Novo Nordisk A/S Q1 2025 Earnings Call Transcript

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Provided by Quartr
May 7, 2025
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Operator

Good day, and thank you for standing by. Welcome to the Q1 twenty twenty five Novo Nordisk AS Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there'll be a question and answer session. Please be advised that today's conference is being recorded.

Operator

I would now like to hand the conference over to your first speaker today, Jakob Roeder, Head of Investor Relations. Please go ahead, sir.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, and welcome to this Novo Nordisk earnings call for the first three months of twenty twenty five. My name is Jakob Roel, I'm the Head of Investor Relations at Novo Nordisk. And with me today, I have CEO of Novo Nordisk, Lars Krogger Janssen Executive Vice President, U. S. Operations, Dave Moore Executive Vice President, International Operations, Mike Duester Executive Vice President and Head of Development, Martin Holzlange and finally, Chief Financial Officer, Carsten Vonklosen.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

All speakers will be available for the Q and A session. Today's announcement and the slides for this call are available on our website, normaneutsche.com. Please note that the call is being webcasted live, and a recording will be made available on our website as well. The call is scheduled to last one hour. Next slide, please.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

The presentation is structured as outlined on Slide two. Please note that all sales and operating profit growth statements will be at constant exchange rates unless otherwise specified. Please turn to the next slide. We need to advise you that this call will contain forward looking statements. These are subject to risks and uncertainties that could cause actual results to differ materially from expectations.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

For further information on the risk factors, please see the company announcements for the first three months of twenty twenty five as well as the slides prepared for this presentation. With that, over to you, Lars, for an update on our strategic aspirations.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Thank you, Jakob. Next slide, please. In the first three months of twenty twenty five, we delivered 18% sales growth and 20% operating profit growth. I'd like to start this call by going through the performance highlights across our strategic aspirations before handing over the word to my colleagues. Starting with our focus on purpose and sustainability, we are now serving nearly forty six million patients with our diabetes and obesity treatments.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

This is an increase of almost four million patients compared to the first three months of twenty twenty four. Our total carbon emissions rose by 37% compared to the first three months of twenty twenty four. This was mainly driven by the acquisition of new production sites and capital expenditure activities related to expansion of manufacturing sites. These are also efforts to meet the high demand for our innovative treatments. To uphold our commitment to being a sustainable employer, we expanded the number of women in senior leadership positions to 42% compared to around 41% last year.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

In R and D, we completed the second and final pivotal trial, REDEFINE two, with our next generation obesity treatment, CACLISAMA. We remain on track for submission in the first quarter of twenty twenty six. Recently, our application for VIGOVY two point four milligram for the treatment of metabolic dysfunction associated steroid hepatitis, or MESH in short, was accepted by the U. FDA and granted priority review. In addition, the new drug application for weight management for oral semaglutide twenty five milligram, or as I personally will call it, Wegovy in a pill, has been submitted to the U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. FDA. If approved, this will be the first oral GLP-one treatment for obesity in The U. S. Lastly, we are in licensed two early stage assets that show promise in addressing obesity and other cardiometabolic diseases.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Martin will come back to this and our overall R and D milestones later. The quarterly sales growth is driven by both operating units. Dave and Mike will go through the details later. In terms of financial details, we delivered sales growth of 18% in the first three months of twenty twenty five. However, we have reduced our full year outlook due to lower than planned branded GLP-one penetration impacted by the rapid expansion of compounding in The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. Novo Nordisk is actively focused on preventing unlawful compounding as well as the efforts to expand patient access on our GLP-one treatments. Carsten will come back to this later. We will continue to drive attractive growth and expand patient access into our innovative treatments. In The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S, this includes recent initiatives with NovoCare Pharmacy, telehealth collaborations and the CVS formulary decision. In international operations, there remains a large unmet need for patients, and we're excited to continue focused commercial efforts in existing and future markets in 2025. Furthermore, we realized the significance of our global footprint, including those activities based in The U. S. Novo Nordisk has a strong presence in The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. With over 10,000 full time employees across the value chain. This includes research and development and substantial manufacturing footprint. We have invested over US24 billion dollars in The U. S.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Over the past ten years, including ongoing expansions and improvements to our manufacturing site in Bloomington, Indiana and Clayson, North Carolina. The existing U. S. Tariffs does not materially change our financial outlook for 2025. That being said, we are closely following potential tariffs on pharmaceutical products in The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. Before we move on to the particulars of the first quarter performance, I'd like to update you on changes to executive management. Please turn to the next slide. After nearly thirty years with Novo Nordisk, Camilla Sylvester decided to step down. Camilla played a pivotal role in establishing our GLP-one and obesity franchises and spearheaded the development of our long term social and environmental goals.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

I would like to thank Camilla for her meaningful contributions to Novo Nordisk and wish her all the best for the future. This development has triggered several organizational changes effective April 3 aimed at enhancing the speed of decision making and strengthening the execution focus within our operating units. Ludwig Helfgard, formerly Executive Vice President, Rare Disease, now heads up Product and Portfolio Strategy. This is a newly established area designed to forge a closer connection between commercial strategy, medical affairs and business development across all our therapy areas. Tilde Hommelberglia becomes the newest member of Executive Management as Executive Vice President of Quality, IT and Environmental Affairs.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

The restructuring will also enable Deimar to focus exclusively on The U. S. Operations as well as Henrik Wolf on CMC and product supply. I'd now like to give an update on our commercial execution in the first three months of twenty twenty five. Please turn to the next slide.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

As of January, North America operations and international operations were reorganized and financial reporting has been divided into U. S. Operations and international operations. More details on the regions can be found in the company announcement. In the first three months of twenty twenty five, our sales increased by 18%.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

