諾和諾德 (NVO) 2025 Q2 法說會逐字稿

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

歡迎參加本次電話會議，本次會議將討論我們今天宣布的諾和諾德高階主管團隊變動以及2025年財務預期下調。

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

我是諾和諾德公司投資者關係主管雅各·羅德。今天與我一同出席的還有諾和諾德公司董事會主席赫爾格·倫德、首席執行官拉斯·弗魯爾加德·約根森、首席財務官卡斯滕·蒙克·克努森、美國運營執行副總裁大衛·摩爾，以及即將於8月7日就任首席執行官的國際運營執行副總裁邁克·杜爾斯塔爾。所有發言人將參與問答環節。

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

今天的公告已發佈在我們的網站 novonordisk.com 上。請注意，本次電話會議將進行網路直播，錄音也將發佈在我們的網站上。會議預計持續最多 45 分鐘。請看下一張投影片。

The presentation is structured as outlined on slide 2. We will briefly cover both of today's announcements First, Helge will cover the appointment of Mike Doustdar as new president and CEO of Novo Nordisk, as well as other executive-level changes briefly. Following that, Karsten will review the update to the financial outlook when Novo Nordisk today lowered the sales and operating profit expectations for 2025. The presentation will be followed by Q&A sessions beginning in approximately 15 minutes. Please note that all sales and operating profit growth statements will be a constant exchange rate unless otherwise specified. Please turn to the next slide.

本次簡報的結構如投影片2所示。我們將簡要介紹今天的兩項公告。首先，Helge將簡要介紹任命Mike Doustdar為諾和諾德新任總裁兼首席執行官，以及其他高階主管變動。隨後，Karsten將回顧諾和諾德今天下調2025年銷售額和營業利潤預期後，財務展望的更新情況。簡報結束後，大約15分鐘後將開始問答環節。請注意，除非另有說明，所有銷售額和營業利潤成長數據均採用固定匯率。請翻到下一張投影片。

Before I hand over to Helge, we need to advise you that this call will contain forward-looking statements. These are subject to risk and uncertainty that could cause actual results to differ materially from expectations. For further information on forward-looking statements and risk factors, please see the company announcement for the first three months of 2025, which was released on May 7.

在將發言權交給Helge之前，我們需要提醒各位，本次電話會議將包含前瞻性陳述。這些陳述受風險和不確定性因素的影響，可能導致實際結果與預期有重大差異。有關前瞻性陳述和風險因素的更多信息，請參閱公司於5月7日發布的2025年前三個月業績公告。

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

接下來，請Helge對Nordisk高階主管團隊的變動進行回顧。

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

謝謝雅各。請翻到下一張投影片。今年五月，諾和諾德董事會宣布，拉爾斯·弗魯爾加德·約根森將卸任執行長一職。此後，我們加快了正在進行的繼任計劃，拉爾斯將繼續擔任首席執行官，以確保平穩過渡到新的領導層。請翻到下一張投影片。

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

今天早些時候，我們宣布，Lars將由Mike Doustdar接任諾和諾德總裁兼執行長一職。此項任命是在經過全面的遴選程序後做出的，遴選過程涵蓋了外部和內部候選人。董事會認為，Mike的領導能力、策略眼光和商業執行經驗使他成為帶領公司應對當前市場挑戰並最大限度地把握未來機會的最佳人選。

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

自2015年以來，Mike一直擔任執行副總裁兼國際營運主管，他始終展現出創造價值和推動成長的能力。在過去十年中，在他的領導下，IO的銷售額翻了一番多，發展成為一家擁有近2萬名員工、服務約3500萬患者的企業。

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

鑑於麥克自2015年以來在國際業務營運和高階主管團隊中的領導經驗，他對公司、公司文化、優勢以及發展機會領域有著深刻的理解。身為首席執行官，麥克將致力於鞏固公司在全球糖尿病和肥胖症領域的領先地位，提升商業執行力，並提高公司整體營運效率。麥克是一位傑出的領導者，他對諾和諾德、我們的使命以及我們服務的病人都充滿熱情。他將於2025年8月7日正式就任總裁兼執行長。

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

在為諾和諾德服務34年後，拉爾斯·弗魯爾加德·約根森先生光榮離任，我們對此深表感激。他富有遠見的領導力和堅定不移的奉獻精神推動了公司取得的顯著增長和全球影響力，並贏得了整個製藥行業的廣泛尊重。我們謹代表董事會和全體員工，向他致以最誠摯的謝意，並祝福他未來一切順利。同時，我們也要特別感謝拉爾斯先生，確保了工作順利交接給麥克先生。

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

除了執行長的任命之外，我們今天還宣布，諾和諾德的研發部門將與早期研發部門合併，並任命馬丁·霍爾斯特·蘭格 (Martin Holst Lange) 為首席科學官兼研發執行副總裁。此外，埃米爾·孔肖伊·拉森 (Emil Kongshoj Larsen) 將接替邁克 (Mike) 擔任國際營運執行副總裁。這些調整將於 2025 年 8 月 7 日生效，屆時我們的團隊將全面到位。我謹代表董事會，非常期待與麥克及其團隊攜手合作，共同推動公司的發展策略。

So now over to Mike for a few words.

現在請麥克說幾句。

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

非常感謝你，赫爾格。能得到這份工作，我深感榮幸。首先，我要感謝拉爾斯多年來的領導與支持。我也要感謝你，赫爾格，以及全體董事會成員的一致支持。我對此感激不盡。

Now, the fact that my announcement comes right after the guidance update, well, it just makes the mandate ahead even more clear. We need to increase the sense of urgency and execute differently. But we'll do that by building on the core strength that makes this company so unique.

現在，我的聲明緊接著業績指引更新之後發布，反而讓未來的任務更加明確。我們需要增強緊迫感，並採取不同的執行方式。但我們將透過發揮公司獨一無二的核心優勢來實現這一目標。

I take this job very seriously. You can expect me to be a CEO that combines strategic clarity with operational urgency. Soon, I'll be working closely with my management team, the Board, and the entire organization to move forward. We will sharpen our focus and move faster. We will operate more efficiently. We will advance our pipeline and keep pushing the boundaries of innovation, and we will invest to accelerate growth and deliver shareholder value. That is my promise to you. I'm looking forward to working with my team after we close Q2, and I'm eager to meet the investor community as soon as possible.

