諾和諾德 (NVO) 2024 Q3 法說會逐字稿

All right. So good afternoon. Great to see you all. We're bringing a great quarter to London in terms of Novo Nordisk Q3 results. So we've been looking forward to seeing you all here as part of the launch meeting at Bank of America.

好的。午安.很高興見到大家。就諾和諾德第三季業績而言，我們為倫敦帶來了出色的季度業績。因此，我們一直期待在美國銀行舉行的啟動會議上見到大家。

As Sachin said, a short introduction -- a short presentation, and then we do Q&A. And of course, as always, it's important to remember that the comments about the future are inherently uncertain and may play out differently. So no changes to that compared to prior presentations.

正如薩欽所說，一個簡短的介紹——一個簡短的演示，然後我們進行問答。當然，像往常一樣，重要的是要記住，關於未來的評論本質上是不確定的，並且可能會產生不同的結果。因此，與先前的演示相比，沒有任何變化。

So when we look at progress on our strategy execution and doing it in each of the core quadrants as we consistently use every quarter as our report card towards you, then we're in a historic phase in terms of growth as a company, growing 24% in the first nine months. And that level of growth, of course, entails a lot of investments and a lot of resources going into that.

因此，當我們審視我們的策略執行進度並在每個核心像限中執行時，因為我們始終使用每個季度作為我們向您提供的成績單，那麼我們作為一家公司正處於成長的歷史性階段，成長了24前九個月的百分比。當然，這種成長水準需要大量投資和大量資源。

And as a consequence, our CO2 emissions are also increasing by year 34%, driven by the CapEx investments we are pursuing to expand our supply chain. So our CO2 emissions across Scope 1, 2 and 3, it's really Scope 3 driven by CapEx.

因此，在我們為擴大供應鏈而進行的資本支出投資的推動下，我們的二氧化碳排放量也每年增加 34%。因此，我們在範圍 1、2 和 3 的二氧化碳排放量，實際上是由資本支出驅動的範圍 3。

Serving more patients than ever before. More than 43 million people with serious chronic diseases now using Novo Nordisk products, a step-up to the tune of DKK3 million compared to last year across our different therapeutic categories of diabetes and obesity.

為比以往更多的患者提供服務。目前，超過 4,300 萬名患有嚴重慢性疾病的患者正在使用諾和諾德的產品，與去年相比，我們在糖尿病和肥胖症的不同治療類別中增加了 300 萬丹麥克朗。

And strong performance in commercial, Camilla will come back to that. And then R&D quadrant or innovation and therapeutic focus quadrant, which is really full and we had to prioritize. So that's why Martin has a very rich pipeline readout coming up in a few slides. So really a pleasure to see progress on the innovation side.

而在商業上的強勁表現，卡蜜拉也會回歸這一點。然後是研發象限或創新和治療重點象限，這真的很滿，我們必須確定優先順序。這就是為什麼馬丁在幾張幻燈片中提供了非常豐富的管道讀數。所以很高興看到創新的進展。

And then financials, 24% sales growth and 22% operating profit growth. But do bear in mind that we have clean reporting of our numbers. So this includes impairments that we did earlier this year. Take that out, our EBITDA growth is 30% over the first nine months.

然後是財務方面，銷售額成長 24%，營業利潤成長 22%。但請記住，我們有清晰的數據報告。因此，這包括我們今年早些時候所做的減值。除去這一點，我們的 EBITDA 在前 9 個月增加了 30%。

So very strong growth, both top and bottom line. And that is converted into cash, and we have a very solid capital return to shareholders of DKK57 billion on a year-to-date measure. So with those comments, I'll give the word to Camilla.

無論是營收還是利潤，成長都非常強勁。這些資金可轉換為現金，以年初至今計算，我們為股東帶來了 570 億丹麥克朗的非常豐厚的資本回報。帶著這些評論，我將轉告卡蜜拉。

Thanks a lot, Karsten. Good afternoon, everyone. Just a highlight on how the sales growth is split, 24% sales growth, 31% in North America and 15% in international operations. We also see on the brand part that a big part of our growth is driven by GLP-1, so our key brands, Ozempic and Wegovy are close to 100% share of our growth. And of course, when you look at the franchises, you see diabetes franchise growing 26% and obesity care growing 44%.

非常感謝，卡斯滕。大家下午好。重點介紹銷售成長的分佈：銷售成長 24%，北美成長 31%，國際業務成長 15%。我們也看到，在品牌部分，我們的成長很大一部分是由 GLP-1 推動的，因此我們的主要品牌 Ozempic 和 Wegovy 幾乎占我們成長的 100% 份額。當然，當您查看特許經營權時，您會發現糖尿病特許經營權增長了 26%，肥胖症護理增長了 44%。

So very strong growth. And of course, that also requires scaling. As you see on this slide, we have basically, over the last three years, tripled our scaling efforts and our reach of patients in GLP1. You also see that we are now covering 65% of the total GLP-1 market across diabetes and obesity in the world in terms of supply. And we will continue, of course, to do scaling efforts as we have talked about the last many quarters, but we continue to do that and we are planning also on continued investments in this space.

所以成長非常強勁。當然，這也需要擴充。正如您在這張投影片中所看到的，在過去三年中，我們基本上將 GLP1 的擴展工作和病患覆蓋範圍增加了兩倍。您還可以看到，就供應而言，我們現在涵蓋了全球糖尿病和肥胖症 GLP-1 市場總量的 65%。當然，我們將繼續進行擴展工作，正如我們在過去的許多季度中所討論的那樣，但我們將繼續這樣做，我們也計劃在這個領域繼續投資。

When we look at the scripts, here, you see the US obesity prescriptions, we continue to have broad formulary access in the US, covering more than 55 million lives. We also are looking at continued rollout plans in international operations now present in more than 15 countries with Wegovy.

當我們查看處方時，您會看到美國的肥胖處方，我們在美國繼續擁有廣泛的處方，涵蓋超過 5500 萬人的生命。我們也正在考慮在國際業務中繼續推出計劃，目前 Wegovy 已在超過 15 個國家/地區開展業務。

And in the US, you also see on this slide that our total scripts makes Wegovy still the leading brand in the US obesity brand. And of course, that doesn't stop with that. We continue also to invest in research and development, and Martin will talk a little bit to what that looks like. So Martin, over to you.

而在美國，你在這張投影片上也看到，我們的總腳本讓Wegovy仍然是美國肥胖品牌中的領導品牌。當然，這還不止於此。我們也繼續投資研發，馬丁將談論它的樣子。馬丁，交給你了。

Thank you very much. So in the R&D space, obviously, we try to think holistically around how we build a competitive pipeline. And having a clear ambition of also expanding into new disease areas, our focus has been expanding from the core, diabetes and obesity, into disease areas where there is a metabolic component, allowing us to build synergies between our research, development, our commercial capabilities, and moving into those spaces.

非常感謝。因此，顯然，在研發領域，我們試圖全面思考如何建立有競爭力的管道。我們有一個明確的目標，即擴展到新的疾病領域，我們的重點已從核心糖尿病和肥胖擴展到具有代謝成分的疾病領域，使我們能夠在我們的研究、開發和商業能力之間建立協同效應，並進入這些空間。

Then you'll see that we are building a pipeline that is now beginning to grow in the cardiovascular space, in the liver space. In the years to come, you'll see us do the same thing in the kidney space. And then obviously, we also have a small focus on Alzheimer's disease, and that's basically because of the data that we've seen so far suggesting that GLP-1 analogs could potentially be beneficial in the Alzheimer's space.

然後你會看到我們正在建立一條管道，現在開始在心血管領域、肝臟領域發展。在未來的幾年裡，你會看到我們在腎臟領域做同樣的事情。顯然，我們也對阿茲海默症有一點關注，這基本上是因為我們迄今為止看到的數據表明 GLP-1 類似物可能對阿茲海默症領域有益。

But the way we go about this is obviously -- and we feel really blessed about that. We have a molecule that is really, really good at doing weight lowering in obesity, really good at doing glycemic control in diabetes, but also has now been shown to have cardiovascular benefits, both on MACE, but also on the heart failure component.