The sales growth was driven by both operating units with U. S. Operations growing 17% and international operations growing 19%. Our GLP-one sales in Diabetes increased by 11%, driven by U. S.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Operations growing 10% and international operations growing 13%. Insulin sales increased by 3%, driven by U. S. Operations growing 13%. The sales increase was driven by phasing of rebates as well as channel and payer mix, partly countered by a decline in volume.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Insideration sales increased 1%, Obesity Care sales increased 65%, driven by U. S. Operations growing 40%, partly impacted by compounded GLP-1s and international operations growing 137%. In both geographies, growth was driven by Wegovy, partly offset by declining Saxenda sales as the obesity care market is growing towards once weekly treatments. Rare disease sales increased by 3%, driven by a 5% sales increase in international operations.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Rare disease sales in U. S. Operations grew 1% compared to last year. Please turn to the next slide. Today, Novo Nordisk remains the global GLP-one volume market leader, serving nearly two thirds of all patients on GLP-one treatments across diabetes and obesity.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Our ongoing scaling efforts have supported close to a tripling of GLP-one patients reached over the past three years. We are dedicated to serving patients who need our medicines and increasing our capacity to meet their needs. By integrating the three acquired filfinicides and expanding our existing capacities, we are ready to reach more patients with serious chronic diseases. With that, I'll hand over to Dave.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Thank you, Lars. Please turn to the next slide. Sales of GLP-one diabetes care products in The US increased by 10% in the first three months of 2025. The sales increase was mainly driven by the continued uptake of Ozempic. Following The US approval of the flow data earlier this year, Ozempic is now the only GLP-one receptor agonist proven to reduce the risk of chronic kidney disease in people living with type two diabetes and chronic kidney disease.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Novo Nordisk remains the market leader in The US with more than 50% market share measured by total monthly prescriptions. Please turn to the next slide. Wegovy sales increased by 39% in US operations in the first three months of 2025. The Wegovy sales growth was driven by increased volumes, which were negatively impacted by wholesaler inventory movements. This was partially countered by lower realized prices.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Wegovy was around 200,000 weekly prescriptions. The total US branded anti obesity market more than doubled with a growth rate of over 160% in the last year. The volume of compounded GLP-1s in The US is estimated to have impacted the uptake of Wegovy prescriptions and the growth of the branded obesity market during the first quarter of twenty twenty five. In February, the FDA removed semaglutide from the drug shortage list. As a result, it is now illegal under US compounding laws to make or sell compounded semaglutide drugs, except with rare exceptions.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Novo Nordisk is working to prevent unlawful and unsafe compounding of semaglutide in The US, while making sure patients have access to safe, legitimate semaglutide produced by Novo Nordisk. Following the resolution of the semaglutide shortage, we have a number of initiatives to support patients with obesity seeking treatment with Wegovy. In March, we introduced self pay, a direct to patient delivery of all doses of Wegovy at a reduced cost of $499 month through our NovaCare pharmacy. Access to Wegovy for cash paying patients was further expanded in April with the announcement of collaborations with three telehealth organizations. And last week, it was announced that CVS chose Wegovy to be the only GLP-one medicine covered for obesity on its national template formulary as of 07/01/2025.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

While Novo Nordisk is committed to providing patients with choices and did not pursue an exclusive formulary placement, we do believe the formulary decision by CVS speaks to the benefits of Wegovy. These include established cardiovascular benefits noted on the Wegovy label, and we await the FDA priority review of the promising data from the ESSENCE trial for potential inclusion of NASH as a primary indication in the label in the second half of twenty twenty five. We will continue to identify additional ways to expand access to Egovy. Now, I'd like to turn it over to Mike for an update on international operations.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Thank you, Dave. If you can go to the next slide, please. Sales in international operations grew by 19% in the first '3 months of '20 '20 '5, driven by GLP-one products. GLP-one diabetes sales increased 13%, driven by all regions. GLP-one diabetes sales growth was negatively impacted by periodic supply constraints.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Obesity care sales grew by 137% to DKK6.5 billion. Sales of BIGOVI reached more than DKK5.5 billion, growing at 392% driven by sales across all regions. Next slide please. Novo Nordisk remains the market leader in international operations with a total diabetes and obesity GLP-one volume market share of over seventy two percent. Diabetes remains a significant global health challenge, affecting more than five fifty million individuals in IO.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Rybelsus is now available in over 40 markets and continues to gain market share in international operations. Meanwhile, Ozempic remains the leading GLP-one diabetes product within IO, having launched in around 80 markets. With improved supply, we are now fully focused on our promotional activities to further expand the number of patients reached. Also, obesity, we see a substantial unmet need with more than eight hundred million people living with obesity in IO and only a few million of these people being treated. We have launched VIGOVI in around 25 countries, including three in just the last month, reflecting a greater supply availability and staying true to our commitment in reaching more and more patients.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

We look very much forward to rolling out ZIGOBI in many more markets as the year goes through. Next slide please. Our rare disease sales increased by 3%. This was driven by sales increase in international operations of 5% and U. S.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Operations sales growth of 1%. Sales of rare endocrine disorder products increased by 14%, driven by nortotropine and improvement in manufacturing output as well as SOGROYO launch uptake in international operations. This is countered by a decrease of 5% in U. S. Operations, mainly driven by nortotropine.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Rare blood disorder sales decreased by 1%, driven by lower sales of NovoSeven. Now over to you, Martin, for an update on R and D.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Thank you, Mike. Please turn to the next slide. In March, Novo Nordisk released the headline results from REDEFINE II, the second and final pivotal trial with cabozyma. The trial included people living with obesity or overweight along with type two diabetes. REDEFINE-two was a sixty eight week efficacy and safety trial with twelve oh six people enrolled.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

People were randomly assigned to receive either cagrelizumab, a fixed dose combination of cagrelinide two point four milligram and semaglutide two point four milligram or placebo. The mean baseline body weight was 102.2. The REDEFINE-two trial incorporated a flexible trial protocol similar to REDEFINE-one. After sixty eight weeks of treatment, assuming all people adhere to treatment, CAGRICEMA resulted in a significant weight loss of 15.7% compared to 3.1% in the placebo group. In the trial, CAGRICEMA appeared to have a safe and well tolerated profile.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

