Earnings call transcript: Novo Nordisk Q2 2025 shows strong growth

Novo Nordisk reported robust financial results for the first half of 2024, with significant growth in both revenue and operating profit. The company highlighted its strategic advancements in product development and market reach during its Q2 2025 earnings call.

Key Takeaways

• Novo Nordisk achieved 18% top-line growth at constant exchange rates in H1 2024.
• Operating profit soared by 29%, reflecting strong operational efficiency.
• The company revised its full-year sales growth guidance to 8-14%.
• Novo Nordisk is preparing to launch oral semaglutide for obesity in the U.S. by early 2026.
• The company now serves 45 million patients globally, expanding its reach by 3 million year-over-year.

Company Performance

Novo Nordisk continues to demonstrate strong performance, driven by its innovative product pipeline and strategic market positioning. The company reported an 18% increase in revenue at constant exchange rates for the first half of 2024 and a 29% rise in operating profit. This growth is attributed to the successful expansion of its patient base and the introduction of new products in the market. The company has maintained a 71% volume market share in key markets, showcasing its competitive strength.

Financial Highlights

• Revenue: 18% growth at constant exchange rates in H1 2024
• Operating profit: 29% increase
• Free cash flow: DKK 34 billion, fully returned to shareholders

Outlook & Guidance

Novo Nordisk has revised its full-year sales growth guidance to 8-14% and operating profit growth to 10-16%. The company is focused on launching its oral semaglutide for obesity in the U.S. by early 2026 and is preparing for the NASH launch with a dedicated sales force. Novo Nordisk anticipates a low single-digit top-line impact from the loss of exclusivity in 2026 but remains optimistic about its product pipeline and market expansion strategies.

Executive Commentary

Carsten Mukhnumsen, CFO, emphasized the company’s extensive reach, stating, "We’re serving more than forty-five million patients." Dave, U.S. President, highlighted the competitive advantage of their product offerings, noting, "We have a product with meaningful weight loss with a known compound." These statements underscore Novo Nordisk’s commitment to innovation and market leadership.

Risks and Challenges

• Competitive pressures in the U.S. obesity market and the slowing growth of the GLP-1 diabetes market could impact future performance.
• The compounding market, estimated at 30% (approximately 1 million patients), poses a challenge.
• The potential loss of exclusivity in 2026 may affect revenue streams.
• International markets represent 90% of global unmet needs, requiring strategic expansion efforts.
• The company is approaching peak capital expenditure, which may affect financial flexibility after 2024-2025.

Novo Nordisk’s strategic focus on product innovation and market expansion positions it well for future growth, despite the competitive challenges and potential risks ahead.

Full transcript - Novo Tellus Alpha Acquisition (NOVO) Q2 2025:

James Quigley, European Pharma Analyst, Goldman Sachs: Welcome everybody. I’m James Quigley, European Pharma Analyst here at Goldman Sachs. It’s my pleasure to welcome you to Novo’s Second Quarter Results Presentation. Today, we’ve got Carsten Mukhnumsen, CFO also joined by Marcin Langer, our Chief Scientific Officer who is going to say more, Head of North American Operations and Head of Product and Portfolio Strategy. Karsten is going to kick off as usual with presentation and then we’ll go straight to the Q and

Carsten Mukhnumsen, CFO, Novo Nordisk: Thank you, James, and welcome to the Novo Nordisk Q2 results meeting here in London, the launch meeting. Thank you all for coming, and thank you to the ones listening in online. So we have a good team here. So again, we have Martin Lange in his first day as CSO of Novo Nordisk. So congratulations to you, Martin, on the I queue on that think a good timing of becoming CSO.

We’ll talk more about that later. And then Dave Moore from The U. S, a known person, so President of our U. S. Business and Ludwig from running Commercial Strategy and our Portfolio Planning.

So we have we’re going to go through our results briefly, and then we’re going to host the Q and A session moderated by Jakob Roel, our Head of Investor Relations. So as always, then there will be forward looking statements discussed today. And forward looking statements, they are associated with risks and assumptions. Unfortunately, that’s also what we saw last week with our downgrade because we made some assumptions that unfortunately didn’t fully pan through, and that’s why we had to downgrade our outlook for the year that I’m sure we’ll come back to. So talking about the results in the first half of the year in our through our strategic aspirations, I would say, we continue to expand our patient reach.

And I think this is really the core of Novo Nordisk driving change for patients suffering from serious chronic disease, progressive diseases within diabetes and obesity. And now we’re serving more than forty five million patients. We added more than three million patients compared to a year ago. So it speaks to the scaling of our business and also the future prospects of what we are operating under. On the commercial side, my colleagues will come into it and the same for R and D and financials.

We delivered 18% top line growth at constant exchange rates in the first half of the year and 29% operating profit growth in the first half. Operating profit impacted by an impairment in the first half of last year and then some additional costs due to M and A and Catalent this year. So net net operating profit underlying is closer to the 20% growth, but still very healthy operating profit growth. And in terms of cash flow generation, that’s, of course, a key premise for the company. We generated almost DKK 34,000,000,000 in free cash flow despite investing DKK 28,000,000,000 in CapEx in the first half of the year.

And we returned also more or less our full free cash flow to shareholders here in the first half of the year. So a disciplined approach on capital allocation. Then I’ll hand it over to Ludo for Very commercial

Ludo, Commercial Strategy, Novo Nordisk: quickly. From a sales perspective, the region U. S. Actually grew 17% in the first part of the year and the IO grew 19%, which is an overall 18% growth for Novo Nordisk in the first half of the year. If you look at the IO in particular, really double digit growth on UK and Emerging Markets and APAC and a 6% in China.

