwards, we'll take whoever has a question for Martin on R&D.

Speaker #15: Sorry , thanks .

Ludovic Helfgott: Sorry.

David Evans: Thanks. David Evans from Kepler Cheuvreux. I was about to ask about oral semaglutide launch also. I mean, given that there are tens of millions of overweight people in the US who just won't use an injection, do you sense that markets' investors you speak to are overly cautious on the opportunity near term, even in the next couple of years, for oral semaglutide? I mean, if you could just reiterate or clarify, you definitely won't have any supply limitations. Or if you could talk through, you know, are there any other reasons we should be a little bit cautious? Because it seems like a game-changing opportunity to me. Thanks.

Speaker #18: David Evans from Kepler . Just I was about to ask about oral launch . Also . I mean , given that there are tens of millions of overweight people in the US who just won't use an injection , do you do you sense that markets in investors you speak to are overly cautious on the opportunity near term , even in the next couple of years , for oral semma , I mean , if you could just reiterate or clarify , you definitely won't have any supply limitations or if you could talk through , you know , are there any other reasons we should be a little bit cautious ?

Speaker #18: Because it seems like a game changing opportunity to me . So thanks .

Speaker #4: So, we believe that there is a significant part of the market, as you said, that will be sensitive to oral for many reasons.

Ludovic Helfgott: We believe that there's a significant part of the market, as you said, that will be sensitive to all for many reasons. It's not just the convenience of a pill versus an injection. If we've been working really super deep on the various segments of the market that could be entered by oral, and the motivations can be very different. They can range from, indeed, I don't like injections, but more importantly, getting a pill is, for me, I don't feel sick. I want to regain functionality, but I don't feel necessarily sick. For these patients, and we have significant groups of patients that are entering these characteristics, the oral is actually a good argument.

Speaker #4: And it's not just a convenience of a pill versus an injection . If we are , we've been working really super deep on the various segments of the market that could be interested by oral and the motivations can be very different .

Speaker #4: They can range from indeed , I don't like injections , but more importantly , getting getting a pill is for me . I don't feel sick .

Speaker #4: I want to regain functionality , but I don't feel necessarily sick . And for this patients and we have significant groups of patients that are answering these characteristics , they're all is actually a good a good argument .

Speaker #4: So we believe we strongly believe that this will be a key way to unlock the market and move beyond the three 4 million we were discussing beforehand what we also know is that each group has its own behaviors , characteristics , way to get to the obesity medicines motivations .

Ludovic Helfgott: We believe, we strongly believe that this will be a key way to unlock the market and move beyond the $3-4 million we were discussing beforehand. What we also know is that each group has its own behaviors, characteristics, way to get to the obesity medicines, motivations. It has to be, it will be gradual, we know, and that is why we believe that you cannot, you don't unlock a market snapping fingers. By the way, this is why the injectable market right now is still in its infancy.

Speaker #4: So it has to be gradual. We know, and that is why we believe that you do not unlock a market by snapping your fingers.

Speaker #4: By the way , this is why the injectable market right now is still in its infancy . But with the oral and different messaging for different kind of populations , including on comorbidities .

Ludovic Helfgott: With the oral and different messaging for different kind of populations, including on the comorbidities, by the way, we can definitely move to propose the oral to different groups that will be in a staged manner, we believe, not in one single go, based on what we've seen in the injectable market. Opportunity, yes, and progressively unlocking.

Speaker #4: By the way, we can definitely move to a proposal. The oral presentations will be to different groups in a staged manner.

Speaker #4: We believe not in one single go based on what we've seen in the injectable market . So opportunity . Yes . And progressively unlocking .

Speaker #6: Good . Let's move to James . Once again . And then after that , a final question .

[Company Representative] (Novo Nordisk A S): Good. Let's move to James once again. Then after that, a final question.

Moderator: Good. Let's move to James once again. Then after that, a final question.

Speaker #8: Great . Thank you , James . Quickly for so Martin Ziltivekimab , you mentioned that yesterday and it mentioned again today . So could you characterize your expectations here .

James Gordon: Great. Thank you. James Quigley from Sachs. Martin, ziltivekimab, you mentioned that yesterday, and it got mentioned again today. Could you characterize your expectations here? What are you looking for in terms of a clinically meaningful benefit in the ASCVD population? There are a number of other indications as well, so heart failure and in post-heart attack patients. Are there any of the three indications that are more dependent on IL-6 reduction and in-inflammation reduction, and therefore, you're more excited or more cautious on across those-

James Quigley: Great. Thank you. James Quigley from Sachs. Martin, ziltivekimab, you mentioned that yesterday, and it got mentioned again today. Could you characterize your expectations here? What are you looking for in terms of a clinically meaningful benefit in the ASCVD population? There are a number of other indications as well, so heart failure and in post-heart attack patients. Are there any of the three indications that are more dependent on IL-6 reduction and in-inflammation reduction, and therefore, you're more excited or more cautious on across those-

Speaker #8: What are you looking for in terms of a clinically meaningful benefit in the Ascvd population . And there are a number of other indications as well .

