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    NVO
    Earnings call· Dec 2025(FY25)

    NOVO NORDISK A S FY25 earnings call NVO

    Feb 5, 2026 Source

    Executive summary

    Novo Nordisk FY25 — Strong GLP-1 Growth and Wegovy Pill Launch Amidst 2026 Pricing Headwinds

    Novo Nordisk delivered robust FY25 performance, driven by strong GLP-1 sales and the successful launch of the Wegovy pill in the U.S. The company is sharpening its strategic focus on obesity and diabetes, supported by significant pipeline advancements. However, the outlook for 2026 anticipates sales and operating profit declines due to substantial pricing headwinds and increased competition, which the company views as an investment in future volume growth.

    Highlights

    5
    • Total sales grew 10% at constant exchange rates in FY25.

    • Obesity care sales increased 31% in FY25, driven by Wegovy.

    • Wegovy pill approved by FDA in December 2025 and launched in January 2026 with over 50,000 prescriptions in its first three weeks.

    • GLP-1 market share in International Operations remains strong at 62% volume share.

    • CagriSema demonstrated superior A1c reduction of 1.91 percentage points and 14.2% weight loss in REIMAGINE 2 trial.

    Concerns

    4
    • 2026 adjusted sales growth is expected to be -5% to -13% at constant exchange rates due to pricing headwinds.

    • Operating profit decreased 1% in DKK in FY25, impacted by DKK 8 billion in restructuring costs.

    • Lower realized prices in the U.S. due to market access investments and MFN agreement are anticipated in 2026.

    • Reduced anti-obesity medication coverage in Medicaid in some states is impacting injectable Wegovy prescriptions.

    Guidance & targets

    21
    CategoryTargetConfidence
    Adjusted sales growth
    -5% to -13%
    high materiality
    Medium
    Adjusted operating profit growth
    -5% to -13%
    high materiality
    Medium
    Total cash returns to shareholders
    over DKK 60 billion
    medium materiality
    High
    Share repurchase program authorization
    up to DKK 15 billion
    medium materiality
    High
    Free cash flow
    DKK 35 billion to DKK 45 billion
    medium materiality
    Medium
    Capital expenditure
    around DKK 55 billion
    medium materiality
    High
    EU regulatory decision
    oral semaglutide 25 milligram and injectable semaglutide 7.2 milligram
    medium materiality
    Medium
    FDA regulatory decision
    semaglutide 7.2 milligram
    high materiality
    High
    FDA regulatory decision
    CagriSema
    high materiality
    Medium
    Phase III HIBISCUS readout
    etavopivat in sickle cell disease
    medium materiality
    High
    Regulatory decisions
    denecimig (formerly Mim8)
    medium materiality
    Medium
    Phase II data readout
    UBT251 (GLP-1, GLP/glucagon tri-agonist)
    low materiality
    High
    Initiate Phase II study
    UBT251 in type 2 diabetes
    low materiality
    High
    First readout from ZEUS Phase III trial
    ziltivekimab
    medium materiality
    High
    Results from REDEFINE 4 trial
    Wegovy vs tirzepatide
    high materiality
    High
    Results from REDEFINE 11 trial
    CagriSema weight loss potential
    medium materiality
    High
    New Phase III trial initiation
    CagriSema high dose
    low materiality
    High
    Phase II data readout
    UBT251 (in-licensed triagonist)
    low materiality
    High
    Initiate Phase Ib/II study
    Internal triagonist in obesity
    low materiality
    High
    AMBITION Phase III program start
    zenagamtide in type 2 diabetes
    medium materiality
    High
    AMAZE Phase III program start
    zenagamtide in obesity
    medium materiality
    High