I’m sure we might come back to that at a later stage. From a therapeutic area perspective, you can clearly grow an 18% overall growth logically GLP-one diabetes plus 10% the obesity care fifty eight percent and the rare disease actually back to growth with a fifteen percent growth rate across the board. Of course with Dave here we can delve a bit more into that I guess at some point. If you look from an IO perspective, the international operations growth, so nineteen percent driven by the GLP-one diabetes and obesity care. You had this overall GLP-one diabetes care sales growth of ten percent, I said, with double digits in UK and Emerging Market and APAC and this decrease in China, which is driven by the market itself.

It’s not a competition issue. It’s actually a market expansion discussion. We might want to talk about that at a later stage. On the obesity side, in IOU, a growth of one hundred and twenty five percent versus last first semester in 2024. U Can 64%, Emerging market one hundred fifty seven and then three sixty one percent for APAC.

China is growing a lot, but of course out of a small base. Mathematically, it doesn’t make much sense, but really a healthy growth on obesity care in sales and growth for the first six months in IO. And then, to you, Dave, for The U. S.

Dave, President of US Business, Novo Nordisk: Thanks, Ludo. So, when we think about the obesity market in The U. S, everyone knows we’re in a competitive environment. We’re in a competitive environment with Lilly. We’ll talk a little bit about that.

We’re also in a competitive environment with fake, cheaper alternative of our medicine that’s being imported by China, which we are keenly focused on, putting an end to that so we go back to competing in the branded obesity market. So, if you think about the dynamics in the branded market, this is what we typically see when you have the lead, the first mover position, another product comes in. It’s an easier position to be in to go into the doctor and say, Switch to my product. Start new patients on my product. By the way, I experienced the same thing when I launched Ozempic versus Trulicity and it works, and that’s the dynamic that we had.

And what we learned in the beginning of the year, I took this job over in January, there was a shift last year just in terms of messaging. It actually makes sense. You have select data. It’s compelling. It’s meaningful clinical data, real world outcomes, and you switch the message to be beyond weight.

That was actually the name of the campaign, treat beyond the weight. What we learned is it’s a little premature to do that. There probably will be a time to do that, and there’s a meaningful discussion to have around comorbidities, but there’s two players in the game and it’s still about weight loss. That’s the primary reason for prescribing is around weight loss. It’s what patients are looking for.

It’s what doctors are looking for. We changed that message in June to go back to driving the weight loss competitive message. We have real world data that is head to head versus tirzepatide and semaglutide. We have semaglutide data where we follow patients for two years and we see the average weight loss is 20%. Actually, it just got updated to 21 because we continue to follow these patients in the We Go Together campaign.

That’s starting to resonate again. We’re starting to see the impact of having that weight loss message. Once we solidify that competitively, then you move on to the other elements, right? And you have a discussion about aspects. The And so, what we’re starting to see is a shift in NBRxs.

NBRxs is our sign of health. It’s the leading indicator. How’s your brand doing? And from about May 2024, April 2024 to May 2025, the NBRxs of Agovy were going down. That’s a bad indicator of your health of your brand.

We’re still growing. The market’s growing. You can see there’s growth, but the NBRxs were going down. In May, that has stopped and we’re starting to see growth. We’re seeing growth with Wegovy competitively, especially versus devices.

Nationally, NBRx of Wegovy device passed Zepbound device, and that is in part due to CVS conversion, but that’s not all of it. It’s also that we’re seeing growth outside of the CVS conversion. So, we will continue in this competitive dynamic. We now have an opportunity to go out and talk about a difference in CVOT outcomes. Once again, we saw outcomes last week with the SURPASS data, and our reps are armed to go in and say that this is not a class effect.

It’s very easy to walk in and say, You know, we have a little bit better data. And by the way, it’s a class effect. They’ll all be the same. It is not. They’re not the same.

12% is not 26%. So, that’s a conversation with Ozempic and also a conversation with Wegovy. Moving forward, in weeks, we’ll launch NASH. NASH is a primary indication, one that entire companies have been built upon, and we have an opportunity to go out and differentiate Wegovy further in terms of that strength of the label and go out and start selling, in the MASH market. We have a dedicated sales force, small.

We’ve hired about 130 people. They’ll call on hepatologists and GIs. There’s only about 300 hepatologists in The U. S. And we’ll focus on about 15,000 gastroenterologists, and our obesity sales reps will be armed with the NASH launch.

Remember, it’s about eighty percent overlap with obesity, forty percent overlap with type two diabetes. We’re not waving any victory flags. We’ve got a long way to go, but this is a growth story. It’s an expansion of the obesity market story, And in the beginning of the year, we’ll be launching oral

Martin, Chief Scientific Officer, Novo Nordisk: semaglutide for obesity in U. S. Earlier this year. We expect to see an approval of that filing at the towards the end of this year with a strong U. S.

Launch starting 2026. Just to remind you of the data, with oral semaglutide and obesity, we saw a sixteen percent weight loss, almost seventeen percent weight loss with the safety and tolerability profile that we already know very well from semaglutide subcutaneously, so we’re actually able to achieve the same weight loss, the same safety and tolerability orally as we do That’s very, very strong, and again, percent weight loss, we think that is going to be all unsurpassed for a long period of time. In addition to that, and this is a potential, we aim to have the comorbidity benefits in the label starting with the MACE benefits that we know well from subcutaneous semaglutide. So a really, really exciting offering in the obesity space to be launched in The U. S.

