Novo Nordisk A/S Sponsored ADR

Company Overview

Business Model: Novo Nordisk is a global healthcare company focused on the discovery, development, manufacturing, and marketing of pharmaceutical products and services. The Company is a world leader in Obesity and Diabetes care, also maintaining a portfolio in Rare disease. Its core value proposition revolves around providing innovative treatments that make a significant difference to patients, the medical profession, and society. Revenue is primarily generated through the sale of its pharmaceutical products across various therapeutic areas.

Market Position: Novo Nordisk holds a leading position in the global pharmaceutical markets for Obesity and Diabetes care. In the global diabetes market, Novo Nordisk and Eli Lilly are identified as the most significant companies by market share. Similarly, in the anti-obesity medication market, primarily GLP-1s, Novo Nordisk and Eli Lilly are the most significant companies by market share, though competition is increasing. Novo Nordisk's Ozempic® was the Company's best-performing product by sales in 2025, with global sales exceeding DKK 127 billion. However, in 2025, Novo Nordisk lost volume market share in the GLP-1 markets for both obesity and diabetes due to increased competition in both US and ex-US markets.

Recent Strategic Developments:

• Leadership Transition: On August 7, 2025, Maziar Mike Doustdar succeeded Lars Fruergaard Jørgensen as President and Chief Executive Officer.
• Organizational Transformation: On September 10, 2025, Novo Nordisk initiated a company-wide transformation to simplify its organization, improve decision-making speed, and reallocate resources towards growth opportunities in obesity and diabetes. This transformation resulted in approximately 9,000 global employee reductions and was largely completed by the end of 2025.
• Strategic Acquisition: On December 9, 2025, Novo Nordisk acquired Akero Therapeutics Inc. for $4.7 billion in cash, plus a Contingent Value Right (CVR) of $0.5 billion upon US regulatory approval of Akero’s lead candidate, efruxifermin (EFX), for compensated cirrhosis due to MASH. This acquisition aligns with Novo Nordisk’s strategy to focus on patients with obesity, diabetes, and related comorbidities like MASH.
• US Market Access Agreement: During 2025, Novo Nordisk announced an agreement with the U.S. Administration to expand access and improve affordability for semaglutide medicines, including Wegovy® and Ozempic®, in 2026 through U.S. Medicare Part D, Medicaid, and the direct-to-patient self-pay channel. Medicare Part D coverage for obesity medicines is expected to begin around mid-2026 through a pilot program.

Geographic Footprint: Headquartered in Denmark, Novo Nordisk employs more than 69,500 employees in approximately 80 countries and markets its products in around 170 countries. The Company's financial reporting is divided into US Operations (covering the United States) and International Operations. International Operations cover EUCAN (Europe and Canada), Emerging Markets (mainly Latin America, Middle East, and Africa), APAC (Japan, Korea, Oceania, and Southeast Asia), and Region China (Mainland China, Hong Kong, and Taiwan). In 2025, the most important markets by sales were the United States, China, Canada, Japan, and major European countries.

Cross-Border Operations: Novo Nordisk operates globally through consolidated subsidiaries, distributors, and independent agents. Key international subsidiaries include Novo Nordisk Pars in Iran, which conducts limited business related to pharmaceutical products for chronic and rare disease care, complying with US sanctions. The Company has major production facilities in Denmark, the United States, France, China, and Brazil. International operations are subject to multi-jurisdictional regulatory frameworks, including those from the US Food and Drug Administration, European Medicines Agency, China's National Medical Products Administration, and the Japanese Ministry of Health, Labour and Welfare.

Financial Performance

Revenue Analysis

The provided 20-F filing refers to the Annual Report 2025 for detailed financial statements, which are not explicitly included in this document. Therefore, a comprehensive revenue analysis table cannot be populated with verifiable facts from the provided text.

Profitability Metrics: The provided 20-F filing refers to the Annual Report 2025 for detailed financial statements, which are not explicitly included in this document. Therefore, profitability metrics cannot be populated with verifiable facts from the provided text.

