I would now like to turn the conference over to your speaker, Jacob Martin Wiborg Rode, Head of Investor Relations. Please go ahead.

Thank You. Welcome to this conference call regarding the changes to Novo Nordisk executive leadership as well as the lowering of the financial outlook for 2025 that we announced today.

My name is Jacob Rode, and I’m the Head of Investor Relations at Novo Nordisk. With me today, I have Helge Lund, Chair of the Board of Directors of Novo Nordisk; CEO of Novo Nordisk, Lars Jorgensen; Chief Financial Officer, Karsten Knudsen, Executive Vice President, U.S. Operations; Dave Moore; and finally, Executive Vice President, International Operations and incoming CEO as of August 7, Mike Doustdar. All speakers will be available for the Q&A.

Today’s announcements are available on our website, novonordisk.com. Please note that the call is being webcasted live, and a recording will be made available on our website, too. The call is scheduled to last for a maximum of 45 minutes.

Next slide, please. The presentation is structured as outlined on Slide 2. We will briefly cover both of today’s announcements. First, Helge will cover the appointment of Mike Doustdar as new President and CEO of Novo Nordisk as well as other executive level changes briefly. Following that, Karsten will review the update to the financial outlook, where Novo Nordisk today lowered the sales and operating profit expectations for 2025. The presentation will be followed by a Q&A session beginning in approximately 15 minutes.

Please note that all sales and operating profit growth statements will be at constant exchange rate, unless otherwise specified.

Please turn to the next slide. Before I hand over to Helge, 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. For further information on forward-looking statements and risk factors, please see the company announcement for the first 3 months of 2025, which was released on May 7.

And with that, over to you, Helge, for a review of the changes to Novo Nordisk executive leadership.

Thank you, Jacob. Please turn to the next slide. In May of this year, it was announced that Lars Fruergaard Jorgensen will step down from his role as CEO of Novo Nordisk by mutual agreement with the Novo Nordisk Board. Following this announcement, we accelerated our ongoing succession process with Lars continuing as the CEO to support a smooth transition to new leadership.

Please go to the next slide. Earlier today, we announced that Lars will be succeeded by Mike Doustdar as President and CEO of Novo Nordisk. This announcement comes after a comprehensive search process, which included both external and internal candidates. The Board believes that Mike’s leadership, strategic vision and commercial execution experience makes him best suited to lead the company through the current market challenges while maximizing future opportunities.

Mike has been Executive Vice President and Head of International Operations since 2015, where he has consistently demonstrated his abilities to create value and drive growth. Under his leadership over the past decade, IO has more than doubled sales and grown to an organization of nearly 20,000 employees, serving around 35 million patients.

Given his leadership of international operations and his role on executive management since 2015, Mike has an extensive understanding of the company, its culture, its strength and also areas of opportunity. As CEO, Mike will be focused on strengthening the company’s global leadership in diabetes and obesity, enhancing commercial execution and driving greater efficiency across the company. Mike is an outstanding leader and truly committed to Novo Nordisk, our purpose and the patients we serve. He will take up the position as President and CEO from August 7, 2025.

After 34 years of exceptional service, Lars Fruergaard Jorgensen leaves Novo Nordisk with our deepest gratitude. His visionary leadership and steadfast commitment have driven the company’s remarkable growth and global impact, earning him widespread respect throughout the pharmaceutical industry. On behalf of the Board and all employees, we extend our sincere thanks and best wishes for his future endeavors, and a special thank you to Lars for ensuring a smooth handover to Mike.

In addition to the CEO announcement, we announced today that Novo Nordisk research and early development and the development function will be merged into one, appointing Martin Holst Lange as the Chief Scientific Officer and EVP for the full R&D function. In addition, Emil Kongshoj Larsen will succeed Mike in the role as Executive Vice President for International Operations. Also, these changes will be effective as of August 7, 2025. So we have a full team in place. And on behalf of the Board, I look very much forward to working with Mike and the team to deliver the company’s growth strategy.

