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    NVO
    Earnings call· Sep 2025(Q3 FY25)

    NOVO NORDISK A S NVO

    Nov 5, 2025 Source

    Executive summary

    Novo Nordisk Q3 FY25 — Strategic Refocus and Pipeline Expansion Amidst Competitive Headwinds

    Novo Nordisk delivered solid Q3 FY25 results, driven by strong obesity care sales and a strategic refocus on diabetes and obesity, supported by pipeline acquisitions and a company-wide transformation. Despite competitive pressures and a narrowed full-year outlook, the company is expanding its portfolio and commercial efforts, including direct-to-patient initiatives and preparing for the launch of the Wegovy pill, to address the substantial unmet medical need in its core therapeutic areas.

    Highlights

    5

    • Sales grew by 15% at constant exchange rates in the first 9 months of 2025.

    • Operating profit increased by 10% at constant exchange rates in the first 9 months of 2025.

    • Approximately 46 million people are now benefiting from Novo Nordisk treatments, an increase of 3 million GLP-1 users in 12 months.

    • Obesity care sales increased 41%, driven by 83% growth in International Operations and 24% in U.S. Operations.

    • Mim8 for hemophilia A has been submitted for regulatory approval in both the U.S. and EU.

    Concerns

    5

    • Full-year sales growth guidance narrowed to 8%-11% (from 10%-13%) due to lower expectations for GLP-1 treatments in diabetes and obesity.

    • Full-year operating profit growth guidance narrowed to 4%-7% (from 7%-10%) due to lower sales growth and acquisition costs, despite DKK 8 billion in restructuring savings.

    • Gross margin decreased to 81.0% from 84.6% in 2024, impacted by DKK 3 billion in restructuring costs and impairments.

    • Free cash flow guidance lowered to DKK 20 billion-DKK 30 billion (from DKK 30 billion-DKK 40 billion) reflecting lower-than-expected trade receivables and adjusted capex.

    • GLP-1 market share loss in International Operations, with market share declining from 80% two years ago to 50% currently.

    Guidance & targets

    9
    CategoryTargetConfidence
    Full-year 2025 Sales Growth
    8%-11%
    high materiality
    High
    Full-year 2025 Operating Profit Growth
    4%-7%
    high materiality
    High
    Full-year 2025 Net Financial Items
    gain of around DKK 2.6 billion
    medium materiality
    High
    Full-year 2025 Capital Expenditure
    around DKK 60 billion
    medium materiality
    High
    Full-year 2025 Free Cash Flow
    DKK 20 billion-DKK 30 billion
    high materiality
    High
    2026 Global Sales Growth Impact from Semaglutide Patent Expiry
    negative low single-digit impact
    high materiality
    High
    2026 Operating Profit Growth Impact from Akero Acquisition
    negative 3 percentage points
    high materiality
    High
    Semaglutide MFP Impact (hypothetical 2025)
    negative low single-digit impact on global sales growth
    high materiality
    High
    Semaglutide MFP Effective Date
    1st of January 2027
    high materiality
    High

    Segment performance

    3
    SegmentRevenueYoYQoQMargin
    Total Company
    Sales growth at constant exchange rates for the first 9 months of 2025. Operating profit growth at constant exchange rates for the first 9 months of 2025.
    		15%15%—10%
    U.S. Operations
    Sales growth for the first 9 months of 2025. GLP-1 diabetes sales driven by Ozempic uptake, partially countered by Victoza and Rybelsus. Insulin sales positively impacted by gross-to-net adjustments and channel/payer mix, partially offset by volume decline. Wegovy sales growth driven by increased volumes, partially countered by lower realized prices. FDA approved Wegovy for MASH in August.
    GLP-1 diabetes sales growth: 10%Insulin sales growth: 18%Obesity care sales growth: 24%Rare disease sales growth: 14%Ozempic weekly prescriptions: 670,000 standard units (vs 690,000 in Q2 FY25)Wegovy weekly prescriptions: 270,000 (vs 280,000 at end of last quarter)People with Wegovy coverage: 55 millionPeople with Medicaid coverage for Wegovy (estimated): 10 millionCompounded GLP-1 patients (estimated): well above 1 millionCash market share of total Wegovy prescriptions: around 10%
    		—15%——
    International Operations
    Sales growth for the first 9 months of 2025, driven by GLP-1 products. GLP-1 diabetes sales driven by Ozempic and Rybelsus. Region China GLP-1 diabetes sales decreased by 4% due to wholesaler inventory movements. Wegovy sales driven by growth across all regions. Oral semaglutide 25-milligram submitted in EU.
    GLP-1 diabetes sales growth: 10%Insulin sales growth: -2%Obesity care sales growth: 83%Rare disease sales growth: 13%Wegovy sales: DKK 20 billionWegovy sales growth: 168%GLP-1 market volume share: 68%GLP-1 class growth: 35%Rybelsus availability: >40 countriesOzempic availability: ~80 countries
    		—16%——