The most common adverse events were gastrointestinal, with the vast majority being mild to moderate and decreasing over time in line with the GLP-one receptor agonist class. We've now completed the second and last pivotal Calcrossema Phase III trial for weight management. We look forward to sharing more data from REDEFINE one and two at the American Diabetes Association in June. We are on track with scaling of the Calcruzema supply chain, and we still expect to file for the first regulatory approval in the first quarter of twenty twenty six. Next slide, please.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Building on the learnings from REDEFINE I and II trials, we have extended the duration of REDEFINE four, which is now anticipated to read out in the first quarter of twenty twenty six. Turning to REDEFINE 11, we expect the trial to be initiated during the second quarter of twenty twenty five. The purpose of REDEFINE 11 is to investigate the potential for further weight loss by prolonging the duration of the trial to eighty weeks and focusing on dose re escalation throughout the study. Next slide, please. In February, we submitted the oral semaglutide twenty five milligram to the U.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

S. FDA as the potential first oral GLP-one treatment for obesity. Oral semaglutide twenty five milligram demonstrates an overall efficacy and safety profile similar to once weekly injectable semaglutide two point four milligram. For context, I would like to revisit the OASIS-four results. OASIS-four was a sixty four week efficacy and safety trial comparing once daily oral semaglutide twenty five milligram to placebo in three zero seven adults with obesity or overweight with one or more comorbidities.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

In the trial, adults with obesity or overweight who received oral semaglutide twenty five milligram experienced an average weight loss of 16.6% from a baseline body weight of one hundred and five point nine kilograms when assuming full adherence to the treatment regimen. Around one third of participants achieved a weight loss greater of 20% or more. Secondary endpoints from OASIS IV demonstrated improvements in cardiometabolic risk factors such as waist circumference, blood pressure, and inflammation in patients treated with oral twenty five milligram versus placebo. In addition, oral semaglutide twenty five milligram appeared to have a safe and well tolerated profile on par with semaglutide two point four milligram. The full publication of OASIS IV is expected later this year.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Altogether, oral and injectable semaglutide has been studied in robust clinical development programs with more than 43,000 semaglutide exposed patients and exposure from post marketing use of over 33,000,000 patient years. If approved oral semaglutide twenty five milligram is expected to be the first oral GLP-one receptor agonist for weight loss. The manufacturing of the active pharmaceutical ingredient, bulk tablet manufacturing, and packaging of oral semaglutide twenty five milligram are all carried out in The United States, and all manufacturing steps are up and running. We anticipate the U. S.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

FDA review will be completed around the turn of this year. Next slide, please. Turning to the upcoming R and D milestones, we look forward to a year with exciting trial readouts. Before speaking to the remainder of 2025, I would like to highlight some of the milestones from the last few months. In addition to the completion of REDEFINE-two and the submission of oral twenty five milligram semaglutide for obesity in The U.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

S, Novo Nordisk continues to pursue the expanded treatment optionality for people living with obesity. Although not shown in the slide, I would like to mention our newest agreements to in license two early stage assets for the treatment of obesity and other cardiometabolic diseases. These include a first in class oral non incretin preclinical candidate in obesity and associated metabolic disorders, and a GLP-one GIP glucagon triple receptor agonist. The latter triple G acid is the second tri agonist in our pipeline, and we expect the Phase I results from our internal tri agonist in the second half of twenty twenty five. Within rare disease, the main phases of two Phase IIIa trials, REAL-eight and REAL-nine, were successfully completed with SEGROIA for non replacement indications and submitted for regulatory approval in EU.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Within cardiovascular and emerging therapeutic areas, we're excited to have submitted the ESSENCE Part one trial with once weekly semaglutide two point four milligram for regulatory approval in both EU and U. S. For the treatment of mesh and moderate to advanced liver fibrosis, namely F2 and F3. As a reminder, ISN achieved both primary endpoints. By week seventy two, thirty seven percent of people treated with semaglutide two point four milligram achieved improved liver fibrosis with no worsening of steatohepatitis, while sixty three percent achieved a resolution of steatohepatitis with no worsening of liver fibrosis.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

To put this into perspective, the ESSENCE Phase III trial results are the best Phase III results within MeSH to date. In U. S. Alone, around thirteen million people live with MeSH and currently have limited treatment options available. We're excited that the U.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

S. FDA has accepted the supplemental new drug application and granted priority review for Wegovy to treat mesh in adults with moderate to advanced fibrosis with a decision anticipated in second half of this year. Moving to upcoming milestones in 2025, I would like to start with a few data readouts in type two diabetes in the second half. Specifically, we expect the first Phase III results from Calcursema from REIMAGINE-three, investigating Calcursema as an add on to basal insulin in people with type two diabetes. Moreover, we expect results from the subcutaneous and oral amicretin Phase II trial.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Our upcoming readouts and clinical programs in obesity demonstrate the breadth of our pipeline in both modalities and mechanisms of actions to meet the needs of patients. In addition to the initiation of REDEFINE 11 with GALCOSEMA in the first half of twenty twenty five that I mentioned earlier, we also expect the Phase II readout from the once weekly GIPGRP1 co agonist in the second quarter of twenty twenty five. We're also very excited to initiate the Phase III program for quinolone type in monotherapy in late twenty twenty five. Within rare disease, we expect U. S.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Submission for SEGROIA in non replacement indications in the second quarter of twenty twenty five as well as regulatory submissions for MiM8 in The U. S. And EU in the second half of twenty twenty five. Lastly, we look forward to the readout of the EVOQUE and EVOQUE plus trials in patients with early Alzheimer's disease. With that, over to you, Karsten.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Thank you, Martin. Please turn to the next slide. In the first three months of twenty twenty five, our sales grew by 19% in Danish kroner and 18% at constant exchange rates, driven by both operating units. The gross margin decreased by 83.5 decreased to 83.5% compared to 84.8% in the first three months of twenty twenty four. The decrease mainly reflects amortizations and depreciations related to Catalent as well as costs related to ongoing capacity expansions, partially countered by positive product mix driven by increased sales of GLP-one based treatments.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Sales and distribution costs increased by 12% in Danish kroner and by 10% at constant exchange rates. In U. S. Operations, the cost increase is mainly driven by promotional activities related to BIGOVI and Ozempic. In international operations, the increase is mainly related to BIGOVI launch and promotional activities.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Research and development costs increased by 20% in Danish kroner and 19% at constant exchange rates. The increase in cost is mainly driven by obesity care and reflecting increased late stage trial clinical trial activity as well as increased early research activities. Administration costs increased by 5% both in Danish kroner and at constant exchange rates. Operating profit as a consequence increased by 22% measured in Danish kroner and by 20% at constant exchange rates. EBITDA increased by 23% in Danish kroner and by 21% at constant exchange rates.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Net financial items showed a net loss of DKK 1,800,000,000.0 compared with a net gain of DKK 72,000,000 last year. This primarily reflects losses on its currencies and financing costs related to the funding of the Catalent transaction. The effective tax rate was 21.6% in the first three months of twenty twenty five compared to 20.4% in 2024. Net profit increased by 14% and diluted earnings per share increased by 15% to SEK 6.53. Free cash flow in the first three months of twenty twenty five was DKK 9,500,000,000.0 compared to DKK 5,000,000,000 in the first three months of twenty twenty four.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Free cash flow is reflecting higher net cash generated from operating activities, partially countered by increased capital expenditure. Capital expenditure for property, plant and equipment was 13,400,000,000.0 compared to DKK 8,400,000,000.0 in 2024. This was primarily driven by investments in additional capacity for API and fill finish capacity for both current and future injectable and oral products. We have returned 36,700,000,000.0 to shareholders, mainly as dividends in the first three months of 2025. Following the step up in CapEx investments in 2025, Novo Nordisk is not conducting a share buyback program.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