So now over to Mike for a few words.

Thank you very much, Helge. It’s really a privilege to get this job. Let me start by thanking Lars for your leadership and support over so many years. I also want to thank you, Helge and the entire Board for their unanimous support. I really appreciate that.

Now the fact that my announcement comes right after the guidance update, well, it just makes the mandate ahead even more clear. We need to increase the sense of urgency and execute differently. But we’ll do that by building on the core strength that makes this company so unique. I take this job very seriously. You can expect me to be a CEO that combines strategic clarity with operational urgency. Soon I’ll be working closely with my management team, the Board and the entire organization to move forward.

We will sharpen our focus and move faster. We will operate more efficiently. We will advance our pipeline and keep pushing the boundaries of innovation and we will invest to accelerate growth and deliver shareholder value. That is my promise to you. I’m looking forward to working with my team after we close Q2, and I’m eager to meet the investor community as soon as possible.

Now back to you, Jacob.

Thank you, Mike. Please turn to the next slide. I would like to turn it over to Karsten for an update on Novo Nordisk’s financial performance and outlook for 2025.

Thank you, Jacob. Please turn to the next slide. In the first 6 months of 2025, Novo Nordisk sales increased by 18% and operating profit increased by 29%, both at constant exchange rates. Sales growth in the first 6 months of 2025 was positively impacted by gross to net sales adjustments related to prior years of around DKK 3 billion related to the 340b U.S. rebate provision.

Operating profit growth is positively impacted by the ocedurenone impairment in the second quarter of 2024 of DKK 5.7 billion. This was partially countered by the incremental impact related to the acquisition of the 3 former Catalent manufacturing sites of around DKK 2.6 billion in 2025.

Please go to the next slide. As announced earlier today, Novo Nordisk has lowered the full year outlook for 2025 compared to the outlook issued in May of this year. For 2025, the range for sales growth is now expected to be 8% to 14% at constant exchange rates. Given the current exchange rates versus the Danish kroner, sales growth reported in DKK is expected to be 4 percentage points lower than at constant exchange rates, primarily due to the depreciation of the U.S. dollar to the Danish kroner exchange rate.

The change in sales outlook for 2025 is driven by lower growth expectations for the second half of 2025. This is related to lower growth expectations for Wegovy in the U.S. obesity market lower growth expectation for Ozempic in the U.S. GLP-1 market as well as lower-than-expected penetration for Wegovy in select IO markets.

The lower growth expectation for Wegovy in the U.S. obesity market reflects the persistent use of compounded GLP-1 along with slower market expansion and competition. Despite the expiry of the FDA grace period for mass compounding on May 22, 2025, Novo Nordisk market research shows that the unsafe and unlawful mass compounding has continued, and that multiple providers continue to market and sell compounded GLP-1s under the [ 4 guise ] of personalization. Novo Nordisk is pursuing multiple strategies, including litigation to protect patients from knockoff semaglutide.

Novo Nordisk is deeply concerned that without aggressive intervention by federal and state regulators and law enforcement, patients will continue to being exposed to the significant risk both by knockoff semaglutide drugs, made by illicit foreign active pharmaceutical ingredients. As unsafe and unlawful mass compounding continues that Wegovy penetration in the cash channel is below expectations.

Within the cash channel, Wegovy prescriptions via NovoCare Pharmacy, including telehealth collaborations are currently around 11,000 total weekly prescriptions. This is in addition to around 20,000 weekly prescriptions in the retail cash channel.

Novo Nordisk will continue to invest in the expansion of direct-to-patient initiatives such as NovoCare Pharmacy and further collaborations with the telehealth organizations. The sales outlook also reflects lower-than-expected penetration of Wegovy in the insured channel. This is due to lower market expansion and competitive dynamics despite the initiation of new commercial activities for Wegovy in the first half of 2025.