    Operational metrics

    10
    Gross Margin
    81.0%decreased from 84.6% in 2024
    9M FY25

    Decline mainly reflects impact of restructuring costs and impairments related to production assets, as well as amortization/depreciation related to Catalent and capacity expansions.

    Sales and Distribution Costs
    15%YoY at constant exchange rates
    9M FY25

    Increased by 12% in DKK and 15% at constant exchange rates, driven by U.S. and International Operations, primarily related to Wegovy. Includes DKK 2 billion in one-off restructuring costs.

    Research and Development Costs
    10%YoY at constant exchange rates
    9M FY25

    Increased by 9% in DKK and 10% at constant exchange rates, reflecting increased R&D activity, particularly in obesity care. Includes DKK 4 billion in one-off restructuring costs and impairments from closing non-core projects, partially offset by 2024 impairment losses.

    Operating Profit (Adjusted for Restructuring Costs)
    21%YoY at constant exchange rates
    9M FY25

    Operating profit increased by 16% measured in Danish kroner and 21% at constant exchange rates when adjusted for restructuring costs.

    Shareholder Returns
    DKK 53 billion
    9M FY25

    Returned to shareholders mainly through dividend payments.

    Annual Savings from Transformation Program
    DKK 8 billion
    Annual

    Expected annual savings from the company-wide transformation program, which includes a reduction of approximately 9,000 positions globally. Savings will be redeployed to expand diabetes and obesity franchises.

    Headcount Reduction
    9,000
    ongoing

    Expected reduction as part of the company-wide transformation designed to simplify the operating model and reallocate capital.

    GLP-1 Diabetes Market Growth (U.S.)
    10%vs Q3 FY24
    Q3 FY25

    The GLP-1 diabetes market grew around 10% in the third quarter of 2025 compared to the third quarter of 2024.

    People Served with Diabetes and Obesity
    46 million3 million more than 12 months ago
    9M FY25

    Number of people living with diabetes and obesity served by Novo Nordisk's GLP-1 treatments.

    Gross-to-Net Favorability Impact on Group Sales Growth
    2 percentage points
    FY25

    Estimated impact on group sales growth for FY25 that will not repeat in FY26.

    Industry KPIs

    10
    MetricValueDetails
    Prescription volume670,000 standard unitsprescriptions
    EPS revenue guidance8%-11% (sales), 4%-7% (operating profit)%
    Pricing policy impactnegative low single-digit impact%
    Pipeline clinical milestonesPhase Ib/II trial initiated
    Regulatory approvals filingsSubmitted
    Therapeutic drug market share68%%
    Glp 1 incretin franchise metricsDKK 20 billionDKK
    Geographic regional revenue growth15%%
    Clinical trial efficacy safety data11.8% weight loss%
    Business development capacity deal appetiteUSD 10 billionUSD

    Deals & partnerships

    5
    Akero TherapeuticsAcquisition of efruxifermin, a once-weekly subcutaneous long-acting FGF21 analog for MASH.

    Agreement to acquire Akero's efruxifermin, with potential to be first-to-market in F4 and best-in-class. Complements Novo Nordisk's MASH pipeline. Phase IIb data showed significant fibrosis regression in F4 patients.