我非常重視這份工作。您可以期待我是一位兼具策略遠見和營運緊迫感的執行長。很快，我將與我的管理團隊、董事會以及整個公司緊密合作，共同推動公司發展。我們將更聚焦重點，加快步伐，提高營運效率，推動產品研發，不斷突破創新邊界，並加強投資以加速成長，為股東創造價值。這是我對各位的承諾。我期待在第二季結束後與我的團隊攜手共進，並渴望盡快與投資者見面。

Now back to you, Jcob.

現在把鏡頭交還給你，Jcob。

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

謝謝，麥克。請翻到下一張投影片。我想請卡斯滕介紹一下諾和諾德的財務表現以及2025年的展望。

Thank you, Jacob. Please turn to the next slide. In the first six months of 2025, Novo Nordisk sales increased by 18% and operating profit increased by 29%, both at constant exchange rates. Sales growth in the first six months of 2025 was positively impacted by growth to net sales adjustments related to prior years of around DKK3 billion related to the 340B US rebate provision.

謝謝雅各。請翻到下一張投影片。 2025年上半年，諾和諾德的銷售額成長了18%，營業利潤成長了29%（均以固定匯率計算）。 2025年上半年的銷售成長主要得益於與往年相關的約30億丹麥克朗的淨銷售額調整，該調整與3,400億美元的美國回扣準備金有關。

Operating profit growth is positively impacted by the ocedurenone impairment in the second quarter of 2024 of DKK5.7 billion. This was partially countered by the incremental impact related to the acquisition of the three former Catalent manufacturing sites of around DKK2.6 billion in 2025. Please go to the next slide.

2024年第二季度，由於奧塞杜酮減損57億丹麥克朗，營業利益成長受到正面影響。但2025年收購原Catalent三家生產基地帶來的約26億丹麥克朗的額外影響部分抵銷了這項影響。請看下一張投影片。

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

正如今天早些時候宣布的那樣，諾和諾德下調了2025年全年業績預期，與今年5月發布的預期相比有所下調。目前，以固定匯率計算，2025年銷售額成長率預估為8%至14%。鑑於目前美元兌丹麥克朗的匯率，以丹麥克朗計價的銷售額成長率預計將比以固定匯率計算低4%，這主要是由於美元兌丹麥克朗匯率貶值所致。

The change in sales outlook for 2025 is driven by lower growth expectations for the second half of 2025. This is related to lower growth expectations for Wegovy in the US obesity markets, lower growth expectations for Ozempic in the US Glp-1 market, as well as lower than expected penetration for Wegovy in select IO markets. The lower growth expectation for Wegovy in the US obesity market reflects the persistent use of compounded GLP-1 along with slower market expansion and competition.

2025年銷售預期調整的主要原因是下半年成長預期降低。這主要與Wegovy在美國肥胖症市場的成長預期降低、Ozempic在美國GLP-1市場的成長預期降低以及Wegovy在部分免疫腫瘤（IO）市場的滲透率低於預期有關。 Wegovy在美國肥胖症市場成長預期降低反映了複合型GLP-1的持續使用、市場擴張放緩以及競爭加劇。

Despite the expiry of the FDA grace period for mass compounding on May 22, 2025, non-Nordic market research shows that the unsafe and unlawful mass compounding has continued, and that multiple providers continue to market and sell compounded GLP-1s under the false guise of personalization. Novo Nordisk is pursuing multiple strategies, including litigation, to protect patients from knockoff semaglutide.

儘管美國食品藥物管理局 (FDA) 針對大規模配製藥物的寬限期已於 2025 年 5 月 22 日到期，但非北歐市場的調查顯示，不安全且非法的大規模配製藥物仍在繼續，多家供應商仍在以「個人化」為幌子銷售配製的 GLP-1 受體激動劑。諾和諾德公司正採取包括訴訟在內的多種策略，以保護患者免受假冒索瑪魯肽的侵害。

Novo Nordisk is deeply concerned that without aggressive intervention by federal and state regulators and law enforcement, patients will continue to be exposed to the significant risk posed by knockoff semaglutide drugs made by illicit foreign active pharmaceutical ingredients.

諾和諾德公司深感擔憂，如果沒有聯邦和州監管機構及執法部門的積極幹預，患者將繼續面臨由非法外國活性藥物成分製成的仿冒索瑪魯肽藥物帶來的重大風險。

As unsafe and unlawful mass compounding continues, the Wegovy penetration in the cash channel is below expectations. Within the cash channel, Wegovy prescriptions via NovoCare Pharmacy, including telehealth collaborations, are currently around 11,000 total weekly prescriptions. This is in addition to around 20,000 weekly prescriptions in the retail cash channel. Novo Nordisk will continue to invest in the expansion of direct-to-patient initiatives such as NovoCare Pharmacy and further collaborations with the telehealth organizations.

由於不安全和非法的大規模配藥行為持續存在，Wegovy在現金管道的滲透率低於預期。目前，透過NovoCare Pharmacy（包括遠距醫療合作）開立的Wegovy處方，每週總量約11,000張。此外，零售現金管道每週的處方量約為20,000張。諾和諾德將繼續投資拓展直接面向患者的業務，例如NovoCare Pharmacy，並進一步加強與遠距醫療機構的合作。

The sales outlook also reflects lower-than-expected penetration of Wegovy in the insured channel. This is due to lower market expansion and competitive dynamics despite the initiation of new commercial activities for Wegovy in the first half of 2025.

銷售前景也反映出Wegovy在保險通路的滲透率低於預期。這主要是由於市場擴張放緩和競爭格局變化，儘管Wegovy在2025年上半年啟動了新的商業活動。

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

諾和諾德在美國最新的NBRx資料中開始看到一些正面跡象，我們也將繼續進行其他商業活動。此外，我們仍預計在2025年下半年將就Wegovy的大規模適應症做出監管決定。而且，諾和諾德預計CVS國家處方集（CVS National Template Formulary）的調整將帶來積極的銷售增長，自7月1日起，Wegovy成為唯一一種被納入CVS國家處方集用於治療肥胖症的GLP-1藥物。

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

就美國市場而言，Ozempic的最新前景受到美國市場競爭的負面影響。諾和諾德將繼續投資商業活動和標籤更新，以進一步提升Ozempic的市場滲透率。此外，儘管Wegovy在國際業務中的銷售額高速成長，且上市進展順利，但由於市場擴張速度放緩和競爭加劇，Wegovy在部分免疫腫瘤市場的滲透率低於預期。全球約有10億肥胖症患者，而接受治療的患者僅有數百萬，因此，該前景反映了Wegovy在全球範圍內持續向更多市場推廣的趨勢。

Operating profit growth is now expected to be 10% to 16% at constant exchange rates. Given the current exchange rates versus the Danish kroner, growth reported in DKK is expected to be 7 percentage points lower than at constant exchange rates. This is primarily due to the depreciation of the US dollar to Danish kroner exchange rate.