Novo Nordisk is starting to see some positive indicators reflected in the latest NBRx data in the U.S., and we continue to engage in additional commercial activities. Further, we continue to expect a regulatory decision around the Wegovy MASH indication during the second half of 2025. Moreover, Novo Nordisk expects a positive volume contribution from the changes to the CVS national template formulary where Wegovy is now the only GLP-1 medicine covered for obesity as of July 1.

For Ozempic in the U.S., the updated outlook is negatively impacted by competition in the U.S. market. Novo Nordisk continues to invest in commercial activities and label updates towards driving further market penetration of Ozempic. In addition, although Wegovy sales in international operations are growing at high rates and launches are progressing, the sales outlook is reflecting lower-than-expected penetration of Wegovy in select IO markets due to slower market expansion and competition. With around 1 billion people living with obesity globally and only a few million on treatments, the outlook reflects a continued global rollout of Wegovy to more markets.

Operating profit growth is now expected to be 10% to 16% at constant exchange rates. Given the current exchange rates versus the Danish kroner, growth reported in DKK is expected to be 7 percentage points lower than at constant exchange rates. This is primarily due to the depreciation of the U.S. dollar to Danish kroner exchange rate. The updated expectation for operating profit growth reflects the lower sales growth outlook, partially countered by reduced spending. This includes a negative mid-single-digit operating profit growth impact related to the acquisition of the 3 former Catalent manufacturing sites.

Novo Nordisk now expects net financial items for 2025 to amount to a gain of around DKK 3 billion. 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 free cash flow is now expected to be DKK 35 billion to DKK 45 billion, reflecting the lower-than-planned expected sales growth. The lower growth is mainly driven by lower volume growth of GLP-1-based treatments in the U.S. and related cash flow implications amplified by the U.S. gross to net system. Novo Nordisk full disclosure of the financial results for the first 6 months of 2025 will be published on August 6, where more information will be available.

That covers the financial outlook for 2025. Now over to Lars.

Thank you, Karsten. Our performance in the first 6 months of 2025 with 18% sales growth reflects our continued commitment to treating more people with serious chronic diseases. That said, we cannot ignore the fact that we have reduced our full year outlook with headwinds from compounding in the U.S. slower market growth and competition challenging previous expectation.

With the updated outlook and plans to execute on recent commercial initiatives, the organization is poised to perform as Karsten described. Finally, I’d like to congratulate Mike with the role as CEO. I am confident that Mike that — under Mike’s leadership, Novo Nordisk will see significant growth opportunities and ultimately reach millions more patients.

Now back to you, Jacob.

Thank you, Lars. And next slide, please. With that, we are now ready for the Q&A.

[Operator Instructions]

I remind that the focus of this call, including this Q&A session is only on the changes related to Novo Nordisk executive leadership team as well as the financial outlook for 2025.

Operator, we are now ready to take the first question, please.

[Operator Instructions] And the questions come from the line of Michael Novod from Nordea.

Michael Novod from Nordea in Copenhagen. So looking into the second half of the year and very sort of muted expectations, can you try to give us a split between growth in IO versus U.S. for the second half? And also what kind of implications that could have for sort of the exit rates or entry rate into 2026, which also could sort of drive some concerns?

Thank you for that question, Michael. On the question, I’ll hand it over to you, Karsten.

Yes. Thank you, Michael, and thank you, Jacob. So — so with 8% growth in the first half of the year and the guidance range that we put out today with a midpoint of around 11%, then the applied growth in the second half of this year is mid-single digits. Do bear in mind, we have a tough comparator from last year linked to the gross to net adjustment of DKK 5 billion we did in the fourth quarter last year, which would take growth rate up from the mid-single digits to probably high single digits.

In terms of growth contribution from a geography point of view, then it’s important to note that the lowering of outlook we’re doing today is predominantly linked to the performance of our U.S. business. It’s a smaller piece that is related to a slower-than-planned penetration of Wegovy and IO, and as a consequence, when we release our results next week, you will see very healthy growth in IO in the first half of this year, and we expect that to continue into the second half of this year.