    Segment performance

    16
    SegmentRevenueYoYQoQMargin
    Total Sales
    Growth at constant exchange rates in 2025.
    10%
    U.S. Operations
    Growth at constant exchange rates in 2025, positively impacted by one-offs.
    8%
    International Operations
    Growth at constant exchange rates in 2025, driven by GLP-1 products in obesity and diabetes care.
    GLP-1 volume growth: 44% in 2025GLP-1 market share: 62% volume share
    14%
    GLP-1 Diabetes Sales
    Total GLP-1 diabetes sales growth in 2025.
    6%
    GLP-1 Diabetes Sales (U.S. Operations)
    Growth driven by continued uptake of Ozempic, partially countered by Victoza and Rybelsus. Positively impacted by gross to net sales adjustments and market growth, partially countered by market share losses and lower realized prices.
    5%
    GLP-1 Diabetes Sales (International Operations)
    Growth driven by Ozempic sales.
    7%
    GLP-1 Diabetes Sales (Region China)
    Negatively impacted by wholesaler inventory movements.
    -5%
    Insulin Sales
    Total insulin sales decrease in 2025.
    -1%
    Insulin Sales (U.S. Operations)
    Positively impacted by positive channel and payer mix, partially countered by a decline in volume.
    2%
    Insulin Sales (International Operations)
    Impacted by market share losses.
    -2%
    Obesity Care Sales
    Total obesity care sales increase in 2025, driven by both operating units.
    31%
    Obesity Care Sales (U.S. Operations)
    Growth driven by Wegovy.
    15%
    Obesity Care Sales (International Operations)
    Growth driven by Wegovy, which launched in 35 new countries in 2025.
    73%
    Rare Disease Sales
    Total rare disease sales increase in 2025.
    9%
    Rare Disease Sales (U.S. Operations)
    Primarily driven by rare endocrine disorder products, mainly Sogroya launch uptake.
    7%
    Rare Disease Sales (International Operations)
    Primarily driven by rare endocrine disorder products, mainly Sogroya launch uptake.
    10%

    Operational metrics

    34
    Gross margin
    81%vs 84.7% in FY24
    FY25

    Decrease impacted by amortization and depreciation related to the acquisition of 3 Catalent manufacturing sites as well as one-off restructuring costs related to company-wide transformation.

    Operating profit (excluding restructuring)
    13%growth at constant exchange rates
    FY25

    Operating profit would have increased by 13% at constant exchange rates excluding the DKK 8 billion company-wide restructuring cost.

    Cash from operating activities
    DKK 120 billion
    FY25

    Generated from a net profit of DKK 102 billion.

    Capital expenditure
    DKK 60 billion
    FY25

    Towards manufacturing capacity expansion.

    Business development activities spend
    DKK 30 billion
    FY25

    To expand the R&D pipeline.

    Dividends returned to shareholders
    DKK 52 billion
    FY25

    Part of capital deployment.

    Proposed final dividend
    DKK 7.95
    FY25

    To be proposed at the Annual General Meeting on March 26, 2026.

    Total 2025 dividend
    DKK 11.702.6% increase vs last year
    FY25

    Including interim dividend paid in August 2025, marking the 30th consecutive year with increasing dividend per share.

    Sales rebate provisions reversal (340B)
    USD 4.2 billion
    2026

    Related to the 340B Drug Pricing Program in the U.S., positively impacting sales and operating profit in 2026.

    Restructuring costs
    DKK 8 billion
    FY25

    Company-wide transformation, main impact on operating profit.

    Global GLP-1 market growth
    over 30%
    2025

    The global GLP-1 market expanded significantly.

    GLP-1 volume growth (International Operations)
    44%
    2025

    Driving sales in International Operations.

    GLP-1 market share (International Operations)
    62%
    2025

    Novo Nordisk remains the overall GLP-1 market leader.

    Wegovy pill total prescriptions
    around 50,000over twice that of any prior anti-obesity drug launches
    week ending Jan 23

    Encouraging early uptake following January 5 launch, most prescriptions appear to be for new patients.

    Wegovy pill self-pay prescriptions
    around 45,000
    week ending Jan 23

    A significant portion of early Wegovy pill uptake is through self-pay.

    Wegovy pill commercial access coverage
    just below halfvs injectable Wegovy
    current

    Coverage currently via CVS, Prime, Optum and Anthem.

    Wegovy weekly prescriptions (injectable)
    around 230,000
    holiday week ending Jan 23

    Recent decline attributed to benefit changes at the turn of the year, including Medicaid coverage drops.

    Wegovy injectable self-pay prescriptions
    around 30%of total scripts
    current

    Increased efforts in the self-pay channel have led to a significant portion of injectable Wegovy scripts being cash-driven.

    Ozempic weekly prescriptions
    around 610,000
    current

    Current weekly prescription volume in the U.S.

    Ozempic self-pay prescriptions
    around 8,000
    per week

    Self-pay offering for Ozempic in the U.S.

    GLP-1 diabetes market growth (US)
    just over 10%vs Q4 2024
    Q4 2025

    Growth in the U.S. GLP-1 diabetes market.

    Branded anti-obesity market size growth (US)
    more than doubled
    last year

    The branded anti-obesity market in the U.S. has seen significant expansion.

    Total weekly TRx (Wegovy + Ozempic self-pay)
    close to 120,000
    current

    Across Wegovy and Ozempic brands through self-pay channels.