以固定匯率計算，預計營業利潤成長率為10%至16%。鑑於目前美元兌丹麥克朗的匯率，以丹麥克朗計價的成長率預計將比以固定匯率計算的成長率低7個百分點。這主要是由於美元兌丹麥克朗匯率貶值。

The updated expectation for operating profit growth reflects the lower sales growth outlook, partially countered by reduced spending. This includes a negative mid-single-digit operating profit growth impact related to the acquisition of three former Catalent manufacturing sites.

更新後的營業利潤成長預期反映了銷售成長前景的下調，部分被支出減少所抵銷。這其中包括收購原Catalent三家生產基地帶來的營業利益成長負面影響，預計約為個位數中段。

Novo Nordisk now expects net financial items for 2025 to amount to a gain of around DKK3 billion. This is mainly driven by expected gains on hedge currencies, primarily the US dollar, partially offset by interest expenses related to funding of the debt-financed Catalent transaction.

諾和諾德目前預計2025年的淨財務專案收益約為30億丹麥克朗。這主要得益於對沖貨幣（主要是美元）的預期收益，但部分被與債務融資的Catalent交易相關的利息支出所抵銷。

The free cash flow is now expected to be DKK35 billion to DKK45 billion, reflecting the lower-than-planned expected sales growth. The lower growth is mainly driven by lower volume growth of GLP-1 based treatments in the US and related cash flow implications amplified by the US gross-to-net system. Novo Nordisk's full disclosure of the financial results for the first six months of 2025 will be published on August 6, where more information will be available.

預計自由現金流為350億至450億丹麥克朗，反映預期銷售成長低於預期。成長放緩的主要原因是GLP-1療法在美國的銷售成長放緩，以及美國毛利淨利計價體系放大了相關現金流影響。諾和諾德將於8月6日發布2025年上半年的完整財務業績揭露，屆時將提供更多資訊。

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

以上就是2025年的財務展望。現在，請拉爾斯發言。

Thank you, Karsten. Our performance in the first six months of 2025 with 18% sales growth reflects our continued commitment to treating more people with serious chronic diseases. That said, we cannot ignore the fact that we have reduced our full-year outlook with headwinds from compounding in the US, slower market growth, and competition challenging previous expectations. With the updated outlook and plans to execute on recent commercial initiatives, the organization is poised to perform as Karsten described.

謝謝卡斯滕。我們在2025年上半年實現了18%的銷售成長，這反映了我們持續致力於為更多患有嚴重慢性疾病的患者提供治療的承諾。儘管如此，我們也不能忽視這樣一個事實：由於美國市場複合成長、市場成長放緩以及競爭加劇等不利因素，我們下調了全年業績預期。但憑藉更新後的預期以及近期商業舉措的執行計劃，公司已做好準備，實現卡斯滕所描述的業績目標。

Finally, I would like to congratulate Mike with the role as CEO. I am confident that Mike -- that under Mike's leadership, Novo Nordisk will see significant growth opportunities and ultimately reach millions more patients. Now, back to you, Jacob.

最後，我要祝賀麥克擔任執行長一職。我相信，在他的領導下，諾和諾德將迎來巨大的成長機遇，最終惠及數百萬病患。現在，雅各布，把麥克風交還給你。

Thank you, Lars. And next slide, please. With that, we are now ready for the Q&A. We are kindly asking all participants to limit her or himself to one question. I remind that the focus of this call, including this Q&A session, is only on the changes related to the Novo Nordisk executive leadership team as well as the financial outlook for 2025.

謝謝，拉爾斯。請看下一張投影片。現在，我們準備好進入問答環節。請各位參加者每人限提一個問題。我再次提醒，本次電話會議（包括問答環節）的重點僅限於諾和諾德高階主管團隊的變動以及2025年的財務展望。

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

接線員，我們現在可以開始回答第一個問題了。

(Operator Instructions) Michael Novod, Nordea.

（操作說明）Michael Novod，Nordea。

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

非常感謝。我是來自哥本哈根北歐銀行的Michael Novod。鑑於下半年市場預期較為低迷，您能否預測一下下半年印度洋地區和美國地區的成長情況，以及這會對2026年的退出率或進入率產生哪些影響？這些影響也可能引發一些擔憂。謝謝。

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

謝謝你的提問，麥可。關於這個問題，我把問題交給你回答，卡斯滕。

Thank you, Michael, and thank you, Jacob. So with 80% growth in the first half of the year and the guidance range that we put out today, with a midpoint of around 11%. Then the applied growth in the second half of this year is mid-single digits. Do bear in mind we have a tough comparison from last year linked to the gross net adjustment of DKK5 billion we did in the fourth quarter last year, which would take a growth rate up from the mid-single digits to probably high single digits.

謝謝邁克爾，也謝謝雅各。今年上半年成長了80%，我們今天公佈的預期區間中位數為11%左右。那麼，下半年的實際成長率預計為個位數中段。需要注意的是，去年同期基數較高，因為我們在第四季進行了50億丹麥克朗的淨調整，這將使成長率從個位數中段提升至接近兩位數。

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

從地理角度來看，此次下調成長預期主要與美國業務的表現有關。其次，Wegovy IO 的市場滲透率低於預期也造成了一定影響。因此，在下周公布業績時，您將會看到 IO 在今年上半年實現了非常強勁的成長，我們預計這一成長勢頭將推遲到下半年。

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

至於對2026年的影響，我們今天當然不會給予2026年的業績指引。我們將在2月份發佈全年業績報告時一併給出。因此，今天我不會就2026年的相關事宜做進一步討論。

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

謝謝卡斯滕，解釋得很清楚。也謝謝邁克爾的提問。那麼，我想我們已經準備好回答下一個問題了。

Sachin Jain, Bank of America.