As to implications into 2026, of course, we will not guide for 2026 today. We’ll do that in conjunction with our full year results come February. So I’ll not go into further deliberations around 2026 for today.

Thank you for that, Karsten. Very clear. And thank you also to you, Michael, for the question. With that, I believe we are ready for the next question, please.

We are now going to proceed with our next question and the questions come from the line of Sachin Jain from Bank of America.

I just wanted to get a better understanding of what you’re assuming for both Wegovy and Ozempic as we exit this year and into next year. So for Wegovy, I guess you’re citing the main issue being compounders. So any color on how many patients still do you think compounded versus 1 million prior? And outside of litigation, which I guess could take quite a while. Is there anything that you can point to that would change that on a 6- to 9-month time frame?

And I guess similar question on Ozempic, you have much looser commentary within the PR around path to growth. Comp remains tough, scripts aren’t inflecting, assuming given the 5% to 10% price decline, fair to think that Ozempic is now trending towards sales declines from here?

Thank you for that question, Sachin. On compounding, I’ll give it first to Karsten.

Yes. Thank you, Sachin. So specifically on compounding at Q1 in May, we said that our market research estimate was 1 million patients using compounded GLP-1 for obesity treatment. Then the FDA grace period for all compounding on the 503b ended on May 22, and our assumption was that, that would lead to increased patients using branded GLP-1s in the second half of this year. Unfortunately, our latest market research indicates that, that has not happened, and that’s one of the assumptions that we have changed. So the latest market research still indicates 1 million patients or more being on compounded GLP-1 obesity the U.S. market.

Thanks for that, Karsten. Your second question, Sachin, on Ozempic dynamics, I’ll hand it over to, Dave.

Thank you for the question, Sachin. Yes, in regards to your question about Ozempic, we are seeing a flattish TRx development currently. We’re seeing approximately 690,000 TRxs per week on par with competition. But the current competitive dynamics, we see we’re capturing about 40% of the NBRx, and we do see patients switching from Ozempic to the competitor product as well. We haven’t seen a solid pickup from our newly approved indication in chronic kidney disease, although we do hear positive comments from clinicians. We haven’t seen that materialize into prescriptions as of yet.

And then secondly, we continue to see slower class growth of GLP-1 diabetes. And to some degree, there is also an impact from compounding, Meaning if someone is coming in and looking for Ozempic branded product, it is possible that they would end up on a compounded semaglutide.

Thank you, Dave, and I’ll hand over to you, Karsten, for some final comments.

Yes. So just adding on to my prior comments on compounded GLP-1s in the U.S. marketplace, it’s important that this is something we don’t take lightly. It’s a key safety concern. And of course, we are active on many, many fronts in [indiscernible] improving patient safety and using compounding to what is legally allowed. So we — and most other things are active in litigations and we’re working with regulators. And of course, we are hopeful that this can, over time, lead to a reduction in compounding and hence, a potential inflow of additional patients into the branded segments.

Thanks for that, Karsten. And also thank you to you, Dave. Then we are ready to move on to the next question, please.

We’re now going to proceed with our next question and the questions come from the line of Harry Sephton from UBS.

Brilliant. So maybe can you just contextualize the bottom end of the guidance. So it would imply that there’s limited sequential growth in the second half for that bottom end. We’ve seen the uptick in prescriptions with the CVS switch. NovoCare seems to have come through even if modestly and below your initial expectations? What are you expecting for the bottom end of that conservative? And then maybe just to add on to that, what are you expecting in terms of the net price erosion for both Wegovy and Ozempic in the U.S. for the full year and going forward?

Thanks for that, Harry. And I’ll get that question to you, Karsten.

Yes. So first of all, we have narrowed our range compared to the first quarter release back in May. So now we are guiding a plus/minus 3 to the midpoint. It’s not like we have a specific scenario taking us to the floor. It’s an assessment of the risk profile that we’re looking at that can — that can take us both to the top end and to the low end of the range. And of course, we are working hard each and every day to get the closest possible to the top end.