Investment in Growth:

• R&D Expenditure: Novo Nordisk’s research and development organization comprises more than 10,000 employees as of December 31, 2025. Historically, approximately 70-80% of total R&D expenditures are on clinical development activities, and 20-30% on research activities. The Company expects R&D spending to follow a trend in line with or slightly above sales growth, gradually increasing the R&D cost to sales ratio from the current level of around 15-17% of sales.
• Capital Expenditures: Novo Nordisk has significant ongoing capital expenditure programs to expand manufacturing and R&D capacity globally. As of December 31, 2025, realized spend for major projects includes:
  • Kalundborg, Denmark (new purification, recovery, and fermentation facilities): DKK 20.3 billion (expected total DKK 22.3 billion, operational 2027).
  • Hjørring, Denmark (NovoFine® Plus needles capacity): DKK 525 million (expected total DKK 550 million, finalized 2026).
  • Bagsværd, Denmark (clinical manufacturing facilities): DKK 8.2 billion (expected total DKK 9.2 billion, finalized 2026).
  • Hillerød, Denmark (API production facility): DKK 10.7 billion (expected total DKK 15.9 billion, operational 2028).
  • Kalundborg, Denmark (API production facility expansion): DKK 23.1 billion (expected total DKK 49.6 billion, operational 2029).
  • Chartres, France (manufacturing site expansion): DKK 6.8 billion (expected total DKK 16.9 billion, finalized 2026-2028).
  • Tianjin, China (manufacturing site expansion): DKK 2.1 billion (expected total DKK 4.1 billion, operational 2028).
  • Clayton, North Carolina, United States (manufacturing site expansion): DKK 13.4 billion (expected total DKK 27.0 billion, operational 2029).
  • Hillerød, Denmark (QC facilities expansion): DKK 0.7 billion (expected total DKK 2.9 billion, operational 2027).
  • Odense, Denmark (new manufacturing facility): DKK 3.6 billion (expected total DKK 8.5 billion, operational 2027).
• Strategic Investments: The acquisition of Akero Therapeutics Inc. for an aggregated value of $4.7 billion in cash (plus a potential $0.5 billion CVR) represents a significant strategic investment in treatments for metabolic dysfunction-associated steatohepatitis (MASH).

Currency Impact Analysis: The provided 20-F filing refers to Note 4.4 ‘Financial risks’ and Note 4.5 ‘Derivative financial instruments’ in the Annual Report 2025 for a detailed description of foreign currency exposure and hedging activities. Specific quantitative impacts on revenue and earnings are not explicitly stated in the provided text.

Business Segment Analysis

Obesity and Diabetes care

Financial Performance:

• Revenue: Total sales of obesity care products (Saxenda® and Wegovy®) were DKK 82,347 million in 2025, up from DKK 65,146 million in 2024. The majority of this growth came from Wegovy®.
• Key Growth Drivers: The segment's growth is driven by the increasing global prevalence of obesity and diabetes, and the rising use of GLP-1 drug category. Wegovy® revenue grew 36% to DKK 79 billion in its fifth year after launch. Ozempic® global sales exceeded DKK 127 billion in 2025.

Product Portfolio:

• Major product lines: Glucagon-like-peptide-1 (GLP-1) receptor agonists for obesity and diabetes (Ozempic®, Rybelsus®, Wegovy®, Saxenda®, Victoza®), and modern and human insulins for diabetes (Awiqli®, Fiasp®, Levemir®, NovoLog®/NovoRapid®, NovoLog Mix®/NovoMix®, Ryzodeg®, Tresiba®, Xultophy®).
• New product launches or major updates: Wegovy® Pill recently launched in the first quarter of 2026.
• Pipeline: Multiple Phase 3 programs including oral semaglutide 25 mg and 50 mg for Obesity (approved in US), semaglutide 7.2 mg for Obesity (regulatory submission in 2025), Cagrisema (NN9388) for Diabetes (Phase 3 initiated 2023), Cagrisema (NN9838) for Obesity (regulatory submission in 2025), Cagrilintide for Obesity (Phase 3 initiated in 2025), and IcoSema (NN1535) for Diabetes (regulatory submission in 2024).

Market Dynamics:

• Competitive positioning: Novo Nordisk and Eli Lilly are the most significant companies in both the global diabetes and anti-obesity markets by market share. However, Novo Nordisk has lost volume market share in the GLP-1 markets for both obesity and diabetes due to increased competition. In the US, Wegovy® was overtaken by a competing GLP-1 based product in early 2025 as the leading anti-obesity medication by total weekly prescriptions. Similarly, Ozempic® was overtaken by a competing GLP-1 based product for type 2 diabetes in the US during 2025.
• Regulatory environment: Most countries where Novo Nordisk sells insulin and GLP-1 products subsidize or control pricing. In the US, pharmacy benefit managers exert pressure on product prices, and the Inflation Reduction Act has led to negotiations with the US administration on Medicare Part D drug prices for semaglutide-based products (Ozempic®, Rybelsus®, Wegovy®), with negotiated prices taking effect in 2027.
• Compounding pharmacies: The Company faces challenges from compounding pharmacies introducing unapproved copies of its anti-obesity GLP-1 products, which continued illicitly after the resolution of drug shortages. Novo Nordisk is actively working to prevent this.