An authorization to the Board of Directors to buy back shares was, however, in line with previous years adopted at the Annual General Meeting on 03/27/2025, should the initiation of a share buyback program later be deemed relevant. For 2025, the range for sales growth is now expected to be 13% to 21% at constant exchange rates. Given the current exchange rate versus Danish kroner, sales growth reported in Danish kroner is expected to be three percentage point lower than constant exchange rate growth. The new range reflects lower than planned penetration of branded GLP-one treatments in The U. S, impacted by compounded GLP-1s.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

The outlook reflects expectations for sales growth in U. S. Operations and international operations, mainly driven by volume growth of GLP-one based treatments for obesity and diabetes. Following the U. S.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

FDA removal of semaglutide injectables from the drug shortage list, the sales outlook assumes a reduction in patients on compounded GLP-one treatments during the second half of twenty twenty five. The updated guidance reflects several efforts already underway, as mentioned by Lars, Mike and Dave. Operating profit growth is now expected to be 16% to 24% at constant exchange rates. Given the current exchange rates versus Danish kroner, growth reported in Danish kroner is expected to be around five percentage points lower than at constant exchange rates. The updated expectation for operating profit growth primarily reflects the lower sales growth outlook, partially countered by reduced spending.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Novo Nordisk expects net financial items to show a gain of around 900,000,000.0. This is mainly driven by expected gains on hedge currencies, primarily the U. S. Dollar, partially offset by interest expenses related to funding of the debt financed Catalent transaction. The effective tax rate for 2025 is still expected to be between 2123%.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Capital expenditure is still expected to be around 65 in 2025, reflecting expansion of the global supply chain. In the coming years, the capital expenditure to sales ratio is still expected to be low double digits. Free cash flow is now expected to be DKK 56,000,000,000 to 66,000,000,000, reflecting the lower than expected sales growth, mainly driven by lower volume growth of GLP-one treatments in The U. S. All of the 2025 expectations are based on assumptions that the global and regional macroeconomic and political environment will not change significantly business conditions for Novo Nordisk during 2025, including changes in tariffs and duties.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

The announced tariffs currently in effect do not materially change our financial outlook for 2025. However, a potential expansion or increase of tariffs may have a negative impact on Novo Nordisk and our industry. That covers the outlook for 2025. Now back to you, Lars.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Thank you, Carsten. Please turn to the final slide. The performance in the first three months of twenty twenty five with 18% sales growth reflects that nearly 46,000,000 people are now benefiting from our treatments. Further, we progressed our R and D pipeline, including completing the final pivotal trial for our next generation obesity treatment, glimepresema. We have reduced our full year outlook due to lower than planned GLP-one penetration, which is impacted by the rapid expansion of compounding in The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. I'm confident in our recent initiatives in The U. S. To support patients to seek benefits of our GLP-one treatments. Furthermore, the obesity opportunity remains large in its natural operations and we look forward to reaching more patients with the additional rollouts of Begobi globally.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

At Novo Nordisk, we'll continue to focus on commercial execution, the progression of our R and D pipeline and expansion of our production capacity in the pursuit of treating more people living with serious chronic diseases. With that, I would like to hand over the word to Jakob.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Lars. And next slide, please. And with that, we are ready to take the Q and A. We are currently ask all participants to limit her or himself to one or maximum two questions, including sub questions. With that, operator, we are now ready to take the first question.

Operator

Thank you. We'll now take the first question. And your first question comes from the line of Richard Fosser from JPMorgan. Please go ahead.

Richard Vosser
Richard Vosser
Managing Director at JP Morgan

Hi, thanks for taking my questions. Two please. First one on the compounders in The U. S. You've obviously done a partnership with HIMSS, but HIMSS themselves are suggesting that they will continue to personally compound and have a significant contribution to their business from personal compounding.

Richard Vosser
Richard Vosser
Managing Director at JP Morgan

That seems to be at odds with the partnership and at odds with your commentary of trying to reduce compounding and it being only allowed in rare circumstances. So could you just talk about how you expect that to go and how you expect to deal with that in the second half? And then a second question, if I can, please. Just on the competitive effects from Mounjaro you're seeing on IO and how easy you expect to be able to grow Ozempic once the supply constraints in IO are removed? How ready is the sales force?