By David and his team early twenty twenty six. Broader in the R and D space, obviously, you know our focus on diabetes and obesity. We also have other therapy areas and we see progress and activities across the board. Obviously, in the diabetes space, it’s going to be very exciting to see what CACRESMA could do in Reimagine III, I. E.

Glycemic control and weight loss in patients with type two diabetes for CAQUOTESMA. It’s going to be very interesting to see the Phase II data for amicretin also in the diabetes space. In the obesity space, we continue to progress. We aim to have a seven point two milligram EU submission already here in Q3. We aim to see the readout of our triple agonist and importantly, we’ll initiate the caquilin site in monotherapy Phase three program also later this year.

That’s going to be incredibly exciting in the diabetes and obesity space. I would be remiss. Ludovig is no longer so interested in rare disease, but I still had to mention U. S. Approval and positive CHMP opinion for LHEMO and imminent regulatory filing of MiMATE, And then obviously in other disease areas we closed down salfermin, not because it was a bad offering, it was just not better than semaglutide.

And as you know right now we have at least in the Phase III space the strongest data in NASH and as Dave mentioned, we expect regulatory approval for that in U. S. Within a couple of months. Finally, obviously the evoked data, I have to remind you we see that as high risk, high reward, But the readout will come towards the end of the year in Q4 and obviously going to be exciting. And with that, back to you, Carsten.

Carsten Mukhnumsen, CFO, Novo Nordisk: Great. Thank you, Martin. Then on outlook, which we announced last week. So we lowered our outlook linked to predominantly a lower volume growth in The U. S.

Compared to what we expected back at our Q1 release. So lower volume outlook for Ozempic and VIGOVI. Dave was just just touching on that we do see positive signs on VIGOVY now over the last few weeks and data points. So sales growth outlook now 8% to 14% for the full year and operating profit 10% to 16% for the full year. Currency is updated based on July 31, so a slight tweak compared to last week.

So now three and five percentage points lower respectively, mainly linked to the U. S. Dollar. And the corresponding adjustment to net financials linked to the hedging of our core currencies. CapEx unchanged, while free cash flow is reduced to between DKK 35,000,000,000 and 45,000,000,000, mainly as a function of the lowest U.

S. Outlook amplified by the gross to net payment term in that model. So that’s really what drives the cash flow delta compared to the Q1 guidance. A few comments around cash flow in the second half of the year versus what we realized in the first half of the year. And the simple explanation is really twofold.

One is higher CapEx spend in the second half of the year compared to the first half of the year. And the second reason is that on account tax payments, mainly in Denmark, is back end loaded into the second half of the year compared to the first half of the year. Adjusting for that, it’s way more normalized in terms of cash flow generation across the year. So that covers the financial outlook. And now we’re ready to move over to Q and A.

So over to you, Jager. Thank you, Carsten.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Thank you, Dave, Ludo and Martin. And we play by the usual ground rules. So one question per person, please. Please state your name and institution, and we start with James, our host.

James Quigley, European Pharma Analyst, Goldman Sachs: Excellent. Thank you, Jacob. James Creedy from Goldman Sachs. So a quick question, Martin, on orfagliophone Phase III data from ATAME-one has just been released. So the placebo adjusted weight loss of around 11.5% at seventy two weeks, 24% vomiting, 10% discontinuations at the highest dose.

So what is your view on the products relative to Wegovy and to oral sema twenty five milligrams? And then Dave and Ludwig, you had a good slide in the back of the presentation yesterday on the segmentation of the market. Does this data change how you think the competition will develop in those segments? Thank you.

Martin, Chief Scientific Officer, Novo Nordisk: So I think the number speaks for themselves. If we were to compare 17% weight loss to 12% weight loss, withdrawal rate due to adverse event on the highest dose of ten percent versus seven percent, overall withdrawal rate on the highest dose twenty five percent, which was I think eighteen for somataglutide twenty five milligram, it speaks for itself. It appears that and again, it’s an indirect comparison. There is a substantial difference in weight loss potential, but also in the safety and tolerability profile between the two offerings. At the same time, we can scale oral semaglutide and therefore I think it’s fair to say we’re super excited about launching that product in a competitive space.

Dave, President of US Business, Novo Nordisk: We’re really excited to launch this product. This is a good old fashioned Novo Nordisk launch where we have a competitive compelling profile. The reason we decided to move forward with this launch regardless of Orfo was because we had a product with meaningful weight loss with a known compound and familiarity and safety in millions of people using this worldwide in addition to, the broadest label. That’s the reason we decided to bring it forward. We know what 16%, 17% weight loss means, and I think what we’re really excited about is this sort of segments of the market that are not motivated to go and seek treatment today, either because of the way they see their disease or they’re not motivated to go and seek a medicine that would require an injection.

There is another segment of people out there living with obesity, that are very interested in an oral daily GLP-one, and we’re going to, treat it that way in an unconstrained type of launch in The U. S.

Ludo, Commercial Strategy, Novo Nordisk: And if you take a step back at the whole idea that we shared, which is this idea that you don’t have one single population of people with obesity, but actually sub segments of them can only be reinforced by that view. We don’t believe that if anything, we believe that the share of the oral market will actually grow significantly given the quality of what you have here, efficacy wise, tolerability wise and including with the cardiovascular benefits, we can really bang that into the profile. And that will be very helpful to start unlocking all these groups of segments that are today not really already getting to the obesity market, but we’ll get there. And we start to have quite precise ideas of who these groups could be. So in other words, we believe in the oral part of the market.

