Annual
Report 2023
Juan Pablo Villaseñor lives with
obesity and cardiovascular disease.
Until recently, Juan struggled with
stigma and often blamed himself for
not being able to lose weight. Today,
he exercises regularly and spends
quality time with his son.
Watch Juan’s full story here
Participants at the Future
Scientists Summer Camp,
organised by Novo Nordisk
and the LIFE Foundation to
celebrate Novo Nordisk’s
100-year anniversary in 2023.
3 Introducing Novo Nordisk
4 Letter from the Chair and the CEO
6 Novo Nordisk at a glance
7 Our value creation
8 Performance highlights
10 Strategic Aspirations
11 Purpose and sustainability
23 Innovation and therapeutic focus
30 Commercial execution
34 Financials
40 Risks
41 Risk management
42 Key operational risks
43 Management
44 Board of Directors
47 Executive Management
50 Consolidated financial statements
50 Income statement and Statement
of comprehensive income
51 Cash flow statement
52 Balance sheet
53 Equity statement
54 Notes to the consolidated
financial statements
86 Consolidated ESG statement
86 Statement of ESG performance
87 Notes to the consolidated
ESG statement
95 Statements and Auditor’s Reports
95 Statement by the Board of Directors
and Executive Management
96 Independent Auditor’s Report
98 Independent Assurance Report
on the ESG statement
99 Additional information
100 More information
101 Product overview
102 ESG initiatives
104 Sustainability frameworks and performance
Management
review
Consolidated statements
and additional information
Novo Nordisk Annual Report 2023 2Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information
Quresha Nur comes from a
village near Mombasa, Kenya. She
was diagnosed with type 1 diabetes
aged seven and was discriminated
against because of it. People in her
community said she could not go to
school or be active, and expectations
of what she would achieve in life
were low. She decided to prove them
wrong. After graduating, Quresha
co-founded a start-up developing a
non-invasive blood sugar monitoring
device. She also launched ‘Diabetes
Champions’, an organisation that
empowers young girls with diabetes.
When you educate a girl, she says,
you educate a whole community.
Watch Quresha’s full story here
Introducing
Novo Nordisk
4 Letter from the Chair and the CEO
6 Novo Nordisk at a glance
7 Our value creation
8 Performance highlights
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 3
LETTER FROM THE CHAIR AND THE CEO
An extraordinary year of
innovation, growth and impact
The choices we make at this pivotal moment for our company are key to
shaping our long-term vision – one that extends beyond strengthening
leadership positions in our core therapy areas to becoming a driving
force for improving human health worldwide.
As our business continues to grow, so does our role in society. The
global burden of serious chronic diseases casts a long shadow, and
demands innovative, disruptive solutions that are as sustainable as they
are impactful. Our core contribution to this fight remains our industry-
leading therapeutic innovations, which benefited more than 40 million
people living with serious chronic diseases in 2023. Yet we are also
increasingly focused on prevention as we seek to understand and
address the root causes of the diseases we treat.
The unmet needs in type 2 diabetes and obesity are growing by the
day, and the rising prevalence of these closely related threats to global
health has created surging demand for our GLP-1-based therapies. This
has enabled us to reach more patients than at any point in our 100-year
history, contributing to strong sales growth across North America and
International Operations. However, it has also increased pressure on
our supply chain, resulting in periodic constraints across our portfolio
as we strive to keep pace with demand.
We have responded by investing heavily in expanding our production
capacity with the aim of serving millions more patients worldwide. In 2023
alone, we announced investments totalling more than DKK 75 billion
It is a rare privilege for
any company to reach its
centenary; and even more
so to arrive at this milestone
in a position of strength.
As we reflect on 100 years
of driving change to defeat
serious chronic diseases, we
nevertheless acknowledge
that what got us here will
not be enough to take us
where we want to go.
President and CEO, Lars
Fruergaard Jørgensen (left)
and Chair of the Board of
Directors, Helge Lund (right).
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 4
in the expansion of our production sites across the globe. With
construction now underway on these projects, we strive to operate our
existing facilities 24 hours a day, seven days a week, as we produce
more of our life-changing medicines than ever before.
Our response to supply challenges does not stop there. We are also
changing the way we launch and distribute our products, making sure
we do this in a responsible manner with a clear focus on safeguarding
access to appropriate treatment options for our existing patients.
Recent examples of this refined approach include the launches of
Wegovy
®
in the UK and Germany, where we are collaborating with
health authorities to ensure that some of those in greatest need of
medical intervention can access our flagship obesity therapy.
Improving health equity remains a cornerstone of our commitment to
patients, and we are working hard to enhance access to care worldwide.
Our new production partnership with manufacturer Aspen
Pharmaceuticals in South Africa will significantly increase the supply
of affordable insulin to the African continent, while long-established
initiatives, including Changing Diabetes
®
in Children and our Access
to Insulin Commitment, continue to support vulnerable patients in
low- and middle-income countries. In the US, a growing number of
people living with serious chronic diseases have been able to access
our expanded range of affordability offerings, which include unbranded
biologics, low-cost human insulin and our Patient Assistance Program.
Despite these efforts, the burden of chronic diseases on healthcare
systems is only set to grow, pushing us to break new ground in our
pursuit of innovative treatments. To this end, we are building a pipeline
of considerable breadth and depth, powered by the interplay between
our world-class in-house R&D capabilities and an increasing focus on
external innovation and business development. Our distinct ownership
structure, with the Novo Nordisk Foundation retaining the majority vote,
gives us the security we need to take a long-term perspective on our
investments and strategies.
The past year has seen us make significant progress on our pipeline.
The SELECT trial showed that semaglutide 2.4 mg reduces the risk of
major adverse cardiovascular events by 20% in people with obesity
compared to placebo, prompting us to seek label updates for Wegovy
®
,
while the FLOW kidney outcomes trial for semaglutide closed early
following a positive analysis of interim data. Novel combination therapy
CagriSema entered phase 3 development in both type 2 diabetes and
obesity, and insulin icodec, potentially the world’s first once-weekly
basal insulin, is pending regulatory approval. We have also expanded
our footprint in cardiovascular disease with the acquisition of
ocedurenone for uncontrolled hypertension, and bolstered our
late-stage pipeline in rare blood disorders with phase 3 trials of Mim8
in haemophilia and etavopivat in sickle cell disease.
Furthermore, we continue to reap the rewards of recent partnerships
and investments in novel technology platforms, with our first-ever RNA
interference-derived therapy, Rivfloza™, now approved in the US. The
recent expansion of our R&D presence in the Greater Boston area – a
world-renowned life sciences cluster – will potentially open the door to
even more collaboration opportunities as we seek to accelerate our
drug discovery and development efforts.
Nevertheless, we understand that it will take more than medicine
to transition from a disease-focused company to one that prioritises
broader human health to the benefit of society at large. Leveraging
a decade’s worth of insights from our pioneering Cities Changing
Diabetes programme, we are enhancing our prevention efforts,
expanding our partnership with UNICEF to address childhood obesity,
and establishing a Transformational Prevention Unit to deliver scalable,
preventive solutions to the obesity pandemic.
Innovation plays an equally important role in our ambition to reach net
zero emissions across our entire value chain by 2045 – particularly with
our manufacturing output at an all-time high. Having already switched
our production sites to sourcing 100% renewable power, we are now
supporting a similar transition among our 60,000-plus network of
suppliers, with the aim of significantly cutting carbon emissions across
our supply chain.
The resilience and dedication of our growing global workforce
have been instrumental in scaling our operations in the face of
unprecedented demand. As we onboard more colleagues than ever
before, we are focusing on making Novo Nordisk a more diverse
and inclusive place to work, nurturing a culture built on openness,
accountability and respect. Above all, we remain a purpose-driven
company, guided by a clear ambition to drive change to defeat serious
chronic diseases, building on our heritage in diabetes. Our position
today in the vanguard of progressive global businesses is a testament
to the strength and longevity of that purpose – and to the drive and
motivation it provides for our people all over the world.
We would like to extend our gratitude to all colleagues for their
unwavering commitment and invaluable contributions during a
particularly demanding year, and to our shareholders for their
continued support of our company.
Helge Lund Lars Fruergaard Jørgensen
Chair of the Board President and CEO
of Directors
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 5
Novo Nordisk
at a glance
Novo Nordisk is a leading global healthcare company,
founded in 1923 and headquartered in Denmark
Our purpose and strategy
Our business is built around the Novo Nordisk Way, our commitment to be a sustainable
business and our clear patient-centric purpose: driving change to defeat serious chronic
diseases. Our key contribution is to discover and develop innovative medicines and make
diabetes and obesity, secure a leading position within rare disease and establish
ourselves in cardiovascular disease (CVD). We also aim to build a presence in emerging
therapy areas, such as metabolic dysfunction-associated steatohepatitis (MASH), chronic
kidney disease (CKD) and Alzheimer’s disease (AD), and to move toward disease-modifying
and curative therapies.
1. Other Serious Chronic Disease (OSCD) has been renamed to Cardiovascular & Emerging Therapy Areas (CETA) to reflect that cardiovascular disease has
been the main strategic priority within OSCD.
Obesity
Strengthen leadership through
market development and by
offering innovative medicines and
driving patient outcomes
Rare Disease
Secure a leading position
by leveraging full portfolio and
expanding into adjacent areas
Diabetes
Strengthen leadership
by offering innovative
medicines and driving
patient outcomes
Cardiovascular &
Emerging Therapy
Areas
1
Establish position in
cardiovascular disease and
build a presence in emerging
therapy areas
N
o
v
o
N
o
r
d
i
s
k
W
a
y
S
u
s
t
a
i
n
a
b
l
e
b
u
s
i
n
e
s
s
Driving change
to defeat serious
chronic diseases
102,574
DKK million
in operating profit
232,261
DKK million
in net sales
80
countries with
affiliates
64,319
employees
worldwide
41.6
million people living with
diabetes and obesity reached
68,326
DKK million
in free cash flow
5
countries with
R&D facilities
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 6
Our value creation
Creating long-term value
We strive to be a sustainable company, creating value for society and for our future endeavours. We do business in a financially,
environmentally and socially responsible manner and we do this the Novo Nordisk Way. By succeeding, we will create long-term
value for people with chronic diseases, employees, partners, shareholders and society.
Research and developmentResources Manufacturing Distribution Patients
Insights from patients,
healthcare experts
and partners
Raw materials
Diverse talent
Financial resources
The Novo Nordisk Foundation
holds 77.1% of votes and 28.1%
of shares in Novo Nordisk A/S
through Novo Holdings A/S
The Novo Nordisk Foundation
awards grants in three strategic
areas: Health, Sustainability and
Life Science Ecosystem. In 2023,
more than DKK 9 billion were
awarded in grants.
Invested over DKK 45
billion in R&D – a 35%
increase vs 2022
Reduced our
CO
2
equivalent emissions
from operations and
transportation by 34%
vs 2019, while supporting
our 60,000-plus suppliers
with the transition to
100% renewable power
Invested more than
DKK 25 billion to meet
demand for current
and future products
Added more than
9 thousand employees
bringing Novo Nordisk’s
total workforce to over
64 thousand, while
supporting job-creation
amongst our suppliers
A total tax
contribution of
DKK 51 billion
Paid out DKK 61.7
billion via dividends
and share buybacks to
shareholders, including
Novo Holdings A/S
Reached 6.7 million
vulnerable patients with
our insulin medicines
through access and
affordability initiatives
Reached an all-time
high 41.6 million people
living with diabetes
and obesity
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 7
Our strategy execution progress
Strategic Aspirations 2025 Progress
Purpose and
sustainability
Progress towards zero environmental impact • Carbon emissions from operations and transportation decreased by 34% compared to 2019 (decreased by 8% compared to 2022)
Being respected for adding value to society • Medical treatment provided to 40.5 million people living with diabetes
• Reached more than 52,000 children in Changing Diabetes
®
in Children programme
• Human insulin with more flexible storage without refrigeration now approved in 29 countries
• Partnership with Aspen to produce human insulin for people living with diabetes in Africa
Being recognised as a sustainable employer • Share of women in senior leadership positions has increased to 41% from 39% in 2022
Innovation and
therapeutic focus
Further raise the innovation-bar for diabetes treatment • Regulatory submission of once-weekly insulin icodec in the EU, the US and China
• Successful completion of phase 3 trial with higher doses of oral semaglutide
• Initiation of phase 3a trial with CagriSema in type 2 diabetes
• FLOW kidney outcomes trial stopped based on interim analysis due to efficacy
• Successful completion of phase 3 trial with IcoSema
Develop a leading portfolio of superior treatment solutions for obesity • Successful completion of phase 3 trial with 50 mg of oral semaglutide
• Successful completion of SELECT cardiovascular outcomes trial
• Successful completion of STEP HFpEF phase 3 trials
• Acquisition of Inversago Pharma and phase 2 trial initiated with INV-202 and phase 1 trial initiated with INV-347
• Successful completion of phase 1 trial with oral amycretin
Strengthen and progress the Rare Disease pipeline • Somapacitan approved in the US, EU and Japan for the treatment of growth hormone deficiency in children
Establish presence in Cardiovascular & Emerging Therapy Areas focusing on CVD, MASH and CKD • Phase 1 trials initiated with cell therapy treatment in heart failure and Parkinson’s disease
• Acquisition of ocedurenone for the treatment of hypertension
• Phase 1 trial initiated with ANGPTL3i mAb
• Phase 1 trial initiated with VAP-1i in MASH
Commercial
execution
Strengthen diabetes leadership – aim at global value market share of more than 1/3 • Diabetes value market share increased by 1.9 percentage points to 33.8% (MAT)
More than DKK 25 billion in Obesity sales by 2025 • Obesity care sales increased by 154% (CER) to DKK 41.6 billion
Secure a sustained growth outlook for Rare Disease • Rare disease sales decreased by 15% (CER) to DKK 17.2 billion
Financials
Deliver solid sales and operating profit growth • Sales growth of 36% (CER)
• Operating profit growth of 44% (CER)
Drive operational efficiencies across the value chain to enable investments in future growth assets • Operational leverage reflecting sales growth
Deliver free cash flow to enable attractive capital allocation to shareholders • Free cash flow of DKK 68.3 billion
• DKK 61.7 billion returned to shareholders
PERFORMANCE HIGHLIGHTS
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 8
Financial highlights
PERFORMANCE HIGHLIGHTS
DKK million 2019 2020 2021 2022 2023 2022-23
Financial ratios Change
Gross margin
3
83.5% 83.5% 83.2% 83.9% 84.6%
Sales and distribution costs in percentage of sales 26.1% 25.9% 26.3% 26.1% 24.4%
Research and development costs in percentage of sales 11.7% 12.2% 12.6% 13.6% 14.0%
Operating margin
3
43.0% 42.6% 41.7% 42.3% 44.2%
Net profit margin
3
31.9% 33.2% 33.9% 31.4% 36.0%
Cash to earnings
1
88.4% 67.8% 61.4% 103.3% 81.6%
Return on invested capital
1
98.0% 82.8% 69.0% 73.6% 88.5%
Share performance and capital allocation
Basic earnings per share/ADR in DKK
3,5
8.21 9.03 10.40 12.26 18.67 52%
Diluted earnings per share/ADR in DKK
3,5
8.19 9.01 10.37 12.22 18.62 52%
Total number of shares (million), end of year
3,5
4,800 4,700 4,620 4,560 4,510 (1%)
Dividend per share in DKK
3,4,5
4.18 4.55 5.20 6.20 9.40 52%
Total dividend (DKK million)
4
19,651 21,066 23,711 27,950 41,987 50%
Dividend payout ratio
3,5
50.5% 50.0% 49.6% 50.3% 50.2%
Share repurchases (DKK million) 15,334 16,855 19,447 24,086 29,924 24%
Closing share price (DKK)
3,5
194 214 368 469 698 49%
DKK million 2019 2020 2021 2022 2023 2022-23
Financial performance Change
Net sales 122,021 126,946 140,800 176,954 232,261 31%
Sales growth as reported 9.1% 4.0% 10.9% 25.7% 31.3%
Sales growth in constant exchange rates
1
5.6% 6.7% 13.8% 16.4% 35.6%
Operating profit 52,483 54,126 58,644 74,809 102,574 37%
Operating profit growth as reported 11.1% 3.1% 8.3% 27.6% 37.1%
Operating profit growth in constant exchange rates
1
5.6% 6.8% 12.7% 14.6% 43.7%
Depreciation, amortisation and impairment losses 5,661 5,753 6,025 7,362 9,413 28%
EBITDA
1,2,3
58,144 59,879 64,669 82,171 111,987 36%
Net financials (3,930) (996) 436 (5,747) 2,100
Profit before income taxes 48,553 53,130 59,080 69,062 104,674 52%
Effective tax rate
3
19.8% 20.7% 19.2% 19.6% 20.1%
Net profit 38,951 42,138 47,757 55,525 83,683 51%
Purchase of property, plant and equipment
3
8,932 5,825 6,335 12,146 25,806 112%
Purchase of intangible assets
3
2,299 16,256 1,050 2,607 13,090 402%
Cash used for acquisition of businesses — — 18,283 7,075 —
Free cash flow
1
34,451 28,565 29,319 57,362 68,326 19%
Total assets 125,612 144,922 194,508 241,257 314,486 30%
Equity 57,593 63,325 70,746 83,486 106,561 28%
1. See Non-IFRS financial measures. 2. EBITDA is defined as ’net profit’, adjusted for 'income taxes', 'financial items', 'depreciation and amortisation' and 'impairment losses'. 3. See Financial definitions. 4. Total dividend for the year including interim dividend of DKK 3.00 per share, corresponding to DKK 13,430 million, which was paid in August 2023.
The remaining DKK 6.40 per share, corresponding to DKK 28,557 million, will be paid subject to approval at the Annual General Meeting in March, 2024. 5. As of 13 September 2023, the trading unit of the Novo Nordisk B shares listed on NASDAQ Copenhagen and ADRs listed on the New York Stock Exchange (NYSE) was changed from DKK 0.20 to DKK
0.10. Comparative figures have been restated to reflect the change in trading unit from DKK 0.20 to DKK 0.10.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 9
Jenica Leah lives with sickle cell
disease. It is a condition most cannot
see, yet it leads to excruciating
pain and countless complications.
Aged 13, Jenica had a stroke; three
years later, her lungs collapsed.
This was a turning point, where she
decided to tell the untold story of
living with sickle cell disease. Jenica
wrote a children’s book and now
hosts a podcast where she gives this
condition the attention it deserves.
Her quest is one of making the
invisible visible.
Watch Jenica’s full story here
Strategic
Aspirations
11 Purpose and sustainability
23 Innovation and therapeutic focus
30 Commercial execution
34 Financials
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 10
Human health is under threat from a perfect storm of health
inequity, climate change and biodiversity loss. As a leading
healthcare company committed to serving patients across the
globe, we have an important role to play in addressing these
challenges. Our commitment to social responsibility and
minimising our environmental impact are key to achieving our
purpose and sustainability goals – and essential for our
long-term success.
That is why we are striving to improve access to affordable care
for vulnerable patients across the globe. More than three
quarters of people with diabetes, for example, live in low- and
middle-income countries, and that proportion is likely to grow
as global prevalence rises from an estimated 537 million adults
today to a predicted 643 million by 2030. Although we are now
serving more people with diabetes than ever before, expanding
our reach by more than four million patients to a total of 40.5
million last year, we recognise the need to do more.
Our key contribution to society remains our therapeutic
innovation. However, we realise it will take more than medicine
to defeat serious chronic diseases. This need is particularly
acute in obesity, where medical intervention with treatments
like Wegovy
®
must be supplemented with prevention measures
to head off a global pandemic that threatens to overwhelm
healthcare systems. To this end, we have strengthened our
focus on public-private partnerships and established a
dedicated Transformational Prevention Unit tasked with
delivering scalable commercial solutions that can help predict
and pre-empt obesity.
We are also stepping up efforts to reduce our environmental
impact by focusing on our supply chain emissions. Having already
switched our production sites to sourcing 100% renewable power
in 2020, we are now focused on supporting our 60,000-plus
suppliers through a similar transition, with the aim of reaching
net zero emissions across our full value chain by 2045.
To ensure that sustainability is integrated into Novo Nordisk’s core
business, we have a series of governance measures in place that
supplement the incorporation of environmental, social and
financial responsibility in our Articles of Association. These include
our Sustainability Advisory Council, established in 2022, which
provides external input on our goals from experts in academia,
public policy and patient advocacy, and an executive remuneration
package directly linked to our progress on sustainability targets.
PURPOSE AND SUSTAINABILITY
STRATEGIC ASPIRATIONS 2025
1. Progress towards zero
environmental impact
2. Being respected for adding
value to society
3. Being recognised as
a sustainable employer
In a world facing urgent societal
and environmental challenges,
Novo Nordisk is playing a proactive
role in the fight against health
inequity and climate change. Guided
by our purpose of driving change
to defeat serious chronic diseases
and a steadfast commitment to
social, environmental and financial
responsibility, we are raising the
bar to stay at the forefront of
progressive global businesses.
Driving change for
a sustainable future
For an overview of our purpose and
sustainability initiatives, frameworks
and performance, see the tables on
pages 102-104.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 11
Novo Nordisk conducted an initial double materiality
assessment in 2023 to determine which environmental, social
and governance (ESG) topics are material for the company.
This assessment considers both the impact of Novo Nordisk’s
business on society and the environment (impact materiality)
and how ESG matters affect the company (financial materiality).
The assessment involved experts and leaders from within Novo
Nordisk, as well as input from external stakeholders, such as
patient organisations, suppliers and investors.
The purpose of the assessment is to prepare for the
implementation of the Corporate Sustainability Reporting
Directive (CSRD) in 2024. It covers all topics defined in the CSRD,
along with other ESG topics relevant to Novo Nordisk. The table
on the right shows the preliminary, aggregated results of the
assessment, and includes both current and potential ESG topics
from a short-, medium- and long-term perspective. The ESG
topics will help guide the preparation of the company’s ESG
reporting from 2024 onwards.
Many of the preliminary, material ESG topics reflect Novo
Nordisk’s strategic sustainability focus. For social topics, this
includes our efforts to provide access to life-saving medicines
without compromising safety or quality, improve patients’
quality of life and support resilient healthcare systems.
Workers’ wellbeing, both within and outside of our operations,
reflects the importance of remaining a relevant and attractive
workplace while respecting adequate working conditions. We
also consider our local impact in the communities we operate
in and pay tax where value is created.
Double materiality assessment
The preliminary, material environmental topics reflect Novo
Nordisk’s environmental initiatives to reduce carbon emissions
and promote a circular economy, for example on plastic. ESG
topics such as biodiversity and water reflect the company’s
dependence on nature-based resources. To this end, Novo
Nordisk is already increasing sustainability efforts directly
related to nature and biodiversity. Moreover, the company
strives to limit any negative effects resulting from its business
operations, including pollution.
Business conduct reflects our efforts to adhere to the highest
ethical standards, including bioethics. Overall, Novo Nordisk
aims to be respected for its contributions to society and to
build trust through its sustainability efforts.
Preliminary assessment of material ESG topics
Climate change Patient protection
1
and quality of life
Business conduct
Resource use and
circular economy
Own workers Bioethics
Water and marine
resources
Workers in the
value chain
Biodiversity and
ecosystems
Sustainable
tax
Pollution Affected
communities
1. Includes topics related to consumers and end-users.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 12
78
15
3,738
2019
309
2020
174
170
221
203
According to the World Health Organization, climate change is
the single biggest health threat facing humanity. We recognise
that caring for our patients also means caring for our planet,
and with the healthcare sector as a whole accounting for
approximately 5% of global emissions, we take our environmental
impact seriously. We are determined to play our part in creating
a sustainable, healthy environment for the long term, and our
ambition is bold and simple: to have zero environmental impact.
To achieve this, one of our key tasks is to decouple the growth
in our business from our CO
2
equivalent (CO
2
e) emissions;
otherwise, our carbon footprint will continue to climb as we
serve increasing numbers of patients.
On this front, we have made significant progress in curbing
our company’s emissions. Since 2020, all our production sites
have sourced 100% renewable power and we aim to reach zero
CO
2
e emissions from operations and transportation by 2030.
However, focusing solely on our own activities is not enough.
We must also ensure our 60,000-plus suppliers play their part
in this transformation, since their activities account for the
majority of our total CO
2
e emissions – amounting to 98% in
2023. Our target is that all goods and services from suppliers
will be based on 100% sourced renewable power by 2030.
We are engaging with suppliers in high-impact areas to
understand how we can collectively reduce emissions using
novel approaches to decarbonisation. This involves working on
innovative Power-to-X solutions that use renewable electricity
to produce green fuels and low-carbon chemicals, or using
organic waste materials to produce biofuels.
Recent examples include our membership of the Sustainable
Aviation Buyers Alliance (SABA) to support the expansion of
sustainable aviation fuel facilities, and our partnership with
global logistics firm Maersk on low-emission fuels for ocean
freight. Both these investments are contributing to the global
uptake of innovative green technologies.
“Focusing solely on our own activities
is not enough. We must also ensure
our 60,000-plus suppliers play their
part in this transformation.”
Cutting emissions in
collaboration with our suppliers
SCOPE 1, 2 AND 3 EMISSIONS IN 2023
(1,000 tonnes CO
2
e)
Scope 1:
Direct emissions from owned or
controlled sources
Scope 2:
Indirect emissions from the
generation of energy purchased
from an utility provider
Scope 3:
All indirect emissions – not included
in scope 2 – that occur upstream and
downstream in our value chain
Target 2045: net zero CO
2
e emissions across
our full value chain
EMISSIONS FROM OPERATIONS
AND TRANSPORTATION
(1,000 tonnes CO
2
)
1
Company cars (scope 1)
Business flights (scope 3)
Product distribution (scope 3)
Office buildings and
laboratories (scope 1, 2)
Production (scope 1, 2)
Target 2030: zero CO
2
e emissions
from operations and transportation
1. Emissions in 2023 are measured in CO
2
e.
2021 2022 2023
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 13
Injection pens’ components
that have been discarded
from our production lines in
Hillerød, Denmark.
“In 2023 we established the world’s
first industry solution for recycling
injection pens in Denmark.”
Reducing our
plastic footprint
Minimising the use of plastic derived from fossil fuels is a
priority for Novo Nordisk – and a significant challenge given the
rapid growth in demand for our medical injection devices. We
currently manufacture more than 800 million pre-filled plastic
pens every year, equivalent to some 14,000 tonnes of plastic.
As the number of patients we serve continues to grow, those
numbers will rise markedly unless we take decisive action.
We are tackling our plastic challenge on multiple fronts, with
a threefold ‘reduce-change-avoid’ approach. This includes
reducing plastic consumption by converting to reusable
devices, changing to the use of non-virgin-fossil plastics in our
device production and harnessing recycling to avoid plastic
ending up in landfill.
The task is not simple. When it comes to recycling, for example,
used injection pens cannot be dealt with in the same way as
other household recycling because they are classified as
medical waste, which most countries are not equipped to
handle. To address this challenge, we have expanded a series
of pioneering take-back programmes across Denmark, the UK,
France and Brazil, and in 2023 we established the world’s first
industry solution for recycling injection pens in Denmark.
Pharmaceutical companies Lilly, Sanofi and Merck have all
joined the initiative, and we now share a goal of recycling 25%
of the pens distributed by all four companies in Denmark within
the first 12 months.
Another important initiative involves rethinking medicine
delivery by switching from disposable to reusable devices –
some with an expected lifespan of up to 5 years. Over the past
year, we have converted selected products in a number of
countries and we expect to switch more in 2024. We are also
steadily building device durability into the development of new
medicines and expect that a trend from daily to once-weekly
administration for many products will contribute to reduced
plastic use per patient in the long term.