Geographic Revenue Distribution (2025, DKK million):

• United States (US Operations):
  • Wegovy®: 51,015
  • Ozempic®: 88,467
  • Rybelsus®: 8,833
  • Victoza®: 471
  • Saxenda®: 268
• International Operations:
  • Wegovy®: 28,091
  • Ozempic®: 38,622
  • Rybelsus®: 13,260
  • Victoza®: 2,549
  • Saxenda®: 2,973
• EUCAN:
  • Wegovy®: 15,383
  • Ozempic®: 22,774
  • Rybelsus®: 7,065
  • Victoza®: 694
  • Saxenda®: 1,444
• Emerging Markets:
  • Wegovy®: 6,100
  • Ozempic®: 7,235
  • Rybelsus®: 2,061
  • Victoza®: 1,050
  • Saxenda®: 1,238
• APAC:
  • Wegovy®: 5,812
  • Ozempic®: 3,214
  • Rybelsus®: 3,514
  • Victoza®: 204
  • Saxenda®: 263
• Region China:
  • Wegovy®: 796
  • Ozempic®: 5,399
  • Rybelsus®: 620
  • Victoza®: 601
  • Saxenda®: 28

Rare disease

Financial Performance: The provided 20-F filing states that Obesity and Diabetes care is Novo Nordisk’s largest segment, comprising more than 90% of sales. Specific revenue figures for the Rare disease segment are not explicitly provided in the text.

Product Portfolio:

• Major product lines: Growth hormone (Norditropin®) and haemophilia products (NovoSeven®), and other modes of action for treatment of growth disorders and other rare endocrine disorders, and rare blood disorders.
• Pipeline: Concizumab (NN7415) for Haemophilia A and B with inhibitors (approved for some indications, patent expiration 2034 in US, 2035 in EU, 2034 in Japan), Mim8 (NN7769) for Haemophilia (regulatory submission in 2025, patent expiration 2040 in US, 2041 in EU, 2044 in Japan), Etavopivat (NN7535) for Rare blood disorders (Phase 3 initiated in 2022, patent expiration 2039 in US, 2038 in EU/Japan), Coramitug (NN6019) for Transthyretin amyloidosis cardiomyopathy (Phase 3 initiated in 2025, patent expiration 2041).

Market Dynamics: The filing notes that the Rare disease portfolio mainly consists of growth hormone and haemophilia products. No specific market dynamics or competitive positioning details for this segment are provided in the text.

International Operations & Geographic Analysis

Revenue by Geography: The provided 20-F filing refers to the Annual Report 2025 for detailed financial statements, which are not explicitly included in this document. However, product-specific sales by region are available and presented in the Business Segment Analysis section.

International Business Structure:

• Subsidiaries: Novo Nordisk operates through a network of consolidated subsidiaries globally. An example is Novo Nordisk Pars, a wholly-owned subsidiary in Iran, which handles local distribution and manufacturing.
• Joint Ventures: No specific joint ventures are explicitly mentioned in the provided text.
• Licensing Agreements: Novo Nordisk enters into licensing agreements as part of its business operations, though specific cross-border licensing arrangements are not detailed in the provided text.

Cross-Border Trade:

• Export Markets: Novo Nordisk markets its products in approximately 170 countries. The Company's main production facilities are located in Denmark, the United States, France, China, and Brazil, serving global markets.
• Import Dependencies: The impact on overall profitability from variations in raw material prices is unlikely to be significant, and currently, there is no raw material supply shortage expected to significantly impact the Company’s ability to supply any significant market.
• Transfer Pricing: The provided 20-F filing refers to Note 4.4 ‘Financial risks’ in the Annual Report 2025 for information on transfer pricing.