So really, the uncertainty factors to this is related to, I would say, the fairly usual uncertainty factors around performance of Ozempic and Wegovy and then the classic uncertainties around gross to net estimates in the U.S.

Perfect. Thanks for that, Karsten. And with that, I think we’re ready to move to the next question.

We are now going to move to the next question. And the questions come from the line of Martin Parkhoi from SEB.

Yes. Martin Parkhoi from SEB. Just a question to Mike. Now as the new CEO but you have, of course, also been there your entire career. So if we look back over the last 2 years, what would you have done differently in Novo Nordisk in order to prevent this situation that you’re standing in today? And what do you see as the main catalyst to see a rebound in growth over the next 2 or 3 years, will it — can it be driven by improved commercial execution or do we need a new product like all-sema and CagriSema before we can see a real change to where you are today.

Thanks for that, Martin, I’ll give that to you, Mike, reflecting on past challenges and leading into the future also.

Yes. Thanks very much. Martin, I would say in the tumult of high growth, we sometimes can overlook things, and that’s probably a bit what has happened. As we go forward, my promise is that we’re going to accelerate the growth and the shareholder value creation by predominantly 2 big things. One, we need to progress our pipeline and the innovation that helps us mid and longer term but also short term, get more out of what we have, the assets that we have and predominantly, we do that by improving the commercial execution.

We will focus more on some of the things that matters most in terms of that growth. I have no doubt we’re going to be faster and become more clear in our decision-making, reducing the white space in various different processes that we have. We’ll bring the performance culture that I’m very well aware of from my part of the world and try to do that across the whole organization. And then we will invest competitively in finding in the areas where we really need to invest and we will try to find efficiency and savings in the so-called less important areas.

Thank you for that, Mike. And also thank you to you, Martin. With that, we are ready to move to the next question, please.

We’re now going to proceed with our next question. And the question comes from the line of Evan Seigerman from BMO Capital Markets.

My question providing the update today. So as we think about kind of the go forward for your businesses, what are — how would you characterize the competitive dynamics in the United States? I know there’s a lot with compounding. Do you believe that the CVS switchover will be enough to reignite sales? Or do you need to look at other potential factors that can help kind of reignite the business?

Evan, thanks for those questions. Dave, I’ll turn it over to you on U.S. dynamics.

Thanks for the question, Evan. Overall, we believe there’s still substantial growth opportunity in the U.S. for GLP-1s. This is in both diabetes and in obesity. And we do have to continue to execute on the roadmap that we’ve presented earlier in the year. And as Mike said, with a focus and a sense of urgency around commercial execution. And let me just comment on a few areas and put a finer point to it.

The first, it is compounding, as you mentioned, and we have to continue to be aggressive and push avenues to limit unlawful compound. You could say in a way, we’re competing against compounded with a fake alternative of our medicine that is not safe for patients. We take it seriously, and we have stepped up our dialogue recently with FDA. And you may have seen last week, there were some letters from congressional leaders asking FDA to move on the illicit importation of API coming in from around the world, which is not even approved for use from where it’s coming from. It has to stop.

Secondly, as you mentioned, we do continue to expand in other channels. And right now, the expansion of the cash channel is important. We are encouraged with some of the signs that we have seen but it has still not picked up to our expectation that we guided in May, which is still overly due to compounding. But we have seen our cash business move from 4% early in the year to now 12%. And that is an encouraging sign that there’s an opportunity to meet patients where they are and have a cash offering.

Second — the third is commercial execution, and that is of utmost importance. Continuing to push our investments behind campaigns that we know are working. We have a new Wegovy DTC campaign that we’ll launch in the second half of the year, and we have launched real-world evidence around weight loss that we also discussed with you earlier in the year. And then lastly, the CVS conversion is on track. We think it’s an important element but we’re also seeing the opportunity for increased growth in other channels of retail as well. We are encouraged with recent trends but we still have a ways to go to meet the expectations. Thanks, Evan.