但我們採取的方式顯然是——我們對此感到非常幸運。我們有一種分子，它非常非常擅長減輕肥胖症患者的體重，非常擅長控製糖尿病患者的血糖，而且現在已被證明對心血管有益，不僅對 MACE 有益，而且對心臟衰竭成分也有益。

We look at potential liver; we look at potential kidney; we look at potential, as I talked about, Alzheimer's disease. Having that holistic approach with one molecule allows us actually to build capabilities in the research and the development and also in the commercial space. And obviously, we are really excited about what we see from semaglutide.

我們關注潛在的肝臟；我們關注潛在的腎臟；正如我所說，我們著眼於潛在的阿茲海默症。採用單一分子的整體方法使我們能夠真正建立研究和開發以及商業領域的能力。顯然，我們對索馬魯肽所看到的結果感到非常興奮。

In the cardiovascular space, it appears to have the potential to be a cardiovascular drug in and of itself. And obviously, we continue to -- towards the end of this decade, continue to generate new data informing us of what can semaglutide do.

在心血管領域，它本身似乎有潛力成為心血管藥物。顯然，在本十年末，我們將繼續產生新的數據，告訴我們索馬魯肽的作用。

I'm going to show the ESSENCE trial in just a minute. Next year, we'll see the results of the EVOKE trials. And towards the end of the decade, we also are looking at primary cardiovascular prevention in the ASCEND PLUS trial. So that kind of approach allows us to broaden the value of semaglutide, broaden the promise of semaglutide, and adding continuous pieces to the puzzle of semaglutide.

我將在一分鐘內展示 ESSENCE 試用版。明年，我們將看到 EVOKE 試驗的結果。到本世紀末，我們也在 ASCEND PLUS 試驗中研究初級心血管預防。因此，這種方法使我們能夠擴大索馬魯肽的價值，擴大索馬魯肽的前景，並為索馬魯肽的拼圖添加連續的碎片。

One of those pieces is something that some of us have been working on for many, many years. It's been a long and somewhat bumpy road. And it was super-gratifying to see the first outcomes of the ESSENCE trial.

其中一件作品是我們中的一些人多年來一直致力於的。這是一條漫長且有些坎坷的路。看到 ESSENCE 試驗的第一個結果真是令人非常高興。

To those of you who don't remember the ESSENCE trial, two-part trial. One part is for regulatory approval based on liver biopsies. The continued part of the study is basically to generate heart evidence on liver endpoints, on cardiovascular endpoints, to document that there's not only just a liver biopsy upside to the intervention that we have investigated, but also outcomes benefit for patients.

對於那些不記得 ESSENCE 試用版的人，試用版分為兩部分。一部分是根據肝臟活檢獲得監管批准。研究的後續部分基本上是產生有關肝臟終點和心血管終點的心臟證據，以證明我們研究的干預措施不僅有肝臟活檢的好處，而且對患者的結果也有好處。

For now, we have what we call the regulatory part of the trial because that is sufficient to cater to regulatory submission and hopefully approval. The regulatory requirement in the US is to have improvement in hepatosteatitis without worsening on fibrosis or vice versa.

目前，我們擁有所謂的試驗的監管部分，因為這足以滿足監管提交並希望獲得批准。美國的監管要求是改善肝脂肪炎而不惡化纖維化，反之亦然。

In Europe, they require both. And we are super-happy to see that we both win on reducing the hepatosteatitis. We do that by 63% as compared to placebo 34%. But we're also reducing fibrosis 37% compared to placebo approximately 23%. We have really, really strong data from a statistical perspective, but also from a clinical relevance perspective.

在歐洲，兩者都需要。我們非常高興地看到我們雙方都在減少肝脂肪炎方面取得了勝利。我們的比例為 63%，而安慰劑為 34%。但與安慰劑約 23% 相比，我們也減少了 37% 的纖維化。從統計角度以及臨床相關性角度來看，我們擁有非常非常強大的數據。

I can't say a lot more because actually -- and this is super-annoying also to me, some of the data have been redacted basically because we have an ongoing trial and I and people who can make decisions on the trial cannot be influencing the ongoing trial. So to preserve the integrity of the trial, there are data that I have not seen. Karsten is also super-annoyed about that.

我不能說更多，因為實際上 - 這對我來說也非常煩人，一些數據已被編輯，基本上是因為我們正在進行一項試驗，而我和能夠在試驗中做出決定的人無法影響正在進行的審判。因此，為了保持試驗的完整性，有些數據我還沒看到。卡斯滕對此也非常惱火。

On the safety part, we once again confirm that semaglutide has an attractive safety profile. No new safety concerns identified in the ESSENCE trial, and that is gratifying in a new population. So yet another piece to the puzzle of the value offering that we can do with semaglutide to patients with serious chronic disease and unmet need.

在安全性方面，我們再次確認索馬魯肽具有有吸引力的安全性。 ESSENCE 試驗中沒有發現新的安全問題，這在新人群中是令人欣慰的。因此，我們可以用索馬魯肽為患有嚴重慢性疾病和未滿足需求的患者提供價值，這是另一個難題。

But it doesn't stop there. We have three other focus areas. First focus area is obviously maximize our knowledge base and value of semaglutide. Second, build a leading and competitive obesity and diabetes pipeline. And as you can see from the slide, and I promised Karsten not to leave it up there for too long, a lot of progress and a lot of data coming in in both the diabetes and the obesity space over the next couple of quarters.

但它不止於此。我們還有其他三個重點領域。第一個重點領域顯然是最大化我們的知識基礎和索馬魯肽的價值。其次，打造領先且具競爭力的肥胖和糖尿病產品線。正如你從幻燈片中看到的那樣，我向卡斯滕保證不會把它放在那裡太久，在接下來的幾個季度裡，糖尿病和肥胖領域將取得大量進展和大量數據。

But we also are building the cardiovascular -- beyond semaglutide, cardiovascular, liver and kidney-related pipeline, where we again see progress in both Phases 1, 2 and 3. And given that we defined that focus area only a couple of years ago, it's gratifying to see that level of clinical activity at this point in time.

但我們也在建造心血管——超越與索馬魯肽、心血管、肝臟和腎臟相關的管道，我們再次看到第一、第二和第三階段的進展。該重點領域，很高興看到此時此刻的臨床活動水平。

And finally, obviously, we are super happy with the progress that we're also doing in rare disease, specifically in the hemophilia space, but we also now see progress of our sickle cell disease, which obviously again speaks to a disease area with a huge unmet need. So across the Board, as Karsten said, increased investments, but also increasing excitement in R&D.

最後，顯然，我們對我們在罕見疾病（特別是血友病領域）方面取得的進展感到非常高興，但我們現在也看到了鐮狀細胞病的進展，這顯然再次說明了一個具有巨大的未滿足的需求。因此，正如卡斯滕所說，全面增加投資，同時也增加了研發的熱情。

Great. Thank you, Martin. We really appreciate the return on investment in R&D. We continue to have it, of course. All right. So thank you to Martin

偉大的。謝謝你，馬丁。我們非常欣賞研發投資的回報。當然，我們繼續擁有它。好的。所以謝謝馬丁

This is our outlook for the full year. We reiterated our outlook in terms of the midpoint compared to Q2, but narrowed the range as time is passing and only not even two months left to go. So really continuing executing on a plan and a growth level at a very high magnitude in now midpoint 25% growth on a base, as you will recall, of DKK232 billion last year. So very high both relative and absolute growth levels for the company.

這是我們對全年的展望。我們重申了對第二季中點的展望，但隨著時間的推移，我們的區間縮小了，而且只剩下不到兩個月了。因此，我們確實繼續執行一項計劃，並在去年 2,320 億丹麥克朗的基礎上實現了 25% 的中點成長。公司的相對和絕對成長水準都非常高。

Small tweaks to currencies, nothing to comment about. And fine-tuning of tax rate, nothing changes on tax. This is the same effective tax rate we reported in Q3 as Q2, and therefore, the guidance of between 20% and 21%. And small technical tweaks to cash flow, nothing fundamental.

貨幣的小調整，沒什麼好評論的。稅率的微調，稅收方面沒有任何變化。這與我們在第三季報告的有效稅率與第二季相同，因此指導值為 20% 到 21% 之間。對現金流進行小的技術調整，沒有什麼根本性的。

So this concludes the introductory presentation. And then we have Jacob Rode, our new Head of Investor Relations, not so new anymore, to control Q&A. So over to you, Jacob.