Capital Allocation Strategy

Shareholder Returns:

• Share Repurchases: The 2024 share repurchase program of DKK 20 billion, initiated in February 2024, was completed in February 2025, with a total of 24,802,593 B shares repurchased. No new repurchase program was initiated in 2025.
• Dividend Payments: The provided 20-F filing refers to ‘Shares and capital structure’ on pages 18-19 of the Annual Report 2025 for dividend information, which is not explicitly included in this document.
• Future Capital Return Commitments: The Board of Directors is authorized by the annual general meeting to acquire up to 10% of the share capital, with this authorization renewed annually.

Balance Sheet Position: The provided 20-F filing refers to ‘Balance sheet’ on page 85 and Note 4.6 ‘Borrowings’ in the Annual Report 2025 for information on current and non-current debt, and to Note 4.8 'Financial assets and liabilities' for restrictions on fund transfers from subsidiaries. This information is not explicitly included in the provided text. Novo Nordisk believes its financial resources are sufficient to meet its requirements for at least the next 12 months.

Cash Flow Generation: The provided 20-F filing refers to ‘Cash flow statement’ on page 84 of the Annual Report 2025 for detailed cash flow information. The most significant source of cash flow from operating activities is sales of Obesity and Diabetes care and Rare disease products. Capital expenditures are expected to be financed with cash flow from operating activities.

Currency Management: The provided 20-F filing refers to Note 4.4 ‘Financial risks’ and Note 4.5 ‘Derivative financial instruments’ in the Annual Report 2025 for further description of foreign currency exposure and hedging activities. Novo Nordisk only hedges commercial exposures, including selected business development activities, and does not enter into derivative transactions for trading or speculative purposes. Currency hedging is done with foreign exchange forwards and foreign exchange options.

Operational Excellence

Production & Service Model: Novo Nordisk manufactures and markets pharmaceutical products. The Company's supply capacity has gradually increased to meet growing demand. Its production facilities are strategically located globally to support its diverse product portfolio.

Global Supply Chain Architecture: Key Suppliers & Partners:

• Raw Materials: The Company relies on various raw materials for production. The impact of raw material price variations on overall profitability is unlikely to be significant, and no current supply shortages are expected to significantly impact the Company's ability to supply significant markets.
• Manufacturing Partners: Novo Nordisk engages in contract manufacturing organization (CMO) related activities at facilities such as Bloomington, Indiana, United States, Anagni, Italy, and Brussels, Belgium.
• Technology Partners: The Company utilizes research technology platforms including RNAi therapies and small molecules.

Facility Network:

• Manufacturing: Major production facilities are located in Denmark (Kalundborg, Hillerød, Bagsværd, Gentofte, Måløv, Odense, Hjørring), the United States (Clayton, North Carolina; Bloomington, Indiana; New Hampshire), France (Chartres), China (Tianjin), and Brazil (Montes Claros). These facilities produce active pharmaceutical ingredients (API) for obesity, diabetes, haemophilia, glucagon, and growth hormone, as well as finished products and durable devices.
• Research & Development: R&D centers are mainly located in Denmark, the United States, the United Kingdom, and China. Clinical trials are carried out globally.
• Distribution: Products are marketed and distributed through subsidiaries, distributors, and independent agents responsible for specific geographic areas.

Operational Metrics: The filing mentions capacity increases and expansion projects but does not provide specific operational metrics like capacity utilization or efficiency measures.

Market Access & Customer Relationships

Go-to-Market Strategy: Distribution Channels:

• Direct Sales: Novo Nordisk markets and distributes its pharmaceutical products through its subsidiaries in specific geographic areas.
• Channel Partners: The Company also utilizes distributors and independent agents.
• Digital Platforms: Online sales channels and e-commerce initiatives are not explicitly detailed in the provided text.

Customer Portfolio: Enterprise Customers:

• Tier 1 Clients: The Company's products are prescription drugs, indicating relationships with healthcare professionals and institutions.
• Strategic Partnerships: Novo Nordisk enters into partnerships and license agreements.
• Customer Concentration: The Company faces pressure from pharmacy benefit managers in the US, indicating significant relationships with these entities.
• 340B Drug Pricing Program: Novo Nordisk has a policy related to facilitating delivery of its discounted medicines to commercial pharmacies that contract with covered entities participating in the 340B Drug Pricing Program in the US.

Regional Market Penetration:

• United States: The US is Novo Nordisk's most important market in terms of sales. The Company has faced increased competition in the GLP-1 market, losing volume market share for both obesity and diabetes.
• Growth Markets: The global pharmaceutical market for diabetes treatment continues to grow due to the increasing number of people with diabetes. The market for anti-obesity medications is also growing and expanding. Novo Nordisk has launched Wegovy® in the United States and more than 50 other countries outside the United States.

