2024 was a year of significant growth for Novo Nordisk, characterised by continued innovation, capacity expansions and strong commercial execution. As we reflect on our progress, we also recognise the magnitude of the challenges that lie ahead.

The global prevalence of serious chronic diseases is growing by the day, impacting millions of lives and placing a heavy burden on overstretched healthcare systems. This has created unprecedented demand for our life-changing GLP-1-based medicines. Over the past four years, we have more than quadrupled the number of people reached with these treatments and increased our volume market share in the GLP-1 segment to 63%. In 2024, we served more than 45.2 million people living with serious chronic diseases, while our global sales and operating profit both grew by 26% at constant exchange rates.

As we strive to keep pace with the growing demand for our medicines, our production capacity has been stretched. In response, we have continued to invest heavily in scaling up our manufacturing capabilities with capital expenditure and acquisitions amounting to more than DKK 129 billion in 2024. The acquisition of three fill-finish sites formerly run by contract and development manufacturer Catalent Inc., along with significant expansions of our existing production facilities in Denmark, France, Brazil, China and the US, are testament to our commitment to improving supply stability.

In order to meet increasing demand and ensure a stable supply of our medicines, we are also taking steps to consolidate our product portfolio by gradually phasing out some of our older insulin products. This will create much-needed space in our global manufacturing network as we seek to reach millions more people with our medicines over the next decade. At the same time, we strive not to leave existing patients without alternative treatment options, either from Novo Nordisk or other companies, and we remain committed to working closely with local health authorities and the medical community to enable access to affordable care.

Our belief that health is a fundamental human right drives our extensive partnership programmes and access initiatives. In times of geopolitical instability, safeguarding access to care for those in conflict zones and underserved areas is paramount. Our partnerships with humanitarian organisations such as the Danish Red Cross play a crucial role in this effort, demonstrating our dedication to making a difference where it is needed most.

Moreover, we are increasing our investment in preventive health measures through initiatives like Cities for Better Health – a pioneering urban health partnership now active in 51 cities worldwide – and our collaboration with UNICEF to prevent childhood obesity. These efforts aim to address the root causes of serious chronic diseases, thereby reducing the global health burden and fostering a healthier future. Our Transformational Prevention Unit complements our partnership-driven approach, looking to develop scalable, science-based solutions that can predict and pre-empt obesity and its consequences.

The same scientific rigour is being applied across our R&D activities, which are driving transformative change across multiple therapy areas. Rooted in our deep understanding of proteins and peptides and fuelled by research partnerships, AI-driven drug discovery and the acquisition of new technology platforms, we are striving to accelerate the discovery of new targets and optimise our clinical trials to the benefit of people living with serious chronic diseases.

Innovation remains our core contribution to society and the driving force behind our continued growth. The past year has seen us add to the growing body of clinical evidence supporting the broad cardiometabolic and societal benefits of semaglutide – the molecule at the heart of our flagship GLP-1-based medicines Ozempic^®, Wegovy^® and Rybelsus^® – and we are confident that our pipeline has the potential to add even more value.

In obesity, we completed the first phase 3 trial of CagriSema, currently in development for the treatment of obesity or overweight and type 2 diabetes. After 68 weeks, if all people adhered to treatment, CagriSema demonstrated a statistically significant weight loss of 22.7% vs 2.3% with placebo alone. This is among the highest weight reductions yet seen in a phase 3a programme for a GLP-1 combination therapy. We intend to further explore the weight loss potential of CagriSema in an additional study.

Earlier in our obesity pipeline, topline results from a phase 1b/2a trial of subcutaneous amycretin have demonstrated the weight lowering potential of the unimolecular GLP-1 and amylin receptor agonist, supporting previous data seen with the oral formulation. When evaluating the effects of treatment if all people adhered to treatment, those receiving a 20 mg dose of amycretin experienced an estimated average weight loss of 22.0% over 36 weeks compared to 2% weight gain with placebo.

In diabetes, the first launches of Awiqli^® – the world’s first once-weekly basal insulin – exemplify our enduring commitment to innovation in this space more than 100 years after we first started producing insulin. Moreover, our dedication to addressing unmet needs within rare disease is exemplified by the pending regulatory submission of Mim8 for the treatment of haemophilia A.

The growth of our business has inevitably led to an increase in our environmental footprint, and we are stepping up efforts to mitigate this impact. We have introduced comprehensive, updated roadmaps targeting reductions in our emissions, plastic footprint and impact on nature and biodiversity. Achieving these ambitions will be no small feat given the increasing global demand for our medicines, but we are rising to the challenge. Our roadmaps include measures to decouple our environmental impact from our continued growth by incorporating the use of low-carbon materials across our value chain, supporting our suppliers through a transition to renewable energy and facilitating a switch from disposable to reusable injection devices for our medicines wherever possible.

Our operating environment is also becoming more complex, shaped by geopolitical tensions, global conflicts and technological advancements. Our unique ownership structure, underpinned by the Novo Nordisk Foundation as controlling shareholder, provides us with the stability we need to navigate these uncertainties. This model supports our sustainable growth by allowing us to take a long-term view on our investments and strategies; crucial in a volatile world where short-term market pressures can often lead to reactive decision-making.

We are similarly mindful of the importance of sustainably scaling our organisation. We are now 77,349 colleagues worldwide – an increase of 20% compared to 2023 that reflects our commitment to scaling up in the face of growing demand. Our focus is on ensuring new hires receive the support and resources they need to fully integrate into our global workforce and connect with the Novo Nordisk Way – the core guiding principles that underpin everything we do. This approach also safeguards our focus on diversity and inclusion, fostering an environment where every employee feels valued and included.

As we look forward to 2025 and beyond, we are optimistic about the opportunities that lie ahead as we strive to serve millions more people with serious chronic diseases. However, we are also mindful of the challenges inherent to our growth and the need to balance short-term costs with long-term societal value.

Our purpose remains clear: driving change to defeat serious chronic diseases. By staying true to our purpose and values, we are confident in our ability to navigate the complexities of the ever-evolving global healthcare landscape and to continue making a meaningful difference in the lives of millions of people worldwide.

We would like to extend our gratitude to all Novo Nordisk colleagues worldwide for their hard work and dedication at a time of unprecedented demand for our life-changing medicines, and to our shareholders for their continued support of our company.