Speaker #8: So heart failure and in Post-heart attack patients . So are there any of the three indications that are more dependent on on IL six production and inflammation reduction .

Speaker #8: And therefore you're more excited or more more cautious on across those indications ?

Martin: First I have to say in the space of ASCVD and inflammation, we are still in the exploratory phases. There have been one or two studies documenting that reducing inflammation in these patients improved outcomes actually quite dramatically, but they were also associated with some unacceptable side effects and therefore not pursued further. We do believe that ziltivekimab has the potential to not only reduce inflammation, but also doing that in a safe way. Given that we are building those assumptions based on albeit quite substantial phase 2 data, we are still assuming a risk first in ASCVD, subsequently in heart failure with preserved ejection fraction, and finally in MI.

Speaker #15: Yeah .

Speaker #5: So first I have to say in the space of ascvd and inflammation , we are still in the exploratory phase . There have been 1 or 2 studies documenting that reducing inflammation in these patients improved outcomes .

Karsten Munk Knudsen: First I have to say in the space of ASCVD and inflammation, we are still in the exploratory phases. There have been one or two studies documenting that reducing inflammation in these patients improved outcomes actually quite dramatically, but they were also associated with some unacceptable side effects and therefore not pursued further. We do believe that ziltivekimab has the potential to not only reduce inflammation, but also doing that in a safe way. Given that we are building those assumptions based on albeit quite substantial phase 2 data, we are still assuming a risk first in ASCVD, subsequently in heart failure with preserved ejection fraction, and finally in MI.

Speaker #5: Actually quite dramatically . But there were also associated with some unacceptable side effects and therefore not pursued further . We do believe that has the potential to not only reduce inflammation , but also doing that in a safe way .

Speaker #5: But given that we are building those assumptions based on, albeit quite substantial phase two data, we are still assuming a risk.

Speaker #5: First , in a CV , subsequently , in heart failure with preserved ejection fraction , and finally in MI if if I am without going into numbers again , we see this as reasonably high risk .

Martin: If I am without going into numbers again, we see this as reasonably high risk, but also in a very high unmet need space, high reward for the patients. From a probability of success perspective, I think as more data established that intervening and reducing inflammation in ASCVD will impact outcomes, slightly less with heart failure with preserved ejection fraction. In the MI space, it's right now primarily correlations, but very substantial correlations that prompt us to believe that there is something here. There is uncertainty both on the efficacy side in all three spaces, and obviously we also have to establish safety and tolerability.

Karsten Munk Knudsen: If I am without going into numbers again, we see this as reasonably high risk, but also in a very high unmet need space, high reward for the patients. From a probability of success perspective, I think as more data established that intervening and reducing inflammation in ASCVD will impact outcomes, slightly less with heart failure with preserved ejection fraction. In the MI space, it's right now primarily correlations, but very substantial correlations that prompt us to believe that there is something here. There is uncertainty both on the efficacy side in all three spaces, and obviously we also have to establish safety and tolerability.

Speaker #5: But also in a very, very high unmet need space, there is a high reward for the patients from a probability of success perspective. I think there's more data established that intervening and reducing inflammation in ASCVD will impact outcomes slightly less with heart failure with preserved ejection fraction.

Speaker #5: And in the MI space , it right now primarily correlations , but very substantial correlations that prompt us , prompt us to believe that there is something here , but there is uncertainty both on the efficacy side in all free spaces .

Speaker #5: And obviously we also have to establish safety and tolerability . I would say with the number of patients that we have exposed at this point in time , and given that that all studies are monitored by DMC , I'm becoming more hopeful .

Martin: I would say with the number of patients that we have exposed at this point in time, and given that all studies are monitored by a DMC, I'm becoming more hopeful. I don't want to say confident, but more hopeful on the safety and tolerability side. Obviously everything has to pan out and it would be a first in class proposition.

Karsten Munk Knudsen: I would say with the number of patients that we have exposed at this point in time, and given that all studies are monitored by a DMC, I'm becoming more hopeful. I don't want to say confident, but more hopeful on the safety and tolerability side. Obviously everything has to pan out and it would be a first in class proposition.

Speaker #5: I don't want to say confident , but more hopeful on the safety and tolerability side . But obviously everything has to pan out and it would be a first in class proposition .

Speaker #6: Good . Thanks , Martin . Final question from Simon before I'll give it to Carsten to round off .