We believe that the RigorVP is actually has the potential to be best in class there right now given the data that we saw this morning, and we have a trust that we can really do a super launch in The U. S.

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes, thank you. I mean,

Dave, President of US Business, Novo Nordisk: we’re going to team up pretty well as we start putting these things together. You can already imagine the type of DTC I’m thinking about. I’m a pretty simple sales and marketing guy. When you can say your product is better, things usually happen in the marketplace, and at least from what we’ve seen in the first generation oral small molecule, taking the lead from our CSO, we made a good move in terms of thinking about oral semaphore obesity, and it was a good call.

Ludo, Commercial Strategy, Novo Nordisk: Building on that and to finish up your question, it’s not only good for the oral market, it’s also good because you’re increasingly seeing that the patients will have a journey towards obesity. They might start with an oral and get to injectable. They might start with injectable and get to an oral. So it’s not just the subgroup themselves you are opening. It’s actually the full lifetime value of a patient you can actually multiply by having several different offerings of high quality, which is the one we believe we are bringing to patients today.

It’s a double whammy in a sense for us.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Brilliant. Wonderful. Let’s move to the front table here, Thibault first, then we’ll go to Simon Peck afterwards.

Speaker 6: Thank you. Actually, just a clarification from Martin on single chamber. I think you mentioned yesterday you need to run a clinical equivalent study. Can you just help us a bit with the timeline when you think you can start this study? How long it would take?

What does the submission process look like for this type of study? And I guess, I mean, the reason I ask this question is just to sort of compare the timeline for Calculation single chamber with amiclatin subcut Because if they get closed, how do you think of one versus the other?

Jakob Roel, Head of Investor Relations, Novo Nordisk: Maybe you do on the timelines afterwards, then Lulu, you can do on MicroTenz versus Calcasimha.

Martin, Chief Scientific Officer, Novo Nordisk: So absolutely. And obviously, we see a benefit in terms of supply flexibility to have the single chamber. I do want to call out, we are scaling to have a very strong launch with the dual chamber device, but it will give us that flexibility. It’s an upside if we can do it. And I had to do the clinical equivalent study.

It’s going to be smaller and shorter than what you would conventionally think with a Phase III study. So we just had to show similar weight loss and trajectory weight loss and similar safety and tolerability profile. We intend to initiate the study around the turn of the year, and I won’t go further into the time lines.

Jakob Roel, Head of Investor Relations, Novo Nordisk: And on having multiple treatments in the market, Ludo?

Carsten Mukhnumsen, CFO, Novo Nordisk: Again, I

Ludo, Commercial Strategy, Novo Nordisk: think the whole is bringing the diversity to the different patient populations and we really believe in the value and efficacy and to end safety profile of amikritin. By the way, we have the injectable, we have the oral as well, which is not the case for karystomast. Again, you’re offering to the patients a portfolio of options that are really based on helping them adapting the treatments to what they really need and the associated comorbidities. Because for me, what’s really interesting beyond the formats is the kind of programs we’re designing. And I’m sure that Martin will come to that later on.

But the idea is to replicate from a scientific perspective the diversity of patients that you find in the market and enriching the AMACE program, as an example, with sub studies on which we are going to study the very specific needed endpoints, sleep apnea, talk of osteoarthritis, we talk to other benefits that we will enrich the program with. So for me, it’s not just a formal discussion, it’s the ability to answer the wait first, because we won’t do the same effect twice, wait first, and then the comorbidities that are associated with the various subpopulations we’re targeting.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Very good. Thanks a lot, both. Let’s go to Simon then, and onwards to Harry afterwards.

Speaker 7: You. Simon Baker from Rothschild and Co Redburn. Let’s go back to the market as it stands today. You are seeing encouraging upticks in NBRx, but you still got the problem of compounding, which you said is pretty much unchanged. So can you give us some sort of help in thinking what is a reasonable timeframe over which to expect that to change?

I know it’s a difficult thing to ask, but if things go as planned, would we expect this to be meaningfully low in ’26 or ’27? How long do you or indeed ’25? How long would it take to have an impact there? And related to that, it doesn’t look like you filed a Section three thirty seven complaint with the International Trade Commission to block infringing API coming into the state. Is that true?

And if not, do you plan to do so? If so, when? Thank you.

Dave, President of US Business, Novo Nordisk: Yeah. I may let Carson answer kind of any legal action or comments, but let me focus on U. S. And enforcement right now. We have not seen a meaningful change in the compounding in The U.

S. After May 22, which is when compounding became illegal again, except for rare circumstances, which is a grace period after, being removed from the drug shortage list. We have seen some change in the dynamics in terms of moving from 503B to 503A, kind of the who is compounding, and kind of moving towards a more mass personalization versus just mass production and compounding. We haven’t seen a change in where it’s coming from, Simon. We track it.

We see it. Most of it’s coming in from China, largely from plants that are not approved. Certainly, the methodology is not approved in terms of the way that they’re producing synthetic API, fake synthetic, and the way that it’s coming into the country, and it’s coming in in containers that says, Not for human use, for research purposes only, right? That is where we’re in active dialogue right now with FDA, and we’re having meaningful dialogue. You can imagine we’ve been having conversations for a couple of years, right, since we were put on the shortage list and we saw this compounding.

That dialogue has changed to be productive, to be responsive. I can’t put a date like in terms of when we’re going to see something. We do have expectations. We do have timelines we discuss with them unless it’s going to escalate, on our end to further action. In terms of how fast does it go away, it’s a little bit difficult to say.