Sachin Jain，美國銀行。

Hi there. Thanks for taking my question. I just wanted to get a better understanding of what you're assuming for both Wegovy and Ozempic as we exit this year and into next year. So for Wegovy, I guess you're citing the main issue being compounders. So any color on how many patients do you think compounded versus a million prior? And outside of litigation, which I guess could take quite a while, is there anything that you can point to that would change that on a six- to nine-month timeframe?

您好。感謝您回答我的問題。我只是想更深入了解您對 Wegovy 和 Ozempic 在今年年底和明年的發展預期。關於 Wegovy，我猜您提到的主要問題是複方製劑。那麼，您認為複方製劑的患者數量與先前一百萬例相比如何？除了訴訟（我猜訴訟可能會持續很長時間）之外，您認為還有什麼因素會在六到九個月內改變這種情況？

And I guess a similar question on Ozempic, you have much looser commentary within the PR around path to growth. Comps remain tough, scripts are inflecting. Assuming given a 5% to 10% price decline, fair to think that Ozempic is now trending towards sales declines from here. Thank you.

我想問Ozempic的類似問題，你們的公關稿對成長路徑的解釋比較含糊。同店銷售依然艱難，處方藥市場也在波動。假設價格下降5%到10%，那麼可以合理地認為Ozempic的銷售額將從此開始下滑。謝謝。

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

謝謝你的提問，薩欽。關於複利，我先請卡斯滕來解答。

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

是的，謝謝你，Sachin。具體來說，關於複方製劑，我們在5月的第一季市場調查中估計，有100萬名患者使用複方GLP-1治療肥胖症。之後，FDA對503表格中批量複方製劑的寬限期於5月22日結束，我們當時假設這將導致今年下半年使用品牌GLP-1的患者數量增加。遺憾的是，我們最新的市場調查表明，這種情況並沒有發生，這也是我們調整的假設之一。因此，最新的市場調查仍顯示，美國市場上有100萬或更多患者正在使用複方GLP-1治療肥胖症。

Thanks for that, Karsten. And your second question, Sachin, on Ozempic dynamics. I'll hand it over to Dave.

謝謝你，卡斯滕。薩欽，你的第二個問題是關於奧贊比克動力學的，我這就交給戴夫來回答。

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

謝謝你的提問，Sachin。是的，關於你提到的Ozempic，我們目前觀察到的治療處方量成長較為平緩。每週的治療處方量約為69萬張，與競爭對手持平。但就目前的競爭格局而言，我們僅佔新處方量的40%左右，而且我們也看到一些患者從Ozempic轉而使用競爭對手的產品。雖然我們收到了一些臨床醫生的正面回饋，但尚未看到新核准的慢性腎病適應症的顯著增長。到目前為止，我們還沒有看到這些正向回饋轉化為實際的處方量。

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

其次，我們看到GLP-1類糖尿病藥物的成長速度持續放緩。此外，複方製劑也在一定程度上產生了影響，也就是說，如果患者前來諮詢Ozempic品牌產品，他們最終可能使用的是複方製劑的索瑪魯肽。謝謝。

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

謝謝你，戴夫，接下來就交給你，卡斯滕，請你做最後的總結發言。

Yeah, so just adding on to my prior comments on compounded yield points in the US marketplace, it's important that this is something we don't take lightly. It's a key patient safety concern. And, of course, we are active on many, many fronts in terms of improving patient safety and reducing compounding to what is legally allowed. So we, amongst other things, are active in litigation and we're working with regulators. And, of course, we are hopeful that this can, over time, lead to a reduction in compounding and hence a potential inflow of additional patients into the branded sector.

是的，我之前提到過美國市場上的複合報酬率問題，我想補充一點，我們絕對不能掉以輕心。這關係到病人安全。當然，我們在許多方面都積極努力，以提高病人安全，並將複方用藥限制在法律允許的範圍內。例如，我們積極參與訴訟，並與監管機構合作。我們希望隨著時間的推移，這些努力能夠減少複方用藥，從而吸引更多患者使用品牌藥。

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

謝謝你，卡斯滕，也謝謝你，戴夫。那麼，我們就可以進入下一個問題了，請。

Harry Septhon, UBS.

瑞銀集團的哈里·塞普頓。

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

太好了。非常感謝您回答這個問題。您能否解釋一下業績指引下限的涵義？這是否意味著下半年該下限的環比成長有限？我們已經看到CVS更換藥局後處方量增加。 NovoCare的表現似乎也符合預期，儘管幅度不大，低於您最初的預期。您對此保守預期的下限有何預期？另外，您預計Wegovy和Ozempic在美國全年及未來一段時間的淨價格下降幅度如何？謝謝。

Thanks for that, Harry, and I'll get that procedure with you, Karsten.

謝謝你，哈里，我會跟你一起去做這個手術的，卡斯滕。

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

是的，首先，與五月發布的第一季預期相比，我們縮小了預期範圍，現在我們將中點上下浮動了3個百分點。這並不是說我們預設了某種特定情境會導致預期跌至最低點。我們評估的是風險狀況，這種狀況既可能使預期跌至區間上限，也可能跌至區間下限。當然，我們每天都在努力，力求讓預期盡可能接近區間上限。

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

所以，實際上，這方面的不確定因素與 Ozempic 和 Wegovy 業績相當常見的不確定因素有關，也與美國淨成長預期方面經典的不確定性有關。

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

太好了。謝謝你，卡斯滕。那麼，我想我們可以進入下一個問題了。

Martin Parkhoi, SEB.

Martin Parkhoi，SEB。

Yes, Martin Parkhoi from SEB. Just a question to Mike. Now as a new CEO, but you have of course also been there your entire career. If we look back over the last two years, what would you have done differently in order to prevent this situation that you're standing in today?

是的，我是SEB的Martin Parkhoi。我有個問題想問Mike。您現在是新任CEO，當然，您也一直在SEB工作。回顧過去兩年，為了避免今天這種局面，您會採取哪些不同的措施？

And what do you see as the main catalyst to see a rebound in growth over the next two or three years? Can it be driven by improved commercial execution or do we need a new product like Oral Sema and CagriSema before we can see a real change to where you are today.