介紹性示範到此結束。然後我們有新任投資者關係主管雅各布·羅德（Jacob Rode）來控制問答，他不再那麼新鮮了。現在就交給你了，雅各。

Thank you. And I welcome Martin and Camilla back on stage. And we'll follow our usual procedure. And that we will start with the host, Sachin, and please state your institution and your name before asking questions.

謝謝。我歡迎馬丁和卡米拉回到舞台。我們將遵循通常的程序。我們將從主持人 Sachin 開始，請在提問前說明您所在的機構和您的姓名。

Sachin Jain, Bank of America. One clarification from yesterday and then one question. So given my question yesterday generated a lot of furore, I might just ask you to clarify, Karsten. So high teens, did you mean 19%? And the reason I ask that, there was a lot of misunderstanding as to high-teens, mid-teens, low-teens. I just wanted to clarify.

薩欽‧賈恩 (Sachin Jain)，美國銀行。昨天的一項澄清，然後是一個問題。鑑於我昨天的問題引起了很大的憤怒，我可能只是請你澄清一下，卡斯滕。這麼高的青少年，你是說19%嗎？我之所以問這個問題，是因為人們對高中、中、低年級有許多誤解。我只是想澄清一下。

And given it was so close to consensus at 20%, just the intent, was it essentially took less consensus to provide a floor this early in '24 ahead of guide? So that's question one.

鑑於它如此接近 20% 的共識，僅就意圖而言，在 24 年這麼早提供一個下限，是否實質上需要更少的共識才能領先於指南？這是問題一。

Question two is a bigger picture on oral strategy. So level of confidence in CB1 given the data you see? And will you pursue an external backup scalable strategy given you won't know the outcome of CB1 until the end of next year? There's obviously a lot of interest in this given IQVIA data Phase 3 coming next year. Thank you very.

問題二是關於口頭策略的更大的圖像。那麼根據您看到的數據，您對 CB1 的信心程度是多少？鑑於您要到明年年底才能知道 CB1 的結果，您是否會採取外部備份可擴展策略？鑑於明年即將推出的 IQVIA 第三階段數據，顯然人們對此很感興趣。非常感謝。

Thank you, Sachin. I think the first one is clearly to you, Karsten, and then the second one goes to Camilla, and then to Martin.

謝謝你，薩欽。我認為第一個顯然是你的，卡斯滕，然後第二個是卡米拉，然後是馬丁。

Yeah. Thank you for that question, Sachin. I appreciate it. And I appreciate also kind of the noise in the market yesterday or the reaction in the market. So just to reiterate, including also my intention. So first of all, we are driving historic high levels of growth in the company, super-high growth as a company now this year in the mid-20s.

是的。謝謝你提出這個問題，薩欽。我很感激。我也很欣賞昨天市場的噪音或市場的反應。所以只是重申一下，包括我的意圖。首先，我們正在推動公司歷史性的高水準成長，作為一家公司，今年在 1920 年代中期實現超高成長。

What I said yesterday was we continue to scale our supply chain and scale the company to continue to drive very attractive growth into next year. That's point number one. Point number two, when growth is at this magnitude, then the base effect becomes really important when we talk about growth rates. It's simple math. So this is just a reminder about that.

我昨天所說的是，我們將繼續擴大我們的供應鏈和公司規模，以繼續推動明年非常有吸引力的成長。這是第一點。第二點，當成長達到如此規模時，當我們談論成長率時，基數效應就變得非常重要。這是簡單的數學。所以這只是一個提醒。

And then the third piece was we had a one-off we already reported in the first quarter around favorable gross to net that we do not expect to repeat next year. So that has to be adjusted. So these were really just reminders around the technicalities when looking into next year.

第三件事是我們已經在第一季報告了一次關於有利的總淨值的一次性報告，我們預計明年不會再發生這種情況。所以必須對此進行調整。因此，這些實際上只是在展望明年時提醒人們注意一些技術細節。

So overall, this is going to be guidance in February, and we look forward to come back with our '25 guidance in February. And again, we're delivering record-breaking growth currently. So of course, we're pushing to continue that.

總的來說，這將是 2 月份的指導意見，我們期待在 2 月份提供我們的 '25 指導意見。再說一次，我們目前正在實現破紀錄的成長。當然，我們正在努力繼續這樣做。

Thank you, Karsten. And let's go to Camilla, first on the oral market, and next we can go to Martin.

謝謝你，卡斯滕。讓我們先談談卡米拉，首先是口腔市場，然後我們可以去找馬丁。

Yes. On the oral market, first of all, I'd like to say that we do believe that the injectable GLP-1 segment will be the biggest segment in the years to come. But of course, over time, it's also likely that there will be an oral segment.

是的。在口服市場上，首先，我想說的是，我們確實相信注射 GLP-1 細分市場將是未來幾年最大的細分市場。但當然，隨著時間的推移，也可能會有口頭環節。

Then you asked about our priorities. And I would say, in our pipeline, we have oral semaglutide high dose. We also have oral amycretin, and then, of course, monlunabant that you also referred to. So for us, it's not either or.

然後你問了我們的優先事項。我想說，在我們的產品線中，我們有口服高劑量索馬魯肽。我們還有口服阿黴素，當然還有您提到的蒙魯那班。所以對我們來說，這不是非此即彼。

This is a portfolio of products. And of course, short term, with high dose or obesity, we would also be able to bring that to market as soon as we find that relevant. So these are some of our considerations.

這是一個產品組合。當然，短期內，對於高劑量或肥胖症，一旦我們發現相關，我們也能夠將其推向市場。所以這些是我們的一些考慮因素。

Over time, the obesity market is big. It's likely that there will be a need for different types of options for different patients. We have not even seen the market segment itself yet in different patient populations. But of course, that is likely to happen. And then, of course, also there will be different geographical considerations. So it's absolutely not an either/or strategy that we are applying in the obesity segment.

隨著時間的推移，肥胖市場很大。不同的患者可能需要不同類型的選擇。我們甚至還沒有看到不同患者群體中的市場區隔本身。但當然，這很可能會發生。當然，還會有不同的地理考量。因此，我們在肥胖領域應用的絕對不是一種非此即彼的策略。

And maybe to build on that, I mean, when we build pipeline, when we build portfolio, we think optionality. And that basically means, as Camilla said, we have optionality given that we have currently the only Phase 3 completed oral offering in this space with really, really good efficacy comparable to that of injectable, and with the CV and other benefits that we know come from semaglutide.

也許在此基礎上，我的意思是，當我們建立管道時，當我們建立投資組合時，我們會考慮可選性。正如卡米拉所說，這基本上意味著我們有選擇權，因為我們目前在這個領域擁有唯一的第三階段完成的口服產品，具有與注射劑相當的非常非常好的功效，並且具有我們所知道的CV和其他好處來自索馬魯肽。

And to Camilla's point, if that is something that we intend to launch, then we can do that as an option. We can think about the same way of approaching this with amycretin. Both of those options are obviously less scalable than the subcutaneous offering.

對於卡米拉來說，如果這是我們打算推出的東西，那麼我們可以將其作為一種選擇。我們可以考慮用同樣的方法來處理阿黴素。這兩種選擇的可擴展性明顯低於皮下注射。

Monlunabant is still a high potential approach in this space. Given the data that we've seen, it was very, very clear that two high doses had been tested that led also to some side effects that, from a commercial perspective, would not be acceptable. And that basically means that we have to investigate lower doses.

蒙魯那班仍然是該領域極具潛力的方法。鑑於我們所看到的數據，非常非常清楚的是，已經測試了兩種高劑量，這也導致了一些副作用，從商業角度來看，這是不可接受的。這基本上意味著我們必須研究更低的劑量。

But given that the doses tested were very high on the dose response curve and the exposure response curve, we can actually allow ourselves to decrease the dose, still expect good efficacy in monotherapy, potentially also in combination therapy, and mitigate the safety concerns.

但考慮到所測試的劑量在劑量反應曲線和暴露反應曲線上非常高，我們實際上可以允許自己減少劑量，仍然期望單一療法（甚至聯合療法）也能取得良好的療效，並減輕安全性擔憂。

So when you ask into our confidence, we are still confident and optimistic about monlunabant. But obviously, given what we have seen, the risk is somewhat higher. Our approach to this, however, remains the same. I think even before the data came out, I said we would do an additional Phase 2b trial to make sure that we have a safe and efficacious drug before we go into Phase 3, and that's still the plan.