[Company Representative] (Novo Nordisk A S): Good. Thanks, Martin. Final question from Simon before I'll give it to Carsten to round off.

Moderator: Good. Thanks, Martin. Final question from Simon before I'll give it to Carsten to round off.

Speaker #9: Thank you Simon , back from Redburn . Just going back to the question , I tried to sneak past the regulator earlier in terms of the differences in duration of therapy in the consumer channel .

Simon Baker: Thank you. Simon Baker from Rothschild & Co Redburn. Just going back to the question I tried to sneak past the regulator earlier, in terms of the differences in duration of therapy in the consumer channel, and what does that extra duration look like? Is this people on maintenance dose, lower dose, more frequent dose spacing? Because it either way, it all feels like volume that we're not assuming or haven't assumed. Thank you.

Speaker #9: And what does that extra duration look like ? Is this people on maintenance dose , lower dose , more , more frequent dose spacing .

Speaker #9: Because either way, it all feels like volume that we're not assuming or haven't assumed.

Speaker #15: Thank you .

Speaker #4: Two things on this one . Two factors . The first one is that many of the direct channels are actually also offering different subscription models , which means that when you it's like a subscription , you buy your drugs for a year or so .

Ludovic Helfgott: Two things on this one. Two factors. The first one is that many of the direct channels are actually also offering different subscription models, which means that when you like a subscription, you buy your drugs for a year or so, in which means that by definition, there's a natural sort of a loyalty reward if you stay longer on therapy. It's a way of actually pricing the medicine that is influencing this. The second one is back to your question regarding the average. Don't look at the average, look at the dispersion. You have people that are very convinced of the value long term that are already integrating the cardiovascular health element or the kidney health element. Others are more volatile in nature. That's what you said earlier in the first place. Please don't look at the average.

Speaker #4: And which means that by definition , there's a natural sort of a loyalty reward if you stay longer on therapy . So it's a way of actually pricing the medicine that is influencing this .

Speaker #4: The second one is back to to your question regarding the average , don't look at the average . Look at the dispersion . You have people that are very convinced of the value long term that are already integrating the cardiovascular health element or the kidney health element .

Speaker #4: Others are more volatile in nature . That's what you said earlier in the first place . So please don't look at the average .

Speaker #4: Look at the at the dispersion . And when you look at the overall direct look at the way people are actually purchasing their medicine .

Ludovic Helfgott: Look at the dispersion. When you look at the overall direct look at the way people are actually purchasing their medicine. All in all, that tells one thing. We need to be able to cater for the needs of the patient on the lifetime, not just in one go. That is definitely one of the things we are pushing and one of the big value adding your portfolio.

Speaker #4: All in all , that tells one thing we need to be able to cater for the needs of the patients on the lifetime , not just in one go .

Speaker #4: And that is definitely one of the things we are pushing . And one of the big value of having a portfolio .

Speaker #6: Thank you, Ludvig. I'll hand over to you to round off.

[Company Representative] (Novo Nordisk A S): Thank you, Ludovic. I'll hand over to the word to you, Carsten, to round off.

Moderator: Thank you, Ludovic. I'll hand over to the word to you, Carsten, to round off.

Speaker #3: Yeah , absolutely . So so thank you for attending our Q3 London launch Roadshow meeting . Great questions . Great great dialogue . We'll stay around for for some additional minutes for for some subsequent Q&A .

Martin: Yeah, absolutely. Thank you for attending our Novo Nordisk Q3 London launch roadshow meeting. Great questions, great dialogue. We'll stay around for some additional minutes for some subsequent Q&A. As you can note, then the company has gone into a different phase after some years of hypergrowth, then growth has decelerated. The important notion is, we have a plan both in the short term really to execute on commercially launching the Wegovy pill in the US as one of the key levers. I would say the next 12 months, a number of attractive pipeline milestones and read out so much more to come in terms of driving future growth for the corporation. Thank you for attending.

Karsten Munk Knudsen: Yeah, absolutely. Thank you for attending our Novo Nordisk Q3 London launch roadshow meeting. Great questions, great dialogue. We'll stay around for some additional minutes for some subsequent Q&A. As you can note, then the company has gone into a different phase after some years of hypergrowth, then growth has decelerated. The important notion is, we have a plan both in the short term really to execute on commercially launching the Wegovy pill in the US as one of the key levers. I would say the next 12 months, a number of attractive pipeline milestones and read out so much more to come in terms of driving future growth for the corporation. Thank you for attending.

Speaker #3: As you can note . Then then the company has gone into a different phase . After some years of hypergrowth then growth has decelerated .

Speaker #3: The important notion is we have a plan , both in the short term , really to execute on on commercially launching the Gobi pill in in the US as one of the key levers and then I would say the next 12 months , a number of attractive pipeline milestones and readouts .

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