您認為未來兩三年內推動成長反彈的主要催化劑是什麼？是商業執行力的提升，還是我們需要像Oral Sema和CagriSema這樣的新產品，才能真正改變目前的情況？

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

謝謝你，馬丁·帕霍伊。麥克，我同意你的看法，反思過去的挑戰也有助於我們展望未來。

Thanks very much. Martin, I would say in the tumble of high growth, we sometimes can overlook things, and that's probably a bit what has happened. As we go forward, my promise is that we're going to accelerate the growth and the shareholder value creations by predominantly two big things.

非常感謝。馬丁，我想說，在高速成長的浪潮中，我們有時會忽略一些事情，這可能是我們目前遇到的情況。展望未來，我承諾我們將主要透過兩大措施來加速成長並提升股東價值。

One, we need to progress our pipeline and the innovation that helps us mid- and longer-term, but also short-term, get more out of what we have, the assets that we have, and predominantly we do that by improving the commercial execution. We will focus more on some of the things that matters most in terms of that growth. I have no doubt we're going to be faster and become more clear in our decision-making, reducing the white space in various different processes that we have.

首先，我們需要推動產品線研發和創新，這有助於我們在中長期乃至短期內更好地利用現有資源和資產，而實現這一目標的主要途徑是提升商業執行力。我們將更加專注於對成長至關重要的事項。我相信，我們將加快決策速度，提高決策清晰度，並減少各流程的空白環節。

We will bring the performance culture that I'm very well aware of from my part of the world and try to do that across the whole organization. And then we will invest competitively in the areas where we really need to invest, and we will try to find efficiency and savings in the so-called less important areas.

我們將把我在家鄉非常熟悉的績效文化引入整個組織，並努力將其推廣到各個方面。然後，我們會對真正需要投資的領域進行具有競爭力的投資，並努力在那些所謂的「次要」領域提高效率、節省成本。

Thank you for that, Mike, and also thank you to you, Martin. With that, we're ready to move to the next question, please.

謝謝你，麥克，也謝謝你，馬丁。那麼，我們準備好進入下一個問題，請。

Evan Seigerman, BMO Capital Market.

Evan Seigerman，BMO 資本市場。

Thank you so much for taking my question and providing the update today. So as we think about kind of the go-forward for your businesses, how would you characterize the competitive dynamics in the United States? I know there's a lot with compounding. Do you believe that the CVS switchover will be enough to reignite sales, or do you need to look at other potential factors that can help kind of reignite the business? Thank you very much.

非常感謝您回答我的問題並提供今天的最新資訊。那麼，在考慮貴公司未來的發展方向時，您如何看待美國市場的競爭格局？我知道其中有很多因素會疊加。您認為CVS的轉型足以重振銷售嗎？還是需要考慮其他可能有助於重振業務的潛在因素？非常感謝。

Hi, Evan. Thanks for those questions. Dave, I'll turn it over to you on US dynamics.

嗨，埃文。謝謝你的提問。戴夫，關於美國經濟動態，接下來就交給你了。

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

謝謝你的提問，Evan。總的來說，我們認為GLP-1在美國市場仍有龐大的成長空間，無論是在糖尿病或肥胖症領域。我們必須繼續執行年初公佈的路線圖，正如Mike所說，要專注於並加快商業化進程。接下來，我想就幾個方面做更詳細的說明。

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

首先，正如您所提到的，是藥物配製。我們必須繼續積極主動地採取措施，限制非法配製藥物的行為。可以說，我們正面臨一種假冒偽劣藥物的競爭，這種藥物對病人來說並不安全。我們對此高度重視。最近，我們加強了與FDA的溝通。您可能已經注意到，上週一些國會領導人致函FDA，要求採取行動，制止從世界各地非法進口原料藥的行為，這些原料藥甚至未經原產地批准使用。這種行為必須停止。

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

其次，正如您所提到的，我們仍在繼續拓展其他管道。目前，現金通路的拓展尤為重要。我們看到了一些令人鼓舞的跡象，但現金管道的成長仍未達到我們五月的預期，這主要是由於複利效應。不過，我們的現金業務佔比已從年初的4%成長到目前的12%。這是一個令人鼓舞的跡象，表明我們有機會在患者需要的地方提供現金支付服務。

Second -- the third is commercial execution, and that is of utmost importance. Continuing to push our investments behind campaigns that we know are working. We have a new Wegovy DTC campaign that will launch in the second half of the year. And we have launched real-world evidence around weight loss that we also discussed with you earlier in the year.

第二點－第三點是商業執行，這一點至關重要。我們會繼續加大對那些行之有效的行銷活動的投入。我們即將於今年下半年推出一項新的 Wegovy DTC 行銷活動。此外，我們也發布了一些關於減肥的真實世界研究數據，這些內容我們在今年稍早也和大家討論過。

And then lastly, the CVS conversion is on track. We think it's an important element, but we're also seeing the opportunity for increased growth in other channels of retail as well. We are encouraged with recent trends, but we still have a ways to go. to meet the expectations. Thanks, Evan.

最後，CVS的轉換率正在穩定提升。我們認為這是一個重要因素，但我們也看到了其他零售通路的成長潛力。我們對近期的趨勢感到鼓舞，但要達到預期目標，我們還有很長的路要走。謝謝，埃文。

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

謝謝你，戴夫。在進入下一個問題之前，先把問題交給你，麥克，談談目前國際營運的動態吧。

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

當然，關於國際業務，我們下週會公佈完整的數據。但大家可以看到，目前Wegovy的成長勢頭非常強勁，這得益於遠超原計劃的發布數量。誠然，我們距離之前訂定的目標和計畫還有一段距離，但希望這些數據能讓大家放心，一切都很順利。

Besides, of course, expanding the footprint on Wegovy across the world, we're also, as alluded to some time ago at the last quarter, we have restarted our Ozempic promotions across the world, and that should give us, in addition to Wegovy, an extra bit of growth.

當然，除了擴大 Wegovy 在全球的影響力之外，正如上個季度提到的那樣，我們也重新啟動了 Ozempic 在全球範圍內的推廣活動，這應該會給我們帶來額外的增長，再加上 Wegovy 的增長。

And we are increasing our online presence and telehealth partnerships, so we also open up that channel besides, of course, the other channels that we have had. And if you look at IQVIA numbers today, we basically have about two-thirds of the patients and the value of GLP-1 in international operations. If you add rebalances to that number, then you're closer to three-fourths, and I would say we are very serious on upholding that and defending that as we go forward.