Competitive Intelligence

Global Market Structure & Dynamics

Industry Characteristics: The global pharmaceutical market for diabetes treatment continues to grow due to the increasing number of people with diabetes, projected to rise from 589 million in 2025 to over 780 million in 2045. The market for anti-obesity medications, primarily GLP-1s, is also growing and expanding, driven by innovative treatments and significant unmet medical need. Over 800 million people currently live with obesity, a number expected to grow. Market conditions include efforts by private and governmental entities to reduce or control costs, with most countries subsidizing or controlling pricing for insulin and GLP-1 products.

Competitive Positioning Matrix:

Direct Competitors

Primary Competitors:

• Eli Lilly: Identified as the most significant competitor in both the global diabetes market and the anti-obesity medication market (primarily GLP-1s) by market share. Eli Lilly's competing GLP-1 based product overtook Wegovy® as the leading anti-obesity medication in the US in early 2025, and also surpassed Ozempic® as the leading GLP-1 for type 2 diabetes in the US during 2025.
• Other Major International Pharmaceutical Companies and Smaller Biotech Companies: Several other companies have entered or are developing products for the diabetes and anti-obesity markets, contributing to increased competition.
• Compounding Pharmacies: These entities have introduced unapproved copies of Novo Nordisk’s anti-obesity GLP-1 products, posing a competitive threat, particularly in the US.

Regional Competitive Dynamics: Competition has increased in both US and ex-US markets, leading to Novo Nordisk losing volume market share in the GLP-1 market for both obesity and diabetes. Pricing pressure is expected to continue, driven by increasing rebates in the commercial segment, payer consolidation, increased exposure to high rebate channels (Medicare and Medicaid), growth in direct-to-patient cash channels, and increasing competition.

Risk Assessment Framework

Strategic & Market Risks

Global Market Dynamics:

• Competition: Increased competition in GLP-1 markets for obesity and diabetes, leading to loss of volume market share in both US and ex-US markets. Several major international pharmaceutical companies and smaller biotech companies are developing anti-obesity medications.
• Pricing Pressure: Continued pricing pressure is expected, driven by increasing rebates in the commercial segment, payer consolidation, increasing exposure to high rebate channels (Medicare and Medicaid), increasing sales in direct-to-patient cash channels, and increasing competition.
• Regulatory Changes: Government-mandated or market-driven price decreases for products, changes in governmental laws and related interpretation thereof, including on reimbursement, intellectual property protection, and regulatory controls.
• Compounding Pharmacies: The illicit continuation of compounding unapproved copies of GLP-1 products poses a risk, despite Novo Nordisk's efforts to prevent it.

Technology Disruption: Delay or failure of projects related to research and/or development, unplanned loss of patents, and the introduction of competing products.

Operational & Execution Risks

Global Supply Chain Vulnerabilities:

• Supply Constraints: Periodic supply constraints for certain products in some markets, including Ozempic®, occurred during 2025, although the situation improved due to continued scaling of manufacturing capabilities.
• Regional Disruptions: Production facilities are exposed to natural hazards: North Carolina, United States (tornadoes, hurricanes); Indiana, United States (tornadoes, rainfall, lightning); Koriyama, Japan (earthquakes); Tianjin, China (storm surges due to rising sea levels).
• Water Scarcity: Risk of future scarcity of water supply impacting production's ability to withdraw water, particularly in water-stressed regions where the Company withdraws substantial amounts of water.
• Trade Restrictions: Effects of domestic or international crises, civil unrest, war or other conflict, and changes in tariffs and duties.

Cybersecurity Risks: Reliance on IT systems for intellectual property, confidential information, and personal data protection. Significant size and complexity of global IT systems. Potential for significant downtime of critical IT systems or unintended disclosure of confidential information and personal data due to attacks by malicious third parties or vulnerabilities in third-party vendors.

Financial & Regulatory Risks

Currency & Financial Risks: Interest rate and currency exchange rate fluctuations. Regulatory & Compliance Risks:

• Multi-Jurisdictional Compliance: Dependence on government approvals related to production, development, marketing, and reimbursement of products from bodies like the US FDA, EMA, NMPA (China), and Japanese MHLW.
• 340B Drug Pricing Program: Legal challenges and interpretations of applicable laws regarding the Company's policy, which could impact revenue recognition.
• Patent Expiration: Expiration of certain patents could impact sales, as seen with Victoza®.
• Ethical Expectations: Failure to meet regulatory or ethical expectations on environmental impact, including climate change, could expose the Company to increased regulatory or reputational risk.