所以當你詢問我們的信心時，我們對蒙魯那班還是充滿信心和樂觀的。但顯然，鑑於我們所看到的情況，風險要高一些。然而，我們對此的方法保持不變。我想，即使在數據出來之前，我就說過我們會進行額外的 2b 期試驗，以確保在進入 3 期之前我們有一種安全有效的藥物，這仍然是計劃。

Thank you Martin and thank you that and then we'll go to M&A.

謝謝馬丁，謝謝你，然後我們將進行併購。

Hi. Thanks. Emily Field from Barclays. Two questions. The first one, just on the logistics of the Catalent transaction. I know you said that you expect that, that will increase supply from 2026. But do those three facilities transfer to Novo Nordisk as soon as the Novo Holdings deal closes and we won't see an increase in supply just because it's sort of a transitional period?

你好。謝謝。巴克萊銀行的艾米麗·菲爾德。兩個問題。第一個是關於 Catalent 交易的物流。我知道您說過，您預計從2026 年開始供應量將會增加。因為這是一種過渡時期？

And then secondly, I know there was a question asked on promotional efforts broadly yesterday, but more specifically in the US with the current competitive landscape, Lilly said last week that they are going to be heavily increasing promotional efforts in mid-November.

其次，我知道昨天有人廣泛詢問了促銷活動，但更具體地說，在美國，鑑於當前的競爭格局，禮來公司上週表示，他們將在 11 月中旬大幅增加促銷活動。

Maybe just a broader comment. Is that something you think you need to respond to? Or how are you seeing the competitive dynamics between the two molecules in obesity in the US.?

也許只是更廣泛的評論。您認為您需要對此做出回應嗎？或者您如何看待這兩種分子在美國肥胖問題上的競爭動態？

Thank you, Emily. The first one on Catalent goes to you, Karsten.

謝謝你，艾米麗。卡塔倫特上的第一個是你，卡斯滕。

Yeah. So we expect, as I said yesterday, the transaction to close this year. Then we'll do immediately a carve-out from the hold-co into the three sites that the Novo Nordisk operating company takes. So that will happen immediately.

是的。因此，正如我昨天所說，我們預計交易將於今年完成。然後我們將立即從控股公司中剝離出諾和諾德營運公司佔據的三個地點。所以這會立即發生。

And then the reason why we said 2026 is that for us to transfer products to new manufacturing lines, we need to do technology transfers. And that's basically the gap between today and into 2026. But important to remind everybody that we are producing in these facilities. So we have access to certain capacities already with Catalent today. And of course, that will continue and continue to perform as we speak.

然後我們之所以說2026年，是因為我們要將產品轉移到新的生產線上，我們需要進行技術轉移。這基本上就是今天與 2026 年之間的差距。因此，我們今天已經可以使用康泰倫特的某些功能。當然，就在我們說話的時候，這種情況將會持續下去。

Thank you. And then Camilla, on promotional efforts?

謝謝。然後卡米拉，關於促銷工作？

On the promotional efforts in the US, we, of course, will stay competitive. We have a very strong track record of being competitive in the US, establishing leading brands. You're looking at Ozempic and Wegovy. Those are very well-recognized brands that, of course, we have different channels to promote that, and we use the different approaches that it takes to be competitive in such a market. And therefore, we're also happy to see that we have leading TRx both in diabetes and in obesity, and we will remain very competitive.

在美國的推廣工作上，我們當然會保持競爭力。我們在美國具有競爭力，建立了領先品牌，擁有非常出色的記錄。您正在查看 Ozempic 和 Wegovy。這些都是非常知名的品牌，當然，我們有不同的管道來推廣它們，我們使用不同的方法來在這樣的市場中保持競爭力。因此，我們也很高興看到我們在糖尿病和肥胖症方面都擁有領先的 TRx，我們將保持非常強的競爭力。

Then we go to Richard Vosser.

然後我們去找理查德·沃瑟。

Hi, thanks. Richard Vosser JP Morgan. Maybe you could just give us an idea of the latest demand and stay time in markets where you're not supply constrained, such as maybe Denmark or others, just to give us a flavor of how that's panning out.

你好，謝謝。理查德·沃瑟（Richard Vosser），摩根大通。也許您可以讓我們了解最新的需求以及在不受供應限制的市場中停留的時間，例如丹麥或其他國家，只是為了讓我們了解情況如何。

And maybe second question, you talked about increasing supply and increasing the rollout ex-US in Q4 with the acceleration. But maybe you could give us a bit more color on the rollout plans ex-US I think at the start of the year, you may have had 10 markets and now you have 15. How should we think about it relative to those on a market basis?

也許是第二個問題，您談到了第四季度加速增加供應和增加美國以外地區的推出。但也許你可以給我們更多關於美國以外的推出計劃的信息，我想在今年年初，你可能有 10 個市場，現在有 15 個。

Thank you, Richard. I think both of those go to you, Camilla, first and second.

謝謝你，理查。我認為卡米拉，這兩件事都歸你所有，第一和第二。

Yeah. Thank you. So on stay time, we continue to see with Wegovy that stay time is expanding. If we look at particular markets like Denmark, where we have a pretty significant share of the population on the product, we are continuing to see that people stay on for quite a long time.

是的。謝謝。因此，在停留時間方面，我們繼續透過 Wegovy 看到停留時間正在延長。如果我們看看像丹麥這樣的特定市場，我們在該市場上有相當大一部分人使用該產品，我們會繼續看到人們會持續使用相當長的時間。

It is difficult yet to sort of specifically quantify that, because it's still early days, but I can say that it is significantly longer than what we saw with Saxenda. And specifically for the US, we see also stay time improving and continues to improve.

目前還很難具體量化這一點，因為現在還處於早期階段，但我可以說它比我們在 Saxenda 中看到的要長得多。特別是對於美國，我們也看到停留時間有所改善，並且持續改善。

So I'm not yet to say that we are at the end of what it will be, but we definitely have moved from -- you remember a few years back, we were talking with Saxenda for five months. We are more now closer to seven months of stay time with Wegovy. But still, I would say this is not the end of it. So all moving in the right direction.

所以我還沒有說我們已經走到了結局的盡頭，但我們肯定已經擺脫了——你還記得幾年前，我們與 Saxenda 進行了五個月的交談。現在我們在 Wegovy 的停留時間已經接近七個月了。但我仍然想說這還沒結束。所以一切都在朝著正確的方向發展。

To your second question about the rollout in international operations, we rolled out in approximately 15 markets as we speak, but you should expect that we will continue to do that, and there are a few more markets coming up also this year.

關於您關於國際業務推出的第二個問題，我們正在大約 15 個市場推出，但您應該期望我們將繼續這樣做，今年還將推出更多市場。

So it's important for us to also contribute to solving obesity in international operations. And we do see a significant demand in many of these countries also. So most recently, we launched in Australia, we are on our way into Brazil also, and there are more markets on the list for this year also.

因此，對我們來說，在國際業務中為解決肥胖問題做出貢獻也很重要。我們確實看到其中許多國家也有巨大的需求。最近，我們在澳洲推出，我們也正在進入巴西，今年名單上還有更多市場。

Thank you, Camilla. Then I think Richard Parkes here with the next one.

謝謝你，卡米拉。然後我想理查德·帕克斯（Richard Parkes）和下一位。

Yeah. Richard Parkes from BNP Paribas Exane. So I've got a question coming back to 2025, and specifically on capacity expansion, because I'm trying to understand what the risks are to the upside and downside of you executing on that? Because my understanding is your next big API facility will open in 2026 and Catalent won't necessarily benefit you until 2026, when you can repurpose some of that.