In addition, we are exploring more sustainable ways to produce
plastic. A good example is a new agreement signed by Novo
Nordisk, alongside the LEGO Group, to buy e-methanol from
European Energy when the world’s first large-scale production
plant for the commodity starts up in Denmark in 2024. The
e-methanol – made from renewable electricity, water and
captured biogenic CO
2
– will help us to create lower-carbon
plastics for use in our medical devices.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 14
32.8
2020
30.0
2019
36.3
2022
34.6
2021
40.5
2023
PEOPLE REACHED WITH OUR DIABETES MEDICINES (million)
Dr. Karaireho Silver Bahendeka
is a physician for diabetes
and endocrinology at
St Francis Nsambya Hospital
in Kampala, Uganda.
Supporting more
people with diabetes
With the number of adults living with diabetes across the globe
predicted to grow from 537 million today to 643 million by 2030,
it is those in the most vulnerable settings who struggle the most
to access the treatment they need. Last year, we reached more
than 40.5 million people with our diabetes medicines – an
increase of 4.2 million on 2022 – but we recognise the need to
do more. For that reason, we are committed to improving
affordability for vulnerable populations, increasing availability
by strengthening supply chains and expanding the capacity to
diagnose and manage diabetes worldwide.
Over the past year, we reached 6.7 million people living with
diabetes globally with our insulin medicines through access and
affordability initiatives, and we extended support to more than
52,000 children with type 1 diabetes through our Changing
Diabetes
®
in Children programme. In the US, we provided access
to affordable insulin for 1.4 million people and supported a further
2.8 million with initiatives relating to our GLP-1-based therapies.
On the African continent, we doubled down on our commitment
to improve access to insulin, establishing a new partnership with
South African pharmaceutical manufacturer Aspen Pharmaceuticals
to increase production for distribution across the region. The
partnership acknowledges the World Health Organization’s call
for sustainable access to quality-assured and affordable medicine
through local manufacture and aims to produce more than 60
million vials by 2026. This is equivalent to the annual requirements
of around four million people – a significant increase on the
500,000 we currently serve. Sub-Saharan Africa is currently home
to an estimated 24 million adults living with diabetes.
The human insulin produced by the collaboration will be
distributed at low-cost as part of Novo Nordisk’s Access to
Insulin commitment, which reached 2.4 million people in 2023.
The programme guarantees a ceiling price of USD 3 per vial in
77 low- and middle-income countries around the world.
However, increasing the availability of insulin alone is not enough.
To enhance access to equitable care in Sub-Saharan Africa, we
have built a business integrated model – iCARE – which is now
active in 49 countries. Through public-private partnerships we
aim to improve capacity to treat diabetes, increase affordability
of insulin and enhance patient empowerment. Our ambition is
to reach more than two million vulnerable people living with
diabetes in Sub-Saharan Africa by 2030.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 15
Preventing obesity,
starting with children
The obesity epidemic is one of the greatest threats to global
health, currently impacting more than 813 million adults
worldwide and responsible for five million deaths each year.
In addition, obesity impacts the sustainability of health
systems and economic productivity. While Novo Nordisk’s core
contribution to the fight remains our therapeutic innovations,
which reached more than 1.1 million people worldwide in
2023, we recognise that medicine alone will never be enough
to defeat obesity. We are therefore committed to addressing
the disease holistically by scaling up our focus on prevention
– and nowhere is this more urgent than in childhood.
More than 310 million children and adolescents are expected to
be living with obesity by 2030, with those in vulnerable settings
more at risk. These individuals are more likely to develop early-
onset type
2 diabetes, and their weight in early life can also be a
strong predictor of adult obesity and cardiometabolic disease.
We believe that preventing childhood obesity is a shared
societal responsibility that requires systemic change. Many
of the risk factors driving the epidemic are outside of an
individual’s control, reflecting rapid urbanisation and the
health challenges that come in its wake, from physical
inactivity to the prevalence of foods high in fats, sugar and salt.
Our childhood obesity partnership with UNICEF – which was
expanded in 2023 and aims to reach 10 million children across
the globe – zeroes in on exactly these key issues through
policies, programmes and practices that directly impact the
nutrition, wellbeing and development of children.
Since its launch in 2019, the partnership has positively
impacted the lives of more than 2.7 million children and
caregivers across Latin America and the Caribbean. Now it is
expanding its reach, bringing its proven approach to new
geographies with an increased focus on driving policy change
at national level and action at city level.
Through local engagement and cross-sector collaboration, we
are focusing on interventions with demonstrable track records.
These include advocating for healthy school food regulations
in Brazil, addressing unhealthy food marketing directed at
children online in Mexico and trialling innovative measures to
improve urban food retail environments in Indonesia.
The partnership will draw upon insights from our Cities Changing
Diabetes programme, now active in 47 cities globally, which over
the past decade has addressed the systemic issues underpinning
the rise in type 2 diabetes and obesity in urban environments.
Our broader obesity prevention efforts will be boosted by our
recently-established Transformational Prevention Unit, a
semi-autonomous team of multi-disciplinary experts tasked with
delivering high-impact, scalable and accessible solutions that can
predict and pre-empt obesity and its consequences.
Girls playing in the Mexican state of Chiapas.
Mexico was among the launch countries for
our partnership with UNICEF, and Mexico City
was the first metropolis to join Cities Changing
Diabetes. Photo: UNICEF.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 16
Michele De Gier Gustafsson
heads a clinical digital systems
team in Søborg, Denmark.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 17
1. Cf. the Danish Companies Act, section 139 (c). 2. Cf. the Danish Financial Statements Act. section 99(b). 3. Shareholder-elected Board members of Novo Nordisk A/S. 4. Chief executive officer and executive vice presidents employed by Novo Nordisk A/S as well as their direct reports, also employed by Novo Nordisk A/S, with leadership responsibility.
5. Cf. the Danish Companies Act, section 139(c)(1)(1). 6. Intellectual property rights based on sales from where intellectual property rights are located. 7. Production based on number of production employees in the region. 8. Sales based on location of the customer.
8
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 18
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 19
1. Directive 2004/25/EC.
In 1924, August Krogh
announced that profits from
the sale of insulin would be
used for the public good.
This year, the Novo Nordisk
Foundation celebrates its
100-year anniversary.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 20
ESG Governance
We strive to conduct our activities in a financially, environmentally
and socially responsible way. To achieve this objective and
integrate sustainability considerations in Novo Nordisk’s strategy
and core business, ESG is anchored and discussed in relevant
governance bodies across the organisation.
Our ESG Governance model includes the Board of Directors’
and Board Committees’ oversight and advice on ESG matters
such as strategic direction and ambition level, as set by Executive
Management. Their oversight also includes approval of our ESG
reporting, variable remuneration components and more.
Operational decisions are anchored at the executive level in the
Sustainable Business Execution Steering Group. It is composed
of our Commercial Strategy & Corporate Affairs executive vice
president and other senior sustainability leaders, including
representatives of North America and International Operations.
Supported by the underlying steering groups, the Sustainable
Business Execution Steering Group provides guidance on
implementation related to our social and environmental initiatives.
To ensure a well-rounded governance setup, we actively seek
external input through our Sustainability Advisory Council.
Comprised of experts from various fields, this independent body
offers invaluable perspectives that challenge us to continuously
improve our sustainability efforts. They provide constructive
feedback on our current initiatives and help us explore innovative
opportunities for the future. You can learn more about the council
and its members at: www.novonordisk.com/sustainable-business/
esg-portal.html.
Oversees strategic
direction and advises
on ambition level.
Decides on strategic
direction, ambition level,
targets, roadmaps and
central funding, as well as
financial and ESG reporting.
Takes operational decisions to
implement Executive Management’s
decisions regarding core
sustainable business priorities.
Drive social initiatives, related
to global health equity, business
ethics and others.
Board of
Directors
Executive
Management
Sustainable Business
Execution Steering Group
Social steering
groups
Drive environmental
initiatives, particularly with
regards to circularity.
Environmental
steering groups
Provides guidance on
ESG reporting, including
implementation of new
regulatory requirements.
ESG Reporting
Steering Group
1
Oversees financial and
ESG reporting.
Assesses the
competencies of the
Board of Directors,
including within ESG.
Audit
Committee
Nomination
Committee
Determines executive
remuneration, including
based on sustainability
targets.
Remuneration
Committee
Provides non-binding
recommendations on our
Strategic Aspirations regarding
purpose and sustainability.
Composed of external experts.
Sustainability
Advisory Council
1. The responsibility of the consolidated ESG statement resides in Finance.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 21
1. A.1., A.2., A.1.+A.2. and B. refer to Annex V to the Commission Delegated Regulation (EU) 2023/2486 of 27 June 2023. Not disclosed data are all either 0 (zero) or not applicable. 2. None of the reported economic activities are Enabling or
Transitional and we do not have any economic activities substantially contributing to ‘Climate Change Adaption’, ‘Water’, ‘Circular Economy’ or ‘Biodiversity’. 3. When allocating CapEx and OpEx to economic activities, we prioritise those that
directly contribute to an environmental objective and for which specific technical screening criteria are set. Secondly, we link CapEx and OpEx associated with our primary economic activity, ‘1.2. Manufacture of medicinal products’.
EU Taxonomy
The EU Taxonomy is a European sustainability classification framework. It
enables corporates to communicate to stakeholders which of their business
activities have the potential to be considered sustainable (i.e. are Taxonomy-
eligible) and report to which extent eligible activities fulfil EU requirements
to be considered sustainable (i.e. are Taxonomy-aligned). For each relevant
business activity, the company has to disclose how much of its Turnover,
Operating Expenditures (OpEx) and Capital Expenditures (CapEx) can be
considered eligible and aligned, respectively.
In 2023 we identified eligible economic activities based on the six published
environmental objectives . Each of the economic activities was assessed on its
percentage of Taxonomy-eligibility and, for those related to the environmental
objectives of ‘Climate change mitigation’ and ‘Climate change adaptation’, also
on their percentage of Taxonomy-alignment. As a result, we report 100%, 60%
and 5% Taxonomy-eligible Turnover, CapEx and OpEx in 2023, respectively.
Accounting policies
Total Turnover consists of total revenue from sale of goods, as defined
under IFRS. The Turnover KPI is defined as Taxonomy-eligible Turnover
divided by total Turnover.
Total CapEx consists of additions to fixed assets (including financial
lease) and intangible assets. Additions resulting from business
combinations are also included. Goodwill is not included in CapEx as
it is not defined as an intangible asset in accordance with IAS 38. The
CapEx KPI is defined as Taxonomy-eligible CapEx divided by total CapEx.
Total OpEx consists of direct non-capitalised costs that relate to research
and development, building renovation, short-term lease, maintenance
and repair and any other direct expenditures relating to the day-to-day
servicing of property, plant and equipment assets. OpEx excludes
amortisations and impairments. The OpEx KPI is defined as Taxonomy-
eligible OpEx divided by total OpEx.
None of our activities contribute to multiple objectives and hence do not
require disaggregation of KPI’s. For the CapEx and OpEx allocations, we
have identified the relevant purchases and measures as well as the
primary related economic activity. Thereby, we ensure that no CapEx or
OpEx is double counted. We are adjusting the R&D cost for
amortisations to not double count these costs, as the amortisation
would also have been part of CapEx in prior years.
Contextual information about the KPIs
We consider all Novo Nordisk’s revenue related to Manufacture of medicinal
products. As Taxonomy-eligible, we only include CapEx directly associated
with the manufacturing process or related to construction or renovation of
buildings, hence intangible assets are excluded. This is the main reason for
reported eligibility being less than 100%. Eligible CapEx mainly relates to
the expansion of production capacity and consist of additions to property,
plant and equipment, cf. note 3.2 to the Consolidated financial statements.
Eligible OpEx mainly relates to research and development directly linked to
manufacturing processes. The narrow EU Taxonomy OpEx definition is the
main reason for a reported low eligibility.
Eligibility and alignment
We followed a two-step process to arrive at our Taxonomy disclosures. Firstly,
we screened the economic activities defined in the EU Taxonomy to identify
those relevant under the Novo Nordisk business model. Based on our review
and materiality considerations, we identified one new economic activity
to report on in 2023: ‘1.2 Manufacture of medicinal products’ under the
environmental objective of ‘Pollution prevention and control’. Furthermore,
like in 2022, we report Taxonomy-eligible CapEx for the economic activities
‘7.1 Construction of new buildings’ and ‘7.2 Renovation of existing buildings’
under the environmental objective ‘Climate change mitigation’.
Secondly, we evaluated whether we could classify any of our Taxonomy-eligible
CapEx for economic activity 7.1 and 7.2 as Taxonomy-aligned. Although we
have made progress in fulfilling the technical screening criteria, certain
requirements in the design phase of the projects have not been fully met.
Consequently, the existing projects do not meet the criteria for alignment in
2023. We strive for alignment of certain projects in 2024. Furthermore, we have
started investigating the requirements, including CapEx plans, for reporting
alignment of the activity ‘Manufacture of medicinal products’ with the aspiration
of reporting alignment for part of the activities in 2024.
EU TAXONOMY ELIGIBILITY AND ALIGNMENT
1
Turnover CapEx OpEx
Environmental objective Economic activity
2
2022 2023 2022 2023 2022 2023
(DKK
million) (%)
(DKK
million) (%)
(DKK
million) (%)
(DKK
million) (%)
(DKK
million) (%)
(DKK
million) (%)
Total Turnover, CapEx, OpEx 176,954 100% 232,261 100% 23,961 100% 44,498 100% 23,348 100% 31,115 100%
Taxonomy-non-eligible activities (B.) N/A N/A 0 0% 20,788 87% 17,996 40% 23,348 100% 29,646 95%
Climate change mitigation 7.1. Construction of new buildings 0 0% 0 0% 1,166 5% 6,010 14% 0 0% 0 0%
7.2. Renovation of existing buildings 0 0% 0 0% 2,007 8% 2,406 5% 0 0% 0 0%
Pollution prevention and control 1.2. Manufacture of medicinal products N/A N/A 232,261 100% N/A N/A 18,086 41% N/A N/A 1,469 5%
Eligible not aligned (A.2. / A.1.+ A.2.)
3
0 0% 232,261 100% 3,173 13% 26,502 60% 0 0% 1,469 5%
Eligible and aligned (A.1.) 0 0% 0 0% 0 0% 0 0% 0 0% 0 0%
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 22
Guided by our purpose to drive change to defeat serious chronic
diseases, we are broadening our pipeline of potential new
treatments with an approach that is as comprehensive as it is
innovative. Building on our 100-year heritage in protein and
peptide engineering, we are harnessing the power of novel
research technology platforms, leveraging cutting-edge data
science tools and forging new strategic partnerships. This
multi-faceted approach is enabling us to accelerate our research
efforts and expand our footprint across multiple disease areas.
As our evolution from a diabetes-focused organisation to a
broader cardiometabolic-focused company continues, our
attention remains on areas with the highest unmet needs – and
those where we are best positioned to compete. Strengthening
our leadership position in both diabetes and obesity remains
our top priority, while expanding our presence in cardiovascular
disease and rare blood disorders is also a key focus.
We are stepping up our investment in these areas to build and
maintain industry-leading pipelines, while at the same time
seeking new opportunities to complement our in-house
expertise with external innovation. Over the past year, this
emphasis on business development has resulted in the
acquisition of biotechs including Inversago Pharma and Embark,
two companies developing novel therapies with a potential
application across a range of cardiometabolic diseases.
To further expand our capabilities, we have established a
significant presence in the Greater Boston area, a world-
renowned hub for innovation and cutting-edge science and
technology. Through strategic partnerships, such as those
with technology firm Valo Health and the Broad Institute of
MIT and Harvard, we aim to accelerate our drug discovery and
development efforts, expanding our use of human data, artificial
intelligence and machine learning and tapping into our partners’
innovative genetics and genomics tools.
These extensive, wide-ranging efforts are already yielding
positive results, including the initiation of clinical testing for
cutting-edge cell therapy and siRNA (small interfering ribonucleic
acid) treatments. Armed with an increasing array of novel
research and development tools, we aim to move a greater
number of projects into clinical testing at a faster pace, reducing
the cost per project without compromising safety or quality.
INNOVATION AND THERAPEUTIC FOCUS
Broadening our pipeline for
long-term innovation
STRATEGIC ASPIRATIONS 2025
1. Further raise the innovation-bar
for diabetes treatment
2. Develop a leading portfolio of superior
treatment solutions for obesity
3. Strengthen and progress the
Rare Disease pipeline
4. Establish presence in Cardiovascular
& Emerging Therapy Areas focusing
on CVD, MASH and CKD
As the world grapples with the
increasing impact of serious chronic
diseases, Novo Nordisk is amplifying
its research and development efforts
to tackle these global health
challenges head-on. Diseases like
diabetes, obesity, cardiovascular
disease and rare blood disorders
pose significant threats to human
health and society, demanding
urgent action.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 23
Once-weekly insulin to set
new standard in treatment
Our company was founded on the discovery and
production of insulin, and we remain committed
to pushing the envelope when it comes to insulin
innovation. Our investigational once-weekly
insulin icodec represents the latest major step
forward in insulin care, potentially changing
the basal insulin experience for people living
with diabetes.
Insulin icodec has been filed for regulatory
approval in the US, EU and China, following phase
3a trials that demonstrated superior reductions
in blood glucose levels and reduced incidence of
severe hypoglycaemia compared to once-daily
basal insulin degludec and insulin glargine U100
in insulin-naïve people with type 2 diabetes. If
approved, insulin icodec will become the first
once-weekly basal insulin option for adults with
diabetes, reducing the number of weekly
injections from seven to just one.
In the longer term, we are working on further
improvements in insulin technology. This includes
continuing to pursue the development of
glucose-sensitive insulin, which only becomes
active when the body’s glucose levels start to rise.
“If approved, insulin icodec will
become the first once-weekly
basal insulin option for adults
with diabetes, reducing the
number of weekly basal insulin
injections from seven to just one.”
Taking diabetes treatment to
the next level with CagriSema
Our determination to raise the bar in diabetes
treatment is exemplified by CagriSema, our new
investigational therapy for type 2 diabetes that has
now entered large-scale phase 3 clinical development.
This two-in-one medicine combines semaglutide with
the amylin analogue cagrilintide, offering a novel
mechanism to influence the gut-brain axis with the
aim of improving glycaemic control in people living
with type 2 diabetes. Cagrilintide works by reducing
hunger and increasing satiety signals to the brain,
providing an additive effect to semaglutide.
The decision to move into phase 3 development
follows phase 2 results that showed a once-weekly
subcutaneous injection of CagriSema reduced
long-term blood glucose levels by 2.2 percentage
points and outperformed its individual components
in reducing body weight. CagriSema, which appears
to have a safe and well-tolerated profile, previously
commenced large-scale phase 3 trials in obesity in
2022, reflecting its broad potential across multiple
therapy areas.
Rebecca Commanda lives
with type 2 diabetes in
Ontario, Canada.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 24
Juan Pablo Villaseñor
lives with obesity and
cardiovascular disease in
Ciudad de Mexico, Mexico.
“It is the first time that an approved
weight management medicine
has been shown to reduce the risk
of heart attacks, strokes and
cardiovascular death.”
Landmark trial underscores
cardiovascular benefits of semaglutide
The success of our ground-breaking SELECT cardiovascular
outcomes trial was a powerful endorsement of the efficacy and
clinical importance of semaglutide as a treatment for people
living with obesity and established cardiovascular disease (CVD).
The study was the largest ever completed by our company,
involving more than 17,500 adults aged 45 and above with
obesity and established CVD but no prior history of diabetes.
The findings demonstrated a 20% reduction in major adverse
cardiovascular events (MACE) for trial participants treated with
semaglutide 2.4 mg compared to placebo – showing that
semaglutide not only helps patients lose weight but can also
improve cardiovascular outcomes.
The trial data showed this effect is consistent regardless of
patient age, gender, ethnicity and starting BMI (body mass
index), with risk reductions evident across heart attack,
cardiovascular death and stroke. Importantly, the effect is seen
soon after treatment initiation, suggesting that weight loss
alone may not fully explain the benefits of semaglutide 2.4 mg
in reducing the risk of MACE.
Every year almost 21 million people die from CVD, which is
the leading cause of disability and death worldwide. While
cardiovascular mortality has decreased over the past two
decades, obesity-related cardiovascular deaths have increased
significantly. Obesity leads to cardiovascular morbidity and
mortality and is associated with risk factors such as high blood
pressure and inflammation.
It is the first time that an approved weight management
medicine has been shown to reduce the risk of heart attacks,
strokes and cardiovascular death. Novo Nordisk has filed for
a label update of Wegovy
®
in the US and EU based on these
findings, and a decision is expected in 2024. The US Food
and Drug Administration has granted our submission a
priority review.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 25
CARDIOVASCULAR & EMERGING THERAPY AREAS
Next-generation treatments
for rare blood disorders
Our Rare Disease unit – comprising treatments
for rare blood and endocrine disorders – has a
growing pipeline of exciting products, including two
potential medicines for rare blood disorders with
large unmet medical needs.
Mim8, our next-generation bispecific antibody for
haemophilia A, is now in phase 3 development.
Administered subcutaneously, it works by
mimicking the function of the missing clotting
factor VIII and is being tested as a treatment to
prevent bleeds.
The experimental once-daily oral medicine
etavopivat, also in phase 3 evaluation, offers
potential benefits for people with sickle cell disease
(SCD), a crippling and life-threatening condition
caused by misshapen red blood cells. Acquired as
part of the business development deal that brought
US-based Forma Therapeutics in-house in 2022,
the investigational therapy is designed to modulate
red blood cell health to reduce anaemia, pain,
transfusions and strokes in people living with SCD.
Expanding our footprint in
cardiovascular disease
Cardiovascular disease (CVD) represents one
of the greatest health challenges of our time.
Affecting an estimated 620 million people across
the globe, it takes a major toll on quality of life
and is currently the leading cause of death
worldwide.
At Novo Nordisk, we are determined to reduce
the risk and burden of living with CVD, and over
the past year we have taken significant steps
to increase our footprint in this area of huge
unmet need.
In October 2023, we strengthened our CVD
pipeline with the acquisition of ocedurenone in
a deal worth up to USD 1.3 billion. This mature
clinical candidate targets uncontrolled
hypertension – a leading risk factor for
cardiovascular events, heart failure, chronic
kidney disease (CKD) and premature death.
To date, ocedurenone has been investigated in
nine clinical trials, and is currently in phase 3
development for the treatment of uncontrolled
hypertension in people with CKD. We expect to
initiate further phase 3 trials in the coming years
as we seek to maximise its full potential.
Meanwhile, our first standalone CVD compound,
ziltivekimab, is currently in phase 3 development
for the treatment of atherosclerotic cardiovascular
disease in people living with CKD. The ZEUS trial
will include more than 6,000 patients in 38
countries, with completion expected in late-2025.
Masahiro Umehara (left)
lives with haemophilia A in
Tokyo, Japan. Pictured here
with his son Masatsugu
and his dog.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 26
RARE DISEASEOBESITYDIABETES CARDIOVASCULAR & EMERGING THERAPY AREAS
Pipeline overview
Project Indication Description Phase
Oral Semaglutide
HD
1
NN9924
T2D
2
A long-acting GLP-1
3
analogue, 25.0
and 50.0 mg, intended for once-daily
oral treatment.
Icodec
NN1436
T1D
4
and T2D
A long-acting basal insulin analogue
intended for once-weekly
subcutaneous treatment.
IcoSema
NN1535
T2D A combination of GLP-1 analogue
semaglutide and insulin icodec
intended for once-weekly
subcutaneous treatment.
CagriSema
NN9388
T2D A combination of amylin analogue
cagrilintide and GLP-1 analogue
semaglutide intended for once-weekly
subcutaneous treatment.
GELA
NN9506
T2D A collaboration with GE Healthcare,
using ultrasound for once-monthly
treatment.
Glucose-sensitive
insulin
NN1845
T1D
and T2D
A glucose-sensitive insulin analogue
intended for once-daily subcutaneous
treatment.
Pumpsulin
NN1471
T1D A novel insulin analogue ideal for use
in closed loop pump systems.
DNA
Immuno therapy
NN9041
T1D A novel plasmid encoding pre- and
pro-insulin intended for preservation
of beta cell function.
OW GLP-1 GIP
5
NN9541
T2D A combination of GLP-1 and GIP
co-agonist intended for once-weekly
subcutaneous treatment.
OW Oral
Semaglutide
NN9904
T2D An oral version of semaglutide
intended for once-weekly treatment.
Project Indication Description Phase
Oral Semaglutide
NN9932
Obesity A long acting GLP-1 analogue
intended for once-daily oral
treatment.
CagriSema
NN9838
Obesity A combination of amylin analogue
cagrilintide and GLP-1 analogue
semaglutide intended for once-weekly
subcutaneous treatment.
GELA
NN9505
Obesity A collaboration with GE Healthcare,
using ultrasound for once-monthly
treatment.
INV-202
NN9440
Obesity A CB-1
6
receptor inverse agonist
intended for once-daily oral
treatment.
Amycretin
NN9487
Obesity A long-acting co-agonist of GLP-1 and
amylin intended for once-weekly
subcutaneous treatment or once-daily
oral treatment.
OW GLP-1 GIP
NN9541
Obesity A combination of GLP-1 and GIP
co-agonist intended for once-weekly
subcutaneous treatment.
Project Indication Description Phase
Concizumab
NN7415
Haemophilia
A or B
w/wo
inhibitors
A monoclonal antibody against tissue
factor pathway inhibitor (TFPI)
intended for subcutaneous
prophylaxis treatment.
Nedosiran
NN7022
Primary
hyperoxaluria
type 1
An siRNA targeting lactate
dehydrogenase A (LDHA) intended for
once-monthly subcutaneous
treatment.
Mim8
NN7769
Haemophilia
A w/wo
inhibitors
A next generation FVIIIa mimetic
bispecific antibody intended for
subcutaneous prophylaxis of
haemophilia A.
Etavopivat
NN7535
Sickle cell
disease
A second-generation small molecule
PKR-activator intended for once-daily
oral treatment.
Etavopivat
NN7536
Thalassemia A second-generation small molecule
PKR-activator intended for once-daily
oral treatment.
Etavopivat
NN7537
MDS
7
A second-generation small molecule
PKR-activator intended for once-daily
oral treatment.
NDec
NN7533
Sickle cell
disease
An oral combination of decitabine and
tetrahydrouridine. Project is developed
in collaboration with EpiDestiny.
Project Indication Description Phase
Ziltivekimab
NN6018
CKD
8
+
ASCVD
9
A once-monthly monoclonal antibody
intended for inhibition of IL-6
10
activity.
Ziltivekimab
NN6018
HFpEF
11
A once-monthly monoclonal antibody
intended for inhibition of IL-6 activity.
Ocedurenone
NN6023
CVD
12
A small molecule, non-steroidal
mineralocorticoid receptor antagonist
(nsMRA) intended for oral treatment.
ATTR-CM
NN6019
CVD An anti-amyloid immunotherapy
intended for intravenous treatment.
CM4HF
NN9003
CVD An investigational cell therapy
intended for restoring heart function
in people with chronic heart failure.
Anti-ANGPTL3
mAb
NN6491
CVD An ANGPTL3 neutralising sweeping
antibody intended for once-monthly
subcutaneous treatment.
Semaglutide
NN6535
Alzheimer’s A long-acting GLP-1 analogue
intended for once-daily subcutaneous
treatment.
Semaglutide
NN9931
MASH
13
A long-acting GLP-1 analogue
intended for once-weekly
subcutaneous treatment.
CagriSema
NN9588
MASH A combination of amylin analogue
cagrilintide and GLP-1 analogue
semaglutide intended for once-weekly
subcutaneous treatment.
FGF21
NN9500
MASH A long-acting FGF21 analogue
intended for once-weekly
subcutaneous treatment.
LXRa
NN6582
MASH An siRNA targeting LXRa intended for
once-monthly subcutaneous
treatment.