Geopolitical & External Risks

Country-Specific Risks:

• Russia/Ukraine: Sales in Russia and Ukraine constituted less than 1% of global sales in 2025. Operations in Russia are limited to supplying insulin to local patients, with new launches and clinical investments suspended. Supply of medicines in Ukraine has continued to the extent possible.
• Iran: Limited business activities through Novo Nordisk Pars, a wholly-owned subsidiary, which contracts with entities that may be owned or controlled by the Government of Iran. Gross revenue related to these transactions was not in excess of 1% of Group sales in 2025.
• Danish FDI Rules: Foreign direct investments in certain sensitive sectors in Denmark (including critical infrastructure for prescription drugs) may require prior authorization from the Danish Business Authority.
• International Trade and Financial Sanctions: Evolving sanctions may prevent export/import of capital, affect remittance of payments, and restrict the right to acquire, transfer, hold, or vote shares.

Innovation & Technology Leadership

Research & Development Focus:

• Therapeutic Areas: Insulins, GLP-1s, and other therapeutic compounds for diabetes treatment; GLP-1s, combinations, and other modes of action for obesity care; blood-clotting factors and other modes of action for haemophilia and other rare blood disorders; human growth hormone and other modes of action for growth disorders and other rare endocrine disorders.
• New Indications: New indications with existing assets and other modes of action for cardiovascular diseases, MASH, and other serious chronic diseases related to Diabetes or Obesity.
• Research Technology Platforms: RNAi for treatment of diseases within Obesity and Diabetes and their related comorbidities and within Rare Disease, and small molecules.
• Methodology: Utilizes biotechnological methods based on advanced protein chemistry and protein engineering.
• Pipeline: Multiple Phase 3 programs are in progress, including Concizumab, Insulin Icodec, oral semaglutide (25 mg and 50 mg), semaglutide (7.2 mg), Cagrisema, Cagrilintide, IcoSema, Etavopivat, Mim8, Efruxifermin, Ziltivekimab, and Coramitug.

Global R&D Network:

• R&D Centers: Research and development activities are carried out by Novo Nordisk's R&D centers, mainly in Denmark, the United States, the United Kingdom, and China.
• Innovation Pipeline: The Company has a robust pipeline with several compounds in Phase 3 development or recently filed for regulatory approval, targeting various indications in diabetes, obesity, and rare diseases.

Intellectual Property Portfolio:

• Patent Strategy: Novo Nordisk strives for the strongest possible protection for its inventions and continuously invests in R&D to bring novel products to market and sustain strong patent protection.
• Patent Holdings by Jurisdiction: The compound patent for Victoza® has expired in all countries (Japan 2022, US/Germany 2023, China 2017). The compound patent expiry in the US for semaglutide branded products (Ozempic®, Rybelsus®, and Wegovy®) is 2032. In China, Novo Nordisk’s semaglutide compound patent was upheld by the Supreme People's Court in December 2025.
• IP Litigation: Novo Nordisk has filed complaints for patent infringement against several manufacturers who filed Abbreviated New Drug Applications (ANDAs) for generic versions of Victoza®, Saxenda®, Ozempic®, Wegovy®, and Rybelsus®. Settlement agreements have been reached with several manufacturers for Victoza® and Saxenda®, and with Alvogen Inc., Rio Biopharmaceuticals Inc., Sun Pharmaceutical Industries Limited, Dr. Reddy’s Laboratories, Ltd., Mylan Pharmaceuticals Inc., Zydus Pharmaceuticals Inc., and Apotex Inc. for Ozempic®. Novo Nordisk continues to defend its intellectual property.

Technology Partnerships: Novo Nordisk enters into partnerships and license agreements to support its R&D efforts. Specific strategic alliances or research collaborations are not detailed in the provided text.

Leadership & Governance

Executive Leadership Team

International Management Structure: Executive Management has become a global team. Regional leadership and reporting relationships are in place, with executives based globally.