The most important thing for us is to get enforcement and to stop the fake API from coming in. Then we can go into our next order of execution in combating, this and bringing it back to what is the rule letter of the law, and it’s for rare circumstances. It’s not launching a dose that’s not even approved in a mass marketing way. And that’s what we’re really focused on stopping.

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes. So and just covering, the second part of the question around ITC, that’s correct. I would say that building on Dave’s comments that all options are on the table. So now, we’re the commercial messaging, and the public affairs angle to it, the regulator dialogue and of course, the litigation pathway on several avenues. So we have we are all in on both capabilities, advisers, etcetera, to have all options on the table.

And then we find the best way forward. And for obvious reasons, we cannot comment on yet non disclosed litigations.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Very good. Thanks. Let’s move to Harry.

Speaker 8: Thank you. Harry Sefton from UBS. I just want to touch on capacity. So you’ve previously guided to castling capacity coming more on stream in 2026. And clearly, you’ve been ramping up your CapEx since around 2023, so we should expect that to further add to that.

Combine that with sales having disappointed this year, what are we looking like in terms of capacity utilization going into next year? And then what does that mean in terms of looking to compete maybe more aggressively on price to try and boost volumes? And maybe to just wrap into that, you’ve obviously got the loss of exclusivity of sema in a number of markets next year. Will you look to compete on price in those markets with generics? Thank you.

Jakob Roel, Head of Investor Relations, Novo Nordisk: You’re for that one, Carsten?

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes, absolutely. On capacity, so clearly ramping capacity and we see very good progress on the different programs. And I can inform you that now all three Catalent sites are producing Vigovi. So that builds, of course, a lot of resilience in our system. And then our CapEx plan, of course, yields a lot of extra capacity for the company.

And that’s back to my introductory comment about how much we’re scaling. So we’re scaling more than 3,000,000 patients just compared to a year ago. So enabling that future scaling, then we believe that the CapEx program also in light of the significant unmet needs in our portfolio is spot on what we have to do. In terms of the CapEx program and competition and competitiveness, I would say that clearly, are going for defending our space in this market, and we’re going to defend volumes. And with our productivity, our unit costs and our manufacturing footprint, we’re going to fight for our space.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Great. Thanks, Harry. Thanks, Carsten. Let’s move here to Pete.

Speaker 9: Thanks. Pete Vidal, BNP. Just one question. You talked about the market segmenting. What about price segmentation?

I realize you’re not going to talk about pricing in detail, but high level, it’s pretty obvious. You’re talking about oral twenty five being Wegovy in a pill. So I think everyone in the room would think, you know, parity pricing to where we are today. You’ve got a competitor who had rave reviews about ortho data in diabetes at ADA and have now produced data that is clearly not, tidepiside like. So in terms of base case expectations, when you think about that oral GLP-one segment of the market, are you assuming base case that it’s a much lower priced segment versus the injectable market?

Thank you.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Anyone else for that one, Dave? Yes, happy to. Yes,

Dave, President of US Business, Novo Nordisk: not guiding, of course, on any pricing strategy, right? And we’re not in a hurry to raise, the price down, in this category, right? When you take compounding aside, it’s still largely, two manufacturers and I think there’s a shared view of really balancing the value and access. As you said, it is SEMA in a pill, and we certainly want to protect that ratio of value to access. There is, of course, segments of the population that open up as price goes down, and we’re learning from that in the cash channel.

We’re learning from that in what we see in telehealth and partnerships, and that’s just something that we’re going to continue to watch and get smart about.

Ludo, Commercial Strategy, Novo Nordisk: Maybe on that side, we are looking at price point one off, and it’s actually not the way the market is reacting. People are looking at longer view, at subscriptions, as we can see in some of the direct channels. So it’s actually much more, again, a lifetime value of a patient throughout the journey of initiation and then maintenance that needs to be taken into account. And that’s why the one off doesn’t really matter. What matters is if you discount back you’re going get from a pricing perspective month after month in the whole journey.

That’s actually what we’re experimenting as we speak, more than just having a one single price point. That’s the thing, it’s important. It’s also important to make sure that from a cash perspective, we have to preserve a certain consistency, as you can imagine, between all the various channels we have. Otherwise, it’s becoming messy and we have arbitrage that we don’t want to create.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Thanks, Ludo. Thanks, Dave. Then we have Richard Vasa hiding in the corner.

Carsten Mukhnumsen, CFO, Novo Nordisk0: I just have one question. Just stay time globally, how’s that evolving? And how do you think stay time will evolve in different channels like oral? I can imagine that with the orfagliptin data, maybe the stay time would be rather short. But do you think payers will use that to step through in The U.

S. Market? But just different stay times, different market segments and how is it evolving now?

Ludo, Commercial Strategy, Novo Nordisk: Absolutely. And I think it’s very interesting what you’re saying. You’re right. I think it’s going to be by group of patients. We know that we have right now it’s around seven months, if I’m not mistaken, on Wegovy and I think it’s more years, several years on Ozempic.

We believe that some of these patients also based on the pricing structure of subscription, etcetera, might actually have a longer stay time. We might also have patients that are very active for seven, eight, nine months, and then they will pause and start again. So I think it’s going to be very difficult to have one single weighted average stay time that is meaningful for the variety of patterns and behaviors we’re seeing. This being said, everything we’re doing is to extend stay time. And we’re doing and I’m sure that David commented on that, are launching a lot of initiatives to make sure that the longer you stay, the longer you see the benefits.

And if you think about what we saw with SURPASS in the data, we now see that all the GLP-one 100 are the same, that the CV benefits are gained on the long run. All this actually pleads for longer stay time for the patients. That’s true for Wegovy as much as for Ozempic. So, we’re doing a lot to extend it, but I think that the average will be less and less meaningful with time.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Thank you, Ludo. Then we’ll move here in the middle.