是的。法國巴黎銀行的理查德‧帕克斯 (Richard Parkes)。因此，我有一個關於 2025 年的問題，特別是關於產能擴張的問題，因為我試圖了解您執行此計劃的上行和下行風險是什麼？因為我的理解是，您的下一個大型 API 設施將於 2026 年開放，而 Catalent 不一定會讓您在 2026 年之前受益，屆時您可以重新利用其中的一些設施。

Thank you, Richard. Karsten, to you on the (technical difficulty)

謝謝你，理查。 Karsten，跟你講一下（技術難度）

Thanks, Richard. And I think I'll just go back to Camilla's slide to just repeat this graph, because I think this is really a nice reminder around how we are scaling in terms of reaching more and more patients with our GLP-1. So right now, we have scaled with 4 million patients compared to 12 months ago, patients using Novo Nordisk GLP-1, 4 million.

謝謝，理查。我想我會回到 Camilla 的幻燈片來重複這張圖，因為我認為這確實很好地提醒了我們如何擴大規模，讓我們的 GLP-1 惠及越來越多的患者。因此，與 12 個月前使用諾和諾德 GLP-1 的患者數量相比，目前我們的患者數量已擴大到 400 萬人。

So it's almost the population of Denmark, more or less the adult population of Denmark. In one year, we scaled with people on chronic therapy. And again, a factor three in terms of scaling over three years. And the reason why I bring that is, this scaling doesn't only happen through industrial scaling like factories. These are also portfolio choices that enables the scaling.

所以這幾乎是丹麥的人口，或多或少是丹麥的成年人口。在一年內，我們擴大了接受慢性治療的人的規模。再說一遍，三年內的規模擴大了三倍。我提出這一點的原因是，這種擴展不僅僅是透過工廠等工業擴展來實現。這些也是能夠實現擴展的投資組合選擇。

So how do we use our existing capacities even more efficiently to reach more patients, what are our portfolio choices and our product presentation choices? So on that front, we have multiple levers. So that's one piece to stand on.

那麼，我們如何更有效地利用現有能力來接觸更多患者，我們的產品組合選擇和產品展示選擇是什麼？因此，在這方面，我們有多個槓桿。所以這是一個可以立足的部分。

On the industrial side, while you're correct that there are no, how can I put it, material one-offs kicking in, in '25, then we have the gradual scaling of lines who have gotten online in the past few years, if you take on fill/finish and so on. So we do have scaling of our industrial footprint, both on API for sure, but also on fill/finish, both fill and assembly pack. So look at this as a continued scaling and optimization of our industrial footprint, improvement through portfolio or scaling through portfolio and product presentations. So that's how we work with it into next year.

在工業方面，雖然你說得對，我怎麼說呢，在 25 年，物質上的一次性事件開始出現，然後我們在過去幾年中逐漸擴大了上線的生產線，如果你承擔填充/完成等工作。因此，我們確實擴大了我們的工業足跡，當然既包括 API，也包括填充/完成，包括填充和組裝包。因此，將此視為我們工業足跡的持續擴展和優化，透過產品組合進行改進或透過產品組合和產品展示進行擴展。這就是我們明年的工作方式。

Thank you, Karsten. We go to the middle to James.

謝謝你，卡斯滕。我們去中間找詹姆斯。

James Quigley from Goldman Sachs. I've got two, please. So one on Ozempic momentum. I know there's been some pushes and pulls in supply challenges and things of that nature, but prescriptions in the US seem to have steadied around the 700,000 mark.

高盛的詹姆斯·奎格利。我有兩個，拜託。這是關於臭氧動力的一個。我知道供應挑戰等方面存在一些推動和拉動，但美國的處方數量似乎穩定在 70 萬個大關左右。

So how are you thinking about the market dynamics going forward? What are you seeing in terms of competitive trends in the US, but also ex-US? Q4 is a tough comp, but how confident are you that you can continue to see robust growth into next year and beyond?

那麼您如何看待未來的市場動態呢？您對美國以及美國以外地區的競爭趨勢有何看法？第四季是一個艱難的競爭，但您對明年及以後能夠繼續看到強勁成長有多大信心？

And the second question is on Wegovy US wholesaler dynamics. We've seen some ex-US stocking this quarter, but the third quarter sales for Wegovy pretty much tracked prescriptions. So when we're thinking about an acceleration in Q4, how dependent are we on stocking in Wegovy in the US? How much visibility do you have on imaging movements in the US as well and that can give you some visibility on that?

第二個問題是關於Wegovy美國批發商的動態。本季我們看到了一些美國以外的庫存，但 Wegovy 第三季的銷售幾乎追蹤處方藥。因此，當我們考慮到第四季度的加速時，我們對美國 Wegovy 庫存的依賴程度如何？您對美國的成像運動有多少了解，這可以讓您對此有所了解嗎？

Thank you, James. Then firstly to Camilla on the strong global demand we see for GLP-1s, both in diabetes and obesity.

謝謝你，詹姆斯。首先向 Camilla 介紹我們看到全球對 GLP-1 在糖尿病和肥胖症領域的強勁需求。

Yeah. So in relation to Ozempic in particular, of course, we see Ozempic is a leading brand in the US in diabetes, but also in the rest of the world. We've now launched in 76 countries. So this is indeed a product that is in high demand.

是的。因此，特別是就 Ozempic 而言，當然，我們看到 Ozempic 是美國糖尿病領域的領先品牌，在世界其他地區也是如此。我們現已在 76 個國家推出。所以這確實是需求量很大的產品。

What we also see is that the use of GLP-1 in diabetes is all in all only 6%. So that also means that there is still significant potential. We know that it's recommended in many guidelines. So we see this as the beginning of a journey, as I said in the beginning.

我們也看到，GLP-1 在糖尿病的使用率總共只有 6%。這也意味著仍然存在巨大的潛力。我們知道許多指南都建議這樣做。因此，正如我在開頭所說，我們將此視為旅程的開始。

We expect that there will be in the future an increased demand for injectable GLP-1s, both in diabetes, but also in obesity where, of course, the usage of our GLP-1 product, Wegovy, is still at a very -- you can say, it has a high impact on our overall sales and scaling. But of course, it is still, compared to the obesity population, still early days with a couple of millions of people being treated.

我們預計，未來對可注射 GLP-1 的需求將會增加，無論是在糖尿病還是肥胖症方面，當然，我們的 GLP-1 產品 Wegovy 的使用仍然處於非常--可以說，它對我們的整體銷售和規模影響很大。但當然，與肥胖者相比，目前仍有數百萬人正在接受治療。

So there's a lot more room for rolling out these brands, and we will continue to do that. And as Martin said, that's why we are building a life cycle management plan, where we continue to build on new indications to the semaglutide brand. This will continue to be important for us.

因此，推出這些品牌還有很大的空間，我們將繼續這樣做。正如馬丁所說，這就是我們正在製定生命週期管理計畫的原因，我們將繼續以索馬魯肽品牌的新適應症為基礎。這對我們來說仍然很重要。

Thanks, Camilla. And Karsten, on the moving parts in the US on Wegovy

謝謝，卡米拉。 Karsten 在 Wegovy 上談論美國的動態

Yeah. And internationally, if I understand your question correctly. So what we said in the third quarter was that we have a one-off in terms of Wegovy stocking in international operations. And this is completely normal, because when you launch a product, then you fill inventories with wholesalers and retailers in a specific geography. And the reason why we called it out was that it had a magnitude that it was sufficiently large to call out, first and foremost.

是的。在國際上，如果我正確理解你的問題的話。所以我們在第三季所說的是，我們在國際業務中的 Wegovy 備貨方面有一個一次性的成果。這是完全正常的，因為當您推出產品時，您會向特定地區的批發商和零售商填充庫存。我們之所以把它叫出來，首先是因為它的震級夠大，可以叫出來。

But it's important to note, this is a one-off, but we cannot grow from one-offs, right? But it's also not scaling back. This is inventory that will sit there and then we'll start supplying the market from there as we backfill inventories into those wholesalers and retailers. So that's the logic on ex-US.

但值得注意的是，這是一次性的，但我們不能從一次性中成長，對吧？但它也沒有縮減規模。這些庫存將存放在那裡，然後我們將開始從那裡向市場供應庫存，同時將庫存回填給那些批發商和零售商。這就是前美國的邏輯。

In the US, we have high visibility on inventory levels, of course, in our own warehouses as well as with the wholesalers. And then the retailer inventories, we have less visibility, too. But overall, that's the structure of the inventory in fact.