    Combined injectable and pill Wegovy NBRx
    more than 75,000
    current weekly

    Makes it the leading anti-obesity medication franchise measured by NBRx in the U.S.

    Weight loss (Wegovy pill Phase III)
    16.6%
    Phase III trial

    Reported weight loss for the Wegovy pill.

    Weight loss (Wegovy pill vs orforglipron)
    around 35% greatervs orforglipron
    Phase III trial

    Wegovy pill shows around 35% greater reported weight loss compared to orforglipron (16.6% vs 12.4%).

    A1c reduction (CagriSema in REIMAGINE 2)
    1.91 percentage pointsvs 1.76 percentage points with semaglutide 2.4mg
    REIMAGINE 2

    CagriSema 2.4mg demonstrated superior A1c reduction from a mean A1c baseline of 8.2%.

    Weight loss (CagriSema in REIMAGINE 2)
    14.2%
    REIMAGINE 2

    CagriSema 2.4mg achieved superior weight loss reduction.

    A1c reduction (CagriSema in REIMAGINE 3)
    2.33 percentage pointssuperior to placebo
    REIMAGINE 3

    People treated with CagriSema 2.4mg achieved this reduction as an add-on to basal insulin.

    Weight loss (CagriSema in REIMAGINE 3)
    12%superior to placebo
    REIMAGINE 3

    People treated with CagriSema 2.4mg achieved this weight loss as an add-on to basal insulin.

    A1c reduction (zenagamtide subcutaneous)
    up to 1.8 percentage pointsdose-dependent
    week 36

    Once weekly zenagamtide lowered A1c from a mean baseline HbA1c of 7.8%.

    A1c reduction (zenagamtide oral)
    up to 1.5 percentage pointsdose-dependent
    week 36

    Oral zenagamtide achieved dose-dependent reductions from a baseline of 8%.

    Weight loss (zenagamtide Phase Ib/IIa)
    22%
    36 weeks

    Demonstrated with a 20-milligram dose in people with obesity or overweight.

    Triagonist weight loss (Phase Ib/II)
    minus 3.6% to 5.3%vs 0.5% for placebo
    4 weeks

    Percentage change in body weight from baseline for internal triagonist in first human dose trial.

    Industry KPIs

    10
    MetricValueDetails
    Prescription volumearound 610,000prescriptions
    EPS revenue guidance-5% to -13%%
    Pricing policy impactlow single-digit impact on group sales (roughly double on U.S. sales)%
    Product franchise net salesDKK 82 billionDKK
    Therapeutic drug market share62%%
    Price volume mix decompositionprice declines
    Glp 1 incretin franchise metrics31%%
    Geographic regional revenue growth8%%
    Clinical trial efficacy safety data1.91 percentage points A1c reduction; 14.2% weight loss
    Patent expiry loe biosimilar erosionLOE in specific markets on sema

    Product announcements

    1
    ProductTypeDetails
    Ozempic pill (updated formulation)update

    Deals & partnerships

    3
    Catalentacquisition

    Acquisition of 3 Catalent manufacturing sites.

    U.S. administrationagreement

    Agreement to provide coverage for obesity medicines in U.S. Medicare Part D. Anticipate coverage to begin around mid-2026.

    Amazon Pharmacycollaboration

    Collaboration to expand direct-to-patient initiatives.

    Risks & headwinds

    8
    Pricing headwinds2026

    2026 adjusted sales growth expected -5% to -13% at constant exchange rates

    Mitigation: Pursue volume opportunities in obesity and diabetes; investment for the future to capture more patients with affordable prices.

    Lower realized prices in U.S.2026

    Impacted by investments in market access and MFN agreement (low single-digit impact on group sales, roughly double on U.S. sales)

    Mitigation: Convert price reductions into expanding volume reach and volumes in the marketplace.

    Loss of exclusivity (LOE) for semaglutide moleculeStarting Q2 2026

    Impacts sales in certain International Operations markets; Canada is the biggest contributor.

    Intensifying competition2026

    Countering global GLP-1 market expansion

    Mitigation: Focus on product efficacy (e.g., Wegovy pill's 16.6% weight loss vs. competitor's 12.4%); continued innovation.

    Reduced anti-obesity medication coverage in MedicaidStarting early 2026

    Several states dropping coverage (e.g., California)

    Mitigation: Re-engage with states with lower prices to increase Medicaid access.

    Restructuring costsFY25

    DKK 8 billion

    Mitigation: Company-wide transformation.