我們正在加強線上業務和遠距醫療合作，因此除了我們已有的其他管道之外，我們也開闢了這個管道。如果您查看IQVIA目前的統計數據，我們基本上佔據了國際業務中GLP-1患者和價值的三分之二。如果加上再平衡數據，這個數字接近四分之三。我認為，我們非常重視維護和捍衛這一地位，並將繼續努力。

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

謝謝你，麥克。也再次感謝你，埃文，提出問題。那麼，我們現在可以進入下一個問題了。

Richard Vosser, JPMorgan.

理查沃瑟，摩根大通。

Hi, thanks for taking my question. I just wanted to go back on a question on the pricing dynamics in the US. With the pickup in CVS, I think the guidance, certainly at the bottom end, and probably the middle implies continued price erosion, I think, certainly for Wegovy and some of the brands. So could you give us an idea how to think on pricing going forward in the US?

您好，感謝您回答我的問題。我想再問一下關於美國市場定價動態的問題。鑑於CVS的提貨情況，我認為價格指引（尤其是低端產品，可能也包括中端產品）意味著價格將持續下降，尤其是Wegovy和其他一些品牌。所以，您能否就未來美國市場的定價策略給我們一些建議？

And also, just on gross-to-net, we've seen substantial 340B benefits in the first half this year. What's to stop more benefits from 340B and part of the redesign, et cetera, coming through in the second half. Thanks very much.

此外，僅就毛利潤與淨利而言，我們今年上半年就看到了340B計畫帶來的顯著效益。那麼，340B計畫以及部分重組等措施帶來的更多效益，又有什麼能阻止呢？非常感謝。

Thanks for those two, Richard. We'll go to you, Karsten, firstly on the high-level pricing and then on gross net adjustments.

謝謝你提供的這兩點，理查德。卡斯滕，我們先請你談談整體定價，然後再談談毛利淨額調整。

Thank you for those questions, Richard. So in terms of high-level pricing, then it's important to say that that the lowering of the guidance that we're doing today compared to what we issued back in May is volume-driven. So there are no major changes to pricing compared to what we announced last time.

謝謝您的提問，理查德。關於定價方面，需要說明的是，我們今天下調的指導價（與五月發布的相比）主要是由於銷量下降。因此，與上次公佈的價格相比，並沒有重大變化。

Then on top of that, when we look at pricing between the different brands, I would say that there are no major changes to what we've been discussing on Ozempic, as a general trend. And then for Wegovy, what we've been saying is that as we expand the market and reach more patients, the market should expect that the average pricing to go down gradually over time, linked to channel dynamics and reaching more patients. So a continued gradually decline on ARP, which of course is enabling reaching many, many more patients in US marketplace.

此外，當我們比較不同品牌之間的定價時，我認為Ozempic的定價整體趨勢與我們之前討論的並無太大變化。而對於Wegovy，我們一直強調，隨著市場拓展和病患數量的增加，平均價格會隨著通路動態和病患覆蓋範圍的擴大而逐漸下降。因此，平均價格（ARP）將持續緩慢下降，這無疑有助於我們在美國市場觸及更多患者。

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

然後，就毛利淨利變化和D部分調整而言，首先就D部分調整而言，這對我們的數據影響相對較小。更像是全年幾個百分點的波動，我們討論的就是這個幅度。除此之外，從年度層級來看，這方面並沒有重大變化。

As to 340B, we're still awaiting at least one key legal clarification in terms of interpretation of the rules in place. So pending that and just the general test of time will be kind of the deciding factor to how we deal with the partial income recognition that we have under 340B.

關於340B條款，我們仍在等待至少一項關鍵的法律澄清，以明確現有規則的解釋。因此，在相關法律澄清出台之前，以及時間的檢驗，將是決定我們如何處理340B條款下部分收入確認問題的關鍵因素。

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

謝謝卡斯滕，也謝謝你，理查。那麼，我們現在可以回答下一個問題了，請。

Mike Nedelcovych, TD Cowen.

邁克·內德爾科維奇，TD Cowen。

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

您好，感謝您的提問。我的問題是問Mike的。您是否計劃對諾和諾德的業務拓展策略進行任何調整？目前看來，公司比以往任何時候都更需要成熟的後製研發管線。我知道諾和諾德有意拓展其在心臟病領域的業務。諾和諾德在多大程度上會透過內部研發還是外部研發來實現這些目標？謝謝。

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

謝謝你，麥克。我也要這麼說，麥克。

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

是的。所以，我當然首先要著手準備，並與我的團隊和董事會就細節進行充分的溝通。但我今天可以確定的是，我們將重點放在我之前提到的兩個問題，其中之一是推進產品線和創新。我們需要更快、更好地完成這些工作，這不僅包括外部創新，也包括探索我們內部的創新方向。今天就先說到這裡。

Thank you, Mike. Then we're ready to move to the next question, please.

謝謝你，麥克。那麼，我們可以進入下一個問題了，請。

Thibault Boutherin, Morgan Stanley.

Thibault Boutherin，摩根士丹利。

Thank you. The question is on the dynamics in international markets with Wegovy. You mentioned the growth who launches in new geographies, but also competition in some select markets. When we look at some IQVIA data in Europe on markets like UK, Germany, Spain, we see very, very strong traction for Mounjaro. and maybe a bit more limited update for Wegovy. So if you could give a bit more details on the dynamics you see in these countries, whether there's still any supply gating here and how you think you can reverse that in this key developed market ex-US.

謝謝。我的問題是關於Wegovy在國際市場的動態。您提到了在新地區推出產品所帶來的成長，但也提到了在某些特定市場面臨的競爭。當我們查看IQVIA關於英國、德國、西班牙等歐洲市場的數據時，我們發現Mounjaro的成長勢頭非常強勁，而Wegovy的成長可能相對有限。所以，您能否更詳細地介紹一下您在這些國家觀察到的市場動態，例如是否存在供應瓶頸，以及您認為如何在除美國以外的這些主要發達市場扭轉這一局面？

Thanks a lot for that. I think it goes to you, Mike, on complexity dynamics in international operations.

非常感謝。我覺得麥克，關於國際營運中的複雜性動態，你應該回答這個問題。

Yeah. Thibault, thanks for that. So I think you're correct. If you handpick just a handful of markets, then you will probably find that in those handful of markets amongst which the ones you mentioned, then we are right now not the leading player. And that's something, of course, we'd like to change. But if you actually do look at the rest of the IQVIA data, you will see that in a lion's share of markets, we are upholding those leadership.