在美國，我們對自己的倉庫以及批發商的庫存水準具有很高的透明度。然後是零售商庫存，我們的可見度也較低。但總的來說，這其實就是庫存的結構。

Then we move to Rajesh in the back.

然後我們轉向後面的拉傑什。

Hi. Rajesh Kumar from HSBC. Just on the high teens growth we are thinking of next year. Can you unpack that in terms of how you're thinking about volume versus value in terms of what sort of assumptions are you making on rebates? I know you like making very conservative assumptions there. So that would be really helpful to understand.

你好。來自匯豐銀行的拉傑什·庫馬爾。我們正在考慮明年的青少年高速成長。您能否從如何考慮數量與價值以及您對回扣做出什麼樣的假設方面來解釋這一點？我知道你喜歡在那裡做出非常保守的假設。所以這對理解非常有幫助。

The other one is, let's assume a scenario that, for some reason, Catalent deal either blocked by EU or FTC. How much more CapEx -- or would you be able to absorb the shock with the CapEx program you have now to meet the supply you have planned? Or would you need to rethink in a meaningful way in terms of capacity investment? And the last one is a slightly different one, which is, apart from orforglipron, which other asset you thought we wish we have that?

另一種情況是，讓我們假設一種情況，由於某種原因，康泰倫特交易被歐盟或聯邦貿易委員會阻止。還有多少資本支出——或者您是否能夠透過現有的資本支出計劃來吸收衝擊以滿足您計劃的供應？或者您需要以有意義的方式重新考慮產能投資？最後一項略有不同，除了 orforglipron 之外，您認為我們希望我們擁有哪一項其他資產？

Thank you, Rajesh. Then we'll bundle the first 2 into one since they are both essentially on supply, the short-term trajectory and next steps on Catalent.

謝謝你，拉傑什。然後我們將把前兩個捆綁為一個，因為它們基本上都是供應的，短期軌跡和 Catalent 的後續步驟。

Thank you for those questions, Rajesh. So when you look at our performance right now, it's actually fairly straightforward, as Camilla was alluding to. More or less 100% of our growth comes from Ozempic and Wegovy and its volume-based growth.

謝謝你提出這些問題，拉傑什。因此，當你看到我們現在的表現時，它實際上相當簡單，正如卡米拉所暗示的那樣。我們的成長或多或少 100% 來自 Ozempic 和 Wegovy 及其基於數量的成長。

And we like that because volume-based growth is really a sign of the quality of our products and the demand in the marketplace for what our products are doing. And we don't have any major changes in the portfolio into next year. There might be some portfolio balances and priorities that change, but fundamentally, this is what we're running on also into next year.

我們喜歡這一點，因為銷售成長確實是我們產品品質以及市場對我們產品需求的標誌。明年我們的投資組合不會有任何重大變化。可能會有一些投資組合平衡和優先事項發生變化，但從根本上來說，這也是我們明年的目標。

As to Catalent and a Plan B, of course, we have such a plan in the drawer. We don't want to confuse people about what that plan looks like. But put very simplistically, then this will be a mix between investing even more in our existing facilities and our existing footprint as well as contracting even more with external CDMOs.

至於康泰倫特和B計劃，當然，我們抽屜裡有這樣一個計劃。我們不想讓人們對該計劃的內容感到困惑。但簡單地說，這將是對我們現有設施和現有足跡進行更多投資以及與外部 CDMO 簽訂更多合約的混合。

Thank you, Karsten. And on the last one to Martin, as far as I know, so your darlings are within our pipeline, but what's your is luck.

謝謝你，卡斯滕。最後一封是給馬丁的，據我所知，所以你的寶貝在我們的管道中，但你的運氣是怎樣的。

Yeah. And I really do love my darlings. So I don't know that I would wish to have anything else in my pipeline, because when I look at our current pipeline, starting with CagriSema, it has the potential to become the drug that gives unprecedented weight loss, unprecedented glycemic control.

是的。我真的很愛我的寶貝們。所以我不知道我是否希望在我的產品線中添加任何其他產品，因為當我審視我們目前的產品線時，從CagriSema 開始，它有潛力成為一種能夠實現前所未有的減肥、前所未有的血糖控制的藥物。

Semaglutide is in the mix. So we'll also get the CV benefits and potentially also other benefits. First and best-in-class potential, what's more to like. And I even have amycretin as a strong follow-up to CagriSema. So when I look at the pipelines, I'm super happy with my own.

索馬魯肽就在其中。因此，我們還將獲得簡歷福利以及可能的其他福利。一流的潛力，更令人喜歡的。我甚至還使用了阿黴素作為 CagriSema 的有力後續藥物。所以當我看到管道時，我對自己的管道非常滿意。

Perfect. And we move to the front here and Simon Baker.

完美的。我們走到前面，西蒙·貝克。

Simon Baker from Redburn Atlantic. Just a quick clarification on Catalent. Karsten, you said that the reason for the slight delay is tech transfer. I'm presuming it's also due to termination of existing contracts on the Moderna in those facilities. So how much of that is a delay? You just got to wait for other people to get out?

來自雷德伯恩大西洋公司的西蒙貝克。只是對 Catalent 進行快速澄清。卡斯滕，你說稍微延遲的原因是技術轉移。我推測這也是由於這些設施中 Moderna 的現有合約終止所致。那麼其中有多少是延遲呢？只能等別人出來嗎？

And then a couple of questions on Martin's darlings, as we'll probably start calling them now. Firstly, on the long-acting amylin that's gone into Phase 1. I'd be interested to get your thoughts on the comments from Astra that they see preclinically lean mass preservation with amylin agonism.

然後是關於馬丁的寶貝們的幾個問題，我們現在可能會開始稱呼他們。首先，關於進入第一階段的長效胰淀素。

And then on CagriSema, one of the things that cropped up in the Phase 1 and didn't seem to be a particular issue was the presence of antidrug antibodies, neutralizing antibodies. Firstly, is that anything to worry about? And secondly, how does that factor into your modeling of the 25% weight loss that you expect for the REDEFINE study? Thanks so much.

然後在 CagriSema 上，第一階段出現的一件事似乎不是一個特別的問題，那就是抗藥物、中和抗體的存在。首先，這有什麼值得擔心的事嗎？其次，您對 REDEFINE 研究預期的 25% 體重減輕建模有何影響？非常感謝。

Thank you, Simon. Karsten, on Catalent timelines, confirmation of that?

謝謝你，西蒙。卡斯滕，在康泰倫特的時間表上，證實了這一點嗎？

Yeah. So I think it's a slightly different question you're posing compared to Emily from before. So the first answer is how fast can we move in terms of accessing capacity at Catalent. And I'm saying that there's a lead time from when the deal closes to access free lines at Catalent, there's a lead time linked to tech transfers.

是的。所以我認為你提出的問題與之前艾米麗提出的問題略有不同。因此，第一個答案是我們在 Catalent 的訪問能力方面能採取多快的速度。我是說，從交易完成到獲得康泰倫特的免費線路有一個準備時間，有一個與技術轉移相關的準備時間。

So that's a '26 comment. Of course, as we've been out saying, then we are honoring existing customers and existing contracts, and that will then be the gearing into the medium term. So when existing customers are leaving, then we'll be able to utilize capacities even more and lines even more. So it's a staggered logic over the coming short to medium term.

這是 26 年的評論。當然，正如我們一直所說的那樣，我們將尊重現有客戶和現有合同，這將成為中期的調整。因此，當現有客戶離開時，我們將能夠更多地利用產能和線路。因此，在未來的中短期內，這是一個交錯的邏輯。

Thank you, Karsten. And Martin, firstly on (multiple speakers)

謝謝你，卡斯滕。馬丁，首先是（多位發言者）

So first on the amylin biology and the potential for lean body mass preservation, I've seen the same data. And it's not just from one source, it's from several sources. The issue about amylin biology is that it doesn't always translate from animals to humans. So we just have to say it's early days.

首先，關於胰淀素生物學和保存瘦體重的潛力，我看到了相同的數據。而且它不僅來自一個來源，而且來自多個來源。關於胰淀素生物學的問題是，它並不總是從動物轉化為人類。所以我們只能說現在還為時過早。

And we are obviously investigating this in our clinical trials. So we'll know in the not-too-distant future. But I think that's an interesting aspect of the amylin biology, and that's also why we like it so much.

