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Jacob Rode (Head of Investor Relations)
Welcome to this Novo Nordisk earnings call for the first nine months of 2025. My name is Jakob Ohl and I’m the Head of Investor Relations. With me today are CEO of Novo Nordisk, Mike Dubbs, Executive Vice President, Product and Portfolio Strategy, Nourbeek Heathcott, Executive Vice President, US Operations Dave Moore, Executive Vice President, Research and Development and Chief Scientific Officer Martin Hoitschlangen and Chief Financial Officer Carsten Munklossen. All speakers will be available for the Q and A session. Please note that the call is being webcast live and a recording will be made available on our website as well. The call is scheduled to last a little more than one hour. Please turn to the next slide. The presentation is structured as outlined on slide 2. Please note that all sales and operating profit growth statements will be at constant exchange rates unless otherwise specified. Next slide please. We need to advise you that this call will contain forward looking statements. These are subject to risks and uncertainty that could cause actual results to differ materially from expectations. For further information on risk factors, please see the company announcement for the first nine months of 2025 as well as the slides prepared for this presentation. And with that, over to you Mike for an update on our strategic aspirations.
Mike Doustdar (Chief Executive Officer)
Thank you, Jakob. Next slide please. In the first nine months of 2025 we delivered 15% sales growth and 10% operating profit growth. They’ve also narrowed our guidance range to 8 to 11% on sales and 4 to 7% for operating profit. This is because we expect lower growth for our GLP1 treatments in diabetes and obesity. Carsten will get back to the guidance update later in the call looking into the R and D in diabetes. Rybelsus is now approved in the US and EU with CV indications based on the sole trial within obesity and business development. We have progressed on a number of projects that Martin will come back to later in rare disease. We have not submitted MIMED for regulatory approval in both US and EU. We are now serving around 46 million people living with diabetes and obesity. This is around 3 million more people with our GLP1 treatment compared to just 12 months ago. Furthermore, I would like to note that 2025 strategic aspirations is our current framework for reporting and we look forward to updating this next year as the current strategic aspiration runs out. Next slide please. Since I became CEO, I have said several times that Novo Nordisk will sharpen its focus on core areas, specifically diabetes and obesity. I want to take a moment to explain how we have refined our strategy for more than 100 years. We have been guided by a simple purpose to identify and solve major unmet medical needs. This commitment is unchanged. There are many people who can benefit from expertise in diabetes and obesity and we believe we can serve them better than anyone else. Going forward, we will concentrate on these areas where we can make the greatest difference. Our strategy begins with patients at the center of everything we will do. Way more than 1 billion people are affected by diabetes or obesity. We will work tirelessly to develop products that help them live healthier, fuller lives. Some of these products will be developed internally. Others will be added to our portfolio through partnerships and acquisitions. Many of these assets can address multiple unmet needs. We will explore those opportunities and expand indications where appropriate to serve our patients. Speaking of patients, it is a known fact that obesity and diabetes vary by individual and often comes with comorbidities that lack effective treatments. As with the Akira acquisition, Novo Nordisk will keep pursuing innovation with identification within research and then advancing those to development. To address comorbidities within our core and the overlaps with those cores, we are now shaping our focus, sharpening our focus. In the past, we spread our resources into areas a bit further away from our core. Think about stem cell research for Parkinson disease. Therefore, during this last quarter we have discontinued several non core assets and redirected resources to areas aligned with our strength. We will intensify our commercial efforts to strengthen competitiveness to meet evolving market dynamics and increasingly consumer like behavior. We will, for example, expand telehealth capabilities across markets. In short, we remain disciplined about where we will compete within diabetes, obesity and related comorbidities in the years ahead. We will also continue our targeted research and commercial work in rare disease. And to support this strategy, we have launched a company wide transformation which I would like to give you an update on its progress right now, please go to the next slide. We previously announced a company wide transformation designed to simplify our operating model, accelerate decision making and reallocate capital and resource towards the highest growth opportunities in diabetes and obesity. This program supports our strategy to capture rising global demand and strengthening our competitive position in the increasingly consumer like obesity market. As part of the plan, we expect a reduction of approximately 9,000 positions globally. While this decision was not taken lightly, it is expected to drive approximately 8 billion DKK in annual saving by the end of 2026. Those savings will be redeployed to expand our diabetes and obesity franchises and fund strategic priorities. We recognize the human impact of these changes and remain committed to responsible transition for affected colleagues. At the same time, we’re confident this transformation will increase operational efficiency and strengthen our long term future and enhance return for our shareholders. I will now hand over to Ludovic for an update on our commercial execution for the first nine months of 2025.