MARC1
NN6581
MASH An siRNA targeting MARC1 intended
for once-monthly subcutaneous
treatment.
VAP-1i
NN6561
MASH A VAP-1 inhibitor intended for
once-daily oral treatment.
SC4PD
NN9001
Parkinson’s A cryopreserved cell therapy intended
for disease modifying treatment.
STAT3
NN4002
Oncology A GalXC-derived lipid conjugate
one-time subcutaneous treatment.
1. HD: High Dose. 2. T2D: Type 2 diabetes. 3. GLP-1: Glucagon-like peptide-1. 4. T1D: Type 1 diabetes. 5. GIP: Gastric inhibitory polypeptide. 6. CB-1: Cannabinoid receptor-1. 7. MDS: Myelodysplastic syndromes. 8. CKD: Chronic kidney disease.
9. ASCVD: Atherosclerotic cardiovascular disease. 10. IL-6: Interleukin-6. 11. HFpEF: Heart failure with preserved ejection fraction. 12. CVD: Cardiovascular disease. 13. MASH: Metabolic dysfunction-associated steatohepatitis.
Phase 1 Phase 2 Phase 3 Submission and/or approval
2022 2023
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 27
RARE DISEASEOBESITYDIABETES CARDIOVASCULAR & EMERGING THERAPY AREAS
Research and development progress
Regulatory events
• Rybelsus
®
(oral semaglutide) was approved as first-line
treatment option by the FDA.
• Results from Rybelsus
®
(oral semaglutide) formulation
change and PIONEER PLUS were submitted to the EMA.
• Marketing authorisation application was submitted to the EMA,
FDA, CDE and PMDA for approval of insulin icodec for treatment
of both type 1 diabetes (T1D) and type 2 diabetes (T2D).
• Marketing authorisation application was submitted to the
EMA for the approval of dasiglucagon for treatment of
severe hypoglycaemia.
Clinical progress
• Phase 3b trial, PIONEER PLUS, investigating 25.0 and 50.0 mg
oral semaglutide in patients with T2D was completed.
• Phase 3b trial, ASCEND PLUS, investigating oral semaglutide
in patients with T2D and no history of prior myocardial
infarction (MI) or stroke was initiated.
• Phase 3b kidney outcomes trial, FLOW, investigating
subcutaneous once-weekly semaglutide 2.4 mg in people
with T2D and chronic kidney disease (CKD) was stopped early
based on interim analysis due to efficacy.
• Phase 3a programme, REIMAGINE, investigating once-weekly
combination of semaglutide and cagrilintide in people with
T2D was initiated.
• Phase 2 trial investigating the combination of semaglutide
and GIP in people with diabetes was completed. The project
was terminated.
• Phase 1 trial investigating the effects of the combination of
semaglutide and SGLT2i inhibitor dapagliflozin in people with
T2D was completed. The project was terminated.
• Phase 1 trial investigating the SOMA device for oral treatment
was completed.
• Phase 1 trial investigating oral GLP-1/GIP co-agonist for
treatment of T2D was completed. Novo Nordisk is planning to
initiate a phase 2 trial with a subcutaneous formulation of the
GLP-1/GIP co-agonist.
Regulatory events
• Wegovy
®
(semaglutide 2.4 mg) was approved for treatment
of obesity in adolescents by the EMA.
• Wegovy
®
(semaglutide 2.4 mg) was approved as an adjunct
to diet and exercise for the use of weight management in
adults with obesity by the PMDA.
• Results from the phase 3b cardiovascular outcomes trial
(CVOT) SELECT were submitted to the FDA and the EMA.
Clinical progress
• Phase 3b CVOT trial, SELECT, investigating subcutaneous
once-weekly semaglutide 2.4 mg was completed.
• Phase 3a trial, STEP HFpEF, investigating subcutaneous
once-weekly semaglutide 2.4 mg in people with HFpEF
was completed.
• Phase 3a trial, OASIS 1, investigating oral semaglutide in
people with obesity was completed.
• Phase 1/2 investigating NNC0165-1875 in combination
with semaglutide in people with obesity was completed.
The project was terminated.
• Novo Nordisk acquired Inversago Pharma, with lead assets
INV-202 (a phase 2 ready asset for treatment of obesity) and
INV-347 (a phase 1 ready asset for treatment of obesity).
Regulatory events
• Marketing authorisation application was submitted to the
EMA for the approval of concizumab for treatment of
haemophilia A or B with inhibitors.
• A Complete Response Letter requesting further information
was received from the FDA as a response to the concizumab
marketing authorisation application.
• Alhemo
®
(concizumab) was approved for the treatment of
haemophilia A or B with inhibitors by the PMDA.
• Sogroya
®
(somapacitan) was approved for treatment of
growth hormone deficiency in children by the FDA, EMA
and PMDA.
• Rivfloza
TM
(nedosiran) was approved for the treatment of
primary hyperoxaluria type 1 by the FDA.
Clinical progress
• Etavopivat transitioned from phase 2 to phase 3 trial in the
ongoing seamless phase 2/3 HIBISCUS trial, investigating the
safety and efficacy of etavopivat in adults and adolescents
with sickle cell disease.
Clinical progress
• Phase 3a trial, HERMES, investigating ziltivekimab in
people with HfpEF was initiated.
• Novo Nordisk acquired ocedurenone, a phase 3 oral
administrated small molecule, non-steroidal
mineralocorticoid receptor antagonist for treatment of
patients with uncontrolled hypertension and advanced CKD.
• Phase 1/2 trial investigating the ability of cell therapy HS-001
to restore heart function in people with advanced heart
failure was initiated in collaboration with Heartseed.
• Phase 1 trial investigating ANGPTL3 mAb in people with
cardiovascular disease was initiated.
• Phase 1 trial investigating the ability of cell therapy
STEM-PD to restore dopamine nerve cells lost in the brain
of people with Parkinson’s was initiated in collaboration
with Lund University.
• Phase 1 trial investigating STAT3 in people with tumour-
associated immune cells was initiated.
• Phase 1 trial investigating VAPi-1 in people with MASH
was initiated.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 28
Patent status for products with marketing authorisation
Product US China Japan Europe
2
Human insulin
and Modern
insulins
3
Expired Expired Expired Expired
Victoza
®4
Expired Expired Expired Expired
Tresiba
®
2029 2024 2027 2028
Ryzodeg
®
2029 2024 2024
5
2028
Xultophy
®
2029 2024 2024
5
2028
Fiasp
®
2030
6
2030
6
2030
6
2030
6
Ozempic
®
2032 2026 2031 2031
Rybelsus
®
2032 2026 2031 2031
Product US China Japan Europe
2
Saxenda
®
Expired Expired Expired Expired
Wegovy
®
2032 2026 2031 2031
Product US China Japan Europe
2
Norditropin
®
(SimpleXx
®
)
Expired Expired Expired Expired
NovoSeven
®
Expired Expired Expired Expired
NovoEight
®
No
patent
No
patent
No
patent
No
patent
Refixia
®
(REBINYN
®
)
2028 2027 2032 2027
Esperoct
®
2032 2029 2034 2034
Vagifem
®
10 mcg
Expired No
patent
Expired Expired
The patent expiry dates for products marketed by
Novo Nordisk
1
are shown in the tables on the right.
The dates provided are for expiry in the US, China,
Japan and Europe of patents on the active ingredient,
unless otherwise indicated, and include actual
and estimated extensions of patent term, when
applicable. For several products, in addition to the
active ingredient patent, Novo Nordisk holds other
patents on manufacturing processes, formulations
or uses that may be relevant for exclusivity beyond
the expiration of the active ingredient patent.
Furthermore, regulatory data protection and/or
orphan exclusivity may apply.
1. This overview does not include products whose sales represent less than 0.5% of Novo Nordisk’s total sales. 2. Patent status varies from country to country. The figures in the table are based on Germany. 3. Modern insulins are NovoRapid
®
(NovoLog
®
), NovoMix
®
30 (NovoLog
®
Mix 70/30), Levemir
®
. 4. We have granted and pending patents
covering the Victoza
®
formulation. These patents generally expire in November 2024, except for the US where the formulation patent expires in February 2026. 5. Patent term extension until 2027 may apply. 6. Formulation patent; active ingredient patent has expired.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 29
Our centenary year has been characterised by extraordinary
growth, driven by surging global demand for our medicines.
Faced with these unprecedented circumstances, we have
reshaped our commercial execution strategy to best serve
the record number of patients who rely on our medicines.
By ensuring supply for patients in the greatest need while
continuing to bring innovation to people living with serious
chronic diseases all over the world, we aim to balance our
financial and societal responsibilities.
Finding parity between the value we create and the values
we aspire to has required some radical changes to normal
commercial practices, along with a different mindset among
sales staff. In many ways, we have rewritten the traditional
rulebook for product launches by placing greater focus on the
equitable distribution of limited supplies between different
geographies and patient groups.
Our top priority is that patients currently on Novo Nordisk
medicines continue to have uninterrupted access to an
appropriate treatment option. We are also focusing on introducing
new treatments to new markets in a more measured way, aligned
with our unwavering commitment to deliver innovation to as
many patients across the globe as possible.
At the same time, we are investing heavily in new and upgraded
production facilities in Denmark and other countries, increasing our
capacity to meet current and future demand for our treatments and
laying the foundation for sustainable long-term growth.
These investments include a record DKK 42 billion expansion of
our flagship production site in Kalundborg, Denmark, which is
already producing half of the world’s entire supply of insulin.
Outside of Denmark, we are more than doubling the production
footprint of our long-established facilities in Chartres, France,
with investments totalling DKK 17 billion. Both projects will
include state-of-the-art, multi-product facilities to accommodate
current and future products and processes.
With construction under way on these major expansion projects,
we strive to operate our facilities across the globe 24/7. In the
past year, we have delivered more products to more patients
than ever before, but such is the scale of demand that we expect
periodic supply constraints to continue into 2024.
COMMERCIAL EXECUTION
Stepping up to serve more patients
in the face of unprecedented demand
STRATEGIC ASPIRATIONS 2025
1. Strengthen diabetes leadership
– aim at global value market
share of more than 1/3
2. More than DKK 25 billion in
Obesity sales by 2025
3. Secure a sustained growth
outlook for Rare Disease
Demand for Novo Nordisk
medicines is soaring, driven by a
global obesity epidemic and
exceptional growth in the GLP-1
market. This has resulted in a record
number of people being treated
with our medicines, but also supply
constraints. In response, we are
significantly ramping up production
capacity and have introduced clear
prioritisation principles to ensure
broad and equitable distribution of
our products.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 30
Strengthening diabetes leadership
with strong GLP-1-based product growth
We have extended our leadership in diabetes care and
increased our value market share by 1.9 percentage points
to 33.8% in 2023, fuelled by strong uptake of the GLP-1-based
products Ozempic
®
and Rybelsus
®
in both North America and
International Operations.
Ozempic
®
is now the world’s biggest-selling diabetes medicine.
Available as a once-weekly injection, it is contributing to a
major shift in treatment for type 2 diabetes. At the same time,
our oral GLP-1-based therapy, Rybelsus
®
, is gaining ground by
offering patients with type 2 diabetes an intervention without
injections. Demand for these two products has grown to
unprecedented levels, helping to generate record sales growth
despite supply constraints and a decline in demand for the
first-generation GLP-1-based product Victoza
®
.
Although competition is increasing, Novo Nordisk remains
the market leader in the GLP-1 market with a value share of
54.8%, broadly steady compared to 2022 where our value
share stood at 54.9%.
The high demand for our GLP-1-based medicines is partly
fuelled by a growing understanding of the importance of the
class among healthcare professionals, patients and payers.
This includes a recognition that certain GLP-1-based therapies
are not only highly effective options for controlling blood
sugar levels, but may also offer significant benefits in terms
of reducing weight and cardiovascular risks – positive effects
now reflected in international treatment guidelines.
Despite declining sales of insulin in key markets, reflecting
both pricing pressures and lower volumes in some
geographies, Novo Nordisk’s insulin value market share
remains little changed from 12 months earlier, at 43.9%,
compared to 44.6% in 2022.
Across International Operations, insulin is still an important
and growing segment, although insulin sales in China have
been adversely impacted since the introduction of Volume
Based Procurement in mid-2022. The US has also experienced
a decline in overall volumes and a decrease in realised prices
due to channel / payer mix and higher rebates.
Nevertheless, in a global diabetes market driven by high
GLP-1 growth, we are uniquely positioned to maintain and
strengthen our leadership in this sector and have already
met our target of securing value market share of at least
one-third by 2025.
DIABETES VALUE MARKET SHARE (%)
GLP-1
Insulin
Total diabetes
60
50
40
30
20
29.3%
44.3%
50.4%
30.1%
43.8%
52.7%
31.9%
44.6%
54.9%
33.8%
43.9%
54.8%
DIABETES SALES (DKK billion)
Sales as reported Growth at CER
200
160
120
80
40
0
8%
2020
13%
2021
29%
2023
14%
2022
2020
2021 20232022
Source: IQVIA MAT, Nov 2023.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 31
Controlled launches for
market-leading obesity therapy
Surging demand, limited supply and unprecedented global
media attention on our ground-breaking obesity treatment,
Wegovy
®
, have brought significant challenges – as well as
exciting long-term opportunities.
Demand for Wegovy
®
is still growing strongly in the US, its first
launch market, and we have taken proactive steps to conduct
controlled and limited roll-outs in other major markets, with the
goal of reaching the patients in greatest need of the therapy
despite ongoing supply constraints.
In the UK, for example, Wegovy
®
is now available in specialist
National Health Service weight management services for people
who meet strict criteria, or else privately through a registered
healthcare professional. UK physicians are being urged to
prescribe responsibly and Novo Nordisk is also reserving a share
of Wegovy
®
supply in each new launch market for patients who
cannot afford to pay for the product out of pocket.
The success of Wegovy
®
, which builds on our experience with
our first-generation GLP-1-based obesity product Saxenda
®
,
means that Novo Nordisk has captured most of the growth and
gained a clear leadership position in the obesity market. The
sector remains extremely dynamic, with new players lining up to
enter the space amid a growing appreciation that medicines
tackling obesity have the potential to boost public health and
cut long-term healthcare costs.
Globally, the number of people living with obesity has almost
tripled since 1975 and is set to reach over 1.2 billion adults by
2030. The causes of obesity are complex and its consequences
far-reaching because, so often, it puts people on a path to other
diseases – not only diabetes, but also heart and liver diseases,
cancers and many more.
Today, only one in 10 people living with obesity seek
professional medical help – and only one in five of those receive
treatment with a weight management medication. But attitudes
are changing fast. The past two years have been characterised
by a growing understanding among both the medical
community and the public of the critical need to treat obesity,
while an increasing number of people living with the disease are
actively seeking support. We want to understand more about
their journey and how we can continue to help them maintain
their long-term progress towards better health.
“Novo Nordisk is also reserving a share of
Wegovy
®
supply in each new launch
market for patients who cannot afford to
pay for the product out of pocket.”
GLOBAL PREVALENCE OF OBESITY IN ADULTS (millions)
Obesity
Source: Obesity Atlas, 2023.
2,000
1,600
1,200
800
400
0
813
1,007
1,246
1,532
OBESITY SALES (DKK billion)
Sales as reported Growth at CER
50
40
30
20
10
0
3%
2020
55%
2021
154%
2023
84%
2022
2020
2025 20352030
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 32
PRODUCTION
Targeting sustainable growth
in Rare Disease
Expanding our production
capacity to meet demand
Tackling the supply problems that prevent us
from meeting the growing demand for our
products is a top priority for Novo Nordisk. We
know we must do more to ramp up capacity, and
our colleagues in production are working around
the clock to get additional supplies onto
pharmacy shelves and into the hands of patients.
In the past year we have announced investments
totalling more than DKK 75 billion into expanding
capacity across our global network of production
sites – including major expansions of our facilities
in Kalundborg, Denmark, and Chartres, France,
and the acquisition of a brownfield development
and production site in Athlone, Ireland. There are,
however, limits to how rapidly we can translate
these investments into making more medicines
that are ready for shipment. Pharmaceutical
production must adhere to the highest possible
standards, and we will never compromise on
safety and quality for the sake of speed. In the
meantime, we strive to operate our global
manufacturing facilities 24/7 to maximise output
from the current production base.
We are also thinking strategically about ways to
remove bottlenecks in the supply chain. For
example, we are seeking to alleviate pressure on
device supplies by introducing our medicines in
once-weekly rather than daily formulations, and
we are exploring ways to reduce the reliance on
single-use injection devices.
Our Rare Disease unit had a challenging year,
with sales decreasing by 15% as Norditropin
®
,
our long-established treatment for growth
disorders, was impacted by supply constraints
due to a temporary reduction in manufacturing
output. Sales of rare blood disorder products,
meanwhile, were up 1% as a decline in NovoSeven
®
and NovoEight
®
sales was offset by growing
demand for our newer haemophilia A and B
therapies, Esperoct
®
and Refixia
®
.
Despite the challenges encountered this year, we
remain confident that our rich pipeline in rare
disease can bring growth back on track. The
line-up of new therapies includes significant
advances in both rare blood and endocrine
disorders. Next-generation treatments –
including Mim8 and Alhemo
®
in haemophilia –
will add to growth in the medium term, while
accelerated internal innovation and external
business development will help us to build our
presence in other rare disease areas of high
unmet need, such as sickle cell disease.
In the rare endocrine space, our once-weekly
treatment Sogroya
®
offers a new opportunity for
people living with growth hormone deficiency by
removing the burden of daily injections and
offering demonstrated efficacy.
RARE DISEASE SALES (DKK billion)
Sales as reported Growth at CER
CAPEX INVESTMENTS (DKK billion)
CapEx
CapEx to sales ratio
25
20
15
10
5
0
30
24
18
12
6
0
4%
-15%
1%
1%
2020 2020
2021 20212023 20232022 2022
7%
11%
4%
5%
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 33
Financial performance
Sales increased by 31% measured in Danish kroner and by 36% at CER
to DKK 232,261 million in 2023. Novo Nordisk’s 2023 sales and operating
profit performance measured at CER were within the ranges provided in
November 2023. The free cash flow, effective tax rate, capital expenditure
as well as depreciation, amortisation and impairment losses were all in
line with the guidance.
Geographic sales development
Sales in North America Operations increased by 50% measured in
Danish kroner and by 54% at CER.
Sales in International Operations increased by 11% measured in Danish
kroner and by 16% at CER. Sales in EMEA increased by 15% measured in
Danish kroner and by 17% at CER. Sales in Region China increased by 3%
measured in Danish kroner and by 11% at CER. Sales in Rest of World
increased by 11% measured in Danish kroner and by 15% at CER.
Sales development across therapeutic areas
Sales in Diabetes care increased by 24% measured in Danish kroner and
by 29% at CER. Sales of Obesity care products, Wegovy
®
and Saxenda
®
,
increased by 147% measured in Danish kroner and by 154% at CER.
Sales of Rare disease products decreased by 16% measured in Danish
kroner and by 15% at CER.
In the following sections, unless otherwise noted, market data are based
on moving annual total (MAT) from November 2022 and November 2023
provided by the independent data provider IQVIA.
FINANCIALS
2023 performance
and 2024 outlook
Diabetes care
Sales in Diabetes care increased by 24% measured in Danish kroner and
by 29% at CER to DKK 173,466 million driven by growth of GLP-1-based
products. Novo Nordisk has improved the global diabetes value market
share over the last 12 months to 33.8% from 31.9%.
The market share increase was driven by market share gains in both
North America Operations and International Operations.
GLP-1-based therapy for type 2 diabetes
Sales of GLP-1-based products for type 2 diabetes (Rybelsus
®
, Ozempic
®
and Victoza
®
) increased by 48% measured in Danish kroner and by 52%
at CER to DKK 123,132 million. The estimated global GLP-1 share of total
diabetes prescriptions has increased to 6.0% compared with 4.5% 12
months ago. Novo Nordisk continues to be the global market leader in
the GLP-1 segment with a 54.8% value market share.
Rybelsus
®
sales increased by 66% measured in Danish kroner and by
71% at CER to DKK 18,750 million. Sales growth was driven by North
America Operations as well as EMEA and Rest of World.
Ozempic
®
sales increased by 60% measured in Danish kroner and by
66% at CER to DKK 95,718 million. Sales growth was driven by both
North America Operations and International Operations. Sales growth
STRATEGIC ASPIRATIONS 2025
1. Deliver solid sales and operating profit growth
2. Drive operational efficiencies across the value chain to enable
investments in future growth assets
3. Deliver free cash flow to enable attractive capital allocation
to shareholders
FINANCIAL PERFORMANCE (DKK billion)
North America Operations net sales International Operations net sales
Growth at CER
300
250
200
150
100
50
0
7%
14%
36%
16%
2020 2021 20232022
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 34
Rare Disease
Sales of Rare Disease products decreased by 16% measured in Danish
kroner and by 15% at CER to DKK 17,163 million.
Rare blood disorders
Sales of Rare blood disorder products increased by 1% measured in
Danish kroner and by 3% at CER to DKK 11,776 million driven by the
extended half-life products in haemophilia B and A, partially countered
by NovoSeven
®
.
Rare endocrine disorders
Sales of Rare endocrine disorder products decreased by 46% measured
in Danish kroner and by 47% at CER to DKK 3,836 million reflecting
a reduction in manufacturing output. Novo Nordisk is working on
re-establishing supply of rare endocrine disorder products. Sogroya
®
has now been launched in five countries, and the initial feedback from
patients and physicians is encouraging. Novo Nordisk has a value market
share of 19.3% (MAT) in the global human growth disorder market.
Development in costs and operating profit
The cost of goods sold increased by 26% measured in Danish kroner
and by 28% at CER to DKK 35,765 million, resulting in a gross margin
of 84.6% measured in Danish kroner compared with 83.9% in 2022.
The increase in gross margin reflects a positive product mix, driven by
increased sales of GLP-1-based treatments. This is partially countered
by costs related to ongoing capacity expansions, a negative currency
impact and lower realised prices mainly in the US and Region China.
Sales and distribution costs increased by 23% measured in Danish
kroner and by 26% at CER to DKK 56,743 million. The increase in costs is
driven by both North America Operations and International Operations.
In North America Operations, the cost increase is driven by the relaunch
of Wegovy
®
and promotional activities for Ozempic
®
. In International
Operations, the increase is mainly related to promotional activities for
Rybelsus
®
as well as Obesity care market development activities.
The increase in sales and distribution costs is impacted by adjustments
to legal provisions.
Research and development costs increased by 35% measured in Danish
kroner and by 37% at CER to DKK 32,443 million reflecting increased
late-stage clinical trial activity and increased early research activities
compared to 2022. The acquisition of Forma Therapeutics Inc. in 2022
and Inversago Pharma also increased R&D spending.
Administration costs increased by 9% measured in Danish kroner and
by 11% at CER to DKK 4,855 million.
Other operating income and expenses (net) was DKK 119 million
compared with DKK 1,034 million in 2022, mainly driven by lower income
from partnerships related to Dicerna Pharmaceuticals Inc.
Operating profit increased by 37% measured in Danish kroner and
by 44% at CER to DKK 102,574 million reflecting the sales growth.
has resulted in periodic supply constraints and related drug shortage
notifications across geographies.
Victoza
®
sales decreased by 30% measured in Danish kroner and by 28%
at CER to DKK 8,664 million as the GLP-1 market is moving towards once-
weekly and tablet-based treatments. The sales decline was mainly driven
by North America Operations.
Insulin sales
Sales of insulin decreased by 9% measured in Danish kroner and
by 6% at CER to DKK 48,022 million. Sales decline at CER was driven by
declining sales in the US and Region China.
Obesity care
Sales of Obesity care products, Wegovy
®
and Saxenda
®
, increased by 147%
measured in Danish kroner and by 154% at CER to DKK 41,632 million. Sales
growth was driven by both North America Operations and International
Operations. Wegovy
®
has now been launched in the US, Denmark, Norway,
Germany, the UK, Iceland, Switzerland and the United Arab Emirates. The
volume growth of the global branded obesity market was 116% in 2023.
OPERATING PROFIT AND MARGIN (DKK billion)
Operating profit (left axis)
Operating profit margin (right axis)
Growth at CER
125
100
75
50
25
0
100%
80%
60%
40%
20%
0%
7%
2020
13%
2021
44%
2023
15%
2022
SALES BY THERAPEUTIC AREA (DKK billion)
Diabetes care Obesity care Rare Disease
Growth at CER
300
250
200
150
100
50
0
7%
14%
36%
16%
2020 2021 20232022
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 35
CASH FLOW AND CAPITAL ALLOCATION (DKK billion)
Dividend for prior year Interim dividend Share repurchases
70
60
50
40
30
20
10
0
Financial items (net) and tax
Financial items (net) showed a net gain of DKK 2,100 million compared
with a net loss of DKK 5,747 million in 2022, reflecting gains on hedged
currencies, primarily in US dollar.
In line with Novo Nordisk’s treasury policy, the most significant foreign
exchange risks for Novo Nordisk have been hedged, primarily through
foreign exchange forward contracts. The foreign exchange result was a gain
of DKK 1,652 million compared with a net loss of DKK 4,651 million in 2022.
As per the end of December 2023, a positive market value of financial
contracts of approximately DKK 1.6 billion has been deferred for
recognition in 2024.
The effective tax rate was 20.1% in 2023 compared with an effective
tax rate of 19.6% in 2022.
Net profit increased by 51% to DKK 83,683 million and diluted earnings
per share increased by 52% to DKK 18.62.
Cash flow and capital allocation
Free cash flow realised in 2023 was DKK 68.3 billion compared with
DKK 57.4 billion in 2022 supporting the strategic aspiration to deliver
attractive capital allocation to shareholders. The cash conversion in
2023 is positively impacted by timing of payment of rebates in the US,
including provisions related to the revised 340B distribution policy in
the US. Income under the 340B Program has been partially recognised.
Capital expenditure for property, plant and equipment was DKK 25.8
billion compared with DKK 12.1 billion in 2022, primarily reflecting
investments in additional capacity for active pharmaceutical ingredient
(API) production and fill-finish capacity for both current and future
injectable and oral products. Capital expenditures for intangible assets
was DKK 13.1 billion in 2023 compared with DKK 2.6 billion in 2022
reflecting business development activities.
2024 outlook
Sales growth is expected to be 18% to 26% at CER. Given the current
exchange rates versus the Danish krone, sales growth reported in
DKK is expected to be around 1 percentage point lower than at CER.
The guidance reflects expectations for sales growth in both North
America Operations and International Operations, mainly driven by
volume growth of GLP-1-based treatments for Obesity and Diabetes
care. Intensifying competition and continued pricing pressure within
Diabetes and Obesity Care are included in the guidance.
Following higher than expected volume growth in recent years, including
GLP-1-based products such as Ozempic
®
and Wegovy
®
, combined with the
expectation of continued volume growth and capacity limitations at some
manufacturing sites, the outlook also reflects expected continued periodic
supply constraints and related drug shortage notifications across a
number of products and geographies. Novo Nordisk is investing in internal
and external capacity to increase supply both short and long term. Novo
Nordisk started gradually increasing the supply of the lower dose strengths
of Wegovy
®
in the US in January 2024. A gradual roll-out of Wegovy
®
with
capped volumes in International Operations is included in the guidance.
Operating profit growth is expected to be 21% to 29% at CER. Given the
current exchange rates versus the Danish krone, growth reported in DKK
is now expected to be around 2 percentage points lower than at CER.
The expectation for operating profit growth primarily reflects the sales
growth outlook and continued investments in future and current growth
drivers within Research, Development and Commercial. Within R&D,
investments are related to the continued expansion and progression of
the early and late-stage pipeline. Commercial investments are mainly
related to Obesity care market development activities as well as
increased spend related to GLP-1 diabetes care.
Novo Nordisk now expects financial items (net) to amount to a gain of
around DKK 1.3 billion, mainly reflecting gains associated with foreign
exchange hedging contracts as well as interest gains from cash and
marketable securities.