Richard Vosser
Richard Vosser
Managing Director at JP Morgan

How confident are you on strong growth in IO? Thanks very much.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, Richard. Two questions for Dave and Mike respectively. Let's start with the first question on compounding and next steps and hand it over to you, Dave.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Thank you. And thanks for the question, Richard. To be clear, we do not support unlawful compounding. We are against the illegal importation and the continuation of compounding in The United States. As you mentioned, we did announce collaborations with telehealth providers.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

The reason for this is increasingly people living with obesity are seeking healthcare through telehealth companies. And we need to be where patients are and to have an offering for the real Wegovy. These collaborations allow a link to Noble Care Pharmacy where the real Wegovy can be available through these telehealth companies. As we've mentioned on May 22, we fully expect the FDA to enforce the law. And at that time, we will continue to fight against unlawful compounding, for example, mass personalization.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Thank you. Over to you, Mike.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Thanks very much, David. Richard, I think to answer your question, I'll split it in between Ozempic and V Govi. So, we have Ozempic since 2019 in launched and now in 80 markets across IO. So a very decent footprint, I would say, many, many countries. We have been launching BIGOVI a bit due to the supply constraints, not at the speed we wanted to.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

Also partially because we were servicing and maintaining, of course, the patients that were on Ozempic. But now starting from this year as the supply constraints are lifted, we have seen an acceleration like you would not have seen before. Just in the last couple of months, six new launches and more to come as we go forward. In terms of share number of prescriptions and volumes, if I just give you a couple of data points, we have currently 64% volume market share on injectable GLP-one, so on the back of Ozempic and V Govi. And that 67% market share is rather stable.

Maziar Doustdar
Maziar Doustdar
Executive VP of International Operations & Member of the Management Board at Novo Nordisk

So it's not going down. And we, of course, hope to be able to continue fueling that with these so called new launches, as well as, of course, getting back to promoting Ozempic much more assertively than we have been during the constraint period.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Mike. And thank you, Dave. And also thank you to Richard. With that, we are ready for the next set of questions, please.

Operator

Thank you. Your next question comes from the line of James Quigley from Goldman Sachs. Please go ahead.

James Quigley
James Quigley
Executive Director at Goldman Sachs

Great. Thanks for taking my questions. So one on the guidance and one follow-up on the compounding pharmacy. So on the guidance, if we sort of assume a similar second quarter as in the first quarter, then the scenarios for progression in the second half are quite wide with around 8% growth at the bottom end and 22%, twenty three % growth at the upper end. So could you reconcile the potential outcomes?

James Quigley
James Quigley
Executive Director at Goldman Sachs

What are the most important variables there? And what are the key assumptions for both end of those variables? And secondly, on compounding, you mentioned those having a significant impact, but have you got any more details of what the drag is on Wegovy market share? Have you done any surveys or how of what you think how many patients might drop off versus switch to branded and within the branded switch to Wegovy versus switching to zepatide? Because you mentioned you have factored that into the guidance.

James Quigley
James Quigley
Executive Director at Goldman Sachs

Just wondering how much that is factored into the guidance. Thank you.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, James. And on the first one on guidance, go to you, Carsten.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Yes. Thank you, James, that question. Yes, I think for the dynamics we see in our business then we delivered 80% growth in the first quarter. And of course, our aim is to continue to drive attractive growth. And that entails increasing script trends in The U.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

S. And continuing to drive our GLP-one franchise in IO. So specifically to the guidance ranges, this means in terms of

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

the main

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

drivers that a lot of patients on compounded products will go to branded products in the second half of this year, and we will be able to enable that through the cash channel and NovoCare and the telehealth collaborations. We also do have a label update with MASH we spoke to before, classic commercial tactics and then, of course, the CVS collaboration. So the acceleration to deliver our guidance is mainly in the second half of the year when we talk about U. S, while in international operations, we'll see a continued step up over the coming quarters in terms of sales growth. So that takes us to kind of the basic fundament of our guidance range.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

And I would say, on compounding specifically, given that the data quality on number of patients on compounding is not very high, then it's based on market research where we're looking at 1,000,000 or more patients on compounded GLP-one today. And then we've made estimates based on how many patients will either be able to benefit from the personalized exception or will drop off treatment. And as a consequence, the rest will go to a branded product. So a number of assumptions, but we have a lot of tactics in place to be able to capture patients that will no longer be able to have a compounded product with effect from the second half of this year, given some patients will also have inventories in place personally and therefore, the second half comments. Thank you, James.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, James. And I think that also covered part of question two. Anything from you to add, Dave, on what we see currently in terms of magnitude of compounding, potentially split on branded GLP-one treatments as well?

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Yeah, thank you, Jakob. I will share that the market research that Carsten mentioned also gives us an idea that certainly semaglutide is overweight. We estimate seventy percent of compounding is of semaglutide. But I'd like you to focus on three things, three actions that we're taking to ensure that we're effective in this transition as compounding starts to wind down. Number one, we expand the cash offering.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

The $4.99 via Noble Care Pharmacy was purposeful and planned at the time when compounding would start to diminish, as well as the collaborations with telehealth companies. And soon that cash offering will be available in all 9,000 CVS stores. Number two, we continue to expand better coverage for Wegovy. This helps for some of those patients that may be on compounding that have insurance and would have access to Wegovy for a low copay. And number three, as Karsten mentioned, we have targeted commercial efforts aimed at patients and healthcare practitioners, so that we can focus on SEMA, the safety of real Wegovy versus compounding, as well as the availability and the affordability.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Thank you.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, Dave. And also thanks to you, James. With that, we're ready for the next set of questions, please.

Operator

Thank you. Your next question comes from the line of Peter Ferdows from BNP Paribas. Please go ahead.

Peter Verdult
Managing Director - Pharmaceuticals Equity research at BNP Paribas

Yeah. Thank you. Pete here from BNP Paribas. Lars and Carsten, two quick ones. I suppose I'm still struggling just to understand where the disconnect has been with respect to the your messaging given at February CMD in London about commercial execution being management's top priority and the prescription trends we've seen since then, especially when you have, as you said, 40,000,000 commercial lives where most patients apparently only have to pay $25 a month to get access to Wegovy and you've been smashing it with DTC and reps.