Board Composition: The Board of Directors is responsible for overall strategic management and supervision. As of November 2025, Lars Rebien Sørensen was elected Chair, Cees de Jong as Vice Chair, and Britt Meelby Jensen and Stephan Engels were elected as members. The Board consists of shareholder-elected and employee-elected members. The Audit Committee consists of Stephan Engels (chair, independent), Cees de Jong (independent), and Mette Bøjer Jensen (employee-elected, not independent, relies on exemption). The Remuneration Committee consists of Cees de Jong (chair, independent), Elisabeth Dahl Christensen (employee-elected, not independent), Stephan Engels (independent), and Britt Meelby Jensen (not independent). Novo Nordisk A/S is a "controlled company" and follows Danish corporate governance practices, which differ from some NYSE standards, particularly regarding director independence and committee composition.

Regulatory Environment & Compliance

Multi-Jurisdictional Regulatory Framework: Primary Regulatory Environments:

• United States: Key regulatory body is the US Food and Drug Administration (FDA). Compliance with the Inflation Reduction Act and 340B Drug Pricing Program is critical.
• European Union: Key regulatory body is the European Medicines Agency (EMA).
• China: Key regulatory body is China's National Medical Products Administration (NMPA).
• Japan: Key regulatory body is the Japanese Ministry of Health, Labour and Welfare (MHLW).
• Denmark: Subject to Danish law, including the Danish FDI Rules for foreign direct investments in sensitive sectors.

Cross-Border Compliance:

• Export Controls: Subject to applicable international trade and financial sanctions, which may restrict export/import of capital and affect payments.
• Sanctions Compliance: Conducts limited business in Iran through Novo Nordisk Pars, complying with US sanctions that permit commercial sale and export of medicine and medical devices.
• Anti-Corruption: The Company adheres to a framework of rules and guidelines, including the Novo Nordisk Way and OneCode, which describe corporate values and expectations for business conduct and ethics, including anti-bribery.

International Tax Strategy:

• Transfer Pricing: The provided 20-F filing refers to Note 4.4 ‘Financial risks’ in the Annual Report 2025 for information on transfer pricing.
• Tax Treaties: US Holders of ADRs or B shares are subject to Danish withholding tax on dividends, with potential for reduced rates under the US-Denmark tax convention. Uncertainty exists regarding whether US Holders are considered "shareholders" for Danish tax purposes, impacting refund claims for excess withholding tax.

Environmental & Social Impact

Global Sustainability Strategy: Novo Nordisk identifies and assesses material environmental risks, including climate and water, through its enterprise risk management process. The Company is committed to climate target-setting and continuously recalibrates priority areas within its climate roadmap. Environmental Commitments:

• Climate Strategy: Short- and medium-term climate risks are assessed across business areas, while long-term risks are part of the company-wide strategic risk identification process. The Company's scope 3 decarbonization levers have a delayed effect.
• Carbon Neutrality: Focused on suppliers' transition to renewable electricity to reduce scope 3 emissions.
• Renewable Energy: Actions focused on high-impact categories: procurement of low-carbon feedstocks (e.g., e-methanol, low-carbon ammonia, glucose from regenerative agriculture), low-carbon goods and services, and converting to low-carbon construction materials for investments.

Regional Sustainability Initiatives:

• Supply Chain: Risk assessment includes an annual natural hazards risk rating of production sites and the majority of suppliers, related to natural events like flooding, earthquakes, high-speed winds, tornados, hailstorms, and lightning.
• Water Management: Availability of high-quality water is essential for production. The Company withdraws substantial amounts of water from water-stressed regions and has identified a risk of future scarcity impacting production.

Social Impact by Region:

• Community Investment: Novo Nordisk Pars makes donations to GOI-controlled public health organizations in Iran focusing on diabetes awareness and policy.
• Labor Standards: The Company underwent a transformation in 2025, reducing global employees by approximately 9,000. Executive Management believes the Company has a good relationship with its employees and labor unions.

Currency Management & Financial Strategy

Multi-Currency Operations: The provided 20-F filing refers to Note 4.4 ‘Financial risks’ and Note 4.5 ‘Derivative financial instruments’ in the Annual Report 2025 for detailed information on currency exposure. Specific quantitative currency exposure by revenue, cost, and net exposure are not explicitly stated in the provided text.

Hedging Strategies:

• Transaction Hedging: Novo Nordisk hedges commercial exposures, including selected business development activities (mergers and acquisitions).
• Financial Hedging Instruments: Currency hedging is primarily done with foreign exchange forwards and foreign exchange options. The Company does not enter into derivative transactions for trading or speculative purposes.