The effective tax rate for 2024 is expected to be in the range of 19-21%.
Capital expenditure is expected to be around DKK 45 billion in 2024
reflecting the expansion of the supply chain, including the previously
communicated expansions of the manufacturing facilities in Kalundborg
and Hillerød, Denmark, and Chartres, France. The investments in
Kalundborg will create additional capacity across the entire global value
chain from manufacturing of active pharmaceutical ingredients (API) to
packaging, with the majority invested in API capacity. The API facility will
be designed as a multi-product facility with flexibility to accommodate
current and future processes. In Hillerød, the investments will create
additional production capacity of API within Cardiovascular & Emerging
Therapy Areas. The expansion of the production facilities in Chartres are
related to additional aseptic production and finished production
processes. In the coming years, the capital expenditure to sales ratio is
still expected to be low double digit.
Depreciation, amortisation and impairment losses are expected to be
around DKK 10 billion.
20222021 2024E
1
2023
1. Expectations for 2024.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 36
Expectations are as reported,
if not otherwise stated
Expectations
31 January 2024
Sales growth
at CER 18% to 26%
as reported Around 1 percentage point
lower than at CER
Operating profit growth
at CER 21% to 29%
as reported Around 2 percentage points
lower than at CER
Financial items (net) Gain of around DKK 1.3 billion
Effective tax rate 19% to 21%
Capital expenditure (PP&E) Around DKK 45 billion
Depreciation, amortisation and
impairment losses
Around DKK 10 billion
Free cash flow (excluding impact
from business development)
DKK 64-74 billion
The free cash flow is expected to be DKK 64-74 billion reflecting the sales
growth, a favourable impact from rebates in the US countered by
investments in capital expenditure.
All of the above expectations are based on assumptions that the global
or regional macroeconomic and political environment will not
significantly change business conditions for Novo Nordisk during 2024,
including energy and supply chain disruptions, the potential implications
from major healthcare reforms and legislative changes as well as
outcome of legal cases including litigations related to the 340B Drug
Pricing Program in the US, and that the currency exchange rates,
especially the US dollar, will remain at the current level versus the
Danish krone. Neither does the guidance include the financial
implications of any new significant business development transactions
and significant impairments of intangible assets during 2024.
Novo Nordisk has hedged expected net cash flows in a number of
invoicing currencies and, all other things being equal, movements in
key invoicing currencies will impact Novo Nordisk’s operating profit as
outlined in note 4.4 on Financial risks.
Forward-looking statements
Novo Nordisk’s reports filed with or furnished to the US Securities and
Exchange Commission (SEC), including this statutory Annual Report 2023
and Form 20-F, which are both expected to be filed with the SEC in
January 2024 in continuation of the publication of this Annual Report
2023, and written information released, or oral statements made, to
the public in the future by or on behalf of Novo Nordisk, may contain
forward-looking statements. Words such as ‘believe’, ‘expect’, ‘may’,
‘will’, ‘plan’, ‘strategy’, ‘prospect’, ‘foresee’, ‘estimate’, ‘project’, ‘anticipate’,
‘can’, ‘intend’, ‘target’ and other words and terms of similar meaning
in connection with any discussion of future operating or financial
performance identify forward-looking statements. Examples of such
forward-looking statements include, but are not limited to:
• statements of targets, plans, objectives or goals for future operations,
including those related to Novo Nordisk’s products, product research,
product development, product introductions and product approvals
as well as cooperation in relation thereto,
• statements containing projections of or targets for revenues, costs,
income (or loss), earnings per share, capital expenditures, dividends,
capital structure, net financials and other financial measures,
• statements regarding future economic performance, future actions
and outcome of contingencies, such as legal proceedings, and
• statements regarding the assumptions underlying or relating to such
statements.
In this Annual Report 2023, examples of forward-looking statements
can be found under the section related to our ‘Strategic Aspirations’ and
elsewhere. These statements are based on current plans, estimates and
projections. By their very nature, forward-looking statements involve
inherent risks and uncertainties, both general and specific. Novo Nordisk
cautions that a number of important factors, including those described
in this Annual Report 2023, could cause actual results to differ materially
from those contemplated in any forward-looking statements.
Factors that may affect future results include, but are not limited to,
global as well as local political and economic conditions, such as interest
rate and currency exchange rate fluctuations, delay or failure of projects
related to research and/or development, unplanned loss of patents,
interruptions of supplies and production, including as a result of
interruptions or delays affecting supply chains on which Novo Nordisk
relies, shortages of supplies, including energy supplies, product recalls,
unexpected contract breaches or terminations, government-mandated
or market-driven price decreases for Novo Nordisk’s products,
introduction of competing products, reliance on information technology
including the risk of cybersecurity breaches, Novo Nordisk’s ability to
successfully market current and new products, exposure to product
liability and legal proceedings and investigations, changes in
governmental laws and related interpretation thereof, including on
reimbursement, intellectual property protection and regulatory controls
on testing, approval, manufacturing and marketing, perceived or actual
failure to adhere to ethical marketing practices, investments in and
divestitures of domestic and foreign companies, unexpected growth in
costs and expenses, strikes and other labour market disputes, failure to
recruit and retain the right employees, failure to maintain a culture of
compliance, epidemics, pandemics or other public health crises, effects
of domestic or international crises, civil unrest, war or other conflict and
factors related to the foregoing matters and other factors not
specifically identified herein.
For an overview of some, but not all, of the risks that could adversely
affect Novo Nordisk’s results or the accuracy of forward-looking
statements in this Annual Report 2023, reference is made to the overview
of risk factors in ‘Risk management’ of this Annual Report 2023.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 37
77.1%
of votes
22.9%
of votes
71.9%
of capital
Novo Holding A/S
A shares
1,075m shares
23.8% of capital and
75.8% of votes
B shares
3,435m shares
76.2% of capital and
24.2% of votes
Novo Nordisk A/S
28.1%
of capital
100%
OWNERSHIP STRUCTURE
1
Novo Nordisk
Foundation
Institutional and
private investors
39
32
26
3
Unless required by law, Novo Nordisk has no duty and undertakes
no obligation to update or revise any forward-looking statement after
the distribution of this Annual Report 2023, whether as a result of new
information, future events, or otherwise.
Shares and capital structure
Through open and proactive communication, Novo Nordisk aims to
provide the basis for fair and efficient pricing of our shares.
Share capital and ownership
Novo Nordisk’s share capital of DKK 451 million is divided into A and B share
capital. The A and B shares are calculated in units of DKK 0.10, amounting
to 4.51 billion shares. The A share capital, consisting of 1,075 million shares,
has a nominal value of DKK 107,487,200 and the B share capital, consisting
of 3,435 million shares, has a nominal value of DKK 343,512,800. Each A
share of a nominal value of DKK 0.10 carries 100 votes and each B share of
a nominal value of DKK 0.10 carries 10 votes. Novo Nordisk’s B shares are
listed on Nasdaq Copenhagen and on the New York Stock Exchange (NYSE)
as American Depository Receipts (ADRs).
The general meeting has authorised the Board of Directors to distribute
extraordinary dividends, issue new shares in accordance with the Articles
of Association and repurchase shares in accordance with authorizations
granted.
The company’s A shares are not listed and are held by Novo Holdings A/S
2
,
a Danish public limited liability company wholly owned by the Novo
Nordisk Foundation. According to the Articles of Association of the
Foundation, the A shares cannot be divested. Special rights attached to
A shares include pre-emptive subscription rights in the event of an
increase in the A share capital and pre-emptive purchase rights in the
event of a sale of A shares, while B shares take priority for liquidation
proceedings. A shares take priority for dividends below 0.5%, and B
shares take priority for dividends between 0.5 and 5%. However, in
practice, A and B shares receive the same amount of dividend per share.
As of 31 December 2023, Novo Holdings A/S held a B share capital of
a nominal value of DKK 19,018,300. Together with the A shares, Novo
Holdings A/S’s total ownership amounted to a nominal value of
DKK 126,505,500. Novo Holdings A/S ownership is reflected in the
‘Ownership structure’ chart.
There is no complete record of all shareholders; however, based on
available sources of information, as of 31 December 2023 it is estimated
that shares were geographically distributed as shown in the ‘Geographical
split of shareholders’ chart. As of 31 December 2023, the free float of
listed B shares was 92.96% (of which approximately 12.18% are listed as
ADRs), excluding Novo Holdings A/S and Novo Nordisk’s holding of shares.
As of 31 December 2023, Novo Holdings A/S and Novo Nordisk’s holding
of B shares equaled 241,895,054 shares and had a nominal value of DKK
24,189,505. For details about the share capital, see note 4.2 to the
consolidated financial statements.
GEOGRAPHICAL SPLIT OF SHAREHOLDERS
3
(% of share capital)
Denmark
North America
UK
Other
1. Treasury shares are included; however, voting rights of treasury shares cannot be exercised. 2. Novo Holdings A/S’s registered address is Tuborg Havnevej 19, DK-2900 Hellerup, Denmark. 3. Split of shareholders is denoted according to the location of legal deposit-owners.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 38
Capital structure
Novo Nordisk’s Board of Directors and Executive Management consider
that the current capital and share structure of Novo Nordisk serve the
interests of the shareholders and the company well. Novo Nordisk’s
capital structure strategy offers a balance between long-term
shareholder value creation and competitive shareholder return in the
short term.
In 2021, the capital structure was adjusted following Novo Nordisk’s
Eurobond issuance with an aggregate principal amount of EUR 1.3 billion.
In 2022, Novo Nordisk issued Eurobonds in the amount of EUR 1.5 billion.
The total outstanding Eurobonds in 2023 amounted to EUR 2.8 billion.
Dividend policy
The company’s dividend policy applies a pharmaceutical industry
benchmark to ensure a competitive payout ratio for dividend payments,
which are complemented by share repurchase programmes. The final
dividend for 2022 paid in March 2023 was equal to DKK 4.08 per A and
B share of DKK 0.10 as well as for ADRs. The total dividend for 2022 was
DKK 6.20 per A and B share of DKK 0.10, corresponding to a payout ratio
of 50.3%. The 2022 pharma peer group average was 46.5%.
In August 2023, an interim dividend was paid equaling DKK 3.00 per
A and B share of DKK 0.10 as well as for ADRs. For 2023, the Board of
Directors will propose a final dividend of DKK 6.40 to be paid in March
2024, equivalent to a total dividend for 2023 of DKK 9.40 and a payout
ratio of 50.19%. The company expects to distribute an interim dividend
in August 2024. Further information regarding this interim dividend will
be announced in connection with the financial report for the first six
months of 2024. Dividends are paid from distributable reserves. Novo
Nordisk does not pay a dividend on its holding of treasury shares.
Share repurchase programme for 2023/2024
During the twelve-month period beginning 1 February 2023, Novo
Nordisk repurchased shares worth DKK 30 billion. The share repurchase
programme has primarily been conducted in accordance with the safe
harbour rules in the EU Market Abuse Regulation (MAR)
4
.
For the next 12 months, Novo Nordisk has decided to implement a new
share repurchase programme. The expected total repurchase value of B
shares, for the 12 months beginning 2024, amounts to a cash value of
up to DKK 20 billion. The total programme may be reduced in size if
significant business development opportunities arise during 2024. Novo
Nordisk expects to conduct the majority of the new share repurchase
programme according to the safe harbour rules in MAR. At the Annual
General Meeting in March 2024, the Board of Directors will propose a
further reduction in the company’s B share capital, corresponding to
approximately 1.0% of the total share capital, by cancelling 45 million
treasury shares.
Share price development
The Novo Nordisk price of the B share of a nominal value of DKK 0.20 was
end of December 2022 DKK 938.00. Following the two-for-one stock split
in September 2023, the B share price of a nominal value of DKK 0.10 was
end of December 2023 DKK 698.10. The comparable share prices for B
shares with a nominal value of DKK 0.10 were DKK 469.00 and DKK 698.10
at the end of 2022 and 2023 respectively, an increase of 48.8 %. The total
market value of Novo Nordisk’s B shares, excluding treasury shares
and Novo Holdings A/S shares, was DKK 2,229,925,434,103, as of
29 December 2023.
2024 FINANCIAL CALENDAR
Capital Markets Day 2024
7 Mar 2024
Annual General Meeting 2024
21 Mar 2024
Ex-dividend
22 Mar 2024
Record date
25 Mar 2024
Payment, B-shares
26 Mar 2024
Payment, ADRs
2 Apr 2024
Financial statement for the first three months of 2024
2 May 2024
Financial statement for the first six months of 2024
7 Aug 2024
Ex-dividend, B-shares. Ex-dividend and Record date, ADRs
15 Aug 2024
Record date, B-shares
16 Aug 2024
Payment, B-shares
19 Aug 2024
Payment, ADRs
26 Aug 2024
Financial statements for the first nine months of 2024
6 Nov 2024
Financial statement for 2024 and Annual Report 2024
5 Feb 2025
SHARE PRICE PERFORMANCE 2023
Novo Nordisk share price and indexed peers
5
(%)
Novo Nordisk OMXC25 Peer group
6
DKK
800
700
600
500
400
300
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
5. OMXC25 and pharmaceutical industry development have been rebased to Novo Nordisk share price in January
2023. 6. AstraZeneca, Bristol-Meyers, Eli Lilly, GlaxoSmithKline, Lundbeck, Merck, Novartis, Pfizer, Roche and Sanofi.
4. Regulation (EU) 596/2014.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 39
41 Risk management
42 Key operational risks
Risks
Orley Andreasson lives with
obesity. He was bullied in school
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self-control. He is now more
confident about himself and wants
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rapping sessions, Orley talks about
living with obesity and connects with
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a small change in the fight against
fat-shaming.
Watch Orley’s full story here
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 40
To be a sustainable business, we must remain responsive
to evolving expectations and seize strategic opportunities
as they arise. Managing risks rigorously and systematically
is crucial to our ability to create and protect value.
We apply a dual-lensed approach to risk management. This means we
identify and mitigate both operational risks that pose a threat to our
short- to medium-term plans, as well as strategic risks that could reduce
our ability to achieve our corporate strategy over the long term.
Addressing risks in our strategic planning
Scenario and risk-thinking exercises are part of our strategic planning.
They include analyses of market dynamics, as well as impacts from
socioeconomic, environmental, geopolitical and political developments
that present risks or opportunities for our business. Annually, Executive
Management and the Board of Directors review a strategic risk profile.
The main strategic risks are:
Innovation and competition
Novo Nordisk faces a concentration risk with multiple brands being
dependent on the semaglutide compound as the active pharmaceutical
ingredient. To remain competitive in the long term and thereby mitigate
the innovation risk, we invest in internal and external pipeline opportunities
to ensure patients receive improved treatments.
Production capacity and supply chain risks
Demand fluctuations, resource shortages, geopolitical instability, trade
disputes and local manufacturing requirements are all factors that can
pressure global supply chains. Furthermore, expanding production
capacity is complex and associated with a long lead time. Therefore,
planning and management of our production capacity and supply chain
are key to mitigate this risk.
Access and affordability
Access to affordable care is a global issue as healthcare systems struggle
to provide quality care at a sustainable cost, while the burden of chronic
diseases keeps rising. Ensuring access and affordability is a risk and
responsibility Novo Nordisk shares with all involved in healthcare. We
recognise that we cannot defeat chronic diseases alone, but to mitigate
the risk we can accelerate our actions to find solutions in collaboration
with relevant stakeholders.
Digital disruption
New digital technologies could bring new competitors into the
pharmaceutical industry. They also provide an opportunity for us to
deliver more value to our stakeholders and help patients live a life with
fewer limitations. Digital health solutions bring new risks, particularly
regarding data regulation and privacy, as well as potential quality issues.
We strive to monitor and mitigate these risks in close collaboration with
relevant partners.
Environmental impact
Novo Nordisk has an impact on the environment and changes to the
climate could potentially have an impact on Novo Nordisk’s business.
As part of our ‘zero environmental impact’, we assess, monitor and
mitigate these risks throughout our value chain.
Ethics and compliance
Our commitment to ethics and compliance remains at the forefront of all
our operations. Any inability to uphold our ethical standards could lead to
reputational implications, with potential effects on market access and
pricing negotiations. Our values, encapsulated in the Novo Nordisk Way,
guide every decision we make. OneCode, our code of conduct, further
empowers us to conduct our operations responsibly. These guidelines help
us to maintain integrity, thereby enabling us to fulfil our purpose effectively.
Operational risk management process
In the short- to medium-term, we are exposed to risks throughout our
value chain. Some risks are inherent in the pharmaceutical industry,
such as delays or failures of potential late-stage medicines in the R&D
pipeline. Other risks, such as geopolitical instability, supply disruptions
and competitive threats, are familiar to any manufacturing company
with global production. We will not compromise on product quality,
patient safety and business ethics: these are front and centre of our
enterprise-wide risk management set-up. We assess risks as potential
financial loss or reputational damage likelihood.
Executive Management, the Board of Directors and the Audit Committee
review a risk grid of our biggest operational risks every six months. This
grid is based on insights from management teams across the organisation
and includes all types of risks that could cause significant disruptions to the
business over a three-year horizon, including potential ESG risks. An overview
of our key operational risks, along with detailed descriptions, is provided on
the next page. For more information, see our Corporate Governance Report
available at: www.novonordisk.com/about/corporate-governance.html.
Company reputation
On the following page we also include the Novo Nordisk reputation score.
This is measured among key stakeholders (i.e. the informed general
public, people with diabetes, people with obesity, general practitioners
and diabetes specialists) and is an indicator of the extent to which we live
up to society’s expectations.
Risk management
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 41
1
2
3
4
5
6
Key operational risks
KEY OPERATIONAL RISKS (ILLUSTRATIVE)
REPUTATION SCORE
Risk area Description Impact Mitigating actions
1
Research and
Clinical Pipeline
Risks
Findings in clinical activities, regulatory processes or
misjudging of commercial potential, leading to delays
or failure of products in the pipeline.
• Patients would not benefit from innovative treatments.
• Could have an adverse impact on sales, profits and market position.
• Pre-clinical and clinical activities to demonstrate safety
and efficacy.
• Consultations with regulators to review pre-clinical and
clinical findings and obtain guidance on development path.
2
Product Supply,
Quality and
Safety Risks
Higher-than-expected demand or disruption of
product supply due to, e.g. geopolitical instability or
quality issues may compromise product availability,
ultimately impacting patients and representing a lost
commercial opportunity. In addition, there could be
risks related to safety and product liability.
• Product shortages could have potential implications for patients.
• Could jeopardise reputation and license to operate if regulatory
compliance is not ensured.
• Could have an adverse impact on sales, profits and market position.
• Compromised patient safety and exposure to product liability
legal proceedings.
• Significantly expanding global production with multiple
facilities and safety stock to reduce supply risk.
• Planning and management of supply chain.
• Regular quality audits of internal units and suppliers to
document GMP compliance.
• Identification and correction of root causes when issues
are identified. If necessary, products are recalled.
3
Commercialisation
Risks
Competitive pressures, as well as market dynamics
and geopolitical, macroeconomic or healthcare crises
(e.g. pandemics) leading to reduced payer ability and
willingness to pay.
• Market dynamics could impact price levels and patient access.
• Could have an adverse impact on sales, profits and market position.
• Innovation of novel products, clinical trial data and real-world
evidence demonstrate added value of new products.
• Payer negotiations to ensure improved patient access.
• Increased and new access and affordability initiatives.
4
IT Security
Risks
Disruption to IT systems, such as cyber-attacks or
infrastructure failure resulting in business disruption
or breach of data confidentiality.
• Could limit our ability to produce and safeguard product quality.
• Could compromise patients’ or other individuals’ privacy.
• Could limit our ability to maintain operations or limit future business
opportunities if proprietary information is lost.
• Could have an adverse impact on sales, profits and market position.
• Company-wide information security awareness activities.
• Continuity plans for non-availability of IT systems.
• Company-wide internal audit of IT security controls.
• Detection and protection mechanisms in IT systems and
business processes.
5
Financial
Risks
Exchange rate fluctuations (mainly in USD, CNY, JPY
and CAD), disputes with tax authorities and changes
to tax legislation and interpretation.
• Could lead to tax adjustments, fines and higher-than-expected
tax level.
• Could have an adverse impact on sales and profits.
• Hedging for selected currencies.
• Integrated treasury management.
• Applicable taxes paid in jurisdictions where business activity
generates profits and multi-year Advance Pricing Agreements
with tax authorities.
6
Legal, Patents
and Compliance
Risks
Breach of legislation, industry codes or company
policies. Competitors asserting patents against
Novo Nordisk or challenging patents critical for
protection of commercial product and
pipeline candidates.
• Potential exposure to investigations, criminal and civil sanctions
and other penalties.
• Could compromise our reputation and the rights and integrity
of individuals involved.
• Unexpected loss of exclusivity for, or injunctions against, existing
and pipeline products could have an adverse impact on future sales.
• Could have an adverse impact on sales, profits and market position.
• Legal review of key activities.
• Code of Conduct integrated in our business.
• Compliance Hotline in place.
• Internal Audit of compliance with business ethics standards.
• Internal controls to minimise vulnerability to patent
infringement and invalidity actions.
HighLow
High
Impact
Likelihood
82.1
0.2
We achieved a reputation score
of 82.1 points in 2023 measured
on a scale of 0-100 (0.2 down from
2022). Stable with last year, Novo
Nordisk continues to lead our
selected industry benchmarks. This
excellent reputation score is driven
by positive perceptions of our
products and services, the most
important reputation component,
and growing appreciation from the
informed general public.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 42
42 Board of Directors
45 Executive Management
Management
Banin Mahdi (left) and Anusha
Samia (right) met three years ago
through Pannahouse, a hub in
Copenhagen where young people
gather weekly to play ‘panna’ – an
increasingly popular type of street
football. Before joining Pannahouse,
Banin spent most of the time on
her phone or watching TV, while
Anusha described herself as shy.
They are now confident, willing to
show their true selves and motivated
to help others. The two girls stress
how impactful these initiatives are:
offering young people alternatives to
hanging out on the street, building
community and keeping body and
mind healthy. As they say, it is always
more than just football.
Watch Pannahouse’s full story here
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 43
Board of Directors
Henrik Poulsen
Vice chair
Danish. Born September 1967. Male.
Member since 2021. Term 2024. Chair
of the Remuneration Committee and
member of the Audit Committee and
the Chair Committee.
Positions and management duties:
Chair of the supervisory board, chair of
the nomination committee and member
of the remuneration committee of
Carlsberg A/S. Chair of the board of
directors and chair of the nomination &
remuneration committee at Faerch A/S.
Member of the board of directors of
Novo Holdings A/S. Member of the
supervisory board of Bertelsmann SE &
Co. KGaA. Senior advisor to A.P. Møller
Holding A/S.
Competencies:
Global corporate leadership; finance and
accounting; business development, M&A
and external innovation sourcing; human
capital management; environmental,
social and governance (ESG).
Helge Lund
Chair
Norwegian. Born October 1962. Male.
Member since 2017
1
. Term 2024. Chair
of the Nomination Committee and the
Chair Committee.
Positions and management duties:
Chair of the board of directors and
chair of the people & governance
committee of BP p.l.c. Chair of the board
of directors of Inkerman AS. Member of
the board of directors and member of
the remuneration committee of Belron
SA. Member of the board of directors of
P/F Tjaldur. Operating advisor to Clayton
Dubilier & Rice. Member of the board of
trustees of the International Crisis Group.
Competencies:
Global corporate leadership; healthcare
and pharma industry; finance and
accounting; business development, M&A
and external innovation sourcing; human
capital management; environmental,
social and governance (ESG).
Elisabeth Dahl Christensen
Danish. Born November 1965. Female.
Member since 2022. Term 2026.
Employee representative. Member
of the Remuneration Committee.
Positions and management duties:
Full-time union representative at
Novo Nordisk A/S.
Competencies:
Not mapped for employee
representatives.
Laurence Debroux
French. Born July 1969. Female. Member
since 2019. Term 2024. Chair of the
Audit Committee and member of the
Remuneration Committee.
Positions and management duties:
Member of the board of directors, chair
of the audit committee and member of
the ESG committee of Exor N.V. Member
of the supervisory board and member
of the audit committee of Randstad N.V.
Member of the board of directors of
HEC Paris Business School and of Kite
Insights (The Climate School).
Competencies:
Global corporate leadership; healthcare
and pharma industry; finance and
accounting; business development, M&A
and external innovation sourcing; human
capital management; environmental,
social and governance (ESG).
Andreas Fibig
German. Born February 1962. Male.
Member since 2018. Term 2024.
Member of the Research & Development
Committee.
Positions and management duties:
Member of the board of directors of
Indigo Agriculture Inc., Evodiabio ApS
and ExlService Holdings, Inc. Honorary
director of the German American
Chamber of Commerce.
Competencies:
Global corporate leadership; healthcare
and pharma industry; technology, data
and digital; finance and accounting;
business development, M&A and
external innovation sourcing; human
capital management; environmental,
social and governance (ESG).
Sylvie Grégoire
Canadian and American. Born November
1961. Female. Member since 2015. Term
2024. Member of the Audit Committee,
the Research & Development Committee
and the Nomination Committee.
Positions and management duties:
Co-founder and chair of the board of
directors of CervoMed, Inc. Member of
the board of directors and member of
the nominating & corporate governance
committee and the compensation
& benefits committee of Revvity Inc.
Member of the board of directors of
F2G Ltd. Advisor to the Soffinova
Telethon Fund.
Competencies:
Global corporate leadership; healthcare
and pharma industry; medicine and
science; finance and accounting;
business development, M&A and
external innovation sourcing; human
capital management.
1. Helge Lund was also a member of the Board of Directors for one one-year term from 2014-2015.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 44
Liselotte Hyveled
Danish. Born January 1966. Female.
Member since 2022
2
. Term 2026.
Employee representative. Member of the
Research & Development Committee.
Positions and management duties:
Chief patient officer and principal vice
president of Patient Voice Strategy &
Alliances, Novo Nordisk A/S.
Competencies:
Not mapped for employee
representatives.
Mette Bøjer Jensen
Danish. Born December 1975. Female.
Member since 2018. Term 2026.
Employee representative. Member
of the Audit Committee.
Positions and management duties:
Wash & Sterilisation specialist in
Product Supply, Novo Nordisk A/S.
Competencies:
Not mapped for employee
representatives.
Kasim Kutay
British. Born May 1965. Male. Member
since 2017. Term 2024. Member of
the Nomination Committee and the
Research & Development Committee.
Positions and management duties:
CEO of Novo Holdings A/S. Member
of the board of directors and member
of the nomination and remuneration
committee of Novozymes A/S.
Competencies:
Global corporate leadership; healthcare
and pharma industry; finance and
accounting; business development,
M&A and external innovation sourcing;
human capital management.
Christina Law
Chinese. Born January 1967. Female.
Member since 2022. Term 2024.
Member of the Audit Committee.
Positions and management duties:
Group CEO of Raintree Group of
Companies. Member of the board of
directors of Raintree Group Limited,
Raintree Investment Pte Ltd. and Air
Liquide S.A. Member of the board of
directors and member of the nomination
and compensation committee of
INSEAD Business School. Member of the
board of directors of La Fondation des
Champions.
Competencies:
Global corporate leadership; technology,
data and digital; business development,
M&A and external innovation sourcing;
human capital management.
Martin Mackay
American and British. Born April 1956.
Male. Member since 2018. Term 2024.
Chair of the Research & Development
Committee and member of the
Remuneration Committee.
Positions and management duties:
Co-founder and executive chairman of
Rallybio LLC. Member of the board of
directors and member of the science &
technology committee and the finance
committee of Charles River Laboratories
International, Inc.
Competencies:
Global corporate leadership; healthcare
and pharma industry; medicine and
science; technology, data and digital;
business development, M&A and
external innovation sourcing; human
capital management.