Peter Verdult
Managing Director - Pharmaceuticals Equity research at BNP Paribas

So is it really only about the compounders or do we have to consider your nearest branded competitor doing a better job? And then more quickly and secondly, just your thoughts on the recent Orfagliptron diabetes data, especially given scalability doesn't seem to be an issue there. So, thanks very much.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, Pete. I think both of those go to you, Lars. But let's start with the first one on commercial execution as a priority.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Yes. Thanks, Pete. You are right. This has been our focus for some time. But I think it's important to say that when assess that based on script trends, it is really, really difficult as there is a significant share of the business turning into being compounded, and we estimate that that's a similar amount of business as what we have in The U.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

S. On GLP-one. So I think Dave outlined our tactics, and we feel honestly very confident that we this is the right moment for us to make a serious change in the market. And that's baked into our guidance for the second half of the year. And I think also the point that CVS actually choose our brands without us paying for exclusivity is a sign that there is a very strong perception around Wegovy in the market.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

The added benefits we have on top of the real world experienced weight loss is great. And that is just getting even better assuming we get the mass indication as well. So what you get in one product here is just very, very attractive. In terms of Orpho, I think there's been a lot of interest in how the oral category stays will develop. It's clear for us all along that we have a head start here.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

We have not pushed it as hard as we do now until we have ramped up manufacturing. We have seen significant scaling and efficiency step up in our API facility in The U. S. And when we submit the data to FDA, you can assume that we have what it takes to do a full launch in The U. S.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

And bear in mind, as was also alluded previously, this is a molecule with tremendous safety data, so more than 30,000,000 patient lives. And I think we shouldn't belabor that point as physicians and patients make choice on a trusted product. And of course, efficacy is similar to what we have with Wegovy. So really Wegovy is in a pill I think is a very attractive offering. And assuming positive outcome with agency, we're ready to give this a big push and also on this point show a very strong commercial execution.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

So thank you, Pete, for that.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, Lars, and thanks a lot, Pete, as well. And with that, we are ready to the next set of questions, please.

Operator

Thank you. Your next question comes from the line of Martin Parcouille from SEB. Please go ahead.

Martin Parkhøi
Head of Equity Research at SEB

Yes. Good afternoon. Martin Parcouille, SEB. Just two questions. Just last coming back to CVS again, because one of the buzzwords that you have used for many years now is optionality.

Martin Parkhøi
Head of Equity Research at SEB

And I can understand CVS is a win for Novo, win for Vigovi. But do you think it's a win for patients in U. S. To lose optionality and exclude another obesity product? Then secondly, also back to oral sema twenty five milligram.

Martin Parkhøi
Head of Equity Research at SEB

I just understand that you said that you have you can run with full steam when you launch. But what kind of opportunity do you see? How big a part of a market would actually like to have BIGOWI in a pill instead of BIGOWI as we know it today?

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Great. Thanks a lot for those two, Martin. And I think, again, both will go to you, Lars. So firstly, on the CVS one.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Yes.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

So thank you, Martin, for the questions. You are right that we support optionality and open access to products. We believe it's in the best interest of patients and physicians that they can make the choice for the patient and different patients have different needs, so we support that. So this is a situation where it's not a decision made by us. We have not made, say, a bid on an inclusive contract, but it's a choice that CVS has made.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

We appreciate the partnership we have with CVS over many years. And as Dave also alluded to, it's a partnership that now also includes our cash program in the 9,000 CVS outlets. So it's their choice. So it's not really something we have a say in. But of course, we do appreciate the perception about the product and what it can.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

And I think it talks to the real world experience of Wegovy and, of course, also for a payer, what is the tangible value of reducing the risk of cardiovascular disease and hopefully also near term, say, the best mesh profile you can think about. And getting all of that in one product is very, very attractive from a payer perspective. In terms of the ALL opportunity, I think it's important to note that this is about competition within a category of those who prefer an ALL. We believe a majority of patients would still benefit the best from being on injectable therapy. That's where you get typically efficacy.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

And also, have learned over the past few years that weekly injection is actually very, very convenient. Having to deal with your disease once a week in a very simple device solution is very convenient for patients. And I think physicians are nowadays very comfortable in prescribing injectable. Having said that, there are patients who prefer an oral, and we are pleased that we can compete very well in this segment. We believe it will be way smaller than the injectable segment.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

And being first to the market with a known molecule, known efficacy, known safety and also a very some try to say that it's not as convenient. In our view, it is very convenient. You wake up in the morning, you take a tablet with some water and you're ready for your day. So we believe we can play very well in a smaller segment compared to the oral injectable category and will be first assuming a positive regulatory outcome. Thank you, Martin.

Martin Parkhøi
Head of Equity Research at SEB

Thank

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Lars, and thank you, Martin. And then we're ready to move on to the next question, please.

Operator

Thank you. Your next question comes from the line of Michael Niedelkovic from TD Cowen. Please go ahead.

Michael Nedelcovych
Director - Equity Research at TD Cowen

Thank you for the questions. I have two. My first relates to potential political risk. The current administration in The US has at times singled out GLP-1s when it raises the issue of apparent price disparities between The US and other countries. Novo is presumably deep into negotiations with CMS about the IRA price discount for semaglutide starting in 2027.

Michael Nedelcovych
Director - Equity Research at TD Cowen

Do you sense any risk if the administration plans to take this as an opportunity to make an example of GLP-1s and demand a particularly severe price cut? That's my first question. And then my second question relates to the pipeline and specifically, amicretin. I believe Novo has been in discussion with the FDA about Phase III planning for an obesity trial, but the R and D milestone slide does not include a trial start in 2025. Can you tell us whether a Phase III trial for amicretin could yet start this year?