Carsten Mukhnumsen, CFO, Novo Nordisk0: Callum Morris from Berenberg. I just had another question on pricing. Obviously, in the cash channel, we’ve seen a lower penetration for Wegovy than anticipated. And obviously, we’ve talked about lots of factors for that. But how much do you think that is also to do with price competition with Lilly?

And as Zenpec coming through into that channel in H2 this year, do you expect to go in at a lower price point than what you’ve got with Wegovy at the moment? Thank you.

Dave, President of US Business, Novo Nordisk: In terms of, the dynamics of our cash channel, right, mean, Lilly started about a year before we did in terms of having Lilly Direct and then the Zepbound Vials. We have an interest to continue to expand that, and we will. And you’ll see more efforts and initiatives in order for us to expand that cash channel with partners, with Noble Care Pharmacy, right, and other intermediaries because we think that market is opening up, right, and the sort of consumerism of obesity is clear and it’s apparent, and we intend to participate in that. We’ll have a portfolio of offerings, right, in that cash channel. I think we compete well on price, right now, with Lilly.

I don’t think there’s a meaningful difference that I can glean from the research. It’s a different story, right, in compounding and what dynamic exists there. Why all of our efforts are on the table, as Karsten mentioned, to curtail that. With respect to Ozempic coming into the cash channel, no specific comments that we would make, but you could probably understand why we want would not want those prices to be meaningfully different, as Ozempic does participate in the obesity market even if not by design.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Good. Let’s move over here to Yeon.

Carsten Mukhnumsen, CFO, Novo Nordisk1: Hi. Yi Han Li from Barclays. Thank you for taking our questions. So I think we have one compounding market size because you mentioned, currently, you still have, like, 1,000,000 people on the compounding. And we are just wondering, like, how confident you are in terms of the projecting of the size of the company market, like how bigger or smaller it could be because we previously heard from HIMSS that they were saying there are around like 1,500,000 people on personalized therapy and continues to grow every day.

And, of course, we know it’s not all, GLP ones, but, yeah, just, like, curious. Is it possible, like, the marketing market could be bigger? And also, like, just wondering in terms of your revised guidance, anything you could share, like, that is attributable to this persistence of the company market? Thank you.

Jakob Roel, Head of Investor Relations, Novo Nordisk: You wanna go first, David, and go to you, Karsten, on guidance assumptions?

Dave, President of US Business, Novo Nordisk: Yes, I’m happy to start. I think the level of precision, right, that we can get in terms of this fake, market, which runs through medical spas, aesthetic clinics, places like HimHers that are public companies is certainly not as accurate as we can with our own longitudinal data, in IQVIA, right? Even though I think IQVIA was broke this week with NBRx, it’s just not as precise. We do it through market research. We do qualitative.

We do quantitative, larger studies, and it gives us a good feel in terms of the amount of prescribing that’s happening, the number of patients that are on. And our triangulation of that currently is we still believe it’s 30% of the market around one million patients. Of course, there’s different stay times, people coming on and off and switching, but that’s as precise as we’re able to get at this point.

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes. And on our outlook for the year, we have not included any upside from compounding in our guidance for the year. So even if there were some positive signals, say, from regulators the coming weeks or months. It’s not baked in. And one of the reasons or the key reason is really that there would be a lag effect before inventories are wound down and everything is stopping.

So this would more be a benefit into 2026 and 2027.

Jakob Roel, Head of Investor Relations, Novo Nordisk: It’s very clear. Thank you. Let’s move to Michael for the next one.

Carsten Mukhnumsen, CFO, Novo Nordisk2: Thank you. Michael at Jefferies. Carsten, question for you. Nobody used to guide for the next year with Q3 a long time ago, and there’s quite a few balls in the air for 2026, whether this is a semi trajectory or a launch cost base. Do you think you’d be in a position to offer a view on 2026?

Or would you want to with the Q3 results?

Carsten Mukhnumsen, CFO, Novo Nordisk: Well, so I can only talk to you only about 2026 because as you know, we’re only guiding come our full year results. I believe in the market space we’re in now, that’s the appropriate point in time to be guiding for 2026. The starting point is really the notion of unmet needs and the ramp of patients, as I spoke to before, with more than 3,000,000 patients year over year. So that’s, of course, our key focus to continue to drive that. Then we’re focused on launching autism obesity in The U.

S. So of course, that’s a key priority. MyMate is also getting closer. It may not be a big positive in 2026, but it’s still getting closer. And then you say, in terms of LOE, there’s been some discussion.

So at the call, I was saying what we’re looking into when we take everything we know today in terms of time lines and price points, etcetera, and LOE, then it’s a low single digit impact to top line growth next year. So these are some of the key building blocks that we’re looking into, but very focused on driving growth.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Thank you, Carsten. Thank you, Michael. Let’s move back to James for round two.

James Quigley, European Pharma Analyst, Goldman Sachs: Thank you very much. Question is on health care tourism. So next year, Canada will have generics. So there’s going to be generics flooding into market, and Sandoz were in the Feet yesterday or the day before, talking about 60 to 70% discounts to the list price. So how do you assess the risk of either generic semaglutide, generic Ozempic coming down from Canada through into The U.

S? Or more so if there is branded Ozempic, branded Wegovy in The US that could also potentially where patients go over and get prescriptions and then come back and potentially create a market that way? So what are the defenses that Novo has to guard against that?