Thomas Rantzau
Danish. Born March 1972. Male.
Member since 2018. Term 2026.
Employee representative. Member
of the Nomination Committee.
Positions and management duties:
Lead auditor, Internal Audits,
Novo Nordisk A/S.
Competencies:
Not mapped for employee
representatives.
2. Liselotte Hyveled was also an employee-elected member of the Board of Directors for one four-year term from 2014-2018.
Board of Directors (continued)
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 45
Independence and meeting attendance overview
Meeting attendance in 2023
3
Name Independence
4
Board of
Directors
Chair
Committee
Audit
Committee
10
Nomination
Committee
Remuneration
Committee
R&D
Committee
Helge Lund Independent 9/9 7/7 3/3
Henrik Poulsen Not independent
5, 6, 7, 9
9/9 7/7 5/5 5/6
Elisabeth Dahl Christensen Not independent
8
9/9 6/6
Laurence Debroux Independent
6, 7, 9
9/9 5/5 6/6
Andreas Fibig Independent 9/9 4/4
Sylvie Grégoire Independent
6
9/9 5/5 3/3 4/4
Liselotte Hyveled Not independent
8
8/9 4/4
Mette Bøjer Jensen Not independent
6, 8
9/9 5/5
Kasim Kutay Not independent
5
8/9 3/3 4/4
Christina Law Independent
6
9/9 5/5
Martin Mackay Independent 9/9 6/6 4/4
Thomas Rantzau Not independent
8
9/9 3/3
Board members who stepped down at the Annual General Meeting in March 2023
Jeppe Christiansen Not independent
5
2/2 1/2
3. Number of meetings attended by each Board member out of the total number of meetings within the member’s term. 4. In accordance with recommendation 3.2.1 of the Danish Corporate
Governance Recommendations as designated by Nasdaq Copenhagen. 5. Member of the board of directors or executive management of Novo Holdings A/S. 6. Pursuant to the US Securities Exchange
Act, Ms Debroux, Ms Grégoire and Ms Law qualify as independent Audit Committee members, while Ms Bøjer Jensen and Mr Poulsen rely on an exemption from the independence requirements.
7. Ms Debroux and Mr Poulsen possess the qualifications within accounting and auditing required under part 8 of the Danish Act on Approved Auditors and Audit Firms. 8. Elected by employees of
Novo Nordisk. 9. Designated as financial experts as defined by the US Securities and Exchange Commission (SEC). 10. Collectively, the members have relevant industry expertise.
Lars Fruergaard Jørgensen
and Helge Lund (left) during
the Annual General Meeting
in March 2023.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 46
Executive Management
Lars Fruergaard Jørgensen
11
President and chief executive officer
(CEO). Born November 1966. Male.
Other positions and management duties:
President of the European Federation
of Pharmaceutical Industries and
Associations (EFPIA).
Tania Sabroe
Executive vice president. People &
Organisation. Born July 1977. Female.
Other positions and management duties:
No other management positions.
David Moore
Executive vice president. Corporate
Development. Born January 1974. Male.
Other positions and management duties:
Member of the board of directors of
Naveris Inc., Radius Health Inc. and
Novasenta Inc.
Maziar Mike Doustdar
Executive vice president. International
Operations. Born August 1970. Male.
Other positions and management duties:
Member of the board of directors and the
personnel and remuneration committee
of Orion Corporation.
Ludovic Helfgott
Executive vice president. Rare Disease.
Born July 1974. Male.
Other positions and management duties:
President of the Novo Nordisk
Haemophilia Foundation Council.
Karsten Munk Knudsen
11
Executive vice president. Chief financial
officer (CFO). Born December 1971. Male.
Other positions and management duties:
Member of the board of directors, chair
of the audit committee and member of
the equity & capital markets committee
of Hempel A/S. Member of the board of
directors and chair of the audit committee
of 3Shape Holding A/S.
Doug Langa
Executive vice president. North America
Operations. Born October 1966. Male.
Other positions and management duties:
No other management positions.
Martin Holst Lange
Executive vice president. Development.
Born October 1970. Male.
Other positions and management duties:
Member of the board of directors of
Pharmacosmos A/S.
Marcus Schindler
Executive vice president. Research & Early
Development and chief scientific officer
(CSO). Born September 1966. Male.
Other positions and management duties:
Adjunct Professor of Pharmacology at the
University of Gothenburg.
Camilla Sylvest
Executive vice president. Commercial
Strategy & Corporate Affairs. Born
November 1972. Female.
Other positions and management duties:
Vice chair of the board of directors of
Danish Crown A/S. Member of the board
of directors of Argenx SE.
Henrik Wulff
Executive vice president. Product Supply,
Quality & IT. Born November 1970. Male.
Other positions and management duties:
Member of the board of directors of
Grundfos Holding A/S.
11. Lars Fruergaard Jørgensen and Karsten Munk Knudsen are registered as executives with the Danish Business Authority. The other members of Executive Management are not registered as executives with the Danish Business Authority.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 47
Consolidated
statements
50 Consolidated financial statements
86 Consolidated ESG statement
95 Statement and Auditor’s Reports
Dr. Shellie Morris AO is an
award-winning singer-songwriter
from Australia. She is also part
of ‘Uncle Jimmy Thumbs Up!’,
an organisation dedicated to
improving health outcomes of
First Nations communities through
music workshops, preventative
health education and community
engagement. Shellie believes in music
as a healing and educational tool,
one that First Nations people have
long used to tell their stories and
experiences. When connecting with
people, she always starts off with
a blank piece of paper.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 48
Income statement and Statement of comprehensive income 50
Cash flow statement 51
Balance sheet 52
Equity statement 53
Notes to the consolidated financial statements
Section 1
Basis of preparation
1.1 Material accounting policies and key accounting estimates 54
1.2 Changes in accounting policies and disclosures 54
Section 2
Results for the year
2.1 Net sales and rebates 55
2.2 Segment information 56
2.3 Research and development costs 58
2.4 Employee costs 58
2.5 Other operating income and expenses 59
2.6 Income taxes and deferred income taxes 59
Section 3
Operating assets and liabilities
3.1 Intangible assets 61
3.2 Property, plant and equipment 63
3.3 Inventories 64
3.4 Trade receivables 65
3.5 Provisions and contingent liabilities 66
Consolidated
financial statements
Section 4
Capital structure and financial items
4.1 Earnings per share 68
4.2 Distribution to shareholders 68
4.3 Share capital, Treasury shares and Other reserves 68
4.4 Financial risks 69
4.5 Derivative financial instruments 71
4.6 Borrowings 72
4.7 Cash and cash equivalents 73
4.8 Cash flow statement specifications 73
4.9 Financial assets and liabilities 74
4.10 Financial income and expenses 75
Section 5
Other disclosures
5.1 Share-based payment schemes 76
5.2 Commitments 78
5.3 Acquisition of businesses 78
5.4 Related party transactions 79
5.5 Fees to statutory auditors 79
5.6 General accounting policies 80
5.7 Companies in the Novo Nordisk Group 81
Part of the Management review – not audited
Financial definitions 82
Non-IFRS financial measures 83
Statement of ESG performance 86
Notes to the consolidated ESG statement
Section 6
Basis of preparation
87
Section 7
Environmental performance
7.1 Energy consumption for operations and
share of renewable power for production sites 88
7.2 Scope 1, 2 and 3 emissions 88
7.3 Water consumption for production sites 89
7.4 Waste from production sites 89
7.5 Breaches of environmental regulatory limit values 90
Section 8
Social performance
8.1 Patients reached with Novo Nordisk’s Diabetes
and Obesity care products 90
8.2 Employees 90
8.3 Gender diversity in leadership positions 91
8.4 Sustainable employer score 91
8.5 Health and safety 91
8.6 US pricing 92
8.7 Total tax contribution 92
8.8 Donations and other contributions 92
Consolidated
ESG statement
Section 9
Governance performance
9.1 Business ethics reviews and training 93
9.2 Compliance Hotline 93
9.3 Supplier audits 93
9.4 Product recalls 93
9.5 Failed inspections 93
9.6 Facilitations of the Novo Nordisk Way 94
9.7 Company reputation 94
9.8 Animals purchased for research 94
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 49
Income statement and Statement of comprehensive income
for the year ended 31 December
DKK million Note 2023 2022 2021
Income statement
Net sales 2.1, 2.2 232,261 176,954 140,800
Cost of goods sold 2.2 (35,765 ) (28,448 ) (23,658 )
Gross profit 196,496 148,506 117,142
Sales and distribution costs 2.2 (56,743 ) (46,217 ) (37,008 )
Research and development costs 2.2, 2.3 (32,443 ) (24,047 ) (17,772 )
Administrative costs 2.2 (4,855 ) (4,467 ) (4,050 )
Other operating income and expenses 2.2, 2.5 119 1,034 332
Operating profit 102,574 74,809 58,644
Financial income 4.10 2,945 239 2,887
Financial expenses 4.10 (845 ) (5,986 ) (2,451 )
Profit before income taxes 104,674 69,062 59,080
Income taxes 2.6 (20,991 ) (13,537 ) (11,323 )
Net profit 83,683 55,525 47,757
Earnings per share
Basic earnings per share (DKK) 4.1 18.67 12.26 10.40
Diluted earnings per share (DKK) 4.1 18.62 12.22 10.37
DKK million Note 2023 2022 2021
Statement of comprehensive income
Net profit 83,683 55,525 47,757
Other comprehensive income:
Remeasurements of retirement benefit obligations 13 615 146
Items that will not be reclassified subsequently to the income statement 13 615 146
Exchange rate adjustments of investments in subsidiaries 4.3 (1,404 ) 2,289 1,624
Cash flow hedges:
Realisation of previously deferred (gains)/losses 4.3, 4.5 (1,026 ) 1,740 (1,802 )
Deferred gains/(losses) incurred during the period 4.3, 4.5 1,612 1,026 (1,755 )
Other items 4.3 4 (3 ) 112
Income tax related to these items 2.6, 4.3 (359 ) (889 ) 1,005
Items that will be reclassified subsequently to the income statement (1,173 ) 4,163 (816 )
Other comprehensive income (1,160 ) 4,778 (670 )
Total comprehensive income 82,523 60,303 47,087
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 50
Cash flow statement
for the year ended 31 December
DKK million Note 2023 2022 2021
Cash flow statement
Net profit 83,683 55,525 47,757
Adjustment of non-cash items:
Income taxes in the income statement 2.6 20,991 13,537 11,323
Depreciation, amortisation and impairment losses 3.1, 3.2 9,413 7,362 6,025
Other non-cash items 4.8 32,382 22,310 13,416
Change in working capital 4.8 (12,245 ) (5,336 ) (9,063 )
Interest received 1,072 276 241
Interest paid (491 ) (272 ) (261 )
Income taxes paid 2.6 (25,897 ) (14,515 ) (14,438 )
Net cash generated from operating activities 108,908 78,887 55,000
Purchase of intangible assets 3.1 (13,090 ) (2,607 ) (1,050 )
Purchase of property, plant and equipment 3.2 (25,806 ) (12,146 ) (6,335 )
Cash used for acquisition of businesses 5.3 — (7,075 ) (18,283 )
Proceeds from other financial assets 33 — —
Purchase of other financial assets (271 ) (169 ) (4 )
Purchase of marketable securities (13,018 ) (9,566 ) (7,109 )
Sale of marketable securities 8,260 6,645 1,172
Dividend received from associated companies 5.4 — — 4
Net cash used in investing activities (43,892 ) (24,918 ) (31,605 )
DKK million Note 2023 2022 2021
Purchase of treasury shares 4.3 (29,924 ) (24,086 ) (19,447 )
Dividends paid 4.2 (31,767 ) (25,303 ) (21,517 )
Proceeds from borrowings 4.6 — 11,215 22,160
Repayment of borrowings 4.6 (1,467 ) (13,623 ) (6,689 )
Net cash used in financing activities (63,158 ) (51,797 ) (25,493 )
Net cash generated from activities 1,858 2,172 (2,098 )
Cash and cash equivalents at the beginning of the year 12,653 10,719 12,226
Exchange gains/(losses) on cash and cash equivalents (119 ) (238 ) 591
Cash and cash equivalents at the end of the year 4.7 14,392 12,653 10,719
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 51
Balance sheet
at 31 December
DKK million Note 2023 2022
Assets
Intangible assets 3.1 60,406 50,939
Property, plant and equipment 3.2 90,961 66,671
Investments in associated companies 410 327
Deferred income tax assets 2.6 20,380 13,904
Other receivables and prepayments 1,430 206
Other financial assets 1,253 1,016
Total non-current assets 174,840 133,063
Inventories 3.3 31,811 24,388
Trade receivables 3.4 64,770 50,560
Tax receivables 2,423 940
Other receivables and prepayments 8,068 6,005
Marketable securities 4.4 15,838 10,921
Derivative financial instruments 4.5 2,344 2,727
Cash at bank 4.7 14,392 12,653
Total current assets 139,646 108,194
Total assets 314,486 241,257
DKK million Note 2023 2022
Equity and liabilities
Share capital 4.3 451 456
Treasury shares 4.3 (5 ) (6 )
Retained earnings 104,839 80,587
Other reserves 4.3 1,276 2,449
Total equity 106,561 83,486
Borrowings 4.6 20,528 24,318
Deferred income tax liabilities 2.6 10,162 7,061
Retirement benefit obligations 742 762
Other liabilities 189 100
Provisions 3.5 6,649 4,590
Total non-current liabilities 38,270 36,831
Borrowings 4.6 6,478 1,466
Trade payables 25,606 15,587
Tax payables 7,116 7,091
Other liabilities 28,705 23,606
Derivative financial instruments 4.5 1,272 2,903
Provisions 3.5 100,478 70,287
Total current liabilities 169,655 120,940
Total liabilities 207,925 157,771
Total equity and liabilities 314,486 241,257
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 52
Equity statement
at 31 December
2023 2022 2021
DKK million
Share
capital
Treasury
shares
Retained
earnings
Other
reserves Total
Share
capital
Treasury
shares
Retained
earnings
Other
reserves Total
Share
capital
Treasury
shares
Retained
earnings
Other
reserves Total
Balance at the beginning of the year 456 (6 ) 80,587 2,449 83,486 462 (6 ) 72,004 (1,714 ) 70,746 470 (8 ) 63,774 (911 ) 63,325
Net profit 83,683 83,683 55,525 55,525 47,757 47,757
Other comprehensive income 13 (1,173 ) (1,160 ) 615 4,163 4,778 146 (816 ) (670 )
Total comprehensive income 83,696 (1,173 ) 82,523 56,140 4,163 60,303 47,903 (816 ) 47,087
Transfer of cash flow hedge reserve to intangible assets (note 4.3) — — — — 13 13
Transactions with owners:
Dividends (note 4.2) (31,767 ) (31,767 ) (25,303 ) (25,303 ) (21,517 ) (21,517 )
Share-based payments (note 5.1) 2,149 2,149 1,539 1,539 1,040 1,040
Purchase of treasury shares (note 4.3) (4 ) (29,920 ) (29,924 ) (6 ) (24,080 ) (24,086 ) (6 ) (19,441 ) (19,447 )
Reduction of the B share capital (note 4.3) (5 ) 5 — (6 ) 6 — (8 ) 8 —
Tax related to transactions with owners 94 94 287 287 245 245
Balance at the end of the year 451 (5 ) 104,839 1,276 106,561 456 (6 ) 80,587 2,449 83,486 462 (6 ) 72,004 (1,714 ) 70,746
Refer to note 4.3 for details of movements in Other reserves.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 53
Section 1
Basis of preparation
Notes to the consolidated financial statements
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 54
Section 2
Results for the year
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Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 57
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Section 3
Operating assets
and liabilities
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2
®
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Section 4
Capital structure and
financial items
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Section 5
Other disclosures
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Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 81
Part of the Management review – not auditedNovo Nordisk Annual Report 2023 82
Financial definitions
(part of the Management review – not audited)
Financial ratios have been calculated in accordance with the guidelines from the
Danish Society of Financial Analysts, and supplemented by certain key ratios for
Novo Nordisk. Financial ratios are described below and in the section 'Non-IFRS
financial measures'.
ADR
An American Depository Receipt (or ADR) represents ownership of the shares
of a non-US company and trades in US financial markets.
Basic earnings per share (EPS)
Net profit divided by the average number of shares outstanding.
Diluted earnings per share
Net profit divided by average number of shares outstanding, including the dilutive
effect of the outstanding restricted stock units.
Dividend payout ratio
Total dividends for the year as a percentage of net profit. Total dividends for the
year comprise of interim dividend paid during the year and proposed ordinary
dividend for the year.
EBITDA
EBITDA is defined as ’net profit’, adjusted for 'income taxes', 'financial items',
'depreciation and amortisation' and 'impairment losses'.
Effective tax rate
Income taxes as a percentage of profit before income taxes.
Gross margin
Gross profit as a percentage of net sales.
Net profit margin
Net profit as a percentage of net sales.
Number of shares outstanding
The total number of shares, excluding the holding of treasury shares.
Operating margin
Operating profit as a percentage of net sales.
Purchase of intangible assets
Cash flow statement amount for the purchase of intangible assets.
Purchase of property, plant and equipment
Cash flow statement amount for the purchase of property, plant and equipment.
The definition of capital expenditure was redefined in 2019. Capital expenditure is now
defined as purchase of property, plant and equipment from the cash flow statement.
Shares
The share capital of Novo Nordisk comprise of A-shares and B-shares, with B-shares
listed on Nasdaq Copenhagen in trading units of nominal value DKK 0.10 and ADRs,
that equals B-shares of nominal value DKK 0.10, being listed on New York Stock
Exchange (NYSE). Key ratios per share, including number of outstanding shares,
are aligned with trading units of nominal value DKK 0.10.
Working capital
Working capital measures the liquid assets Novo Nordisk has available for operations.
Part of the Management review – not auditedNovo Nordisk Annual Report 2023 83
Non-IFRS financial measures
Net sales in constant exchange rates
DKK million 2023 2022 2021
Net sales IFRS 232,261 176,954 140,800
Effect of exchange rate 7,658 (13,024) 3,643
Net sales in constant exchange rates 239,919 163,930 144,443
Net sales previous year 176,954 140,800 126,946
% increase/(decrease) in reported currencies 31.3% 25.7% 10.9%
% increase/(decrease) in constant
exchange rates 35.6% 16.4% 13.8%
Operating profit in constant exchange rates
DKK million 2023 2022 2021
Operating profit IFRS 102,574 74,809 58,644
Effect of exchange rate 4,898 (7,578) 2,332
Operating profit in constant exchange rates
107,472 67,231 60,976
Operating profit previous year 74,809 58,644 54,126
% increase/(decrease) in reported currencies 37.1% 27.6% 8.3%
% increase/(decrease) in constant
exchange rates 43.7% 14.6% 12.7%
Earnings before interest, taxes, depreciation, amortisation
and impairment losses (EBITDA)
EBITDA is defined as ’net profit’, before 'income taxes', 'financial items', 'depreciation
and amortisation' and 'impairment losses'.
Management believes EBITDA is a useful measure as it helps analyse operating results
from core business operations without including the effects of capital structure, tax
rates, depreciation, amortisation and impairment losses.
The following table shows a reconciliation of EBITDA with operating profit, the most
directly comparable IFRS financial measures:
EBITDA
DKK million 2023 2022 2021
Net profit IFRS 83,683 55,525 47,757
Income taxes IFRS 20,991 13,537 11,323
Financial income IFRS (2,945) (239) (2,887)
Financial expenses IFRS 845 5,986 2,451
Operating profit (EBIT) IFRS 102,574 74,809 58,644
Depreciation and amortisations 7,289 6,553 5,311
Impairment losses 2,124 809 714
EBITDA 111,987 82,171 64,669
(part of the Management review – not audited)
In the Annual Report, Novo Nordisk discloses certain financial measures of the
Group’s financial performance, financial position and cash flows that reflect
adjustments to the most directly comparable measures calculated and presented
in accordance with IFRS. These non-IFRS financial measures may not be defined
and calculated by other companies in the same manner, and may therefore not
be comparable.
The non-IFRS financial measures presented in the Annual Report are:
• Net sales and operating profit in constant exchange rates (CER)
• 'Net profit’, adjusted for 'income taxes', 'financial items', 'depreciation and
amortisation' and 'impairment losses' (EBITDA)
• Return on invested capital (ROIC)
• Free cash flow
• Cash to earnings
IFRS
refers to an IFRS financial measure.
Sales and operating profit growth in constant exchange rates
'Growth in constant exchange rates' means that the effect of changes in exchange
rates is excluded. It is defined as sales/operating profit for the period measured at
the average exchange rates for the same period of the prior year, compared with net
sales/operating profit for the same period of the prior year. Price adjustments within
hyperinflation countries as defined in IAS 29 'Financial reporting in hyperinflation
economies' are excluded from the calculation to avoid growth in constant exchange
rates being artificially inflated. Growth in constant exchange rates is considered to be
relevant information for investors in order to understand the underlying development
in sales and operating profit by adjusting for the impact of currency fluctuations.
Part of the Management review – not auditedNovo Nordisk Annual Report 2023 84
Return on invested capital (ROIC)
ROIC is defined as 'operating profit after tax' (using the effective tax rate) as a percentage
of average inventories, receivables, property, plant and equipment, intangible assets and
deferred tax assets, less non-interest-bearing liabilities including provisions and deferred
tax liabilities (where the average is the sum of the above assets and liabilities at the
beginning of the year and at year-end divided by two).
Management believes ROIC is a useful measure in providing investors and Manage-
ment with information regarding the Group's performance. The calculation of this
financial target is a widely accepted measure of earnings efficiency in relation to total
capital employed.
The following tables show the reconciliation of ROIC with operating profit/equity in %,
the most directly comparable IFRS financial measure:
Operating profit/equity in %
DKK million 2023 2022 2021
Operating profit IFRS 102,574 74,809 58,644
/ Equity IFRS 106,561 83,486 70,746
Operating profit/equity in % 96.3% 89.6% 82.9%
ROIC
DKK million 2023 2022 2021
Operating profit after tax 81,957 60,146 47,384
/ Average net operating assets 92,566 81,744 68,634
ROIC in % 88.5% 73.6% 69.0%
ROIC numerator
Reconciliation of operating profit to operating profit after tax
DKK million 2023 2022 2021
Operating profit IFRS 102,574 74,809 58,644
Tax on operating profit (using effective
tax rate) (20,617) (14,663) (11,260)
Operating profit after tax 81,957 60,146 47,384
ROIC denominator
DKK million 2023 2022 2021
Intangible assets 60,406 50,939 43,171
Property, plant and equipment 90,961 66,671 55,362
Deferred income tax assets 20,380 13,904 8,672
Other receivables and prepayments (non-
current) 1,430 206 267
Inventories 31,811 24,388 19,621
Trade receivables 64,770 50,560 40,643
Tax receivables 2,423 940 1,119
Other receivables and prepayments
(current) 8,068 6,005 5,037
Deferred income tax liabilities (10,162) (7,061) (5,271)
Retirement benefit obligations (742) (762) (1,280)
Other liabilities (non-current) (189) (100) (360)
Provisions (non-current) (6,649) (4,590) (4,374)
Trade payables (25,606) (15,587) (8,870)
Tax payables (7,116) (7,091) (3,658)
Other liabilities (current) (28,705) (23,606) (19,600)
Provisions (current) (100,478) (70,287) (51,520)
Net operating assets 100,602 84,529 78,959
Average net operating assets 92,566 81,744 68,634
Reconciliation of net operating assets to equity:
IFRS
DKK million 2023 2022 2021
Equity IFRS 106,561 83,486 70,746
Investment in associated companies (410) (327) (525)
Other financial assets (1,253) (1,016) (916)
Marketable securities (15,838) (10,921) (6,765)
Derivative financial instruments (2,344) (2,727) (1,690)
Cash at bank (14,392) (12,653) (10,720)
Borrowings – non-current 20,528 24,318 12,961
Borrowings – current 6,478 1,466 13,684
Derivative financial instruments 1,272 2,903 2,184
Net operating assets 100,602 84,529 78,959
Part of the Management review – not auditedNovo Nordisk Annual Report 2023 85
Free cash flow
Free cash flow is a measure of the amount of cash generated in the period which is
available for the Board to allocate between Novo Nordisk's capital providers, through
measures such as dividends, share repurchases and repayment of debt (excluding
lease liability repayments) or for retaining within the business to fund future growth.
The following table shows a reconciliation of free cash flow with net cash generated
from operating activities, the most directly comparable IFRS financial measure:
Free cash flow
DKK million 2023 2022 2021
Net cash generated from operating
activities IFRS 108,908 78,887 55,000
Net cash used in investing activities IFRS (43,892) (24,918) (31,605)
Net purchase of marketable securities IFRS 4,758 2,921 5,937
Addition on marketable securities through
acquisition of business IFRS — 1,470 861
Repayment on lease liabilities IFRS (1,448) (998) (874)
Free cash flow 68,326 57,362 29,319
Cash to earnings
Cash to earnings is defined as ‘free cash flow as a percentage of net profit’.
Management believes that cash to earnings is an important performance metric
because it measures the Group’s ability to turn earnings into cash. Since Management
wants this measure to capture the ability of the Group’s operations to generate cash,
free cash flow is used as the numerator instead of net cash flow.
The following table shows the reconciliation of cash to earnings to cash flow from
operating activities/net profit in %, the most directly comparable IFRS financial measure:
Cash flow from operating activities/net profit in %
DKK million 2023 2022 2021
Net cash generated from operating
activities IFRS 108,908 78,887 55,000
/ Net profit IFRS 83,683 55,525 47,757
Cash flow from operating
activities/net profit in % 130.1% 142.1% 115.2%
Cash to earnings
DKK million 2023 2022 2021
Free cash flow 68,326 57,362 29,319
/ Net profit IFRS 83,683 55,525 47,757
Cash to earnings 81.6% 103.3% 61.4%
Statement of ESG performance
for the year ended 31 December
Note 2023 2022 2021
Social performance (continued)
Societies
Change in average net price across US product portfolio (% change to previous year) 8.6 (8.2%) (10.5%) (12.3%)
Change in average net price across US insulin portfolio (% change to previous year) 8.6 (24.4%) (19.5%) (10.9%)
Total tax contribution (DKK million) 8.7 51,247 36,003 32,593
Donations and other contributions (DKK million) 8.8 138 126 92
Governance performance
Business ethics reviews 9.1 40 35 37
Employees trained in business ethics 9.1 99% 99% 98%
Number of substantiated cases reported via the Compliance Hotline 9.2 314 288 236
Convictions for violation of anti-corruption and anti-bribery laws 9.2 — — —
Supplier audits 9.3 382 294 253
Product recalls 9.4 2 3 1
Failed inspections 9.5 — — —
Facilitations of the Novo Nordisk Way 9.6 42 36 34
Company reputation (scale 0-100) 9.7 82.1 82.3 82.6
Animals purchased for research 9.8 56,508 79,750 47,879
1. 2023 is the first year of reporting all emission categories in CO
2
e. Comparative figures for scope 1, 2 and part of scope 3 emissions are measured in CO
2
. Refer to section
7.2 for further details. 2. 2022 was the first year of full scope 3 emissions' disclosure, which in 2021 and previously was limited to business flights and product distribution.
3. The methodology for counting number of breaches has changed in 2023. Comparative figures are adjusted accordingly. 4. 2023 is the first year of reporting Obesity as
part of number of patients reached. Comparative figures are adjusted accordingly.