Michael Nedelcovych
Director - Equity Research at TD Cowen

And when a Phase III obesity trial does start, has a decision been made as to whether the oral or subcutaneous formulation would be advanced first? Thank you.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Yeah, thanks a lot for those two, Mike. Again, I think for the first one, we'll go to you, Lars, on GLP-one price negotiations.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Yeah. Thank you, Michael. So, when you look at it, if you take Wegovy first, we have very limited Wegovy exposure in Medicare so far. And if you take some of the other, say, overall governmental funded channels like VA and Medicaid, Those are channels with somewhat lower price point and I think more comparable to what we see in other geographies. If you look at Ozempic, obviously, there's a bigger share of business in Medicare and that's then what's being discussed under the IRA.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

And I cannot go into specifics around it because it's still relatively early days, But I think there is an established, say, mechanism in dealing with that. So I would actually say from an overall political risk point of view, I actually think we're in a good spot because our book of business pricing exposure is either lower or is already in ongoing price negotiations compared to perhaps other products that sit parts of Medicare with higher price point or has not yet been opened up for negotiations. So I see relative limited, say, additional risk compared to what we're already facing. Having said that, it is still early days and an ongoing process.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks for that, Lars. And for the second one on amicotin, we'll hand it over to you, Martin.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Yes. Thank you very much for the question. So, not a lot of new to add from last quarter. As you know, the process is to submit an end of Phase II package specifically to the FDA, but also to other regulatory authorities. We are in that process and respect an outcome within the next couple of months.

Martin Lange
Martin Lange
Executive VP of Development & Member of the Management Board at Novo Nordisk

Then we will know and this is what we plan for, this is what we expect if we can progress into Phase III. And that Phase III program will be initiated with current timelines in Q1 of next year. And the focus for the Phase III program will be both oral and injectable.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Martin, and thank you, Mike. And then we are ready to take the next set of questions, please.

Operator

Thank you. Your next question comes from Sachin James, Bank of America. Please go ahead.

Sachin Jain
Stock Analyst at Bank of America Securities

Hi there.

Sachin Jain
Stock Analyst at Bank of America Securities

Thanks for taking my questions. I'm just going to try and push Kost and Dave on some of topics, if I may, if there's any more color you're willing to give. So firstly, on the compounded semi sort of patient funnel, Kost, maybe you could just give us any color as to what you're seeing for inventory in the system. We've heard estimates as anywhere between three and twelve months. And then any color on what percentage you expect to shift to branded given that they're on compound because they can't afford it or it's not covered.

Sachin Jain
Stock Analyst at Bank of America Securities

And I'm going to be provocative on the branded capture. Some of what we hear is these patients come off compounded CEMA, cash patients may prefer Lilly given a cheaper syringe and vial strategy and Zepbound perception safety is beginning to edge with Gauvee. I know that's provocative, but I wonder if you could just touch on that. And then finally, lot of what we've discussed has been the obesity market, but I wonder if you could touch on Ozempic. I'd assume limited compounding impact, market slowing down, you're losing share to Monjaro, so it's not exactly clear to me what changes there second half.

Sachin Jain
Stock Analyst at Bank of America Securities

Thank you.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Sachin, for those two questions. On the first on compounding, we'll hand it to Carsten, and then we'll hand it over to David. Anything to add before Dave goes on to the second question on Ozempic. But firstly, to you, Carsten.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

Yes. Thanks, Hatin. And I wish I could give you like razor sharp data points based on high quality market data. But this is a fairly young segment in terms of data and market research. So you're correct that within Telehealth, the setup is more towards subscription basis on three, six, nine, even twelve months, where patients get the incentive through a lower subscription rate if they sign up for a longer period of time.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

So, yes, most likely there will be some patients sitting with inventory on May 22. We don't have really good data on that, but that's also why we're cautioning in our outlook section of our company announcement that the market should expect a step up mainly in the second half of this year from compounding and of course the CVS contract. As to brand and drop off to different solutions, price sensitivity, etcetera, I'll hand that over to Dave on the end market understanding of that one. Over to you, Dave.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Thank you, Carson. We believe the strong label Wegovy as well as the brand awareness of Wegovy And the fact that the semi compounded is overweight, we think that there is certainly a focus with healthcare practitioners to maintain that continuity of care. And what we've heard is the availability of branded Wegovy through these new channels, meeting the patients where they are, is a very important step in terms of that transition and the funneling of patients. As Carsten mentioned, of the total number of compounded patients today, some will drop off. But certainly, as you mentioned in our guidance, we do expect to capture and see a real interest in patients coming over to the real ECLOVI.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

And then I'll shift over to Ozempic, Sachin. As we're seeing this year, far, the growth of the GLP-one class, it does continue. It's lower than what we've seen in years past at fifteen percent, but that still leaves plenty of opportunities, still runway for future growth. And this continues to be a game around NBRx and our commercial leverage. So here are the things that we're focused on in The U.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

S. With Ozempic. First of all, our overarching commercial focus is leveraging the Ozempic label, the broadest of any GLP-one label on the market, and continues to be the most widely known GLP-one as well. Our commercial efforts during this year include the launch of a new campaign called the Ozempic Era campaign. We are in the Ozempic Era, and our patients are experiencing that and that the understanding of the broad label is something that now both patients as well as physicians understand.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

And then lastly, we continue to focus on decreasing the outflow, meaning maintaining longer stay time and having patients have the full effect in getting to the two milligram dose. Thank you.

Karsten Knudsen
Karsten Knudsen
Executive VP, CFO & Member of the Management Board at Novo Nordisk

And just building on Dave's comment before we hand it back to Jakob, then for Ozempic, also our market research indicates a certain level of compounding, not a lot, but potentially in the mid single digits of GLP-one diabetes treatment in The U. S. So after May 22, there might also be an uplift there to go for and benefit for with the tactics Dave just covered. Over to you, Jacob.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Carsten. And with that, I think we are ready for the final set of questions, please.

Operator

Thank you. Your final set of questions come from the line of Jo Walton from UBS. Please go ahead.