Jakob Roel, Head of Investor Relations, Novo Nordisk: Cross border trace for you, Dave?

Dave, President of US Business, Novo Nordisk: I think we can probably build on it. There is not a legal mechanism for generic product to enter into The United States that’s not approved, right? And then you could say, well, that’s what we said about compounding, but there’s not an incentive, for Canada or companies operating in Canada to allow that to happen. If you’re talking about border states and crossing the line with your car, I mean, that happens today, right? I think what we have to be really clear about is the legal activities that we can take and we can enforce and be prepared for when there is generics that are approved around the world and make it clear really what our response is here in The U.

S. To stop it.

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes. Not a lot more to add. So it’s part of the building block I gave for outlook. That is erosion in Canada. So it is going to happen in Canada.

And then, of course, our legal and regulatory teams, are looking at defending our U. S. Business in this context from inappropriate parallel trade.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Indeed. Thanks a lot. Let’s move back to Pete before coming to the mid table afterwards.

Speaker 9: Pete Bodotjian from BNP. Carsten, just to follow-up from yesterday’s question on CapEx. I know you’ve been very clear, low double digit, but you are spending an inordinate amount this year at €10,000,000,000 And let’s be fair, if you ask everyone around the room what Novo revenue is going to be in three or four years, there’s going be a wide range of expectations. So can I just ask the question differently? When will the bulk when can you start to get more towards normalized CapEx in terms of not having to spend $10,000,000,000 a year?

So can I just push you a little bit more on that?

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes. You are always welcome to push on your questions, Pete. So the short version is we are very close to the peak, whether it’s this year and next year, but we’re very close to the peak, and then you should see our absolute CapEx levels to be coming down from there.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Good. Then we move to Simon and yes, start with Simon.

Speaker 7: Thank you for taking the second one. Just want to go back to a comment you made yesterday about Rybelsus. You said you’re adjusting deemphasizing the commercial focus on on Rybelsus. And that prompted a client to to ask, well we have a an old version of an injectable drug and they’re deemphasizing commercialization efforts on it because it’s not performing particularly well. Why would obesity be any different?

Now I’m sure there are lots of good reasons why but can you just say why we should not extrapolate from the Ozempic Rybelsus experience towards the obesity setting?

Dave, President of US Business, Novo Nordisk: I’m happy to from a commercial perspective, Martin and Lou may have some too. They’re very different. In terms of what we’ve seen, what we’ve learned about Rybelsus in the diabetes market and the place that it takes up in terms of a place in therapy, is wildly different than obesity. In diabetes, all of the medicines that a patient was on as they sequenced through and their disease progressed were orals. They were all oral medicines, right, right up through SGLT2s, and the meaningful difference in clinicians was changing that to the injectable, right, which came in the form of Trulicity, Ozempic, Mounjaro, and it didn’t have that same sort of level of, you know, an upgrade, if you will, in the way it was viewed in type two diabetes.

Conversely, when we think about oral, we do research and have conversations with oral, it’s just the opposite. There’s only injectables, right? And now there’s the promise and the openness of I could have a GLP-one and a pill. I could have Wegovy in a pill. And it’s viewed very differently in terms of what that unlocks, and what the potential is.

And I think on the company side, it’s more we see more opportunity, more growth, more potential, right, in Ozempic and Wegovy and then oral Wegovy than we have seen with Rybelsus and make those choices.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Anything to add from you, Martin?

Martin, Chief Scientific Officer, Novo Nordisk: Yes. Think fully agree on sort of the preference dynamics, but there is also the fact that with the doses that we have for Rybelsus, the efficacy is not comparable to that of the subcutaneous in the diabetes space. But in the obesity space, we have exactly designed twenty five milligram of oral semaglutide to match what we can do with the subcutaneous. So I think from the clinical perspective, that just gives freedom for the patients to choose.

Ludo, Commercial Strategy, Novo Nordisk: If you summarize, you also have a brand name difference, that’s one. You have the efficacy versus the injectable. Again, the oral V GoV and the injectable are broadly in line with efficacy and tolerability. And then you have the fact that also need to remember that Rybelsus was launched at the moment where we started to make some tough decisions between injectables and orals, which means that in many places where Rybelsus could actually have been successful even in diabetes options, we had to pull back because we had to dedicate some API to the injectable form, which means that the launch of Rybelsus per se is by, for me, not a good predictor of what an oral, irrespective of everything you said, what an oral could be. It’s been stop and go.

And in the markets where actually we could launch, and that’s Spain as an example, we actually did pretty well. So I wouldn’t use Rybelsus as the proxy for the normal behavior in the oral market for the reasons that I just mentioned.

Jakob Roel, Head of Investor Relations, Novo Nordisk: That’s great. Thanks. Let’s move to Harry, and then we’ll go to Thibault afterwards.

Speaker 8: Brilliant. Thank you. Harry Sesten from UBS again. If I could go back to compounding, and you talked about working with the FDA to try and limit some of the API coming into The US. Obviously, since the new administration’s come into power, we’ve seen some flux at the FDA.

Would you say that given your conversations with the FDA that they are acting at the speed that you’d want them to, or would you say that disruption is also adding to the delay in getting this compounding situation sorted?

