Novo Nordisk - ADR

Q2 2026 performance (growth, but margin pressure) - Adjusted sales +7% YoY (constant exchange rates), to DKK 78.5bn (volume growth driven by GLP-1; offset by lower realized prices). - Adjusted operating profit +11% YoY (CER) despite headwinds. - Adjusted gross margin fell to 78.2% vs 82.7% in Q2 2025, mainly due to lower realized prices, one-off ~DKK 3bn manufacturing capacity right-sizing costs, and negative FX, partially offset by productivity and product mix (more GLP-1).

2026 guidance raised—but still negative-growth year expected (key forecast) - Company raised guidance again after a better-than-expected H1. - Now expects adjusted sales growth of 0% to -6% (CER) (i.e., roughly flat to declining). - Expects adjusted operating profit growth of 0% to -6% (CER). - Why improved outlook vs earlier: stronger expectations for GLP-1. - Main offsetting headwinds expected in H2/into next year: - Loss of exclusivity for semaglutide in Canada and Brazil (mostly starting in H2 2026) (this impact annualizes into 2027). - US price/access pressure continuing (incl. Medicaid coverage reduction and further lower realized prices tied to market access investments and MFX-style “most favored nation” effects). - Competition and pricing pressure noted as an expected feature of the US market.

Wegovy pill (US + ex-US) is a major opportunity; access is the constraint - US pill launch progressing strongly: >5 million prescriptions and ~267k weekly prescriptions (as of July 17). Added last 1M prescriptions in ~4 weeks (accelerating). - Market share claim (US, oral obesity meds): pill has ~90% share of the oral obesity medication market (reported as in the face of early-April competition). - Competitive dynamic is more about price/access than uptake: - Despite volume strength, investors were told the US has ongoing price pressure (no “new” pricing shock in Q2 beyond expectations). - Self-pay mix has shifted materially in the US: self-pay is ~35% of Wegovy injectable prescriptions vs ~10–15% a year ago, supporting volume but mixing with different price points. - Access remains “poor” overall; most prescriptions are self-pay even though reimbursed uptake is improving.