Jo Walton
Jo Walton
Pharma Analyst at UBS Group

Thank you. You've talked a lot about pricing and your, you know, strong commercial focus. Could you give us an idea of what you think a typical price point would be for a compounded semaglutide and and how far adrift that is of the $500 that you're charging? The reason that I ask is I assume that this is a price sensitive market, and yet the starter dose from your competitor is only $350. And I wonder whether people just can't move step up from whatever they're paying today up to that 500 and the $3.50 is a very compelling starting point for the compounder.

Jo Walton
Jo Walton
Pharma Analyst at UBS Group

Could I also just ask if you could tell us what the, average stay time is, now that you've got, less of a supply constraint, whether you're seeing that obesity stay time get longer or whether you're still having to reacquire patients every few months. And if nobody minds, I'd also just like to take this opportunity to let people know that after forty years as an analyst, this is my last purely pharma sell side call. Novo was one of the first companies outside of The UK that I covered back before the merger of Novo and Nordisk, so I really am that old. But it'll soon be time for me to move on. I have a couple of projects I need to complete before I leave the UBS team fully in Matthew's very capable hands, but I want to say it's been an enormous privilege to watch the development of many life cycles of drugs and to work with so many people in Novo and other companies, clients and competitors, many of whom I'm very proud to count as friends.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thanks a lot, Joe. And and first and foremost from team Novo, thanks a lot. Congratulations on a very impressive career. On your two questions, let's move to Dave. Dave, first of all, on GLP-one pricing for the real VIGOBI as well as for compounded ones and then on stay time.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

Yeah. Thank you for the question and also congratulations to you. There is a range of prices that we hear in the marketplace and it really does depend on whether or not that is a bundled price with a telehealth company in terms of offering their telehealth services, as well as medicine. As you pointed out, less for the compounded GLP-one than what we're seeing in terms of the cash prices. No question.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

When we think about the funnel, and we talked about the guidance and expectations that Karsten mentioned, certainly we do expect some patients not to transition, meaning they may be on a compound of GLP-one, and they may not transition over to a branded medication. One of the things that's important for us though, is to ensure that we are educating around the availability of Wegovy through commercial insurance. We have over 55,000,000 Americans that have coverage for Wegovy, where they would receive the medicine for a low branded copay. And what we've learned is many patients on compounded GLP-one do have insurance. So educating them, doing insurance verification as part of our commercial efforts is also important.

Dave Moore
Dave Moore
President & EVP - US Operations at Novo Nordisk

And then to answer your question on stay time, the current twelve months average stay time is around seven point four months that continues to increase as the brand grows and more and more patients continue with their therapy over time. Thank you.

Jacob Martin Wiborg Rode
Jacob Martin Wiborg Rode
Head of IR at Novo Nordisk

Thank you, Dave, and thank you, Joe. And with that, we are done with the Q and A, please, and I'll hand it over to Lars for a set of final remarks.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Yes. Thank you, Jago. We delivered 18% growth in the first quarter driven by our innovative treatments. And we had to lower our guidance for the year because of how big compounding has been of semaglutide. I hope you feel we have a clear plan for how to counter that, close that down and really use our credit taxes outlined today to gain a fair share of those patients.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

We remain very confident in the market opportunity, the number of people with obesity willing and interested in seeking care. And as we scale capacity and progress with our R and D pipeline, not least oral semaglutide twenty five milligram, and I would also say upcoming data for cacossema, we feel really excited about our opportunity in this space. So I'll close with that and also thank Joe and wish you the best of luck for the future. And thank you all for participating in this call. Thank you.

Lars Fruergaard Jørgensen
Lars Fruergaard Jørgensen
President & CEO at Novo Nordisk

Bye bye.

Operator

Thank you. This concludes today's conference call. Thank you for participating. You may now disconnect.

Analysts
    • Jacob Martin Wiborg Rode
      Head of IR at Novo Nordisk
    • Lars Fruergaard Jørgensen
      President & CEO at Novo Nordisk
    • Dave Moore
      President & EVP - US Operations at Novo Nordisk
    • Maziar Doustdar
      Executive VP of International Operations & Member of the Management Board at Novo Nordisk
    • Martin Lange
      Executive VP of Development & Member of the Management Board at Novo Nordisk
    • Karsten Knudsen
      Executive VP, CFO & Member of the Management Board at Novo Nordisk
    • Richard Vosser
      Managing Director at JP Morgan
    • James Quigley
      Executive Director at Goldman Sachs
    • Peter Verdult
      Managing Director - Pharmaceuticals Equity research at BNP Paribas
    • Martin Parkhøi
      Head of Equity Research at SEB
    • Michael Nedelcovych
      Director - Equity Research at TD Cowen
    • Sachin Jain
      Stock Analyst at Bank of America Securities
    • Jo Walton
      Pharma Analyst at UBS Group
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Key Takeaways

  • In Q1 2025 Novo Nordisk reported 18% sales growth and 20% operating profit growth, serving nearly 46 million patients with its diabetes and obesity portfolio.
  • Unlawful compounding of semaglutide in the U.S. has weighed on branded GLP-1 penetration, prompting a full-year sales guidance cut to 13–21% growth and deployment of legal, pricing and access measures to transition patients to branded treatments.
  • The company completed the pivotal REDEFINE-2 trial for its next-generation obesity candidate cagriSEMAb, remains on track to file in Q1 2026, filed an NDA for oral semaglutide 25 mg (“Wegovy in a pill”), and secured FDA priority review for its NASH indication.
  • To expand patient access in the U.S., Novo Nordisk launched a $499/month self-pay Wegovy program via NovaCare Pharmacy, struck telehealth partnerships, and gained placement as the sole GLP-1 for obesity on CVS’s national formulary.
  • International Operations delivered 19% sales growth in Q1, led by a 137% surge in obesity care (primarily Wegovy), and maintained a global GLP-1 volume market share above two-thirds.
A.I. generated. May contain errors.
Earnings Conference Call
Novo Nordisk A/S Q1 2025
00:00 / 00:00

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