    OmerosAcquisition of zaltenibart assets, a clinical stage MASP-3 inhibitor for rare blood and kidney disorders.

    Agreement to acquire zaltenibart from Omeros. Currently in Phase II for acquired rare blood disease paroxysmal nocturnal hemoglobinuria (PNH). Plans for global Phase III program in PNH.

    MetseraProposed acquisition to strengthen research and development portfolio in diabetes and obesity with innovative pipeline assets.Upfront payment of USD 62.2 per share in cash (approx. enterprise value USD 6.7 billion); up to USD 2.8 billion in contingent value rights (CVRs); total up to USD 10 billion or USD 86.2 per share.

    Metsera's pipeline includes MET-097 (potential best-in-class once-monthly GLP-1), MET-233 (next-generation amylin asset), and combination/preclinical assets. Deal structure includes upfront cash for nonvoting preferred stock (50% of capital) and CVRs for remaining shares based on clinical/regulatory milestones. Proposal aims to enhance portfolio and meet diverse patient needs in obesity.

    GoodRxCollaboration to expand direct-to-patient initiatives for Wegovy.

    Part of efforts to invest in expansion of direct-to-patient initiatives.

    CostcoCollaboration to expand direct-to-patient initiatives for Wegovy.

    Part of efforts to invest in expansion of direct-to-patient initiatives.

    Risks & headwinds

    8
    Lower GLP-1 Sales GrowthFY25

    Lower expectations for sales growth of GLP-1 treatments in diabetes and obesity led to narrowed FY25 sales guidance (8%-11% from 10%-13%).

    Mitigation: Strategic refocus on diabetes and obesity, pipeline expansion, cost control, and commercial partnerships to expand market access.

    Intensifying CompetitionOngoing, intensifying into 2026

    GLP-1 market share loss in International Operations (from 80% to 50% over 2 years).

    Mitigation: Focus on pipeline differentiation, expanding market access through new products (Wegovy pill), and commercial execution. Acknowledged as a dynamic market.

    Pricing Pressure and Access Challenges (U.S.)Ongoing, into 2026

    Lower realized prices for Wegovy in U.S. operations. Medicaid access to Wegovy affected by state budgetary concerns in 2026. Commercial payers maintaining high barriers.

    Mitigation: Investing in quality of access (lower utilization management, less prior authorization), expanding cash channels through partnerships (NovoCare Pharmacy, GoodRx, Costco), and launching the Wegovy pill to offer more options.

    Compounded GLP-1sOngoing

    Estimated well above 1 million patients in the U.S. currently on compounded GLP-1s.

    Mitigation: Continued investment in expanding access to safe and authentic Wegovy, highlighting safety concerns of non-FDA approved illicit APIs.

    Semaglutide Patent Expiry (IO)FY26

    Estimated negative low single-digit impact on global sales growth in 2026.

    Mitigation: Long-term volume strategy in International Operations, focus on unmet needs, and diversified pipeline.

    IRA Medicare Part D ImpactEffective January 1, 2027

    Hypothetical negative low single-digit impact on global sales growth for FY25 if effective then. Will be effective January 1, 2027.

    Mitigation: Accepted Maximum Fair Price (MFP) for Ozempic, Rybelsus, and Wegovy. Cannot comment on specifics due to CMS confidentiality.

    Acquisition-Related R&D CostsFY26

    Akero acquisition expected to lead to increased R&D costs with an estimated negative impact on full-year operating profit growth of around 3 percentage points in 2026.

    Mitigation: Strategic acquisitions are part of the long-term strategy to expand the pipeline and address unmet needs, with cost savings from transformation program redeployed.

    Alzheimer's Disease Trial (Evoke) OutcomeLater this year (readout)

    High-risk opportunity.

    Mitigation: Acknowledged as a high-risk opportunity, but data will be disclosed regardless of outcome.

    What to watch in Q4 FY25

    5

    Wegovy Pill FDA Decision

    by end of 2025
    CurrentAnticipated by end of 2025
    TargetApproval and launch readiness for early 2026

    Why it matters

    FDA approval of the oral Wegovy formulation is a major catalyst for expanding market access and driving future growth in obesity care.