Note 2023 2022 2021
Environmental performance
Energy consumption for operations (1,000 GJ) 7.1 3,784 3,677 3,387
Share of renewable power for production sites 7.1 100% 100% 100%
Scope 1 emissions (1,000 tonnes CO
2
e)
1
7.2 78 76 77
Scope 2 emissions (1,000 tonnes CO
2
e)
1
7.2 15 16 16
Scope 3 emissions (1,000 tonnes CO
2
e)
1,2
7.2 3,738 2,418 N/A
Water consumption for production sites (1,000 m
3
) 7.3 4,150 3,918 3,488
Waste from production sites (tonnes) 7.4 189,091 213,505 180,806
Breaches of environmental regulatory limit values
3
7.5 12 8 8
Social performance
Patients
Patients reached with Novo Nordisk's Diabetes and Obesity care products (in millions)
4
8.1 41.6 36.9 34.9
• Hereof reached via the Novo Nordisk Access to Insulin Commitment (in millions) 8.1 2.4 1.8 1.7
Children reached through the Changing Diabetes
®
in Children programme
(cumulative) 8.1 52,249 41,033 31,846
People and employees
Year-end employees (total) 8.2 64,319 55,185 48,478
Employee turnover 8.2 5.5% 8.2% 11.0%
Gender in leadership positions (ratio men:women) 8.3 54:46 56:44 57:43
Gender in senior leadership positions (ratio men:women) 8.3 59:41 61:39 64:36
Gender in the Board of Directors (ratio men:women) 8.3 50:50 54:46 67:33
Sustainable employer score 8.4 86% 85% 84%
Frequency of occupational accidents (number per million working hours) 8.5 1.5 1.5 1.3
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 86
Section 6
Basis of preparation
General reporting standards and principles
Novo Nordisk's annual reporting complies with the Danish Financial Statements Act.
Sections 99a, 99b, 99d and 107d specify the requirements to report on the management
of risks related to the environment, climate, human rights, labour and social conditions,
anti-corruption, gender distribution and data ethics. These requirements are addressed in
the Management review.
As recommended by the Taskforce on Climate-related Financial Disclosures (TCFD), Novo
Nordisk is working to integrate two climate change scenarios into the risk management
process, to identify short-, medium- and long-term risks within the production and
supply chain:
• Limiting temperature increase to well below 2ºC scenario, preferably 1.5ºC, compared
to pre-industrial times in accordance with the Paris Agreement.
• A temperature increase of 4ºC scenario as an alternative high-emission scenario.
Scope 1, 2 and 3 emissions have been prepared in accordance with the Greenhouse Gas
(GHG) Protocol. Novo Nordisk also discloses in accordance with the recommendations put
forward by the Carbon Disclosure Project (CDP). For a full breakdown of climate and water
impacts, please refer to the publicly available report on Novo Nordisk's CDP disclosures at:
www.cdp.net.
Inclusivity
As a pharmaceutical business with global reach, Novo Nordisk is committed to being
accountable to those stakeholders who are impacted by the organisation. From the
perspective of social responsibility, the key stakeholder groups are patients who rely on
Novo Nordisk's products, employees at Novo Nordisk and throughout the Group's value
chain, business partners and local communities. Novo Nordisk maps its stakeholders and
has processes in place to ensure inclusion of stakeholder concerns and expectations.
Responsiveness
The Annual Report reflects how Novo Nordisk manages operations in ways that consider
and respond to stakeholder concerns and interests. The report reaches out to a wide
range of stakeholders but is primarily prepared with investors in mind. For most Novo
Nordisk stakeholders, the Annual Report is just one element of interaction and
communication with the Company.
Impact
Understanding, measuring and communicating the positive and negative impacts on
society and the planet of Novo Nordisk's activities is important and remains a priority
for Novo Nordisk.
Materiality
The 2023 consolidated ESG statement includes KPIs as guided by Novo Nordisk's ESG
strategy and ongoing external stakeholder engagement. When assessing whether a KPI
is material to the consolidated ESG statement, Management considers whether the matter
is of such relevance and importance that it could substantially influence the assessment of
Novo Nordisk's ESG performance by the users of the Annual Report 2023.
The provisional Double Materiality Assessment described on page 12, performed at the
end of 2023, will inform our ESG reporting in 2024 in accordance with the Corporate
Sustainability Reporting Directive (CSRD) and will be updated regularly.
Principles of consolidation
The disclosures of energy consumption and CO
2
e emissions cover production sites,
laboratories and offices. The disclosures of water consumption, environmental breaches
and waste cover production sites. Novo Nordisk Engineering A/S is not included in our
environmental reporting.
The social and governance-related disclosures cover the Novo Nordisk Group, comprising
Novo Nordisk A/S and entities controlled by Novo Nordisk A/S. Novo Nordisk Engineering
A/S is not included in our reporting for Sustainable employer score, employees trained in
business ethics, failed inspections and facilitations of the Novo Nordisk Way. Novo Nordisk
Pharmatech A/S is not included in our reporting on employees trained in business ethics
and facilitations of the Novo Nordisk Way.
Changes in accounting policies and disclosures
The accounting policies set out in the notes have been applied consistently in the
preparation of the consolidated ESG statement for all the years presented, unless
stated otherwise.
The following changes to accounting policies and new KPIs have been considered in
the 2023 consolidated ESG statement:
Environmental performance
In 2022, scope 1 emissions, scope 2 emissions and scope 3 emissions from business
travel were calculated as CO
2
. To further align with the GHG Protocol, in 2023 these
KPIs are calculated as CO
2
e. The remaining scope 3 emissions have been calculated as
CO
2
e in 2022 and 2023. CO
2
e includes CO
2
and all other greenhouse gases; for more
information, please refer to section 7.2. Additionally, scope 1 emissions have been
expanded to also include refrigerants. Further scope changes may occur in the future
as more data becomes available.
In 2023, the methodology for counting the number of breaches of regulatory limit
values was changed. Breaches related to the same continued exceedance at the same
site are counted as one breach for the year. Comparative figures for 2021 and 2022
have been adjusted accordingly. Please refer to section 7.5.
Social performance
The KPI on patients reached has been expanded to include patients reached with
Novo Nordisk's Obesity care products. Comparative figures for 2021 and 2022 have
been adjusted accordingly; please refer to section 8.1. New breakdowns including
comparative figures for 2021 and 2022 have been included on employees by gender
and by age group. Please refer to section 8.2.
Governance performance
New KPIs including comparative figures for 2021 and 2022 have been included on
number of substantiated cases reported via the Compliance Hotline and convictions
for violation of anti-corruption and anti-bribery laws. Please refer to section 9.2.
Notes to the consolidated ESG statement
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 87
Section 7
Environmental performance
7.1 Energy consumption for operations and
share of renewable power for production sites
7.2 Scope 1, 2 and 3 emissions
1,000 tonnes CO
2
e 2023 2022 2021
Scope 1
1
78 76 77
• Production 31 25 29
• Office buildings and laboratories 1 3 2
• Company cars 46 48 46
Scope 2
1
15 16 16
• Production 12 11 10
• Office buildings and laboratories 3 5 6
Scope 3
2
3,738 2,418 N/A
• Purchased goods and services
3
2,067 1,473 N/A
• Capital goods
3
1,315 614 N/A
• Fuel and energy related activities 56 55 N/A
• Upstream transportation and distribution 113 123 N/A
• Waste generated in operations 6 5 N/A
• Business travel
1,3
83 73 N/A
• Employee commuting 43 35 N/A
• Downstream transportation and distribution 52 37 N/A
• End-of-life treatment of sold products 3 3 N/A
Total CO
2
e emissions 3,831 2,510 N/A
1. Categories measured in CO
2
in comparison periods. 2. The calculation of scope 3 emissions is substantially
based on estimations and therefore inherently uncertain. 3. 2022 figures have been restated by adding 222, 137
and 18 thousand tonnes, respectively.
In 2023, Novo Nordisk experienced increased production volumes, ramp-up activities
and impact from adverse local weather conditions; however, due to energy-saving
projects and renewable power initiatives, scope 1 and 2 emissions remained broadly
unchanged from 2022. Scope 3 emissions increased by 55% due to substantial
investments in production capacity and increase in supply chain activities to support
company growth. The two categories Purchased goods and services and Capital goods
account for 90% of the scope 3 emissions, and they account for 98% of the overall
scope 3 emissions' increase.
ACCOUNTING POLICIES
Scope 1 emissions
Scope 1 emissions comprise direct CO
2
e emissions from sources that are owned or
controlled by the Novo Nordisk Group. CO
2
e emissions from production, office buildings
and laboratories include consumption of fuel oil, propane, wood and natural gas.
CO
2
e emissions from production sites additionally include emissions from leakage of
refrigerants from cooling systems. Production sites report on refrigerant quantities
when there is leakage of refrigerant over 1 kg. Associated CO
2
e emissions are
calculated based on refrigerant quantities and their respective Global Warming
Potential (GWP).
CO
2
e emissions from company cars cover cars leased or owned by Novo Nordisk.
Emissions are calculated by multiplying the CO
2
e emission factors from the
Environmental Protection Agency (EPA) by the volumes of diesel and petrol used.
Scope 2 emissions
Scope 2 emissions comprise CO
2
e emissions from purchased electricity, heat and
steam. Market-based emissions are calculated based on CO
2
e emission factors
from the previous year. For a full overview of location-based emissions, please visit:
www.cdp.net.
Scope 3 emissions
Novo Nordisk has identified 9 categories, out of the 15 categories of scope 3 emissions
defined by the GHG protocol, as relevant. The remaining 6 categories are not separately
reported on as they are either not applicable to Novo Nordisk or emissions have been
included in the other emission categories.
Purchased goods and services
Purchased goods and services include emissions related to all spend from external
suppliers, except for investment spend and travel categories, which are included
in other scope 3 categories. Purchased goods and services mainly comprise of raw
materials for products, marketing, packaging materials, as well as consumables for
laboratory and IT office equipment. Direct spend is converted into CO
2
e emissions
using the average data method. Material weights are matched with CO
2
e factors
depending on data availability. A spend-based factor is applied for direct spend data
where no weight can be obtained. Indirect spend is converted into CO
2
e using a
spend-based method.
Capital goods
Capital goods include emissions related to all indirect investment spend from external
suppliers, mainly production utilities and equipment. Indirect spend is converted into
CO
2
e emissions via the average spend-based method using emission factors.
Energy consumption for operations
1,000 GJ 2023 2022 2021
Production 3,214 3,091 2,859
Office buildings and laboratories 570 586 528
Total energy consumption 3,784 3,677 3,387
In 2023, Novo Nordisk continued working with energy-saving, optimisation and
stabilisation projects. This included utilising more renewable natural gas and steam,
reducing propane, diesel and heavy fuel usage, and implementing new dehumidification
systems. Energy-saving projects implemented in 2023 within production sites resulted in
annual energy savings of 64 thousand GJ. These efforts could not fully mitigate the
increased production volumes, ramp-up activities and impact from adverse local weather
conditions, and consequently energy consumption for production increased by 4%.
Energy consumption in office buildings and laboratories decreased by 3% due to reduced
use of facilities and implementation of energy-saving measures.
Since 2020, Novo Nordisk has transitioned to sourcing 100% renewable power for
production through a mix of solutions, primarily Renewable Electricity Certificates
(REC), Power Purchase Agreements (PPA), Guarantees of Origin (GO) as well as on-
site renewable solutions.
ACCOUNTING POLICIES
Energy consumption for operations is measured as consumption of power, steam, heat
and fuel. Fuel is mainly natural gas, wood, diesel oil, gas oil and light fuel oil. Energy
consumption is based on metre readings and invoices. Energy consumption in office
buildings outside of Denmark is limited to the consumption of power.
The share of renewable power used at production sites is reported according to the
Greenhouse Gas (GHG) Protocol scope 2 Guideline. The market-based method is used
to account for renewable power at production sites through procurement of contractual
instruments such as Energy Attribute Certificates (EAC), PPAs and GOs from sources such
as wind, hydro, solar and biomass. Contractual instruments are procured based on the
total consumption of power in each country involved in production.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 88
Fuel and energy related activities
Fuel and energy related activities include all upstream CO
2
e emissions of purchased
fuels and energy (beyond scope 1 and 2 emissions). Energy consumption is converted
from GJ to kWh and multiplied by DEFRA's country-specific emission factors to assess
CO
2
e tonnes. The category comprises upstream emissions from electricity, steam and
heat; upstream emissions from transportation and distribution of electricity, steam
and heat and emissions from upstream fuel.
Upstream transportation and distribution
CO
2
e emissions from upstream transportation and distribution are calculated by an
external supplier managing the transportation and distribution processes on behalf of
Novo Nordisk, and using the industry standard EcoTransit solution. CO
2
e emissions are
calculated based on the worldwide distribution of semi-finished and finished products,
raw materials and components by air, sea and road between production sites and
from production sites to subsidiaries, direct customers and importing distributors.
Waste generated in operations
Waste generated in own operations includes CO
2
e emissions associated with
third-party disposal and treatment of waste generated from production sites, offices
and laboratories. Currently, waste data is available for production sites and offices,
as well as laboratories within Denmark. Waste data is not available for offices and
laboratories outside of Denmark, for which CO
2
e emissions are therefore extrapolated
using the waste-type-specific method.
Business travel
Business travel includes CO
2
e emissions from business flights and other travel, such
as hotel stays and taxis. CO
2
e emissions from business flights are estimated based on
mileage and passenger class details obtained from travel agencies. These are
multiplied by CO
2
e emission factors for short-, medium- and long-haul flights. EPA
emission factors are used to perform the calculations. Currently, 90% of emissions
from flights are calculated based on data provided by travel agencies and the
remaining 10% are extrapolated based on travel spend. CO
2
e emissions from other
travel-related activities are calculated using a spend-based approach.
Employee commuting
Employee commuting includes CO
2
e emissions associated with commuting by all
employees except those with company cars, since these emissions are reported as
scope 1 emissions. CO
2
e emissions are estimated using the average data method and
based on assumptions for the top six countries (Denmark, USA, India, China, France
and Brazil) in terms of number of employees, which account for 85% of the employee
base. Average distance and mode of transportation are used to calculate the CO
2
e
emissions for the remaining 15% of employees.
Downstream transportation and distribution
Downstream transportation and distribution include CO
2
e emissions that occur from
transportation and distribution of sold products in vehicles and to facilities not owned
or controlled by Novo Nordisk. Only transportation emissions are included in the
calculations, specifically from the first receiving warehouse to pharmacies, hospitals
and wholesalers. A simulation-based approach is applied to calculate downstream
emissions, using a distance-based method by simulating route networks for four
countries (Denmark, UK, Switzerland and Brazil). Transportation work (tonne-km)
and CO
2
e emissions are estimated by calculating the distance travelled for the weight
of distributed products and cool boxes. Moreover, the modelled route networks
provide the basis for simulating US and China transportation and distribution.
Transportation work per net kg product from the six reference countries (Denmark,
UK, Switzerland, Brazil, China and US) is extrapolated to the remaining countries.
Emissions per country are calculated based on i) the weight of sold products,
ii) reference country transportation work and iii) the emission factor for the region
and mode of transportation.
End-of-life treatment of sold products
End-of-life treatment of sold products includes CO
2
e emissions from end-of-life
treatment of all products sold to the market, including packaging. The amount of sold
products is calculated from the realised sales data for specific devices and markets. It
is assumed that devices are discarded in the markets where they are sold and that the
end-of-life treatment follows the general treatment of the household waste for each
market. Scenarios have been developed for end-of-life treatment for various Novo
Nordisk products (FlexPen
®
, FlexTouch
®
, NovoFine
®
needle etc.). The scenarios cover
the US, EU and Japan. The remaining CO
2
e emissions from other products are
extrapolated by unit sales based on average end-of-life emissions from the products.
7.3 Water consumption for production sites
In 2023, production sites consumed 4,150 thousand cubic metres of water; an increase
of 6% compared to 2022 due to higher production volumes and ramp up activities for
capacity expansion at production sites. Other contributing factors were warmer
months in 2023, hence additional water was used for cooling purposes. Additionally,
a higher number of employees led to increased on-site activities and extra shifts.
Production sites in France, Brazil, China, US, Iran and Algeria are located in areas
of high water stress or with high seasonal variations (please refer to the CDP Water
Security 2023 Reporting Guidance). These sites consume 18% of the total water
for global production. Despite a significant increase in production volumes, water
consumption at these facilities was kept at a 2% increase as the implementation of
water conservation projects in water-stressed areas led to savings of 14 thousand
cubic metres of water.
7.4 Waste from production sites
Tonnes 2023 2022 2021
Organic residues 128,116 166,183 143,254
Other (paper, cardboard, metals, etc.) 19,019 12,820 7,990
Total recycling 147,135 179,003 151,244
Ethanol waste 12,521 14,913 13,232
Other (various combustible waste) 9,390 8,007 8,239
Total waste with energy recovery 21,911 22,920 21,471
Water waste with no energy recovery 141 356 5,499
Other 1,987 827 1,660
Total waste with no energy recovery 2,128 1,183 7,159
Water waste with resource recovery 7,949 7,379 N/A
Other 9,330 2,114 N/A
Total waste with resource recovery 17,279 9,493 N/A
Total waste to landfill 638 906 932
Total waste 189,091 213,505 180,806
In 2023, waste from production sites decreased by 11% compared to 2022 due to
waste reduction initiatives, reuse of waste and implementation of zero landfill
waste strategies.
The amount of waste recycled decreased by 18%, primarily due to initiatives to avoid
waste and efforts to transition from recycling to resource recovery.
The amount of waste sent for energy recovery decreased by 4%, primarily due to
optimisation projects and changes in the composition of waste, which led to a decrease
in the amount of waste being sent to incineration. Less than 0.3% of the total waste was
sent to landfill. In 2023, 20% of the waste was categorised as hazardous waste.
ACCOUNTING POLICIES
Water consumption is measured in thousand cubic metres of water and is based on
metre readings and invoices. It includes drinking water, industrial water and steam
water used at production sites.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 89
ACCOUNTING POLICIES
Waste is measured as the sum of all the waste disposed of at production sites based
on weight receipts. Organic residues for recycling are waste from the production of
the active pharmaceutical ingredients, where the energy is recovered in biogas plants
and the digested slurry is used on local farmland as fertiliser. Ethanol is recovered in
internal regeneration plants and re-used. Energy recovery is waste disposed of at
waste-to-energy plants and at a biogas plant. Waste with no energy recovery covers
water waste and other waste not suitable for other disposal methods, such as
hazardous waste for incineration and various other types of waste.
7.5 Breaches of environmental regulatory limit values
In 2023 there were 12 breaches compared to 8 in 2022. None of the breaches resulted
in any correlated material negative impact on the environment. For all breaches,
mitigation actions are in progress.
ACCOUNTING POLICIES
Breaches of regulatory limit values cover all breaches with limit values reported to the
environmental authorities. Breaches related to the same continued exceedance at the
same site count as one breach for the year.
Section 8
Social performance
8.1 Patients reached with Novo Nordisk's
Diabetes and Obesity care products
ACCOUNTING POLICIES
The number of full-year patients reached with Novo Nordisk's Diabetes and Obesity care
products, excluding devices, is estimated by dividing Novo Nordisk's annual sales volume
by the annual usage dose per patient for each product class, as defined by the WHO (for
Diabetes) and in accordance with the dose strength of the product (for Obesity).
The number of full-year patients reached with human insulin vials via the Novo
Nordisk Access to Insulin Commitment is estimated by dividing Novo Nordisk's annual
sales volume by the annual usage dose per patient reached via the Novo Nordisk
Access to Insulin Commitment, as defined by the WHO. The WHO-defined daily dosage
for these products may not accurately reflect the recommended or prescribed daily
dose. Actual doses are based on individual characteristics (e.g. age and weight) and
pharmacokinetic considerations. Despite this uncertainty, Novo Nordisk assesses this
to be the most consistent way of reporting.
The number of children reached with Diabetes care treatment through the Changing
Diabetes
®
in Children programme is measured as the total accumulated number of
children enrolled since the initiation of the partnership in 2009.
8.2 Employees
Number of employees
Number 2023 2022 2021
Year-end employees (total) 64,319 55,185 48,478
Year-end number of full-time employees 63,370 54,393 47,792
Employees by geographical area
Number 2023 2022 2021
International Operations 56,004 47,935 42,372
Denmark 28,692 22,916 19,150
EMEA (Europe, the Middle East and Africa),
excluding Denmark 8,808 7,954 7,530
China (Mainland China, Hong Kong, Taiwan) 6,485 6,148 5,833
Rest of World (all other countries) 12,019 10,917 9,859
North America Operations 8,315 7,250 6,106
Year-end employees (total) 64,319 55,185 48,478
Estimate in millions 2023 2022 2021
Patients reached with Novo Nordisk's
Diabetes care products 40.5 36.3 34.6
Patients reached with Novo Nordisk's
Obesity care products 1.1 0.6 0.3
Total number of patients reached 41.6 36.9 34.9
The estimated number of full-year patients reached with Novo Nordisk's Diabetes care
products increased from 36.3 million in 2022 to 40.5 million in 2023. The 12% increase
was primarily driven by the GLP-1 franchise, followed by the new-generation insulin
franchise and the human insulin franchise. The increase in number of full-year patients
reached with Novo Nordisk's Obesity care products in 2023 was primarily driven by the
continued launch of Wegovy
®
in new markets.
In 2023, the estimated number of full-year patients with diabetes reached with
Novo Nordisk's human insulin vials through the Access to Insulin Commitment was
2.4 million, compared to 1.8 million in 2022. The 33% growth through the Access to
Insulin Commitment was driven by increased sales through both government and
private market channels, sold at or below the USD 3 ceiling price. Novo Nordisk also
sold human insulin vials at or below the ceiling price of USD 3 in countries outside the
Commitment, reaching an estimated additional 2.6 million patients in 2023. This
represents a total of 5 million patients with diabetes reached with human insulin at
or below USD 3 per vial globally.
Through the Changing Diabetes
®
in Children (CDIC) partnership, 52,249 children and
youth were reached in total by the end of 2023, compared to 41,033 by the end of 2022.
Almost half of the new enrolled children were reached through expansion in Asian
countries, mainly India, Pakistan, Indonesia and Vietnam. The children receive access to
diabetes care in clinics (e.g. patient education), as well as medical supplies if needed.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 90
Employees by gender
% 2023 2022 2021
Male 51% 51% 51%
Female 49% 49% 49%
Other 0% 0% 0%
Not reported 0% 0% 0%
Employees by age group
% 2023 2022 2021
Under 30 years old 17% 15% 14%
30-50 years old 64% 65% 66%
Over 50 years old 19% 20% 20%
The number of employees increased in most areas with the highest growth in EMEA,
notably in Product Supply, Quality and IT. Currently, Novo Nordisk’s HR systems allow
employees to select the gender they most identify with. Moving forward, Novo Nordisk is
committed to increasing awareness of this self-identification option. The breakdown by
age group remained stable in the last three years.
The employee turnover rate decreased from 8.2% in 2022 to 5.5% in 2023, with decline
in almost all business areas.
ACCOUNTING POLICIES
The total number of employees is measured as headcount of all employees at
year-end, except externals, employees on unpaid leave, interns, Bachelor's and
Master's thesis employees and substitutes. All employee data is based on
registrations in Novo Nordisk's HR systems.
Employees are attributed to geographical regions according to their primary
workplace across the commercial units, research and development, production
and support functions. Employees in corporate functions are included in EMEA
and employees in Global Business Services in Bangalore, India, are included in
Rest of World.
The employee turnover rate is measured as the number of employees, excluding
temporary employees, who left the Group during the financial year, divided by the
average number of employees, excluding temporary employees. Employees working for
Group companies that have been disposed of are not counted as having left the Group.
8.3 Gender diversity in leadership positions
Ratio men:women 2023 2022 2021
CEO, EVP, SVP 64:36 71:29 72:28
CVP, VP 59:41 60:40 63:37
Director, manager, team leader 54:46 55:45 57:43
Gender in leadership positions (overall) 54:46 56:44 57:43
Gender in senior leadership positions 59:41 61:39 64:36
Gender in the Board of Directors 50:50 54:46 67:33
The gender diversity in leadership positions overall at Novo Nordisk meets the Danish
gender diversity requirements. At the end of 2023, 46% of leadership positions were
filled by women, compared to 44% at the end of 2022. Within senior leadership, 41%
positions were filled by women at the end of 2023, compared to 39% at the end of 2022.
All management teams, from entry level upwards, are encouraged to focus on enhanced
diversity, with the aim of ensuring a robust pipeline of talent for leadership positions. In
2021, Novo Nordisk introduced a global aspirational target of achieving a balanced gender
representation across all managerial levels with a minimum of 45% for both women and
men in senior leadership positions by the end of 2025.
ACCOUNTING POLICIES
Gender in leadership positions is reported as the percentage split by gender in
leadership and senior leadership positions. Senior leadership positions are defined
as employees in the global job levels chief executive officer (CEO), executive vice
president (EVP), senior vice president (SVP), corporate vice president (CVP) and vice
president (VP). Overall leadership positions are defined as directors, managers,
team leaders and senior leadership positions. Diversity on the Board of Directors is
reported as the percentage split by gender among all members, including employee-
elected members.
8.4 Sustainable employer score
This year’s employee survey revealed an increase in the already high overall
engagement, bringing it to 86% favourable compared to 85% favourable in 2022.
Novo Nordisk continues to score in the top quartile when benchmarked against
external organisations when it comes to providing a purpose-driven workplace.
Improvements were seen on most questions, with a large improvement on
‘I understand how my performance is evaluated’, which was a focus area for
follow up on the 2022 survey results. Opportunities for further improvement
were seen in providing equal career opportunities for all and improving following
through on committed actions, based on survey results across the organisation.
ACCOUNTING POLICIES
The Sustainable employer score measures the average percentage of favourable
answers to the 18 engagement items in the survey. Favourable answers are
defined as ‘Agree’ and ‘Strongly agree’ to positively framed questions. The survey
is administered by an external vendor.
8.5 Health and safety
In 2023, Novo Nordisk had 153 accidents with reported absence compared to 128 in
2022, which is in line with the increase in number of employees. The average lost time
accident frequency was 1.5 in 2023, in line with 2022.
Novo Nordisk had one work-related fatality in 2023 compared to two in 2022, due to
a car accident. Novo Nordisk will continue to train and motivate employees on good
road safety behaviour to reduce the risk of recurrences.
In 2023, Novo Nordisk has harmonised incident reporting into one global reporting
system to ensure standardised reporting and systematic prevention, specifically with
focus on prevention of high-risk incidents.
We offer a healthy and engaging workplace, supported by a comprehensive health
and safety programme based on continuous improvements within safety, physical
health, mental well-being and employee health promotion. To this end, we have
implemented our Health & Safety management system across our entire global
organisation. Performance is overseen by Executive management and the Board of
Directors. In 2023, 13.8% of Novo Nordisk employees reported symptoms of stress, in
line with 2022, and 7.1% reported symptoms of work-related physical pain, compared
to 7.8% in 2022.
For a full overview of Novo Nordisk's Health and safety framework and for the CEO’s
statement on health and safety, please refer to: www.novonordisk.com/sustainable-
business/esg-portal/social.html.
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ACCOUNTING POLICIES
The frequency of occupational accidents is measured as the internally reported
number of accidents with absence per million nominal working hours, also referred to
as Lost Time Injury Frequency (LTIF). Contractors, visitors, employees on unpaid leave,
interns and Bachelor's and Master's thesis students are not included. An occupational
accident with absence is any work-related accident causing at least one day of absence
in addition to the day of the accident.
The percentages of employees reporting symptoms of stress and employees reporting
symptoms of work-related physical pain are monitored in the annual employee survey.
In the survey, stress is defined as a situation where the employee feels tense, restless,
nervous or troubled, or unable to sleep at night due to thoughts about their problems.
With reference to symptoms of physical pain, the employee is asked in the survey if
generally their work causes them physical pain.
8.6 US pricing
% change vs prior year 2023 2022 2021
US product portfolio
List price change – Avg.
2.8% 2.4% 1.6%
Net price change – Avg.
(8.2%) (10.5%) (12.3%)
US insulin portfolio
List price change – Avg.
0.1% 0.0% 0.0%
Net price change – Avg.