Thank you, Dave. And before going to the next question, just hand over to you, Mike, on the current dynamics in international operations.

I would say in international operations, of course, next week, we will release the full numbers but what you will see is that we are having a fantastic growth right now with Wegovy on the back of many, many more launches than what was originally planned. It is true that we are calling a bit short of our own ambition and plans that we made earlier on, but the numbers will hopefully satisfy you that this is going very, very well.

Besides, of course, expanding the footprint on Wegovy across the world. We’re also, as alluded to some time ago at the last quarter, we have restarted our Ozempic promotions across the world, and that should give us, in addition to Wegovy, an extra bit of growth, and we are increasing our online presence and telehealth partnerships. So we also open up that channel besides, of course, the other channels that we have had.

And if you look at IQVIA numbers today, we basically have about 2/3 of the patients under value of GLP-1 in international operations. If you add RYBELSUS to that number, then you’re closer to 3/4. And I would say we are very serious on upholding that and defending that as we go forward.

Thanks for that, Mike. And also thanks again to you, Evan, for the question. And with that, we are now ready to move to the next one, please.

We are now going to move to our next question. And the questions come from the line of Richard Vosser from JPMorgan.

I just wanted to go back on a question on the pricing dynamics in the U.S. With the pickup in CVS, I think the guidance, certainly at the bottom end and probably the middle implies continued price erosion, I think, for certain Wegovy and some of the brands. So could you give us an idea how to think on pricing going forward in the U.S.? And also just on gross to net, we’ve seen substantial 340b benefits in the first half this year, what’s the stop more benefits from 340B and part the redesign, et cetera, coming through in the second half? .

Thanks for those 2, Richard. They both goes to you, Karsten, firstly on high level pricing and then on gross net adjustments.

Thank you for those questions, Richard. So in terms of high-level pricing, then it’s important to say that the lowering of the guidance that we’re doing today compared to what we issued back in May is volume driven. So there are no major changes to pricing compared to what we announced last time. Then on top of that, when we look at pricing between the different brands, I would say there are no major changes to what we’ve been discussing on Ozempic as a general trend.

And then for Wegovy, what we’ve been saying is that as we expand the market and reach more patients, the market should expect that the average pricing to go down gradually over time linked to channel dynamics and reaching more patients. So I continue to gradually decline on ARP, which, of course, is enabling reaching many, many more patients in U.S. marketplace.

Then in terms of gross to net dynamics and Part D redesign, I’d say, for Part D redesign first. This is a relatively smaller impact to our numbers. It’s more like a spacing across the year of a few percentage points that we’re discussing. But beyond that, on an annual basis, no major change on that front.

As to 340B, we are still awaiting at least 1 key legal clarification in terms of interpretation of the rules in place. So pending that, and just with the passage of time will be kind of the deciding factor to how we deal with the partial recognition that we have on the 340B.

Thank you, Karsten, and thank you also to you, Richard. With that, we are then ready to take the next question, please.

We are now going to proceed with the next question. And the questions come from the line of Mike Nedelcovych from TD Cowen.

My question is for Mike. Do you plan to make any changes to Novo’s approach to business development? It would seem that now more than ever, the company is in need of mature late-stage pipeline opportunities? And I know that Novo has ambitions to broaden its cardiology footprint. To what extent will Novo pursue these ambitions through internal versus external R&D?

Thank you, Mike. That goes to you, Mike.

Yes. So I would have to, of course, get started, first and foremost and have a good dialogue with my team and the Board on the details. But what I can say today is we are going to focus on the 2 issues I touched upon earlier on. And one of it was progressing the pipeline and the innovation. We need to basically do that better and faster. And that does not exclude external innovation as well as, of course, seeing what we can do internally. So that’s where I leave it for now.

Thank you, Mike. We’re ready to move to the next question, please.

We are now going to take our next question. And the questions come from the line of Thibault Boutherin from Morgan Stanley.