Ludovic Helfgott (Executive Vice President, Product and Portfolio Strategy)
Thank you very much Mike and please turn to the next slide. In the first nine months of 2025, our total sales increased by 15%. The sales growth was driven by both operating units. US operations grew 15% and international operations grew 16%. Sales growth in the first nine months of 2025 was positively impacted by one offs in the US of around 6 billion Danish krone. Our GLP-1 sales in diabetes increased by 10% driven by both operating units growing. At the same rate. Insulin sales increased by 3% driven by US operations growing 18%. The sales increase was positively impacted by gross to net adjustments related to prior years as well as channel and payer mix. This was partially countered by a decline in volume. International operations sales decreased 2%. For Biopharmaceuticals sales increased 41% driven by US operations growing 24% and international operations growing 83%. Our rare disease sales increased by 13%. This was driven by sales increase in the US of 14% and in international operations of 13%. Next slide please. Sales in international operations grew by 16% in the first nine months of 2025 driven by GLP-1 product. GLP-1 diabetes sales increased by 10% driven by sales growth of Ozempic and Rybelsus. In region China, GLP-1 diabetes sales decreased by 4% which was negatively impacted by wholesaler inventory movements. Obesity care grew by 83% to 22.4 billion Danish Krone. Sales of WeGovy reached approximately 20 billion, growing at 168% driven by sales growth across all regions. Please go to next slide.
In the Combined Diabetes and Obesity GLP-1 Market, Novo Nordisk remains the market leader in international operations with a volume market share of 68%. Rybelsus is now available in more than 40 countries and Ozempic continues to be the leading GLP-1 diabetes product within international operations. Having launched in around 80 countries. In obesity, Wegovy is now launched in more than 45 countries with more to come. Oral semaglutide 25mg or WeGovy in appeal has been submitted in the EU for potential launch in selected EU markets. The GLP on class growth of 35% in international operations is encouraging and while competition in diabetes and obesity across international operations is amplifying, the unmet needs remain substantial. And with that I would like to hand it over to Dave for An Update on our U.S. operations.
David Moore (Executive Vice President, US Operations)
Thank you Ludovig. Please go to the next slide. Sales of GLP-1 diabetes care products in the US increased by 10% in the first nine months of 2025. The sales increase was driven by continued uptake of Ozempic, partially countered by Victoza and Rybelsus. Ozempic sales in the US were positively impacted by gross to net sales adjustments and wholesaler stocking. Weekly Ozempic prescriptions are currently around 670,000 in standard units compared to 690,000 standard units in the second quarter of 2025. The GLP-1 diabetes market grew around 10% in the third quarter of 2025 compared to the third quarter of 2024 in the U.S. we continue to invest in commercial activities and have recently launched Ozempic in our direct to patient cash offering. Please go to the next slide. Wegovy sales increased by 25% in the US operations in the first nine months of 2025. The WeGovy sales growth was driven by increased volumes partially countered by lower realized prices. Wegovy has around 270,000 weekly prescriptions compared to 280,000 weekly prescriptions. If at the end of last quarter in August we announced that the U.S. fDA approved WeGovy for the treatment of MASH in U.S. operations, we have established a sales force targeting U.S. hepatologists and gastroenterologists. While we work to build access in this segment generally, we also continue to work on expanding access to safe and authentic WeGovy. Around 55 million people with obesity have WeGovy coverage in the US with more than 10 million people estimated to be covered with Medicaid. However, looking into 2026, several states have already announced changes to coverage for obesity medicines in response to budgetary concerns which will affect Medicaid access to Wegovy. Regrettably, Novo Nordisk market research shows that compounding has continued to increase. Multiple entities continue to market and sell compounded GLP-1s and it is now estimated to be well above 1 million patients in the US that are currently on compounded GLP-1. Novo Nordisk launched Novo Nordisk Pharmacy in March of 2025 and together with retail channel total cash market is up around 10% of total WeGovy prescriptions. Novo Nordisk will continue to invest in the expansion of direct to patient initiatives like the recently announced collaborations with Goodrx and Costco. We continue to anticipate a regulatory decision regarding Wegovian appeal later this year which then we will be ready to launch in early 2026. Now back to you, Ludovic.
Ludovic Helfgott (Executive Vice President, Product and Portfolio Strategy)
Thanks Dave. Please turn to the next slide. Yesterday we confirmed that we submitted an updated proposal to acquire Medsera to further strengthen our research and development portfolio in diabetes and obesity. As we said before, unlocking the full potential of the obesity market will require a broad and deep portfolio with treatment options, formats, serving different patient groups and their very different preferences. Obesity treatment is still in its early stage and in Novo Nordisk we foresee future patient segments that for example, could be categorized based on bmi, age, gender, lifestyle behaviors and comorbidities. We believe that Medsera’s innovative pipeline would further enhance our opportunity to meet all these very different needs. Of all these very different groups, MET-97 is a potential best in class once monthly GLP1 treatment and MET-233 is a next generation amylin asset. The pipeline of Medsera also includes a combination of the two mentioned above, as well as innovative oral and injectable preclinical assets. Furthermore, medsera’s institutional knowledge and capabilities around peptide engineering and synthesis, high flight extension technologies and oral peptide delivery nicely complements Novo Nordisk’s core strength in research. The proposed deal structure includes an upfront payment of US$62.2 per share in cash, equal to an approximate enterprise value of US$6.7 billion. The cash consideration is paid at signing in exchange for a non voting preferred stock representing 50% of Medsera’s share capital. In addition, up to US$2.8 billion in contingent value rights will be issued upon the closing of the acquisition in exchange for the remaining shares. The CVRs are based on the achievement of certain clinical and regulatory milestones. In total, Medsera is eligible to receive up to USD 10 billion or 86.2 per share. Novon Nordisk believes that the proposal, including the structure of the transaction, complies with all applicable laws and is in the best interest of patients who will benefit from our commitment to innovation as well as Medsera’s shareholder. The offer highlights Novo Nordisk’s commitment to investing in the US and interest in continuing to grow the scale of its US investment. Now over to you, Martin.