(24.4%) (19.5%) (10.9%)
Novo Nordisk has a long history of making products accessible and affordable through
responsible pricing practices and patient access programmes. In 2023, the average net price
of both the US product portfolio and the US insulin portfolio decreased by 8.2% and 24.4%,
respectively, compared to 10.5% and 19.5% in 2022, as a result of enhancements to secure
formulary access for insured patients, as well as the evolution of channel and payer mix.
Novo Nordisk has provided sales discounts and rebates amounting to 74% of US gross
sales in 2023, resulting in the average annual list price across US product portfolio
increasing by 2.8% and the US insulin portfolio by 0.1%.
ACCOUNTING POLICIES
The US product portfolio is inclusive of Diabetes, Obesity and Rare Disease products.
The percentage change represents a sales weighted average list and net price for the
respective year compared to the sales weighted average list and net price for the prior
year, and is not reflective of the magnitude of individual list price actions. The net price
represents the average list price minus rebates, discounts and returns for the specific
product for the year in which it is being calculated.
8.7 Total tax contribution
DKK million
Taxes
borne
Taxes
collected 2023 2022 2021
Corporate income taxes
paid 25,897 6,080 31,977 19,097 18,390
Employment taxes 2,666 13,510 16,176 13,006 10,840
Indirect taxes 2,815 (1,035) 1,780 3,027 2,612
Other taxes 1,314 — 1,314 873 751
Total 32,692 18,555 51,247 36,003 32,593
In 2023, the total tax contribution amounted to DKK 51,247 million, split across 64% of
taxes borne and 36% of taxes collected. In 2022, the split was 55% of taxes borne and
45% of taxes collected.
The overall increase in total tax contribution from 2022 to 2023 is primarily related
to higher corporate income taxes paid in Denmark due to an increase in the profit
before tax. In addition, the corporate income tax in 2022 reflects the partial refund
of tax prepayment made in 2021. Expansion of production and sales worldwide have
required more employees which has increased the payment of employment taxes
including social security contributions.
ACCOUNTING POLICIES
Novo Nordisk's total tax contribution is measured as the taxes borne or collected by
Novo Nordisk, which have been paid in the respective year. Taxes borne are defined
as taxes where Novo Nordisk carries the cost. Taxes collected are defined as taxes
collected by Novo Nordisk on behalf of others, e.g. employee income taxes deducted
from employee salaries and paid to the government.
Corporate income taxes paid primarily consist of corporate income taxes and
withholding taxes on company dividends paid during the year.
Employment taxes primarily consist of taxes collected from employees on behalf of
the government and social security costs (part of payroll taxes in some countries).
Indirect taxes consist of non-refundable VAT, net VAT collections, customs duties,
environmental taxes and property taxes.
Other taxes consist of country-specific taxes not linked to one of the categories
above, e.g. the US branded prescription drug fee.
8.8 Donations and other contributions
DKK million 2023 2022 2021
World Diabetes Foundation (WDF) 119 93 92
Novo Nordisk Haemophilia Foundation
(NNHF) 19 33 —
Total donations and other contributions 138 126 92
The WDF, an independent trust, supports sustainable partnerships and acts as a
catalyst to help others do more. The amount granted to WDF has increased to
DKK 119 million in 2023 in accordance with the donation agreement. For more
information, visit: www.worlddiabetesfoundation.org.
The NNHF supports programmes in low- and middle-income countries. Initiatives
focus on capacity-building, diagnosis and registry, awareness and advocacy. The
residual payment for the agreed donation to the NNHF for the year 2022 was made
in 2023, amounting to DKK 13 million. Additionally, in 2023 Novo Nordisk paid DKK 6
million. Since 2005, the NNHF has provided funding for 311 programmes (237 projects
and 74 fellowships) in 87 countries. For additional information, visit: www.nnhf.org.
ACCOUNTING POLICIES
Donations and other contributions by Novo Nordisk to the WDF and the NNHF are
recognised when the donation or contribution is paid out.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 92
Section 9
Governance performance
9.1 Business ethics reviews and training
In 2023, Group Internal Audit performed 40 business ethics reviews, compared
to 35 in 2022, which was in line with the number of planned reviews for the year.
Annual training on business ethics is mandatory for all employees, including all new
hires. In 2023, 99% of employees completed and documented their training, in line
with 2022. The completion and documentation rate represents the emphasis of Novo
Nordisk diligently following up on employees to ensure completion of the annual
training. The remaining 1% is mainly due to employees being on leave.
ACCOUNTING POLICIES
The number of business ethics reviews is recorded as the number of business ethics
reviews performed by Group Internal Audit in subsidiaries, production sites, vendors
and headquarter areas.
The mandatory ethics and compliance training is based on the principles for ethics
and compliance for employees working at Novo Nordisk. The training is provided
in the form of globally applicable e-learning and related tests. The percentage of
employees trained in business ethics is calculated as the number of employees that
have completed the training divided by the total number of employees at year-end.
9.2 Compliance Hotline
We maintain a Compliance Hotline to enable employees, stakeholders and external
parties to report potential violations of our policies or applicable laws and regulations.
The Compliance Hotline is an important component of our commitment to ethical
conduct and transparency. The increase in number of substantiated cases in the
period from 2021 to 2023 is driven by the increased business growth, including
development in number of employees.
ACCOUNTING POLICIES
Number of substantiated cases reported via the Compliance Hotline includes the number
of cases where reported allegations of suspected misconduct have been substantiated or
partially substantiated. When a case has been substantiated or partially substantiated,
corrective actions are initiated.
Convictions for violation of anti-corruption and anti-bribery laws include convictions
where a Novo Nordisk legal entity (parent or any affiliate) has been found in violation
by a court of law.
9.3 Supplier audits
Number 2023 2022 2021
Responsible sourcing audits 24 14 16
Quality audits 358 280 237
Total supplier audits 382 294 253
The 30% increase in the number of supplier audits from 2022 to 2023 reflects the general
increased activity level in Novo Nordisk. Two critical findings on responsible sourcing were
issued during 2023, both related to wages, benefits and working hours. Three critical
findings were issued during quality audits, related to reprocessing, certificates of
analysis (COAs) and cross-contamination control. Agreements regarding actions to
address all critical findings have been made with the affected suppliers. Of the two
critical findings issued and reported in 2022, one was addressed in the same year, and
remediation for the second critical finding regarding environmental reporting was still
ongoing. An agreement with the supplier has subsequently been reached during 2023.
ACCOUNTING POLICIES
The number of supplier audits concluded by Novo Nordisk's Corporate Quality
function consists of the number of responsible sourcing audits and quality audits
conducted at suppliers.
9.4 Product recalls
In 2023, Novo Nordisk had two product recalls. In Libya, the recall was due to a
labelling error on the sales carton. In Spain, the recall was due to cracked cartridges
in FlexTouch
®
pens.
ACCOUNTING POLICIES
The number of product recalls is recorded as the number of times Novo Nordisk has
instituted a recall, and includes recalls in connection with clinical trials. A recall can
affect various countries.
9.5 Failed inspections
In 2023, Novo Nordisk had not failed any inspection among those that were resolved at
year-end. During 2023, 152 inspections were conducted. At year-end, 117 inspections
were passed and 35 were unresolved, as final inspection reports had not been received,
or the final authority’s acceptance was pending. This is normal practice. Follow-up on
unresolved inspections will continue in 2024.
ACCOUNTING POLICIES
Failed inspections are defined as inspections where Warning Letters or EMA non-
compliance letters related to GMP inspections are received, GMP/ISO certificates for
strategic sites are lost, pre-approval inspections result in a Complete Response Letter,
study conclusions are changed due to GCP/GLP inspection issues, or marketing or import
authorisations are withdrawn due to inspection issues. Strategic sites are defined as the
manufacturing sites in Brazil, China, Denmark, France and the US. Acquired companies
inspections are defined as inspections run by the acquired company. Inspections at
acquired companies run by Novo Nordisk are reported as Novo Nordisk inspections.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 93
9.6 Facilitations of the Novo Nordisk Way
In 2023, a total of 42 units were facilitated and approximately 2,300 employees were
individually interviewed. In addition, feedback on those units was collected from
approximately 550 stakeholders. Out of the 42 units, one unit was assessed not to be
working in accordance with the Novo Nordisk Way, and for five units immediate actions
were required, which if not taken would lead to breaches of the Novo Nordisk Way.
Across all units facilitated, the accelerated growth and supply-demand challenges
are the two main factors which consistently impact the organisation and drive most
improvement opportunities from the facilitations conducted. The most frequent
observations raised to management teams for action are associated with five out of
our ten Essentials: 2) We set ambitious goals and are empowered to achieve them, 5)
We build and maintain good relations with our stakeholders, 7) We focus on
performance and personal development, 8) We have a healthy and engaging work
environment, and 9) We strive for agility and simplicity in everything we do.
ACCOUNTING POLICIES
Facilitations of the Novo Nordisk Way are measured as the number of facilitations
completed. A facilitation is an internal process for assessing adherence to the Novo
Nordisk Way. The assessments are based on a review of documentation and feedback
from stakeholders, followed by an on-site visit during which randomly selected
employees and management are interviewed. Identified gaps and improvement
opportunities related to the Novo Nordisk Way are presented to, and discussed with,
Management. The facilitators and Management agree on an action plan to address
those gaps and improvement opportunities. For the full list of the Novo Nordisk Way
Essentials, please refer to page 19 in the Management review.
9.7 Company reputation 9.8 Animals purchased for research
Scale 0-100 2023 2022 2021
People with diabetes 81.4 81.3 81.5
People with obesity 77.9 79.4 79.4
General practitioners 82.9 84.0 84.8
Diabetes specialists 88.9 90.3 90.3
Informed general public 79.6 76.3 77.1
Total score (average) 82.1 82.3 82.6
Company reputation is a comprehensive approach to analysing reputational intelligence.
Novo Nordisk’s excellent reputation score is driven by positive perceptions of products
and services, and by growing appreciation from the informed general public.
ACCOUNTING POLICIES
The reputation score is based on four factors measuring esteem, admiration, trust
and feeling of the stakeholders towards Novo Nordisk, across ten key markets: France,
Denmark, the US, Canada, Brazil, China, Japan, Germany, Italy and the UK. The data
is collected through online surveys carried out by an external consultancy firm.
Responses are aggregated to produce an overall score on a Likert scale of 1-7, which
is rebased on a 0-100 scale.
Number 2023 2022 2021
Mice, rats and other rodents 54,410 63,760 35,675
Pigs 608 427 759
Rabbits 289 606 184
Dogs 356 146 114
Non-human primates 807 700 495
Fish 36 14,098 10,638
Other vertebrates 2 13 14
Total animals purchased 56,508 79,750 47,879
The number of animals purchased for research in 2023 decreased by 29% compared
to 2022. 96% of the animals purchased were rodents. The significant decrease in the
number of fish and rodents in 2023 is attributable, respectively, to specific research
projects using fish larvae that have been discontinued in the year, and to our
continuous efforts to reduce the number of animals used for research.
ACCOUNTING POLICIES
Animals purchased for research comprises the number of animals purchased for all
research undertaken by Novo Nordisk either in-house or by external contractors. The
number of animals purchased is based on internal registration of purchased animals
and yearly reports from external contractors.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 94
Statement by the Board of Directors and Executive Management
Registered Executive Management
Board of Directors
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 95
Independent Auditor’s Report
Report on the Financial Statements
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 96
Business Registration No 33 96 35 56
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 97
Independent Auditor’s Assurance Report on the ESG statement
Novo Nordisk A/S engaged us to provide limited assurance on the consolidated ESG
statement (‘the ESG statement’) for the period 1 January – 31 December 2023, presented on
pages 86 to 94 in the Annual Report 2023 of Novo Nordisk A/S.
Management’s responsibility
Management of Novo Nordisk A/S is responsible for designing, implementing and
maintaining internal controls over information relevant to the preparation of the ESG data
and information in the ESG statement, ensuring it is free from material misstatement,
whether due to fraud or error. Furthermore, Management is responsible for establishing
objective accounting policies for the preparation of the ESG statement, for the overall content
of the ESG statement, and for measuring and reporting ESG data in accordance with the Basis
of preparation and the ESG accounting policies.
Auditor’s responsibility
Our responsibility is to express a limited assurance conclusion based on our engagement with
Management and in accordance with the agreed scope of work. We have conducted our work
in accordance with ISAE 3000 (Revised) Assurance Engagements Other than Audits or Reviews
of Historical Financial Information and ISAE 3410 Assurance Engagements on Greenhouse
Gas Statements, and additional requirements under Danish audit regulation, to obtain limited
assurance about our conclusion. Greenhouse Gas emissions quantification is subject to
inherent uncertainty because of incomplete scientific knowledge used to determine emission
factors and the values needed to combine emissions of different gasses.
We are responsible for:
• planning and performing the engagement to obtain limited assurance about whether the
ESG statement is free from material misstatement, whether due to fraud or error, and
prepared, in all material respects, in accordance with the Basis for preparation and the ESG
accounting policies;
• forming an independent conclusion, based on the procedures we performed and the
evidence we obtained; and
• reporting our conclusion to the stakeholders of Novo Nordisk A/S.
Deloitte Statsautoriseret Revisionspartnerselskab applies International Standard on Quality
Management 1 (ISQM 1), which requires the firm to design, implement and operate a system
of quality management including policies or procedures regarding compliance with ethical
requirements, professional standards and applicable legal and regulatory requirements. We
have complied with the requirements for independence and other ethical requirements of
the International Ethics Standards Board for Accountants’ International Code of Ethics for
Professional Accountants (IESBA Code), which is founded on fundamental principles of
integrity, objectivity, professional competence and due care, confidentiality and professional
behaviour and ethical requirements applicable in Denmark.
A limited assurance engagement is substantially less in scope than a reasonable assurance
engagement. Consequently, the level of assurance obtained in a limited assurance
engagement is substantially lower than the assurance that would have been obtained
had we performed a reasonable assurance engagement.
Work performed
We are required to plan and perform our work in order to consider the risk of material
misstatement in the ESG statement. To do so, we have:
• conducted interviews with data owners and internal stakeholders to understand the key
processes and control activities for measuring, recording and reporting the ESG data;
• performed limited substantive testing on a selective basis to check that data has been
appropriately measured, recorded, collated and reported;
• performed analysis of data, selected based on risk and materiality;
• made inquiries regarding significant developments in the reported data;
• considered the presentation and disclosure of the ESG statement;
• assessed that the process for reporting greenhouse gas emissions data follows the
principles of relevance, completeness, consistency, transparency and accuracy outlined
in The Greenhouse Gas Protocol Corporate Standard Revised edition (2015) and The
Corporate Value Chain (Scope 3) Accounting and Reporting Standard (2011); and
• evaluated the evidence obtained.
Our conclusion
Based on the procedures performed and the evidence obtained, nothing has come to
our attention that causes us not to believe that the ESG data on pages 86 to 94 in the
consolidated ESG statement for the period 1 January – 31 December 2023, have been
prepared, in all material respects, in accordance with the Basis of preparation and the
ESG accounting policies.
Copenhagen, 31 January 2024
Deloitte
Statsautoriseret Revisionspartnerselskab
Business Registration No. 33 96 35 56
Anders Vad Dons Mads Stærdahl Rosenfeldt
State-Authorised Public Accountant ESG Partner
mne25299
To stakeholders of Novo Nordisk A/S
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 98
100 More information
101 Product overview
102 ESG initiatives
104 Sustainability frameworks and performance
Additional
information
Once considered the best mountain
biker in Spain, David Lozano (right)
was dropped from his professional
contract after being diagnosed with
type 1 diabetes. Determined to
continue his career, David connected
with Team Novo Nordisk, the world’s
only all-diabetes professional cycling
team. His transition to road biking has
been full of personal triumphs, and his
involvement in the team led his father
– also diagnosed with type 1 diabetes –
to take a more active role in managing
the disease. David is pictured here with
his teammate Matyas Kopecky.
Watch Team Novo Nordisk’s
documentary here
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 99
Additional reporting
Novo Nordisk provides additional disclosure to satisfy legal requirements
and stakeholder interests. Supplementary reports can be downloaded at:
www.novonordisk.com/annualreport, while additional information can
be found at: www.novonordisk.com.
Materiality
Novo Nordisk relies on the International Integrated Reporting
Council’s definition of materiality. Information deemed material for
providers of financial capital in their decision-making is included in
the Annual Report, i.e. it being of such relevance and importance that
it could substantively influence their assessments of Novo Nordisk’s
ability to create value over the short, medium and long term. See
how Novo Nordisk determines materiality and material issues at:
www.novonordisk.com.
Annual Report
This Annual Report is Novo Nordisk’s full statutory Annual Report pursuant
to Section 149(1) of the Danish Financial Statements Act. The statutory
Annual Report will be presented and adopted at the Annual General Meeting
on 21 March 2024 and will subsequently be submitted to and be available
at the Danish Business Authority. The consolidated financial statements
included in this Annual Report have been prepared in accordance with IFRS
Accounting Standards (IFRS) as issued by the International Accounting
Standards Board (IASB) and in accordance with IFRS Accounting Standards
endorsed by the EU and further requirements in the Danish Financial
Statements Act. Moreover, it meets the requirements of an integrated
report, as per the International Integrated Reporting Framework.
Form 20-F
The Form 20-F is filed using a standardised reporting form so that
investors can evaluate the company alongside US domestic equities.
It is an annual reporting requirement by the US Securities and Exchange
Commission (SEC) for foreign private issuers with equity shares listed on
exchanges in the United States.
Corporate Governance Report
The Corporate Governance Report discloses Novo Nordisk’s compliance
with corporate governance to meet the requirements of the Danish
Financial Statements Act.
Remuneration Report
The Remuneration Report describes the remuneration awarded or due
during 2023 to members of the Board and Executive Management
registered with the Danish Business Authority in accordance with section
139b of the Danish Companies Act. The Remuneration Report is
submitted to the Annual General Meeting for an advisory vote.
References
Throughout the Management review section in this report, links are
provided to online sources for additional information. Some of the
references are not mandatory and hence not included in the audit
of the Management review. For more news from Novo Nordisk, please
visit: www.novonordisk.com/investors.html and www.novonordisk.com/
news-and-media/latest-news.html.
Disclaimer
The patients, employees and relatives portrayed in this Annual Report
and ancillary reports have participated of their own accord and solely to
express their own personal opinions on topics referred to, which do not
necessarily reflect the views and opinions of Novo Nordisk. Use of the
pictures as illustrations is in no way intended to associate the patients,
employees or relatives with the promotion of any Novo Nordisk
products.
Credits
Design and production: Kontrapunkt.
Illustrations: Kontrapunkt.
Photography: Carlos Rossini, Helen Orr, Jesper Edvarsen, Jesper Westley,
Junpei Ono, Kelly Mailloux, Martin Nordmark, Marie Hald, Mauricio
Ramos, Thomas Fink.
More information
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 100
Product overview
1
New-generation insulin and combinations
• Tresiba
®
, insulin degludec
• Ryzodeg
®
, insulin degludec/insulin aspart
• Fiasp
®
, fast-acting insulin aspart
• Xultophy
®2
, insulin degludec/liraglutide
Modern insulin
• Levemir
®
, insulin detemir
• NovoRapid
®3
, insulin aspart
• NovoMix
®
30, biphasic insulin aspart
• NovoMix
®
50, biphasic insulin aspart
• NovoMix
®
70, biphasic insulin aspart
4
Human insulin
• Insulatard
®
isophane (NPH) insulin
• Actrapid
®
, regular human insulin
• Mixtard
®
30, biphasic human insulin
• Mixtard
®
40, biphasic human insulin
4
• Mixtard
®
50, biphasic human insulin
Glucagon-like peptide-1
• Victoza
®
, liraglutide
• Ozempic
®
, semaglutide
• Rybelsus
®
, oral semaglutide
Pre-filled delivery systems
• FlexTouch
®
, U100, U200
• FlexPen
®
• InnoLet
®
• Ozempic
®
, FlexTouch
®
Durable delivery systems
• NovoPen
®
6
• NovoPen
®
5
• NovoPen
®
4
• NovoPen Echo
®
Plus
• NovoPen Echo
®
Other delivery systems
• PumpCart
®
, NovoRapid
®
and Fiasp
®
cartridge
to be used in pump
• Penfill
®
cartridge
• Mallya
®
Oral antidiabetic agents
• NovoNorm
®
, repaglinide
Glucagon
• GlucaGen
®
, glucagon (vial and Hypokit
®
)
• Zegalogue
®
, dasiglucagon
Needles
• NovoFine
®
Plus
• NovoFine
®
• NovoTwist
®
• NovoFine
®
AutoCover
®
Glucagon-like peptide-1
• Saxenda
®
, liraglutide 3.0 mg
• Wegovy
®
, semaglutide 2.4 mg
Obesity delivery systems
• Saxenda
®
, FlexTouch
®
• Wegovy
®
Single Dose Device and FlexTouch
®
Rare blood disorders
• NovoSeven
®
, eptacog alfa (recombinant activated factor VII)
• NovoEight
®5
, turoctocog alfa (recombinant factor VIII)
• NovoThirteen
®
, catridecacog (recombinant factor XIII)
• Refixia
®6
, nonacog beta pegol, N9-GP (recombinant factor IX)
• Esperoct
®
, turoctocog alfa pegol, N8-GP (recombinant factor VIII)
• Alhemo
®
, concizumab (anti-TFPI)
Rare endocrine disorders
• Norditropin
®
, somatropin (rDNA origin)
• Sogroya
®
, somapacitan (rDNA origin)
Pre-filled human growth hormone delivery systems
• FlexPro
®
• NordiFlex
®
Other delivery systems
• PenMate
®
, automatic needle inserter for NordiFlex
®
Hormone replacement therapies
• Vagifem
®7
, estradiol hemihydrate
• Activelle
®
, estradiol/norethisterone acetate
• Kliogest
®
, estradiol/norethisterone acetate
• Novofem
®
, estradiol/norethisterone acetate
• Trisequens
®
, estradiol/norethisterone acetate
• Estrofem
®
, estradiol
1. Products listed may not be available in all markets. 2. In the US approved under the brand name Xultophy
®
100/3.6. 3. In the US called NovoLog
®
. 4. The global discontinuation of NovoMix
®
70 and Mixtard
®
40 has been communicated. 5. In the US written Novoeight
®
. 6. In the US approved under the name of REBINYN
®
. 7. In the UK also called gina
®
.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 101
ESG initiatives
Agenda Name Description Reach Ambition 2023 Progress
CO
2
e emissions Purchasing renewable
energy
Range of solutions helping us move towards 100% renewable energy supply. This includes Renewable Electricity Certificates
(REC), Power Purchase Agreements (PPA) and on-site renewable energy solutions.
Global Achieve zero CO
2
e emissions from operations
by 2030.
Across Novo Nordisk, 63.2% of the energy sourced and 99.5% of the power sourced this
year was renewable. At production sites, 61.3% of the energy sourced and 100% of the
power sourced was renewable.
Minimising air
transportation impact
Three-fold approach to reduce CO
2
e emissions associated to air transportation. This includes limiting business flights,
reducing air freight of our products and purchasing Sustainable Aviation Fuel (SAF).
Global Achieve zero CO
2
e emissions from transportation
by 2030.
We reduced CO
2
e emissions associated to air transportation by 32%. We entered into
the Sustainable Aviation Buyers Alliance (SABA) to purchase SAF, hereby securing
significant investment and scalability in SAF solutions.
Decarbonising
supply chains
Holistic effort to decarbonise our supply chain, with over 90% of CO
2
e emissions coming from suppliers, by identifying and
implementing levers within high-impact scope 3 categories.
Global Set an absolute, near-term scope 3 reduction
target by the end of 2024.
We started an in-depth supplier engagement programme and roadmap development.
This will continue throughout 2024.
Sustainable Markets
Initiative (SMI)
Public-private partnership, involving CEOs and leaders from healthcare organisations, that aims to decarbonise healthcare
systems by reducing emissions from supply chains, patient care pathways and clinical trials.
Global Address 3.5 million tonnes of CO
2
e per year across
more than 100 of the members’ largest
pharmaceutical suppliers.
The SMI private sector CEOs launched joint, minimum environmental targets
for suppliers.
Plastic Converting to
reusable devices
Efforts to move away from single-use devices and convert into reusable devices that have a longer lifespan. While Novo
Nordisk has manufactured reusable devices for almost 30 years, we intend to prioritise this conversion going forward.
NWE
1
, AU
2
,
CN
3
, CA
4
Build on this year's conversions to raise the ambition
level for 2024 and beyond.
We increased our efforts to shift more patients towards reusable devices in Region
North West Europe, Australia, China and Canada.
Finding fossil-free
plastic alternatives
Efforts to find viable, lower-carbon alternatives to fossil-based plastic, which is present in the hundreds of millions of pens
we produce every year.
Global Replace plastic in our products with fossil-free
alternatives.
We announced a partnership with the LEGO Group to buy e-methanol from European
Energy and use it as a lower-carbon alternative to conventional plastics. Production of
the resulting plastic is expected for 2025.
Recycling
injection devices
Take-back scheme tasked with recycling injection pens. This includes pilot programmes in a number of countries, and
the world's first industry pilot in Denmark, in collaboration with Lilly, Sanofi and Merck.
DK
5
, UK
6
, BR
7
,
FR
8
Collect 25% of the injection pens in Denmark within
the industry pilot’s first year, and achieve an 85%
recycling rate by the end of 2024.
We launched the world’s first industry pilot in Denmark and are currently achieving a
50% recycling rate of the materials in the returned injection pens.
Access and
affordability
Access to Insulin
Commitment
Commitment to provide human insulin at a ceiling price of USD 3 per vial to governments and public tenders in 77 LMIC
9
,
as well as USD 2 per vial to selected humanitarian organisations and NGOs.
LMIC Secure access to affordable insulin to significantly
more people living with diabetes in LMIC.
An estimated 2.4 million people accessed care under this commitment.
Changing Diabetes
®
in Children
Public-private partnership providing comprehensive care for children and young people living with type 1 diabetes in LMIC.
This includes free life-saving medicine and supplies for those up to 25 years old.
29 countries
across AF
10
,
ME
11
, AS
12
,
SA
13
Reach 100,000 vulnerable children and young people
living with type 1 diabetes by 2030.
So far, we have reached 52,249 children and young people, trained 25,314 healthcare
professionals and refurbished 406 clinics.
Thermostable insulin Cross-functional initiative that challenges and re-evaluates the thermal stability of short- and intermediate-acting human
insulin products. These are widely used in LMIC and humanitarian settings, where people with diabetes, and without access
to stable cooling options, can benefit from revised storage guidance.
LMIC Reach national approvals in the 72 countries
considered for revised storage conditions.
So far, we have 29 national approvals for more flexible storage conditions.
iCARE Integrated business model, driven by our regional affiliate, that uses partnerships across sub-Saharan Africa to improve
access to diabetes care. It does so by establishing and strengthening four building blocks of diabetes management: capacity,
affordability, reach and empowerment.
Sub-Saharan
Africa
Secure access to diabetes care for vulnerable
patients.
We reached 433 thousand people with diabetes and trained 3,523 healthcare
professionals.
Africa for Africa Commitment to significantly increase availability of insulin to people with diabetes on the African continent. It focuses on
local production, and will both reduce the environmental footprint from transportation and support creation of local jobs.
Africa Produce more than 60 million vials by 2026. We announced a partnership with South African-based pharmaceutical manufacturer
Aspen Pharmacare to increase the production of insulin for the African continent.
Partnering for Change Collaboration between the International Committee of the Red Cross (ICRC), the Danish Red Cross and Novo Nordisk
investigating better approaches to care for people living with non-communicable diseases (NCDs) in humanitarian crises.
LB
14
, IQ
15
Publish nine peer-reviewed articles on NCD care
in humanitarian crises.