Question is on the dynamics in international markets with Wegovy. You mentioned the growth through launches in new geographies but also competition in some select markets. When we look at some IQVIA data in Europe, in markets like U.K., Germany, Spain, we see very, very strong traction from Mounjaro and maybe a bit more limited update for Wegovy. So if you could give a bit more details on the dynamics you see in these countries? Is there — was there still any supply gating here? And how you think you can see that in this key developed markets ex U.S.

Thibault, thanks a lot for that. I think it goes to you, Mike, on competitive dynamics in international operations.

Yes. So I think you’re correct. If you handpick just a handful of markets, then you will probably find that in those handful of markets and amongst which the ones you mentioned, then we are right now not the leading player, and that’s something, of course, we like to change. But if you actually do look the rest of the IQVIA data, you will see that in a lion’s share of markets, we are upholding those leadership. We are having, of course, in a number of markets, China, as an example, a bit of a retraction of the market size, and we’ll allude to this more next week. And in other markets where we start with 100% market share and Mounjaro joins, then I think they should get their fair share but not more than that in market share.

And in general, I would say we are seeing in some of the markets where we were trailing behind quite a bit of movement related to our acceleration but we also have said that most of the product supply towards IO will be coming in, in the second half of the year. So that also you need to kind of be aware of.

Thank you, Mike. And also thank you to Thibault for the question. Then we’re ready to the next question, please.

And the next questions come from the line of James Quigley from Goldman Sachs.

Hopefully I had a question on the total U.S. market for obesity. So — how is that developing? And when we look at IQVIA trend since sort of last week of May here, there about — the prescriptions have been around about 670,000 between you and between your and between [indiscernible]. Obviously, the share has been shifting between that. But when you think about that plus the most recent data you have on compounding, what’s the total market doing? And how is that volume opportunity unlocked and what is Novo doing in order to take steps to unlock the total market opportunity? Obviously, the share of the compound is a key growth driver but from a total obesity perspective going forward in terms of patients, how is that progressing? And how Novo going to unlock that opportunity?

Thanks for that question. That goes to you, Dave, on efforts to further expand the market in the U.S.

Yes. Thanks very much, James. I appreciate the question. There’s still a tremendous opportunity in the U.S. market, as you mentioned. Over 100 million people living with obesity. You’ve heard from us before that we now have coverage over — with over 55 million people where employers have opted in to be able to receive Wegovy for low and reasonable co-pay. In terms of the market development and the script trends, we do continue to see Wegovy impacted by compounding. And as Karsten mentioned earlier, we estimate that’s about 30% of the market, around 1 million patients. And I’ll come back to what we’re doing to curtail compounding.

But in terms of the in-market growth, we do — we are encouraged with early signs that we are seeing. We’re seeing Wegovy come in as of late around 275,000 prescriptions per week and the NBRx is now up to 42%. We continue to compete for patients on an ongoing basis. And keep in mind, we are awaiting the MASH indication the second half of this year, which we do believe is an opportunity with 20 million people in the U.S. living with MASH. 80% of them have obesity, over 40% of them have type 2 diabetes, it gives us an encouraging opportunity ahead. But compounding continues to be an issue that we have to address for patient safety and also to bring this back to a traditional safe and branded market.

And here are a few of the things that we are doing, James. First is our own supply of safe approved Wegovy. It’s important to note that we have supply of Wegovy on the injectable side to treat all patients in the U.S., those that are seeking branded medications and those that are on take compounded and wish to transition over.

We also have commercial and medical affairs activities. We continue to raise the awareness of compounding, the safety, the substandard and the uncontrolled manufacturing, and we have an ongoing effort on the legal side. We have issued over 120 lawsuits. We’ve issued 1,000 synthesis letters, and we’re starting to see some of the effects of those efforts where compounding has been shut down. But importantly, we must have regulatory action. We must have enforcement from the FDA. And as I mentioned earlier, we have stepped up that dialogue and we will continue to, around the importation of illicit API as well as compounding that takes place with fake API. And that will give us an opportunity to convert those patients back to branded Wegovy, as Karsten mentioned, just has not developed yet because we haven’t seen that market reduce to this date.