顯然我們正在臨床試驗中對此進行研究。所以我們會在不久的將來知道。但我認為這是胰淀素生物學的一個有趣的方面，這也是我們如此喜歡它的原因。

On the antibodies, I'm not aware of many, if any, injectable proteins or peptides that do not induce antibodies. The trigger is to assess whether it has any clinical bearing on either efficacy or safety with CagriSema, with cagrilintide.

關於抗體，我不知道有多少（如果有的話）可注射的蛋白質或勝肽不會誘導抗體。觸發因素是評估它是否對 CagriSema 和卡格里林肽的療效或安全性有任何臨床影響。

And we have quite a lot of data at this point in time. Some forget that we have already done Phase 2 for cagrilintide in monotherapy. And in that, we saw no impact of neither efficacy or safety variables. That also means then when we look at our model, that has actually been factored in, because the model is based on the clinical response in Phases 1 and I2, and that lands us nicely at the 25% mark.

目前我們擁有相當多的數據。有些人忘記了我們已經完成了卡格林肽單一療法的第二階段。在這一點上，我們沒有看到功效或安全變數的影響。這也意味著當我們查看我們的模型時，這實際上已經被考慮在內，因為該模型是基於 1 期和 I2 期的臨床反應，這使我們很好地達到了 25% 的標準。

Thank you, Martin. We will stay on the same table with Kerry, and we'll move to Emmanuel afterwards. And one, maximum two questions, please.

謝謝你，馬丁。我們將與 Kerry 坐在同一張桌子上，之後我們將移至 Emmanuel。還有一個問題，最多兩個問題。

Kerry Holford, Berenberg. My first question is on the direct-to-consumer approach that you have in the US, this effective self-pay element offering on Wegovy. Is that a temporary offering whilst you're building up more access in the US? Or should we think about this more prolonged? And what proportion of total volume is that today?

凱莉·霍爾福德，貝倫貝格。我的第一個問題是關於美國採用的直接面向消費者的方式，即 Wegovy 上提供的這種有效的自付費用元素。這是您在美國建立更多存取權限時的臨時產品嗎？或者我們應該更長時間地思考這個問題？佔今天總成交量的比例是多少？

And then my second question is essentially housekeeping. CagriSema on the day of the results, what can we expect from you, not with regard to a number, but can we expect to see a number, specific weight loss figure? And then any detail on safety, more broad commentary just to kind of set the scene for us?

然後我的第二個問題本質上就是內務管理。 CagriSema 在結果公佈當天，我們可以對您有什麼期望，不是一個數字，而是我們可以期望看到一個數字，具體的減肥數字嗎？然後還有任何關於安全的細節，更廣泛的評論只是為了為我們奠定基礎？

Thank you, Kerry. Firstly, Camilla?

謝謝你，克里。首先，卡米拉?

Yeah. So on Wegovy US, there are different, of course, channels and approaches that we will take. And I think you should expect that over time, it's likely that there will be more of a, you can say, direct care element. It's still early days, and these are still small numbers. So I would say the traditional channels will play a significant role going forward.

是的。因此，在 Wegovy US 上，我們當然會採取不同的管道和方法。我認為你應該預料到，隨著時間的推移，很可能會有更多的，你可以說，直接護理元素。現在還處於早期階段，而且這些數字仍然很小。所以我想說傳統管道將在未來發揮重要作用。

But in most countries, it's likely that there, over time, will be more of an online approach to things as we've seen the development in the past years. So I would not say that this is significant as of now, but it's likely that it will be slowly growing over the years as technology also improves in this aspect.

但在大多數國家，隨著時間的推移，可能會出現更多的線上處理方式，正如我們在過去幾年所看到的發展那樣。因此，我不會說目前這很重要，但隨著技術在這方面的進步，多年來它可能會慢慢成長。

And of course, also, as we see more and more patients, then there might be more efficient ways of dealing with chronic care in the future. So this is more an evolution than a revolution.

當然，隨著我們看到越來越多的患者，未來可能會有更有效的方法來處理慢性病照護。因此，這與其說是一場革命，不如說是一場演進。

Thank you. And then Karsten on release strategy?

謝謝。然後卡斯滕談發布策略？

Yeah. So we have a very stringent Danish regulator in terms of listed companies and disclosure, which is that material events need to be disclosed immediately. So that's the starting point. So that's what you should expect our process to be. It's a really tight process.

是的。所以我們丹麥的監管對於上市公司和揭露來說是非常嚴格的，就是重大事件需要立即揭露。這就是起點。這就是您所期望的我們的流程。這是一個非常嚴格的過程。

And then what we'll be disclosing is what we assess to be material for the stock market. You can get some direction looking at our historic releases. But ultimately, it is science and the scientific results from REDEFINE that define. So look at historic, but of course if there's something that points in either direction, positive or negative, that we assess to be material, then we are obliged to disclose that.

然後我們將披露的是我們評估的對股市重要的內容。您可以透過查看我們的歷史版本來獲得一些指導。但歸根究底，是科學和 REDEFINE 的科學成果來定義的。所以看看歷史，但當然，如果有一些東西指向任何一個方向，無論是積極的還是消極的，我們評估為重要的，那麼我們有義務披露這一點。

Thank you, Karsten. Very clear.

謝謝你，卡斯滕。非常清楚。

Emmanuel Papadakis, Deutsche Bank.

伊曼紐爾‧帕帕達基斯，德意志銀行。

First question in context of the surprisingly flat Wegovy prescription trends through Q3, can you just confirm that the limitation on volumes in the US market is exclusively on the supply side and not on the demand side, nor are you seeing any changes from payers that are obstructing patient access to therapy?

第一個問題是，在第三季Wegovy 處方趨勢出乎意料地持平的背景下，您能否確認美國市場的銷售限製完全是在供應方面，而不是在需求方面，您也沒有看到付款人的任何變化阻礙患者接受治療？

Second question, since you studiously avoided answering it earlier on pricing outlook. Gross to net was pretty flat Q2 to Q3 for Wegovy. Is that the new normal? What is the expectation we should have for that further widening next year as a similar year-on-year quantum as we've had '23 to '24, likely over '24 to '25? Thank you.

第二個問題，因為您之前刻意避免回答有關定價前景的問題。 Wegovy 在第二季到第三季的毛淨值相當持平。這是新常態嗎？對於明年進一步擴大的預期，我們應該有什麼期望，就像我們在 23 至 24 年（可能是 24 至 25 年）類似的同比量？謝謝。

Thank you. I think both to you, Karsten, on --

謝謝。我認為卡斯滕，對你來說—

I can start on the demand side to say that there is a very high demand continuously for Wegovy in the US, and that when you see sort of ups and downs on NBRx, this is related to also supply and inflow into the market. So that is just to take that part out. And then maybe back to you, Karsten, on the rest of the question.

我可以從需求面開始說，美國對 Wegovy 的需求持續非常高，當你看到 NBRx 的波動時，這也與市場的供應和流入有關。所以這只是把那部分去掉。然後也許會回到你，卡斯滕，關於問題的其餘部分。

Yeah. And just to build one tiny piece on Camilla's comment. So right now, Wegovy is reaching around 1 million Americans if you convert the 220,000 scripts per week into patients served, 1 million out of more than 100 million Americans with obesity and 55 million Americans with obesity with Novo Nordisk with insurance coverage for Wegovy. So we're just at the beginning in terms of penetrating the market.

是的。只是根據卡米拉的評論寫一篇小文章。因此，如果將每週22 萬個腳本轉化為所服務的患者，Wegovy 目前將覆蓋約100 萬美國人，即超過1 億肥胖美國人中的100 萬，以及諾和諾德為Wegovy 提供保險的5500 萬肥胖美國人。因此，就滲透市場而言，我們才剛開始。

And then as to pricing, yes, a fairly clean quarter with a slight exception on Victoza and neutral development between Q2 and Q3 on underlying value prescript. So I agree to that, which would normally also be the case because contracts are not negotiated between Q2 and Q3.

然後就定價而言，是的，這是一個相當乾淨的季度，但 Victoza 略有例外，第二季度和第三季度之間基本價值規定呈中性發展。所以我同意這一點，通常情況也是如此，因為第二季和第三季之間沒有協商合約。

And then as to future outlook on pricing, it's important to note that we are balancing access and reach to as many patients as possible with a rational pricing evolution. And that's the sweet spot we're looking at. But logically speaking, then as the product expands in volume and channels, there will be some give on pricing as you've seen on other products in history.