是的，Thibault，謝謝你的回覆。所以我覺得你說得對。如果你只挑選幾個市場，你可能會發現，在這些市場中（包括你提到的那些），我們目前並非領先者。當然，我們希望改變這種情況。但如果你查看IQVIA的其他數據，你會發現，在絕大多數市場中，我們都保持領先地位。

We are having, of course, in a number of markets, take China as an example, a bit of a retraction of the market size, and we'll allude to this more next week. And in other markets where we start with 100% market share and Mounjaro joins, then I think they should get their fair share, but not more than that, in market share.

當然，在一些市場，例如中國，我們的市場規模有所縮減，下週我們會詳細討論這一點。而在其他一些市場，如果我們一開始就佔據100%的市場份額，而Mounjaro加入，我認為他們應該獲得應有的份額，但不能超過這個比例。

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

總的來說，我認為在某些市場，我們之前的發展速度落後於其他市場，但我們也說過，大部分產品供應來源（例如IO）將在下半年到貨。所以，這一點你們也需要注意。

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

謝謝你，麥克。也謝謝你，蒂博，提出的問題。那麼，我們現在可以回答下一個問題了。

James Quigley, Goldman Sachs.

James Quigley，高盛集團。

Great, hopefully you can hear me. Thank you for taking my questions. I've got a question on the total US market for obesity. So how is that developing? When we look at IQVIA trends since sort of last week of May thereabouts, the prescriptions have been around about 670,000 between you and Zepbound. Obviously, the share has been shifting between that. But when you think about that, plus the most recent data you have on compounding, what's the total market doing? And how is that volume opportunity unlocked and what is Novo doing in order to take steps to unlock the total market opportunity? Obviously, the share of the compound is a key growth driver, but from a total obesity perspective going forward in terms of patients, how is that progressing and how are Novo going to unlock that opportunity?

好的，希望您能聽到我的聲音。感謝您回答我的問題。我有一個關於美國肥胖症整體市場的問題。這個市場的發展如何？從五月底左右開始，我們查看IQVIA的趨勢數據，您和Zepbound的處方量大約在67萬張左右。顯然，兩者的市佔率一直在波動。但考慮到這一點，再加上您掌握的最新複方製劑數據，整體市場的情況又是如何？如何才能釋放這個市場潛能？諾和諾德正在採取哪些措施來釋放整個市場的潛力？顯然，複方製劑的市場份額是關鍵的成長驅動因素，但從肥胖症患者的整體情況來看，未來的發展趨勢如何？諾和諾德將如何釋放這個潛能？

That question goes to you, Dave, on efforts to further expand the market in the US.

戴夫，這個問題要問你，關於如何進一步拓展美國市場。

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

是的，非常感謝，詹姆斯。我很感激你的提問。正如你所說，美國市場仍然蘊藏著巨大的機會。超過1億人患有肥胖症。我們之前也提到過，目前已有超過5500萬人透過雇主選擇加入該計劃，從而能夠以較低且合理的自付費用獲得Wegovy的醫保。就市場發展和處方趨勢而言，我們確實看到Wegovy持續受到複方製劑的影響。正如卡斯滕之前提到的，我們估計這大約佔市場份額的30%，約100萬患者。稍後我會詳細介紹我們正在採取哪些措施來遏制複方製劑的使用。

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

但就市場成長而言，我們看到的早期跡象令人鼓舞。 Wegovy 近期銷售成長，每週處方量約 27.5 萬張，NBRx 佔 42%。我們將繼續持續爭取患者，同時，請記住，我們正在等待今年下半年 MASH 適應症的審批，我們認為這是一個機會。美國有 2000 萬人患有 MASH，其中 80% 的人患有肥胖症，超過 40% 的人患有第 2 型糖尿病。這為我們未來的發展帶來了令人鼓舞的機會。但複方製劑仍然是我們必須解決的問題，這關係到病人安全，也關係到如何將 MASH 重新帶回傳統的、安全的品牌藥市場。詹姆斯，以下是我們正在採取的一些措施。

First is our own supply of safe approved Wegovy. It's important to note that we have supply of Wegovy on the injectable side to treat all patients in the US, those that are seeking branded medications and those that are on fake compounded and wish to transition over. We also have commercial and medical affairs activities. We continue to raise the awareness of compounding, the safeties, the substandard, and the uncontrolled manufacturing. And we have an ongoing effort on the legal side.

首先，我們擁有安全可靠的Wegovy自有供應。值得注意的是，我們擁有充足的注射劑Wegovy供應，可供美國所有患者使用，包括那些尋求品牌藥物的患者以及那些正在使用假冒偽劣產品並希望轉用Wegovy的患者。此外，我們也進行商業和醫療事務活動。我們持續提高大眾對假冒偽劣產品、安全隱患、不合格產品以及不受監管的生產的認識。同時，我們也在法律方面持續努力。

We have issued over 120 lawsuits. We've issued 1,000 cease and desist letters. And we're starting to see some of the effects of those efforts where compounding has been shut down. But importantly, we must have regulatory action. We must have enforcement from FDA. And as I mentioned earlier, we have stepped up that dialogue, and we will continue to around the importation of illicit API as well as compounding that takes place with fake API. And that will give us an opportunity to convert those patients back to branded Wegovy. As Karsten mentioned, just has not developed yet because we haven't seen that market reduced yet to this date. Thank you.

我們已經提起了120多起訴訟，發出了1000多份停止侵權通知函。我們開始看到這些努力的一些成效，一些非法配製行為已被叫停。但更重要的是，我們必須採取監管行動，必須得到FDA的執法。正如我之前提到的，我們已經加強了對話，並將繼續圍繞非法原料藥的進口以及使用假冒原料藥進行的配製行為展開討論。這將使我們有機會讓這些患者重新使用品牌藥Wegovy。正如Karsten所提到的，目前還沒有出現這種情況，因為到目前為止，我們還沒有看到市場萎縮。謝謝。

Thank you. We have time for two quick questions. Let's take the first one, please.

謝謝。我們還有時間回答兩個簡短的問題。請先問第一個問題。

Emily Field Barclays. Please ask your question.