    Gross margin decreaseFY25

    Decreased to 81% in FY25 from 84.7% in FY24

    Mitigation: Impacted by amortization/depreciation from Catalent acquisition and one-off restructuring costs.

    Cannibalization of injectable Wegovy by Wegovy pill2026

    Potential negative impact on the growth of the injectable anti-obesity medication category

    Mitigation: Guidance includes assumptions related to this; overarching intention is to expand markets, not cannibalize.

    Q&A highlights

    7

    Asked for a breakdown of the 2026 guidance between volume and price, particularly for US and International Operations, and how it compares to competitor's pricing expectations.

    Karsten Knudsen explained that International Operations are expected to deliver mid-single-digit growth after adjusting for LOE, implying a high-teens sales decline for the U.S. This U.S. decline is driven by price reductions from market access investments, channel mix shifts (cash channel), and MFN impact, with the goal of expanding volume.

    the U.S. decline is driven by price declines, and it's driven by both investments in market access being a key driver built off the cash channel in the U.S. at a different price point, so channel mix and then the MFN impact

    asked by James Quigley · answered by Karsten Knudsen

    3 min read7 chapters

    Detailed Narrative

    01

    Strategic Achievements and Evolution

    Novo Nordisk concluded its 2025 strategic aspirations, having more than doubled sales and operating profit since 2019. Obesity care sales surged from DKK 6 billion to DKK 82 billion, and the company expanded its reach to an additional 16 million people with obesity and diabetes treatments. Rare disease is now positioned for growth with late-stage assets like denecimig and etavopivat, and over DKK 300 billion has been returned to shareholders since 2019.

    02

    Executive Leadership Transition

    The company announced significant changes to its executive management team, with Dave Moore (EVP, U.S. Operations) and Ludovic Helfgott (EVP, Product and Portfolio Strategy) departing. Jamey Millar will join as EVP of U.S. Operations, bringing extensive U.S. market access and commercial strategy experience. Hong Chow will join as EVP of Product and Portfolio Strategy, with deep global leadership in advancing innovation and product strategies.

    03

    GLP-1 Market Dynamics and International Operations

    The global GLP-1 market grew over 30% in 2025, with Novo Nordisk's total sales increasing 10%. International Operations (IO) sales grew 14%, driven by GLP-1 products in obesity and diabetes, with 44% GLP-1 volume growth. Wegovy launched in 35 new countries in 2025, tripling its reach, and sales reached DKK 28 billion, growing 134%. IO plans further expansion through new online channels and product rollouts like semaglutide 7.2mg for weight loss.

    04

    US Operations and Wegovy Pill Launch

    U.S. GLP-1 diabetes care sales increased 5%, driven by Ozempic uptake. The Wegovy pill received FDA approval in December 2025 and launched in January 2026, showing encouraging early uptake with around 50,000 prescriptions in its first three weeks, primarily through self-pay. Commercial access for the Wegovy pill is progressing, covering nearly half the lives covered for injectable Wegovy. The combined injectable and pill Wegovy brand is now the leading anti-obesity medication franchise by NBRx in the U.S.

    05

    Diabetes Pipeline Advancements

    Novo Nordisk reported positive Phase II data for zenagamtide (formerly amycretin) in type 2 diabetes, showing significant A1c and weight reductions for both subcutaneous and oral formulations. The company plans to initiate extensive Phase III programs (AMBITION for T2D, AMAZE for obesity) for zenagamtide in 2026. Additionally, CagriSema demonstrated superior A1c reduction and weight loss in the REIMAGINE 2 Phase III trial for type 2 diabetes.

    06

    Obesity and Rare Disease Pipeline

    The obesity pipeline includes anticipated results from the REDEFINE 4 trial (Wegovy vs. tirzepatide) in Q1 2026 and the REDEFINE 11 trial (CagriSema weight loss) in early 2027. In rare diseases, the Phase III HIBISCUS readout for etavopivat in sickle cell disease is expected in Q2 2026, and regulatory decisions for denecimig (hemophilia A) are anticipated in H2 2026.

    07

    2026 Outlook and Financial Considerations

    The company projects adjusted sales and operating profit growth for 2026 to be between -5% and -13% at constant exchange rates, primarily due to pricing headwinds, including lower realized prices in the U.S. and loss of exclusivity in some international markets. This outlook also reflects increased investments in R&D and commercial activities. Capital expenditure is expected to be around DKK 55 billion in 2026, with a projected decline in subsequent years.

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