Martin Holst Lange (Executive Vice President, R&D and Chief Scientific Officer)
Thank you, Ludovic. Please turn to the next slide. As Mike described, we are intensifying our focus on key therapeutic areas such as diabetes and obesity, while continuing our commitment to related comorbidities as well as rare disease. The strategy aligns with our recent acquisition agreements of Accuro, Enomeros, and Salzanibar assets. In early October, we announced the agreement to acquire Akira and Nephroxy Ferment a once weekly subcutaneous long acting FGF21 analog with potential to be first to market in F4 and best in class Froxy Fermin complements a strategic position in novo nordisk mesh pipeline. Current treatment options such as Wegoe primarily target patients with F2 and F3 disease stages. Consequently, there remains a significant unmet need in the F4 cirrhosis population for which no approved therapies are currently available. The phase 2 data for fyroxil fermin are encouraging across F2 to F4. Specifically, the Symmetry Phase 2b trial demonstrates that after 96 weeks of treatment, 29% of it for patients for improvement of at least one fibrosis stage with no worsening of mesh and 42% achieved mesh resolution without fibrosis worsening. This is the first phase 2 trial to show statistically significant fibrosis regression in F4 patients for an FGA21 analog effroxib fermin is currently in the phase 3 synchrony program with pivotal readouts in the coming years and expected launch by the end of this decade. As a result, efroxyphurmin has the potential to be first in class FGF21 analog targeting the F4 population as well as playing a role in F2 and F3 patients, including people who are not responsive to existing treatments. We look forward to leveraging our capabilities to further optimize the synchrony program trials, assess the potential combinations with our current GLT1 based portfolio and explore opportunities for additional indications such as alcohol liver disease. Also in October we announced the agreement to acquire the clinical stage mesh 3 inhibitor celtinibar from Ameris for rare blood and kidney disorders. This action aligns with the rare disease strategy with a key focus on rare blood disorders. Centenabad is currently in Phase two for the acquired rare blood disease, paroxysmal nocturnal hemoglobinuria or PNH. Plans are in place to begin a global phase 3 program for Saltinepad in PNA. The molecule holds big potential in a number of additional indications within rare disease and kidney disorders which will be evaluated at a later point in time. We believe our extensive expertise in the development, manufacturing and commercialization of medicines within these fields makes us well positioned to advance these assets, optimize the value of their innovation and ensure they reach the patients in need of these treatments in a very timely fashion. Please turn to the next slide. Looking towards our internal pipeline, we recently published a shop analysis of Redefine1 focusing on Cagillinside in the trial Cagillanside achieved 11.8% weight loss at 68 weeks. Assuming full treatment adherence, about 1 in 3 patients on Cragrilinside lost at least 15% of their body weight. Overall, caglintide was very well tolerated. The most common side effects were gastrointestinal of nature and the discontinuation rate due to gastrointestinal adverse events was 1.3%. Obesity is a global challenge that requires continued scientific innovation. More treatment options also focusing on tolerability are needed to meet the diverse individual needs and preferences. We are very encouraged by the first phase three data for CaguInside from Redefine1 and we look forward to studying it further. In phase three, the so called ReNew program, ReNu1 and ReNu2 will assess the 2.4mg dose in people with obesity with and without type 2 diabetes thryspectomy. Both trials have already been initiated and additional studies evaluating higher doses of caglantide are anticipated in the beginning of first half of 2026. Let’s turn to the next slide. Turning to the upcoming RD milestones, we’re looking forward to the remainder of 2025 with a number of read readouts and milestones. In the first half of 2026 we anticipate the readout of the Reimagine3 which is the first of three pivotal trials for Cachlecema and people with type 2 diabetes. Reimagine3 is a smaller study with Cagrisema as an add on to basal insulin. Reimagine 2 is the larger study which will provide comparison to semaglutide and will read out in the first quarter of 2026. We also look forward to the Phase 2 results of the subcutaneous and oral amitritin in type 2 diabetes in Q4 this year within obesity, we completed the Phase 1 trial with our internal GLP1 GIP AMYN triagonist. The study assessed the safety, tolerability, pharmacokinetics and pharmacodynamics of the triagonist in the trial. All multiple doses tested appear to have a safe and well tolerated profile. The results of this study allowed progression to a Phase 1b2 trial in individuals with overweight or obesity which was initiated in October of 2025. Looking forward, we expect the FDA decision regarding the new drug application for the wegoe pill by the end of this year. Further, the submission of caicosima as well as the readout of the redefined portfolio remains on track for the first quarter 2026 within rare disease. We have filed MIMATE as of once monthly, once every 2 weeks and once weekly ...