    Looking forward, we expect the FDA decision regarding the new drug application for the Wegovy pill by the end of this year.

    Q&A highlights

    6

    Despite a massive 9 percentage point global market share loss in the combined obesity and diabetes GLP-1 market over the last 12 months, what specific strategic initiatives is Novo Nordisk implementing to reverse this trend, especially given the limited impact of Q3 U.S. pricing?

    Mike Doustdar acknowledged the market share loss but emphasized focusing the company's strategy on diabetes and obesity, expanding the pipeline through internal development and acquisitions, controlling costs, and expanding market access through new products like the Wegovy pill and commercial partnerships (Costco, Walmart, GoodRx, LifeMD, Ro). He stated it's a 'marathon, not a sprint' for these measures to take effect.

    “But our job right now is to focus the company's strategy around diabetes and obesity predominantly because we see a huge expansion potential as we go forward. We are expanding our pipeline through our own activities as well as, of course, acquisitions. We are getting our costs under control to invest and really make sure that no stone is unturned and we're really putting most of our efforts at this point in expanding the markets.”

    asked by Carsten Lønborg Madsen · answered by Maziar Doustdar

    2 min read6 chapters

    Detailed Narrative

    01

    Strategic Refocus on Diabetes and Obesity

    Novo Nordisk is sharpening its strategic focus on diabetes, obesity, and related comorbidities, moving away from non-core areas like stem cell research for Parkinson's disease. This commitment aims to address the unmet medical needs of over 1 billion people affected by these conditions. The strategy involves internal product development, partnerships, and acquisitions to expand the portfolio and explore new indications, ensuring resources are directed towards areas of greatest impact.

    02

    Company-Wide Transformation and Cost Savings

    A company-wide transformation program has been launched to simplify the operating model, accelerate decision-making, and reallocate capital. This initiative includes a reduction of approximately 9,000 positions globally, expected to generate DKK 8 billion in annual savings by the end of 2026. These savings will be reinvested into expanding diabetes and obesity franchises and funding strategic priorities, aiming to increase operational efficiency and strengthen long-term growth.

    03

    U.S. GLP-1 Market Dynamics and Access Challenges

    In the U.S., GLP-1 diabetes care sales increased by 10%, driven by Ozempic uptake, but weekly Ozempic prescriptions saw a slight decline to 670,000 standard units. Wegovy sales increased by 25%, but weekly prescriptions also slightly decreased to 270,000. The company faces intensifying competition, pricing pressure, and challenges with access, particularly in Medicaid due to state budgetary concerns. Compounding of GLP-1s continues to be a significant issue, estimated to affect over 1 million patients.

    04

    International Operations Growth and Competition

    International Operations sales grew by 16%, primarily driven by GLP-1 products. Obesity care sales surged by 83% to DKK 22.4 billion, with Wegovy sales reaching DKK 20 billion, growing 168%. Despite strong growth, the company acknowledges intensifying competition, particularly from Eli Lilly, leading to market share loss in some regions. However, Novo Nordisk remains the market leader in the combined diabetes and obesity GLP-1 market in International Operations with a 68% volume share.

    05

    Pipeline Advancements and Strategic Acquisitions

    Novo Nordisk continues to advance its R&D pipeline with key milestones including the submission of Mim8 for hemophilia A in the U.S. and EU. Strategic acquisitions like Akero's efruxifermin for MASH (F4 cirrhosis) and Omeros' zaltenibart for rare blood disorders complement the core focus. The company is also progressing internal assets like cagrilintide and CagriSema, with Phase III trials underway and anticipated readouts for amycretin and the GLP-1/GIP/amylin triagonist.

    06

    Wegovy Pill Launch and Device Strategy

    The U.S. FDA decision for the Wegovy pill is anticipated by year-end, with a launch planned for early 2026. This oral formulation is expected to expand market access, particularly through cash offerings and telehealth partnerships. While a setback occurred with the CRL for Wegovy FlexTouch, the company is exploring other device presentations, including vials, to offer more optionality in the market. The Wegovy pill will also be launched in selected international markets.

    AI-generated summary of the company’s earnings call. Not investment advice.