至於未來的定價前景，值得注意的是，我們正在透過合理的定價演變來平衡盡可能多的患者的獲取和覆蓋範圍。這就是我們正在尋找的最佳點。但從邏輯上講，隨著產品數量和管道的擴大，定價上將會出現一些讓步，就像你在歷史上看到的其他產品一樣。

Thank you, Karsten. Then I think the final set of questions go to Jo.

謝謝你，卡斯滕。然後我認為最後一組問題應該交給喬。

Thanks you. If I can come back again to supply for next year. So you've added 4 million patients worth of coverage this year. And towards the end of the year, you've added more countries. You're going to be adding direct-to-consumer advertising.

感謝您。如果明年我能再回來供應的話。今年您已增加了 400 萬名患者的承保範圍。到今年年底，您新增了更多國家。您將會新增直接面向消費者的廣告。

Your competitor is bringing more interest to the market with direct-to-consumer advertising. Potentially, we have the compounders having to come off the market, because you're all saying you're not in short supply. I can see a very clear view that we could be seeing more than an incremental 4 million patients worth of demand next year, because you've got 55 million people who've potentially got insurance coverage, and they don't know about it as much as they surely will with all of the DTC advertising that's happening.

您的競爭對手正在透過直接面向消費者的廣告為市場帶來更多興趣。有可能，我們的複合材料必須退出市場，因為你們都說你們並不短缺。我可以看到一個非常清晰的觀點，即明年我們可能會看到超過 400 萬患者的需求，因為有 5500 萬人可能獲得保險，而他們並不知道這一點正如他們肯定會對所有正在發生的DTC廣告所做的那樣。

Should we be concerned that it will only be another sort of three months before you're back into telling us that you're in short supply? Because you're not in short supply for the demand that you have today. But if we were to think about the demand in six months' time, is that where we're going to have an issue with our models because we're expecting more demand, and we're expecting you to be able to supply it, because you've deliberately gone ex-US and said, well, we won't supply Brazil and Australia unless we can continue to supply them?

我們是否該擔心，再過三個月您就會再告訴我們供應短缺？因為您今天的需求並不短缺。但如果我們考慮六個月後的需求，我們的模型就會出現問題，因為我們預計會有更多需求，並且我們預計你們能夠供應它，因為你故意離開美國並說，好吧，除非我們能夠繼續向巴西和澳洲供應，否則我們不會向他們供應？

So we think gosh, you've got -- you must have more supply, I think, is implied in our models and expectations for growth. That's the first question. And secondly, if I could just ask a little bit more, you must have more understanding than us about the background of the patients. But there was a PBM report out just recently, where they looked at two years' worth of treatment of people, not diabetic, who were obese, and the health insurers save not a bean of money. In fact, they just had to pay extra for the drug. But they also said that the average BMI was 31.

所以我們認為天哪，你必須有更多的供應，我認為，這隱含在我們的模型和成長預期中。這是第一個問題。其次，如果我能多問一點的話，你一定比我們更了解病人的背景。但最近發布了一份 PBM 報告，研究了肥胖者（非糖尿病患者）兩年的治療效果，而健康保險公司卻沒有節省一分錢。事實上，他們只需要額外支付藥物費用。但他們也表示平均BMI為31。

Now I thought your BMI was much higher than that. So if you could just tell us a little bit more about who you think the patients are that are coming to see this. And I'll just ask one final question, if I may. Well, WeightWatchers is a really sort of solid group of people providing support, et cetera, and they're providing compounded Ozempic. Would you consider perhaps being a supplier to someone like them because you're supplying all of the care as well as the product? Thank you.

現在我認為你的體重指數比那高得多。因此，請您告訴我們更多有關您認為來看這個的患者是誰的資訊。如果可以的話，我只想問最後一個問題。嗯，WeightWatchers 是一個真正可靠的團體，提供支持等，他們還提供複合 Ozempic。您是否會考慮成為像他們這樣的人的供應商，因為您提供所有的護理和產品？謝謝。

Thank you, Jo. And firstly, it goes to you, Karsten, on the supply question, the first one.

謝謝你，喬。首先，卡斯滕，關於供應問題，第一個。

Yeah. So I think it's important to note, linked to the unmet need that Martin covered before, then on a global scale, demand is so much greater than supply in the market. And that is going to be the case for a number of years. So that's why this is really about scaling our company as fast as possible. And that's to Camilla's slide in terms of additional patients reach and the different levers I covered before.

是的。因此，我認為值得注意的是，與馬丁之前提到的未滿足的需求相關，那麼在全球範圍內，市場的需求遠大於供應。這種情況將持續很多年。這就是為什麼這實際上是為了盡快擴大我們公司的規模。這是卡米拉在更多患者覆蓋範圍和我之前介紹過的不同槓桿方面的幻燈片。

So we are scaling to the maximum pace we can, which is possible. And that's basically the approach on that. And then, of course, we make very conscious choices around the scaling that we do, how do we allocate that between brands and between geographies. And we have a very considered process on that front.

因此，我們正在盡可能地擴大規模，這是可能的。這基本上就是解決這個問題的方法。當然，我們會圍繞我們所做的擴展做出非常有意識的選擇，以及如何在品牌之間和地理之間進行分配。我們在這方面有一個經過深思熟慮的流程。

Thank you, Karsten. And Camilla, on patient characteristics?

謝謝你，卡斯滕。卡米拉，關於病人的特徵？

Yeah. On patient characteristics, I would say both from the US, but also from other countries, the average BMI is around 37 approximately, and most of these patients also have one or more comorbidities. So of course, these are average data. You have to bear that in mind. But I think that is a pretty good picture of the patients that we are dealing with in average.

是的。就患者特徵而言，我想說的是，無論是美國或其他國家，平均BMI約為37左右，而且大多數患者還患有一種或多種合併症。當然，這些都是平均數據。你必須牢記這一點。但我認為這對我們正在處理的患者的平均情況來說是一個相當好的描述。

Then I would say, on compounding, we remain concerned about patient safety. And that's why we are accountable for the semaglutide API that we produce, and we are not selling that to anyone else. We have a full value chain of operations. So we are marketing that ourselves also.

然後我想說，在複合方面，我們仍然擔心病人的安全。這就是為什麼我們對我們生產的索馬魯肽 API 負責，並且我們不會將其出售給其他任何人。我們擁有完整的營運價值鏈。所以我們自己也在行銷。

So I think that is the best way that we can ensure that what is out there of semaglutide is well quality checked and approved and according to the pharma standards, which we cannot guarantee on any compounding. And that's basically our concern. And therefore, we would also not be collaborating with compounding companies.

因此，我認為這是我們確保索馬魯肽經過良好品質檢查和批准並符合製藥標準的最佳方式，而我們無法保證任何複合。這基本上就是我們關心的問題。因此，我們也不會與複合公司合作。

Thanks, Camilla. And thanks, everyone. That concludes the Q&A. Karsten, a final set of words from you?

謝謝，卡米拉。謝謝大家。問答到此結束。卡斯滕，您最後說幾句話？

Yeah. I think we've been around the key topics for the company. Just closing out, midpoint of growth this year, 25% in an industry growing mid-single digits. So amazing growth for the company. We are pushing everything we can to scale the company supply chain-wise to meet the unmet need with patients and demand out there. And at the same time, with this growth, that also enables us to invest significantly in R&D.

是的。我認為我們一直圍繞著公司的關鍵主題。剛結束，今年的成長中點為 25%，產業成長率為中個位數。公司的成長如此驚人。我們正在盡一切努力擴大公司供應鏈規模，以滿足患者和市場中未滿足的需求。同時，隨著這種成長，我們也能夠在研發方面進行大量投資。

And then the beauty, as you saw today, then we are able of converting that R&D into return and into assets to the benefit of patients. So we look forward to seeing you all in February and talk about our '25 outlook at that point in time.

然後，正如您今天所看到的那樣，我們能夠將研發成果轉化為回報和資產，造福患者。因此，我們期待在 2 月見到大家，並討論我們屆時對 '25 的展望。