We have time for 2 quick questions. Let’s take the first one, please.

We are now going to take our next question. And the questions come from the line of Emily Field from Barclays.

I just wanted to kind of dig into these efforts to limit compounding. Your company has been very consistent in this message around safety but for better or for worse, that’s not really resonating with whatever the subsegment of American patients. So — and the prior answer, Dave, you mentioned the lawsuits and the season desist letters. But have you followed suit against Hims? Can you see preliminary injunctions as part of these lawsuits?

Given that we’re off the drug shortage list, we all expected compounding to come down following this May 22 grace period date. So I guess I sort of was wondering what is within the company’s purview to get more aggressive in getting this to stop and defend your IT and defend your product?

Thank you, Emily. I’ll give that to you, Dave, to expand on previous answer?

Yes, absolutely. Happy to expand on that. So we won’t rule out anything categorically. All legal actions as well as efforts that we can take with the government as well as taking legal actions. So no ruling any of that out. We can’t comment on specific lawsuits, and we wouldn’t do that. We wouldn’t comment on legal strategies either but certainly pursuing all angles to ensure that we get this back to a branded market. We believe in our brands, and we believe in the opportunity and confident in our ability to compete in a branded pharmaceutical market.

Very clear. Thanks for that, Dave. And then we are ready for the final question, please.

We are now going to proceed with one final question. And the questions come from the line of Carsten Lonborg Madsen from Danske Bank.

All right. So when considering the turmoil and the challenges we have here, and also the huge CapEx program you have been running where you never really have told us exactly how much supply and how many patients you’re actually able to supply semaglutide to, then I was wondering whether you could share some thoughts about what will happen in case that you are not even close to maximizing on the production of semaglutide, whether there could be sort of a write-down of your asset base on the balance sheet or how you’re thinking about this?

Thanks for that, Carsten. I’ll turn that over to you, Karsten.

Yes. Thank you for that question. And in this context, it is important to remember what we heard from both Mike and Dave before around the significant unmet needs in both diabetes and obesity and the portfolio that we’re working with there. So as you know, in diabetes, when we look at the international operations, we’re looking at a penetration of only around 7% of scripts being on the GLP-1 compared to 19 or so in the U.S. So a very significant runway, especially in IO but also in U.S. in the diabetes, GLP-1 penetration, and that runway is even bigger on the obesity side.

And then I’d say on top of that, as I said in the beginning, this is predominantly a U.S. shortfall and the volume split between IO and U.S. is like 90-10 or something like that. So we believe that we will have a good use of the factories that we’re putting in place and we’re building right now in terms of what we’re going to deliver. And then also, do bear in mind that the factories we are building there, of course, for the in-line products that are on the market today but the factories, they are based on technologies that we expect to be able to apply for our pipeline products also. And here I’m thinking of products like CagriSema and amycretin to mention a few. So at this point, there are no indications of any potential write-downs.

Thank you, Karsten. And with that, we are concluding the Q&A session. Thank you for participating and feel free to contact Investor Relations in regards to follow up. Before handing off, I’ll give it to you, Helge for some final comments.

Thank you, Jacob. I would like to once again say thank you to Lars for his service as President and CEO of Novo Nordisk, and congratulations to Mike in his new role. The Board looks forward to working with Mike in the executive level during this important moment in time for Novo Nordisk. I also want to say that the reduction in guidance is a massively approach with utmost seriousness.

Nonetheless, Novo Nordisk has launched a variety of strategic investment and commercial initiatives, and we are already observing positive early indicators that support the company’s revised outlook and progress towards our mission to treat more patients with serious chronic diseases. So thank you.

This concludes today’s conference call. Thank you all for participating. You may now disconnect your lines. Thank you.