As we reflect on 2025 and look towards the future, we write at a pivotal moment in Novo Nordisk’s journey. The past year has been one of profound transformation; testing our resilience, sharpening our focus and positioning us for sustainable success in an increasingly dynamic healthcare landscape.

For decades, Novo Nordisk flourished in the diabetes market, building expertise patient by patient, innovation by innovation. Our entry into obesity treatment – a field we pioneered and shaped – thrust us into an era of unprecedented growth that, frankly, surprised even us. This huge demand changed everything: people with obesity actively seeking our medicines, self-paying consumers seeking faster access and a global spotlight on our every move.

This extraordinary period taught us important lessons about serving consumer-driven markets. We discovered that people living with obesity face completely different challenges than those living with diabetes. Instead of fear, they often feel shame or stigmatisation. Instead of conventional clinical support, they want discretion. This realisation demanded different approaches than our traditional physician-focused model, forcing us to rethink our traditional approaches to patient care and market access.

The competitive landscape has evolved just as dramatically. Where we once enjoyed clear market leadership in obesity treatment, virtually every major pharmaceutical company now recognises this as an attractive market. This competition, whilst challenging, validates the therapeutic area we pioneered and drives continued innovation for patients. We are not intimidated by this new reality; after all, our century-long experience in diabetes has taught us how to compete successfully in crowded markets.

What sets us apart remains compelling: unmatched global reach, extensive manufacturing investments and an unparalleled understanding of metabolic diseases. We have also seen encouraging recognition from the World Health Organization, which has acknowledged the multiple health benefits of GLP-1 treatments and has committed to exploring ways to expand access globally. This growing institutional support opens exciting new pathways to bring our life-changing treatments to more people with obesity and diabetes, wherever they are.

In response to these market shifts, we have made decisive changes to remain the leader in obesity and diabetes care. We have refocused our strategy on these core therapeutic areas – not as a limitation, but as recognition that serving the two billion people living with obesity, overweight or diabetes provides massive opportunities for growth and impact. This sharpened focus reflects our DNA: throughout our history, we have always succeeded when concentrating our efforts where we make the greatest difference.

Operationally, we have merged our research and development functions to accelerate innovation without compromise, creating seamless progression from early research through clinical development. We have also simplified governance structures to increase our operational speed whilst maintaining our commitment to ethics and compliance.

The most challenging decision of 2025 was the reduction of our workforce – the largest in our company’s history. After scaling up rapidly during a period of hyper-growth, we recognised staffing levels had become unsustainable as market dynamics shifted, requiring difficult but necessary action to ensure financial discipline. We approached this with deep respect for those colleagues affected, conducting the process swiftly and with dignity, consistent with the Novo Nordisk Way. These actions preserved our ability to redirect resources towards obesity and diabetes growth opportunities essential to serving patients and driving our future success.

Furthermore, changes to the composition of our Board reflect our commitment to having the right competencies for this new business reality. Following dialogue between Novo Nordisk’s Board and the board of the Novo Nordisk Foundation, different visions for the pace and extent of board renewal made an extraordinary general meeting necessary to provide clarity on governance. Our reconfigured Board stands ready to support management in responding rapidly to market conditions in this dynamic environment. Moving forward, we are committed to constructive engagement with shareholders, ensuring that their perspectives help shape the road ahead.

Our path forward centres on expanding access whilst accelerating innovation. We will develop products for different patient needs, price points and preferences. Just as we serve people living with diabetes with multiple insulin formulations, we will build a comprehensive obesity portfolio offering diverse treatment options. This means developing therapies that address the full spectrum of patient circumstances – from those seeking the highest efficacy outcomes to those who need different delivery methods, dosing frequencies or treatment profiles that better suit their individual needs.

A significant milestone has been the record-breaking launch of the Wegovy^® pill – the world’s first and only once-daily oral GLP-1 therapy approved for weight management. This breakthrough addresses patient preferences whilst leveraging the proven efficacy and safety profile of semaglutide, positioning us uniquely in an increasingly competitive field.

With our expanding treatment options, we view the upcoming loss of exclusivity for semaglutide in certain markets as an opportunity, not a threat. When you have multiple ways to serve patients, patent cliffs become stepping stones to broader access. Generic competition will expand access to obesity treatments, creating a stronger foundation for next-generation innovations whilst our oral formulation, higher-strength versions and novel mechanisms will serve diverse patient needs.

As our transformation continues, so does our long-standing commitment to sustainable business practices. The triple bottom line – balancing financial performance with social responsibility and environmental stewardship – remains fundamental to our identity. Long-term value creation requires attention to these broader impacts, and we continue to invest in sustainable practices whilst setting realistic, achievable targets that we can deliver upon.

Throughout this evolution, we remain anchored by the same patient-first obsession that has guided us for more than a century. Every decision and every innovation must ultimately serve the health and wellbeing of the more than 45.6 million patients who depend on us today, and the hundreds of millions more we aim to serve in future. This patient-centric approach extends across our entire value chain: from researchers designing molecules with real-world patient needs in mind, to pricing strategies reflecting diverse affordability requirements, to commercial approaches that meet people where and how they want to access care.

As we look to 2026 and beyond, we are not promising a rapid return to the extraordinary growth rates of recent years. Market conditions have evolved, competition has intensified and expanding access to our life-changing medicines means finding new ways to reach more patients whilst continuing to invest in the breakthrough treatments of tomorrow. In response, we are building a stronger, more focused organisation that can deliver sustainable value whilst fulfilling our mission to defeat obesity, diabetes and related comorbidities.

The year ahead will test our resolve and capabilities. We face it with confidence, knowing that our renewed focus, strengthened competencies and uncompromising commitment to people with serious chronic diseases position us well for the challenges and opportunities ahead.

Thank you for your continued trust and support as we write Novo Nordisk’s next chapter.