Sustainability commitment

Striving to expand our reach while minimising our footprint

Charlenys Puello lives with type 1 diabetes in the Dominican Republic.

As climate change, widening health inequities, and the growing burden of serious chronic diseases converge, they pose unprecedented threats to human and planetary health. We aim to extend the reach and societal benefit of our medicines and prevention efforts while striving to reduce our environmental impact – transforming growth into meaningful health outcomes that strengthen communities and protect our planet.

In 2025, our medicines reached 45.6 million people worldwide – a testament to our expanding therapeutic footprint. Alongside this broad reach, our diabetes access programmes supported 7.1 million vulnerable patients; a decline from 2024 levels primarily driven by lower insulin tender sales due to portfolio consolidation. This underscores the complex balance we must strike between sustainable growth and ensuring continuity of care for those who need us most – a challenge that has prompted renewed efforts to restore and strengthen our reach.

Central to this mission is strengthening access where millions lack essential treatments. Prevention and early access set the course for a healthier life, but as serious chronic diseases rise worldwide, strained healthcare systems face increasing pressure. Our response combines targeted partnerships with systematic affordability initiatives. In the US, we provide assistance for people with or without insurance and have reduced monthly costs for self‑pay patients. In other parts of the world, our Changing Diabetes^® in Children programme supports children under 25 with type 1 diabetes in low- and middle-income countries, while our Access to Insulin Commitment guarantees low-priced human insulin for the least developed countries and humanitarian settings.

Recognising that treatment alone will not bend the obesity curve, we go beyond medicine, addressing the root causes of this chronic disease. By focusing on reaching people where they live, learn and play, our Cities for Better Health programme – now active in 54 cities worldwide – partners with communities to reduce risk of obesity and type 2 diabetes through targeted interventions addressing the social determinants of health.

"We go beyond medicine, addressing the root causes of this chronic disease"

Sustaining our growth and impact requires both expanded reach and financial discipline. We simplified our organisation in 2025 to address complexities that emerged during hyper-growth while reducing costs to ensure long-term sustainability. To enable faster decisions, sharper execution and improved efficiency, we made the difficult decision to reduce approximately 9,000 positions globally. From 2026, these changes will deliver around DKK 8 billion in annualised savings, which we will reinvest in obesity and diabetes growth opportunities.

Our commitment to sustainable growth extends beyond organisational efficiency to environmental accountability. Our environmental performance demands urgent action. While scaling production to serve unprecedented patient demand, our emissions have increased – a trajectory that challenges our sustainability ambitions. We are working to implement initiatives across emissions, nature and plastics to reverse this trend through partnerships and systematic transformation.

Building on this foundation of access, prevention and environmental responsibility, we will align our organisation to deliver health impact at scale whilst confronting environmental challenges with urgency. We will strengthen partnerships with health systems, expand programmes to reach those who need our medicines the most and build supply chains that serve people and the planet – ensuring our innovations deliver lasting value for the communities we serve and the world we share.

social

Strengthening global access and affordability programmes

Reaching vulnerable people with diabetes involves addressing coverage, affordability and supply challenges in different ways across different markets. Despite this reach declining in 2025 due to portfolio consolidation affecting insulin tenders, we strengthened access through practical, locally tailored solutions that make quality treatment attainable.

In the US, we are expanding practical pathways to treatment across multiple channels. Through NovoCare^® – our patient assistance programme – patients can check coverage, access savings and, where eligible, receive assistance. In late 2025, we introduced time‑limited introductory pricing for new self‑pay patients for Wegovy^® and Ozempic^®, followed by a lower standard monthly self‑pay price for most doses, helping reduce costs and discouraging the use of illicit compounded products.

“In the US, we are expanding practical pathways to treatment across multiple channels. Through NovoCare^® – our patient assistance programme – patients can check coverage, access savings and, where eligible, receive assistance”

Our global programmes focus on people facing the greatest barriers to care. Changing Diabetes^® in Children (CDiC) supports children under 25 living with type 1 diabetes in low‑ and middle‑income countries; since 2009, we have reached almost 82,000 children with life‑saving care delivered through a holistic model.

In Sub‑Saharan Africa, our iCARE approach – integrating capacity, affordability, reach and empowerment across 49 countries – strengthens healthcare infrastructure, supports workforce development and improves product affordability through tiered pricing in collaboration with local partners.

Our Access to Insulin Commitment, established in 2001, continues to guarantee a low price for human insulin for least‑developed and other low‑income countries, and for organisations providing relief in humanitarian settings, helping to ensure continuity of care where health systems are under strain.

We are also aligning efforts across the broader Novo Nordisk family to maximise impact, with our humanitarian focus prioritising product donations while the Novo Nordisk Foundation and World Diabetes Foundation lean in on complementary elements of care and prevention.

Olivia Aka lives with type 1 diabetes in the Ivory Coast and is supported by the CDiC programme. Pictured here with her grandmother. (photo)

Olivia Aka lives with type 1 diabetes in Ivory Coast and is supported by the CDiC programme. Pictured here with her grandmother.

Environmental

Scaling responsibly on the road to Net Zero

We remain committed to delivering on our environmental targets for 2033 and 2045. As with any major transition, meaningful results do not materialise overnight, requiring sustained effort to achieve the fundamental changes needed.

Our rapid production scale-up to meet growing demand for life-saving medicines has driven year-on-year increases in our environmental metrics – presenting a clear challenge to our sustainability ambitions. Getting back on track will require substantial time, effort and investment, but our ambition remains unwavering. We continue reporting transparently on both progress and setbacks as we work to reverse this trend.

Supplier collaboration forms one of the cornerstones of our Net Zero strategy. More than 3,000 suppliers have committed to renewable electricity sourcing, accounting for 54% of our total CO₂e emissions. In our own production, we began sourcing bio-ammonia in 2025, with potential to reduce GHG emissions by around 80% compared to conventional ammonia.

Beyond energy, we are working to reduce the plastic footprint per patient by changing to reusable devices and therapies requiring less frequent dosing. We source e-methanol from Europe’s first large-scale e-methanol facility in Kassø, Denmark, together with the LEGO Group and Maersk, allowing us to explore alternative ways to make lower carbon plastic for our injection pens. Our ReMed™ programme, meanwhile, facilitates pen returns across seven countries.

Even our raw materials reflect this commitment. We are exploring regenerative production methods for glucose – a key raw material in our medicine manufacturing – to improve soil health and biodiversity while securing supply of the natural resources our therapies depend upon.

1. Find more information on targets and ambitions, incl. progress, on p. 63-67 in the full Annual Report 2025 PDF.

2. vs 2024 baseline, covering ~67% of scope 3 emissions.

Environmental targets and ambitions¹

Climate

Reduce scope 3 emissions by 33% by 2033²
Reach Net Zero in 2045

Plastic

Reduce plastic footprint per patient by 30% by 2033

Nature

Halt the loss of nature by 2033
Become nature positive by 2045

% of GHG emissions from suppliers who have committed to sourcing renewable electricity

54%

41% in 2024