Dave, President of US Business, Novo Nordisk: Yeah, thank you for that, Harry. My answer is I would like it to be faster, but that is true regardless how fast they move, given what we’re experiencing right now, right? We haven’t seen, you know, there’s been a noticeable disruption in the conversations or the speed because of that, not by any means. And the support that we’re getting around Congress is also moving with speed. I mean, just last week, we had 80 congressional leaders send a letter to FDA saying this has to stop, and we know that there have been live conversations with some of those leaders, with the leadership, as well as legal leadership at FDA, and they’ve assured us that this is a top priority.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Good, only in the last ten minutes. Thank

Speaker 6: you. Dave, if you could, just, touch on the slowdown of the GLP-one market diabetes market in The U. S. If you could sort of come back on the key reasons behind the general market slowdown for GLP-one diabetes. Are you experiencing any sort of access or reimbursement restrictions as the category become more costly for payers?

Or is it just that the penetration rates are peaking, and the market gets a bit more saturated than before?

Dave, President of US Business, Novo Nordisk: Yes, thank you for that. As we discussed last quarter, right, we are seeing a slowdown in terms of the growth for GLP-one diabetes. It’s still growth, right? I think it’s in the neighborhood of fifteen percent first half of the year. I think there is still room for growth in the diabetes market.

It’s slower than what we’ve seen before, right? So yes, there’s more patients, that have been on a GLP-one. I think we’re in the thirty percent range in The U. S. Very different, than the rest of the world of those that have been on a GLP-one for diabetes.

And, you know, we’re also seeing, you know, this changeover, if you will, from our supply situation where the GLP-one diabetes market participated in the obesity market not by plan, right, but we saw those fluctuations, right, that now we have that sort of smoothing in terms of what the real sort of growth potential looks like as demand has subsided, or sorry, supply issues have subsided, you know, and we’re seeing, you know, in that range. There’s still room for growth. I think if we compare that, you know, that is the area where we see a lot more potential for growth in the future for GLP-one.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Absolutely. Let’s move back to Richie Vasseur

Carsten Mukhnumsen, CFO, Novo Nordisk0: from JP Morgan. Just on amacretin and the Phase two diabetes data that you’re going to get in the second half or fourth quarter, what do you hope to learn from that trial in terms of the doses, dosing and titration to inform on the phase three?

Martin, Chief Scientific Officer, Novo Nordisk: It’s a really good question. As you know, we’ve always tried to acknowledge the fact that at least for the GLP-one biology, the ED-ninety four, good glycemic control versus weight loss is different, and that has led to different doses, actual doses between diabetes and obesity. We see others do it in a different way, which also makes it sometimes a little bit difficult to see full dose response on the clinical doses. That being said, we need to understand fully what does amylin priority do to this dynamic. We need more data to fully understand that.

And specifically on the titration, based on everything that we know. And here we can also include REDEFINE I and II. I don’t expect to learn so much on titration, but the actual doses we need to get right for diabetes versus obesity evaluating are we going for the same doses or are we going for a differentiated dose range.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Thank you, Martin. And before asking Karsten to wrap up, let’s go for final question. Would you, Michael Leuchten?

Carsten Mukhnumsen, CFO, Novo Nordisk2: Thank you. A follow-up to that, Martin, on amicretin dosing into Phase III. I guess one question coming out of the ORFA data today is like how well can one actually model PKPD when compounds change and structures change. You’ve decided to move into Phase III quite quickly with the MACRETE. And are you still confident with the dose selection?

And do you have flexibility to maybe change that is needed in Phase III?

Martin, Chief Scientific Officer, Novo Nordisk: So the actual doses, of course, can change and the dose escalation ranges can also be changed. And it’s actually by design a little bit, I hate to say it, the flexible approach. Some patients will benefit from titrating every four weeks between the individual dose steps. Some will actually be recommended if they lose weight very fast or if they experience gastrointestinal side effects to dose every eight week. And what we have learned so far, again, everything that we know from ampicretin, but also from REDEFINE I and II is giving us confidence that we pick the right doses, and we are also confident on the dose titration and the steps that that will require.

Again, can’t adapt. I don’t think that’s going to be relevant. Obviously, as we’ve also talked to, we’ve had really good dialogues with regulators who also think about these dynamics. So at the end of the day, we will have to wait and see. But at this point in time, we are happy with the doses and the dose steps that we’ve chosen.

Jakob Roel, Head of Investor Relations, Novo Nordisk: Good. And before giving it to Carsten for final remarks, just thank you to everyone tuning in online as well as showing up in the room and reach out to Investor Relations in case of follow ups. With that, over to you, Carsten.

Carsten Mukhnumsen, CFO, Novo Nordisk: Yes. Thank you, Jacob, and thank you to all for attending. I think we actually covered a lot of ground at this launch meeting. I think it’s clear that we’re driving growth for the long term. We spoke about our pipeline, amicretin, calcrosimumab, autosomal obesity, competitive profiles.

We spoke about all the measures we’re taking in The U. S. To get back to stronger growth. We have the portfolio. We have the leadership.

So now it’s really about executing on what we have. What we didn’t talk a lot about was international operations, which in reality is 90% of the unmet needs on a global scale. So just a reminder, 19% growth in the first half and a very consistent portfolio like approach in terms of driving growth in a very big area with sizable unmet needs and a portfolio that’s only started to really roll into those markets with low penetration rates, both in diabetes and BIGOVI. So this is really the name of the game, driving growth not only through the end of this year but also into the years to come. 71% market share

Ludo, Commercial Strategy, Novo Nordisk: volume market share for Novo Nordisk in this. Exactly. Thank you for I’ll comment, please.

Carsten Mukhnumsen, CFO, Novo Nordisk: You for dialing in, and thank you for attending this lunch. And thank you to James and Goldman for hosting. Hope to see you next quarter. Thank you.

Martin, Chief Scientific Officer, Novo Nordisk: Thank you.

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