艾米麗·菲爾德·巴克萊銀行。請提問。

Hi. Thanks for taking my question. I just wanted to kind of dig into these efforts to limit compounding. Your company is very consistent in this message around safety, but for better or for worse, it's not really resonating with whatever the sub-segment of American patients. So in the prior answer, Dave, you mentioned the lawsuits and the cease-and-desist letters. But have you filed suit against HIMSS? Can you see preliminary injunctions as part of these lawsuits? Given that we're off the drug shortage list, we all expected compounding to come down following this May 22 grace period date, so I guess I sort of was wondering, what is within the company's purview to get more aggressive in getting this to stop and defend your IP and defend your product? Thank you.

您好。感謝您回答我的問題。我只是想深入了解一下限制藥品配製的相關措施。貴公司在安全方面一直強調這一點，但不知何故，這似乎並沒有引起美國部分患者的共鳴。戴夫，您在先前的回答中提到了訴訟和停止侵權通知函。請問貴公司是否已對HIMSS提起訴訟？您是否考慮過在這些訴訟中申請初步禁制令？鑑於我們已從藥品短缺名單中移除，我們都預期在5月22日寬限期結束後，藥品配製量會減少。所以我想問的是，貴公司可以採取哪些措施來更積極地阻止這種行為，並保護貴公司的智慧財產權和產品？謝謝。

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

謝謝你，艾米麗。戴夫，我把這個交給你，讓你補充之前的回答。

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

是的，當然。我很樂意詳細解釋。所以我們不會斷然排除任何可能性。所有法律行動，包括我們能與政府合作的努力，以及採取法律行動本身，都在考慮範圍內。所以，我們不會排除任何可能性。我們不能評論具體的訴訟，也不會這樣做。我們也不會評論法律策略，但我們肯定會從各方面著手，確保這款產品重返品牌藥市場。我們對我們的品牌充滿信心，也相信我們有能力在品牌藥市場中競爭。

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

非常清楚。謝謝你，戴夫。那麼，我們準備問最後一個問題。

Carston Lonborg Madsen, Danske Bank.

卡斯頓·隆堡·馬德森，丹斯克銀行。

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

好的，非常感謝。考慮到我們目前面臨的動盪和挑戰，以及您一直在推行的龐大資本支出項目（您從未明確告知我們您實際能夠提供多少索馬魯肽，以及能夠為多少患者提供索馬魯肽），我想請教一下，如果您的索馬魯肽產量遠未達到最大化，將會發生什麼情況？例如，是否需要對資產負債表上的資產進行減損？或者您對此有何看法？

Thanks for that, Carston. I'll turn that over to you, Karsten.

謝謝你，卡斯頓。接下來就交給你了，卡斯騰。

Yeah, thank you for that question. And in this context, it's important to remember what we heard from both Mike and Dave before around the significant unmet needs in both guidance and obesity and the portfolio that we're working with.

是的，謝謝你的提問。在這種情況下，重要的是要記住我們之前從Mike和Dave那裡聽到的關於指導和肥胖症領域以及我們正在處理的項目組合中存在的重大未滿足需求。

So as you know, in diabetes, when we look at the internet corporations, we're looking at a penetration of only around 7% of Scripps being on a GLP-1 compared to 19 or so in the US. So a very significant runway, especially in IO, but also in US in the diabetes GLP-1 penetration. And that runway is even bigger on the obesity side.

如您所知，在糖尿病領域，當我們觀察網路公司時，我們發現斯克里普斯研究所（Scripps Institute）的患者中，使用GLP-1受體激動劑的比例僅為7%左右，而美國這一比例約為19%。因此，GLP-1受體激動劑在免疫腫瘤學領域，以及在美國糖尿病領域的普及率，都存在著巨大的成長空間。而在肥胖症領域，此成長空間則更為顯著。

And then I say on top of that, as I said in the beginning, this is predominantly a US shortfall, and the volume split between IO and US is like 9 to 10 or something like that. So we believe that we will have good use of the factories that we're putting in place and we're building right now in terms of what we're going to deliver.

而且，如我一開始所說，這主要是美國的缺口，印度和美國的產量比例大概是9比10左右。所以我們相信，就我們即將交付的產品而言，我們正在建造和建造的工廠將得到充分利用。

And then also do bear in mind that the factories we're building, they are of course for the inline products that are on the market today, but the factories, they are based on technologies that we expect to be able to apply for pipeline products also. And here I'm thinking of products like CagriSema and the (inaudible) to mention a few. So at this point, there are no indications of any potential write downs.

此外，還要記住，我們正在建造的工廠當然是為目前市場上現有的線上產品而建，但這些工廠所採用的技術，我們預計也能應用於管道產品。這裡我指的是像CagriSema和（聽不清楚）這樣的產品，僅舉幾例。因此，目前沒有任何跡象表明存在潛在的資產減損。

Thank you, Karsten. Very clear. And with that, we are concluding the Q&A session. Thank you for participating, and feel free to contact Investor Relations in regards to follow-up.

謝謝卡斯滕，非常清楚。問答環節到此結束。感謝各位的參與，如有任何後續事宜，歡迎隨時聯繫投資者關係部門。

Before handing off, I'll give it to you, Helge, for some final comments.

在交棒之前，我把麥克風交給你，赫爾格，請你做最後的總結發言。

Thank you, Jacob. I would like to once again say thank you to Lars for his service as president and CEO of Novo Nordisk. Congratulations to Mike in his new role. The Board looks forward to working with Mike and the executive. It's an important moment in time for Novo Nordisk.

謝謝你，雅各。我再次感謝拉爾斯擔任諾和諾德總裁兼執行長期間的卓越貢獻。祝賀邁克履新。董事會期待與麥克和高階主管團隊合作。這對諾和諾德而言是一個重要的歷史時刻。

I also want to say that a reduction in guidance is a matter we approach with utmost seriousness. Nonetheless, Novo Nordisk has launched a variety of strategic investment and commercial initiatives, and they are already observing positive early indicators that support the company's revised outlook and progress towards our mission to treat more patients with serious chronic diseases. So, thank you.

我還想強調，下調業績預期是我們極度嚴肅對待的事。儘管如此，諾和諾德已經啟動了一系列策略性投資和商業舉措，並且已經觀察到一些積極的早期跡象，這些跡象支持公司調整後的業績展望，並有助於我們實現治療更多嚴重慢性疾病患者的使命。謝謝。