Six peer-reviewed articles were published, four are under review and an additional two
are in the pipeline.
We recognise the need to operate with proper regard to our impact on society and the
environment. This table compiles some of our most significant initiatives within ESG.
1. NWE: North West Europe. 2. AU: Australia. 3. CN: China. 4. CA: Canada. 5. DK: Denmark. 6. UK: United Kingdom. 7. BR: Brazil. 8. FR: France. 9. LMIC: Low- and middle-income countries. 10. AF: Africa. 11. ME: Middle East. 12. AS: Asia. 13. SA: South America. 14. LB: Lebanon. 15. IQ: Iraq.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 102
Agenda Name Description Reach Ambition 2023 Progress
Access and
affordability
(continued)
MyInsulinRx
TM
Programme allowing eligible patients to obtain a monthly supply of any combination of Novo Nordisk insulin products
(up to three vials or two packs of pens) for USD 35.
US
16
Provide access to affordable insulin to those in need
in the US.
We replaced My99Insulin with MyInsulinRx
TM
, reducing the out of pocket cost for
patients from USD 99 to 35.
Patient Assistance
Program
Programme offering free diabetes medication to people in need who meet certain eligibility criteria, including annual
household income at or below 400% of the government-defined poverty level.
US Provide access to affordable diabetes medication to
those in need in the US.
We provided free insulin to 63 thousand people and free GLP-1-based medicines to 162
thousand people.
Immediate Supply
Program
Programme providing a free, one-time, short-term supply of our insulin (up to three vials or two packs of pens) to eligible
patients who may be at risk of rationing.
US Provide access to affordable insulin to those in need
in the US.
Nine thousand patients had access to this programme, and we provided education on
availability of our affordability offerings.
Copay Savings Offers Offers reducing the cost for commercially insured patients who are exposed to higher than average copays. US Provide access to affordable diabetes medication to
those in need in the US.
We provided USD 169 million in copay assistance for insulin and USD 599 million in
copay assistance for GLP-1-based medicines.
Prevention Cities Changing Diabetes Programme bringing together a network of 47 city-based public-private partnerships that aim to prevent obesity and type 2
diabetes in vulnerable populations and children.
Global Promote health equity, expand prevention efforts
and address barriers to health for vulnerable
populations and children.
Over 50 research studies were conducted, more than 250 local partnerships were
created or strengthened, and over 85 local interventions on diabetes and obesity were
initiated.
Partnership with UNICEF Collaboration aiming to prevent childhood obesity across Latin America and Asia Pacific. It uses policies, programmes and
practices to directly impact the nutrition, wellbeing and development of children.
MX
17
, CO
18
,
BR, ID
19
Directly impact at least 10 million children through
programmatic activities by 2026.
So far, the partnership has benefitted more than 2.7 million children and caregivers
across Latin America and the Caribbean through direct programmatic reach.
Diversity and
inclusion
Global parental
leave policy
Policy offering a minimum of eight weeks of paid leave within the first year of becoming a parent to all non-birthing parents
globally, regardless of gender.
Global Ensure that all employees get the opportunity to
bond with their child.
Employees worldwide continue to benefit from our enhanced parental leave policy.
Global inclusion index Numerical indicator, included in our annual employee engagement survey, of how employees rate the state of inclusion in
Novo Nordisk. It includes four statements covering psychological safety, equal opportunity, sense of belonging and valuing
of diverse perspectives.
Global Sustain progress on the state of inclusion in
Novo Nordisk.
Of the more than 47,000 employees who completed the survey, 82% rated the inclusion
statements favourable, compared to 78% in 2021 and 82% in 2022.
Yearly equal pay reviews Equal pay reviews conducted on a yearly basis and followed by corrective actions for confirmed equal pay risk cases. Global,
excluding US
Mitigate bias in pay processes and decisions. Out of the more than 49,000 positions covered in the pay review, we identified 0.6%
with an equal pay gap and we are taking corrective actions.
Gender diversity targets Two aspirational gender diversity targets that accelerate progress towards balanced gender representation and ensure
leadership accountability.
Global Achieve a balanced gender representation across all
managerial levels and a minimum of 45% women
and 45% men in senior leadership positions by the
end of 2025.
By end of year, 46% of all leaders were women, and 41% of leaders in senior leadership
positions were women, compared to 44% and 39%, respectively, at the end of 2022.
Company
culture
Novo Nordisk
Way Facilitation
Collaborative assessment that a team of facilitators performs with selected units to evaluate their compliance with the Novo
Nordisk Way.
Global Assess all high-risk units yearly. 42 units were assessed, one of which was deemed to not be working in accordance
with the Novo Nordisk Way. The most frequent findings raised to management teams
relate to ambition, empowerment, stakeholder relations, simplicity or agility.
Ethics and
compliance
Global Ethics and
Compliance Framework
The Novo Nordisk Way, our OneCode and international and local standards for responsible business conduct set the foundation
for ethics and compliance in Novo Nordisk. This covers anti-fraud, anti-bribery, anti-off-label promotion, transparency in dealing
with healthcare professionals and organisations, protection of personal data and respect to human rights.
Global Ensure that all Novo Nordisk employees act with
integrity and in compliance with the ethics and
compliance framework.
We launched OneCode, which sets expectations and guides all Novo Nordisk employees
on how we act as a company and individuals.
Annual Ethics and
Compliance Training
Ethics and compliance training conducted on an annual basis and mandatory for all employees, including all new hires. Global Train all Novo Nordisk employees annually in ethics
and compliance.
99% of all employees completed and documented their training, with the remaining 1%
missing mainly due to employees being on leave.
Business Ethics Reviews Business ethics reviews performed by Group Internal Audit (GIA) in subsidiaries, production sites, vendors and headquarters
to assess the level of ethics and compliance in Novo Nordisk.
Global Complete 45 business ethics reviews in 2024.
40 business ethics reviews were completed, compared to 35 reviews in 2022. Consolidated
conclusions were reported to Executive Management and the Audit Committee. GIA
assessed that the level of ethics and compliance in Novo Nordisk is sound.
ESG initiatives (continued)
16. US: United States. 17. MX: Mexico. 18. CO: Colombia. 19. ID: Indonesia.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 103
Sustainability frameworks and performance
Agenda Name Type Description Scale Result Comment
Value Reporting Foundation (VRF) Standard The VRF (previously known as Sustainability Accounting Standards Board, and now part of the IFRS Foundation)
enables organisations to provide industry-based disclosures on sustainability risks and opportunities affecting cash
flows, access to finance or cost of capital in short, medium or long term.
N/A N/A Novo Nordisk reports on VRF in alignment with the ‘Biotechnology & Pharmaceuticals’ standard. We are
fully or partially aligned with all the 25 indicators required by VRF.
UN Sustainable Development Goals
(UN SDGs)
Commitment The UN SDGs are a set of 17 goals and 169 targets designed to achieve a sustainable future by 2030. The goals
cover a range of issues, including poverty, inequality, climate change and environmental sustainability.
N/A N/A Novo Nordisk uses SDGs to step up sustainability, drive zero environmental impact by 2030 and improve
healthcare for more people. The priority SDGs are Goal 3 (Good health and wellbeing) and Goal 12
(Responsible consumption and production).
UN Global Compact (UNGC)
Ten Principles
Commitment The UNGC requires companies to align strategies and operations with universal principles on human rights, labour,
environment and anti-corruption, and to take actions that advance societal goals.
N/A N/A Novo Nordisk is committed to UNGC principles and has been an active participant since 2002. We submit
the ‘Communication on Progress’ focusing on governance, human rights, labour, environment and
anti-corruption on an annual basis.
Morgan Stanley Capital International
(MSCI) ESG Ratings
Assessment The MSCI ESG Ratings measure an organisation's resilience to financially material ESG risks. They assess how
companies manage risks compared to their peers, using a customised methodology to identify industry leaders and
laggards.
CCC-AAA AAA Novo Nordisk maintained an AAA leadership ESG rating in line with the past six years, and is among the
top 5% of pharmaceutical peers, which comprises 267 companies.
Sustainalytics ESG Risk Ratings Assessment The Sustainalytics ESG Risk Ratings measure an organisation's exposure to industry-specific, material ESG risks as
well as risk management. Sustainalytics ESG Risk Ratings assess the ESG performance of more than 16,000
companies.
>40-0 23.1 Novo Nordisk ranked among the top 15% of the pharmaceutical industry group, with a ranking of 139 out
of 912, incurring an ESG risk rating of 23.1 (medium risk). Sustainalytics ESG Risk Ratings range from
severe (>40) to negligible (0-10) risk.
Standard & Poor's (S&P) Scores Assessment The S&P Global ESG Score measures ESG performance via disclosures, media analysis, modelling approaches and
company engagement. The S&P Corporate Sustainability Assessment (CSA) Score is the ESG Score without utilising
modelling approaches.
0-100 59 in ESG Score
53 in CSA Score
Novo Nordisk ranked in the 91st percentile within the pharma peer group with an ESG score of 59 and a
CSA score of 53.
Corporate Knights Global 100 Assessment The Corporate Knights 19th annual ranking of the world’s 100 most sustainable corporations is based on an
assessment of over 6,000 public companies with revenue over USD 1 billion.
100-1 53 Novo Nordisk ranked 1st within Denmark in the ‘Pharmaceutical & Biotech Manufacturing Peer Group’,
2nd in the healthcare sector globally and 53rd in the overall rank.
Taskforce on Climate-related
Financial Disclosures (TCFD)
Standard The TCFD establishes recommendations for disclosing comparable and consistent information on climate-related
aspects across organisations. TCFD is specifically focused on climate governance, strategy, risk management and
setting of metrics and targets.
N/A N/A Novo Nordisk integrates TCFD-recommended scenarios into its risk management: limiting temperature
increase below 2ºC, preferably 1.5ºC as per the Paris Agreement, and a 4ºC increase scenario as
high-emission alternative. We have assessed production sites on these scenarios and intend to assess the
entire supply chain going forward.
Science Based Targets initiative (SBTi) Standard The SBTi defines best practice in emissions reduction and net zero targets aligned with climate sciences. It also
independently assesses and approves companies’ targets in accordance with its strict criteria.
N/A N/A Novo Nordisk has an approved near-term 2030 target in line with the 1.5 °C requirement from SBTi.
Additionally, Novo Nordisk is committed to achieving net zero emissions by 2045, with an aim to be
aligned with SBTi’s net zero requirements.
Carbon Disclosure Project (CDP) Scores Assessment The CDP measures environmental performance through three disclosure stages: awareness, management and
leadership. The CDP Scores incentivise companies to measure and manage environmental impacts via climate
change and water security questionnaires.
D- to A A in CDP Climate
A- in CDP Water
In 2022, Novo Nordisk maintained an A leadership ranking in CDP Climate and improved from a B to
an A- leadership ranking in CDP Water. Scores for the 2023 CDP Climate & Water will be available at:
www.cdp.net in February 2024.
UN Guiding Principles on Business and
Human Rights (UNGPs)
Commitment The UNGPs comprise of guidelines for states and companies to prevent, address and remedy adverse impacts on
human rights in their business operations.
N/A N/A In accordance with the UNGPs, Novo Nordisk commits to the responsibility to respect human rights
throughout own operations and value chains, as elaborated in our Human Rights Commitment. In
adherence with the UN Guiding Principles Reporting Framework, Novo Nordisk annually publishes a
Human Rights Report which outlines our latest work towards meeting this responsibility. Please refer to:
www.novonordisk.com/sustainable-business/esg-portal/social.html.
Access To Medicine Foundation
(ATMI) Score
Assessment The ATMI evaluates 20 of the world’s largest pharmaceutical companies on their performance on priority
access-to-medicine topics. Companies are assessed based on research and development, governance of access and
product delivery.
0-5 2.97 In 2022, Novo Nordisk ranked 11th, with the strongest performance in the governance of access area,
where a score of 4.43 out of 5 was achieved. ATMI will release updated ranking for top 20 companies in
2024.
World Economic Forum (WEF)
‘Good Work Framework’
Standard The WEF ‘Good Work Framework’ sets out five objectives and goals: promote fair pay and social justice; provide
flexibility and protection; deliver on health and well-being; drive diversity, equity and inclusion; foster employability
and learning culture.
N/A N/A Novo Nordisk published a WEF ‘Good Work Framework’ case study in March 2023 titled ‘Making Inclusivity
a Reality’. It featured work practices and aspirational targets in D&I.
OECD Guidelines for Multinational
Enterprises on Responsible Business
Conduct (OECD Guidelines)
Recommendation The OECD Guidelines are government-backed recommendations on responsible business conduct with the purpose
of fostering business contribution to sustainable development and addressing adverse impacts on people, planet
and society that stem from business activities.
N/A N/A Novo Nordisk adheres to the OECD Guidelines on a corporate level as part of our commitment to ethical
business conduct. We set expectations in line with the OECD Guidelines towards Novo Nordisk suppliers
by integrating the OECD Guidelines to our Responsible Sourcing Standards.
We strive to follow and adhere to international standards, recommendations and commitments set by globally
recognised entities. We are also regularly assessed by independent organisations on our ESG performance. This
table compiles some of the most relevant standards, recommendations and commitments we adhere to, as well as
assessments we receive.
Novo Nordisk Annual Report 2023 Introducing Novo Nordisk Strategic Aspirations Risks Management Consolidated statements Additional information 104
Financial statements of the parent company 2023
The following pages comprise the financial statements of the parent company, the legal entity Novo Nordisk A/S. Apart from ownership of the subsidiaries in the
Novo Nordisk Group, activity within the parent company mainly comprises sales, research and development, production, corporate activities and support functions.
Income statement
For the year ended 31 December
DKK million Note 2023 2022
Net sales 2 198,078 142,656
Cost of goods sold 3 (38,433) (31,060)
Gross profit 159,645 111,596
Sales and distribution costs 3 (42,291) (37,476)
Research and development costs 3 (28,731) (19,209)
Administrative costs 3 (2,002) (2,135)
Other operating income and expenses 1,315 1,012
Operating profit 87,936 53,788
Profit in subsidiaries, net of tax 8 15,973 19,238
Financial income 4 3,636 567
Financial expenses 4 (4,581) (6,280)
Profit before income taxes 102,964 67,313
Income taxes (19,557) (11,975)
Net profit 83,407 55,338
Balance sheet
At 31 December
DKK million Note 2023 2022
Assets
Intangible assets 6 28,755 19,449
Property, plant and equipment 7 53,822 34,547
Financial assets 8 87,543 78,306
Other receivables and prepayments 9 1,238 —
Total non-current assets 171,358 132,302
Raw materials 8,415 5,659
Work in progress 16,211 13,657
Finished goods 4,311 2,975
Inventories 28,937 22,291
Trade receivables 2,348 1,877
Amounts owed by affiliated companies 30,398 18,192
Tax receivables 8 7
Other receivables and prepayments 9 5,494 3,185
Receivables 38,248 23,261
Marketable securities 15,838 10,921
Derivative financial instruments 11 2,344 2,727
Cash at bank 10,623 9,795
Total current assets 95,990 68,995
Total assets 267,348 201,297
DKK million Note 2023 2022
Equity and liabilities
Share capital 10 451 456
Net revaluation reserve 24,696 17,785
Development costs reserve 1,756 1,524
Reserve for cash flow hedges and exchange
rate adjustments 1,594 1,045
Retained earnings 77,185 62,091
Total equity 105,682 82,901
Borrowings 12 16,855 21,199
Deferred income tax liabilities 5 6,282 2,967
Other provisions 13 1,280 1,303
Total non-current liabilities 24,417 25,469
Borrowings 12 5,072 169
Derivative financial instruments 11 1,272 2,903
Trade payables 6,778 4,782
Amounts owed to affiliated companies 108,865 74,059
Tax payables 3,046 3,115
Other liabilities 12,216 7,899
Total current liabilities 137,249 92,927
Total liabilities 161,666 118,396
Total equity and liabilities 267,348 201,297
Financial statements of the parent companyNovo Nordisk Annual Report 2023 105
Equity statement
DKK million
Share
capital
Net
revaluation
reserve
Reserve for cash
flow hedges and
exchange rate
adjustments
Development
costs reserve
Retained
earnings 2023 2022
Balance at the beginning of the year 456 17,785 1,045 1,524 62,091 82,901 70,469
Appropriated from net profit 33,116 33,116 29,532
Appropriated from net profit to net revaluation reserve 8,304 8,304 (2,144)
Exchange rate adjustments of investments in subsidiaries (1,393) (1,393) 2,291
Realisation of previously deferred (gains)/losses on cash flow hedges (998) (998) 1,610
Deferred gains/(losses) on cash flow hedges incurred during the period 1,547 1,547 998
Development costs 232 (232) — —
Other adjustments 1,284 1,284 976
Transactions with owners:
Total dividend for the year 41,987 41,987 27,950
Interim dividends paid during the year (13,430) (13,430) (9,613)
Dividends paid for prior year (18,337) (18,337) (15,690)
Reduction of the B share capital (5) 5 — —
Purchase of treasury shares (29,924) (29,924) (24,086)
Share-based payments (note 3) 562 562 433
Tax related to restricted stock units 63 63 175
Balance at the end of the year 451 24,696 1,594 1,756 77,185 105,682 82,901
Proposed appropriation of net profit:
Interim dividend for the year 13,430 9,613
Final dividend for the year 28,557 18,337
Appropriated to net revaluation reserve 8,304 (2,144)
Transferred to retained earnings 33,116 29,532
Distribution of net profit 83,407 55,338
Refer to note 4.3 in the consolidated financial statements for details on the number of
shares, treasury shares and total number of A and B shares in Novo Nordisk A/S.
Financial statements of the parent companyNovo Nordisk Annual Report 2023 106
Notes
1 Accounting policies
The financial statements of the parent company have been prepared in accordance
with the Danish Financial Statements Act (Class D) and other accounting regulations
for companies listed on Nasdaq Copenhagen.
The accounting policies for the financial statements of the parent company are
unchanged from the previous financial year. The accounting policies are the same as
for the consolidated financial statements with the adjustments described below. For a
description of the accounting policies of the Group, refer to the consolidated financial
statements.
No separate statement of cash flows has been prepared for the parent company; refer
to the statement of cash flows for the Group.
Supplementary accounting policies for the parent company
Intangible assets
Goodwill recognised in subsidiaries is amortised over 23 years, which reflects the
useful life of the underlying assets and activities generating the goodwill.
Financial assets
In the financial statements of the parent company, investments in subsidiaries and
associated companies are recorded under the equity method, using the respective
share of the net asset values in subsidiaries and associated companies. The equity
method is used as a measurement method rather than a consolidation method.
The net profit of subsidiaries and associated companies less unrealised intra-group
profits and amortisation of goodwill is recorded in the income statement of the parent
company. To the extent that net profit exceeds declared dividends from such companies,
the net revaluation of investments in subsidiaries and associated companies is
transferred to net revaluation reserve under equity according to the equity method.
Profits in subsidiaries and associated companies are disclosed as profit after tax.
Amounts owed by affiliates, where settlement is neither planned nor likely within
the foreseeable future, are treated as part of net-investments in subsidiaries, with
exchange rate adjustments recognised directly in equity through reserve for cash
flow hedges and exchange rate adjustments.
Tax
For Danish tax purposes, the parent company is assessed jointly with its Danish
subsidiaries. The Danish jointly taxed companies are included in a Danish on-account
tax payment scheme for Danish corporate income tax. All current taxes under the
scheme are recorded in the individual companies. Novo Nordisk A/S and its jointly
taxed subsidiaries are included in the joint taxation of the parent company, Novo
Holdings A/S.
2 Sales
DKK million 2023 2022
Sales by business segment
Diabetes and Obesity care 197,969 142,413
Rare disease 109 243
Total sales 198,078 142,656
Sales by geographical segment
North America Operations 124,860 79,953
International Operations:
EMEA 40,038 32,789
China 12,800 14,412
Rest of World 20,380 15,502
Total sales 198,078 142,656
Sales are attributed to a geographical segment based on location of the customer.
For definitions of segments, refer to note 2.2 in the consolidated financial statements.
Refer to note 5.7 in the consolidated financial statements for an overview of
companies in the Novo Nordisk Group based on geographical areas.
3 Employee costs
DKK million 2023 2022
Wages and salaries 19,525 14,656
Share-based payment costs 562 433
Pensions 1,709 1,281
Other social security contributions 301 247
Other employee costs 1,039 629
Total employee costs 23,136 17,246
Average number of full-time employees 23,754 19,201
Year-end number of full-time employees 26,111 20,926
For information regarding remuneration to the Board of Directors and Executive
Management, refer to note 2.4 to the consolidated financial statements.
Financial statements of the parent companyNovo Nordisk Annual Report 2023 107
4 Financial income and financial expenses
DKK million 2023 2022
Interest income relating to subsidiaries 487 365
Interest income relating to external counterparties 936 170
Foreign exchange gain (net) 772 —
Financial gain from forward contracts (net) 1,263 —
Capital gain from marketable securities 144 —
Other financial income 34 32
Total financial income 3,636 567
Interest expenses relating to subsidiaries 4,225 1,150
Result of associated company 38 4
Foreign exchange loss (net) — 2,705
Financial loss from forward contracts (net) — 1,659
Capital loss from marketable securities — 463
Other financial expenses 318 299
Total financial expenses 4,581 6,280
5 Deferred income tax assets/(liabilities)
DKK million 2023 2022
Net deferred tax asset/(liability) at the beginning
of the year
(2,967) 228
Income/(charge) to the income statement
(2,797) (2,629)
Income/(charge) to equity
(518) (566)
Net deferred tax asset/(liability)
at the end of the year
(6,282) (2,967)
The Danish corporate tax rate is 22% in 2023 (22% in 2022).
6 Intangible assets
Intangible assets primarily relate to intellectual property rights, internally developed software and costs related to major IT projects. Intangible assets which are not yet available
for use amount to DKK 19,993 million (DKK 10,007 million in 2022).
DKK million
Intellectual
property rights
Software
and other
intangibles 2023 2022
Cost at the beginning of the year 20,167 3,653 23,820 12,572
Additions during the year 11,347 490 11,837 11,399
Disposals during the year — — — (151)
Cost at the end of the year 31,514 4,143 35,657 23,820
Amortisation at the beginning of the year 2,672 1,699 4,371 3,462
Amortisation during the year 840 171 1,011 810
Impairment losses for the year 1,499 21 1,520 250
Amortisation and impairment losses reversed on disposals during the year — — — (151)
Amortisation at the end of the year 5,011 1,891 6,902 4,371
Carrying amount at the end of the year 26,503 2,252 28,755 19,449
Financial statements of the parent companyNovo Nordisk Annual Report 2023 108
7 Property, plant and equipment
DKK million
Land and
buildings
Plant and
machinery
Other
equipment
Assets under
construction 2023 2022
Cost at the beginning of the year 23,801 25,384 4,489 12,018 65,692 55,995
Additions during the year 822 219 150 21,229 22,420 10,223
Disposals during the year (330) (849) (266) (316) (1,761) (526)
Transfer from/(to) other items 597 800 509 (1,906) — —
Cost at the end of the year 24,890 25,554 4,882 31,025 86,351 65,692
Depreciation and impairment losses at the beginning of the year 11,328 16,918 2,899 — 31,145 28,988
Depreciation for the year 1,142 1,180 426 — 2,748 2,597
Impairment losses for the year 5 67 21 316 409 36
Depreciation reversed on disposals during the year (326) (855) (276) (316) (1,773) (476)
Depreciation and impairment losses at the end of the year 12,149 17,310 3,070 — 32,529 31,145
Carrying amount at the end of the year 12,741 8,244 1,812 31,025 53,822 34,547
Of which related to leased property, plant and equipment 1,011 — 72 — 1,083 580
Leased property, plant and equipment primarily relates to lease of office buildings, warehouses, laboratories and vehicles.
Financial statements of the parent companyNovo Nordisk Annual Report 2023 109
8 Financial assets
DKK million
Investments in
subsidiaries
Amounts owed
by affiliated
companies
Investment in
associated
company
Other
securities and
investments 2023 2022
Cost at the beginning of the year 54,660 4,975 105 757 60,497 53,987
Investments during the year 5,170 800 124 6,094 6,697
Divestments and repayments during the year (29) (3,328) (63) (3,420) (187)
Cost at the end of the year 59,801 2,447 105 818 63,171 60,497
Value adjustments at the beginning of the year 34,407 292 90 (268) 34,521 35,933
Profit/(loss) before tax 18,112 18,112 19,713
Share of result after tax in associated company (38) (38) (4)
Income taxes on profit for the year (1,332) (1,332) (1,596)
Market value adjustment (6) (6) (135)
Dividends received (9,127) (9,127) (23,305)
Divestments during the year 29 25 54 —
Effect of exchange rate adjustment charged to the income statement (271) (96) (367) 220
Effect of exchange rate adjustment charged to equity (2,285) (2,285) 1,768
Other adjustments 1,467 1,467 1,927
Value adjustments at the end of the year 41,271 21 52 (345) 40,999 34,521
Unrealised internal profit at the beginning of the year (16,712) (16,712) (18,356)
Unrealised internal profit movements in the year (807) (807) 1,121
Effect of exchange rate adjustment charged to equity 892 892 523
Unrealised internal profit at the end of the year (16,627) — — — (16,627) (16,712)
Carrying amount at the end of the year 84,445 2,468 157 473 87,543 78,306
9 Other receivables and prepayments
Other receivables and prepayments includes prepayments of DKK 5,375 million,
primarily related to prepaid contract manufacturing and R&D activities
10 Share capital
For information on share capital, refer to note 4.3 to the consolidated financial
statements.
11 Derivatives
For information on derivative financial instruments, refer to note 4.5 to the consolidat-
ed financial statements. All derivatives in the group are entered into with Novo Nordisk
A/S as the counterpart.
12 Borrowings
DKK million 2023 2022
Within 1 year 5,072 169
1-5 years 12,889 12,627
More than 5 years 3,966 8,572
Total borrowings 21,927 21,368
Borrowings mainly consist of loans from Novo Nordisk Finance (Netherlands) B.V.
related to issuance of Eurobonds.
For a list of companies in the Novo Nordisk Group, refer to note 5.7 to the consolidated financial statements.
Financial statements of the parent companyNovo Nordisk Annual Report 2023 110
13 Other provisions
Provisions for pending litigations are recognised as other provisions. For information
on pending litigations, refer to note 3.5 to the consolidated financial statements.
Furthermore, as part of normal business Novo Nordisk issues credit notes for expired
goods. Consequently, a provision for future returns is made, based on historical
product return statistics.
14 Related party transactions
For information on transactions with related parties, refer to note 5.4 to the
consolidated financial statements.
The parent company’s share of services provided by NNIT Group amounts to DKK 327
million (DKK 578 million in 2022).
Novo Nordisk A/S is included in the consolidated financial statements of the Novo
Nordisk Foundation.
15 Fee to statutory auditors
DKK million 2023 2022
Statutory audit
1
9 15
Audit-related services 2 2
Tax advisory services 4 1
Other services 15 9
Total fee to statutory auditors 30 27
1. 2022 statutory audit fee includes DKK 6 million of additional fee related to 2021.
16 Commitments and contingencies
DKK million 2023 2022
Commitments
Leases
1
804 95
Research and development obligations 18,448 11,778
Research and development - potential milestones
2
25,218 6,727
Commercial product launch - potential milestones
2
11,780 7,746
Purchase obligations relating to investments in property
plant and equipment 1,072 232
Purchase obligation relating to contract manufactures 33,107 13,362
Other purchase obligations 2,742 2,533
Guarantees given for subsidiaries
3
35,608 31,858
Other guarantees 993 127
1. Lease commitments predominantly relate to estimated variable property taxes and low value assets.
2. Potential milestone payments are associated with uncertainty as they are linked to successful achievements
in research activities; refer to note 5.2 to the consolidated financial statements. 3. Guarantees given for
subsidiaries mainly relate to guarantees towards Novo Nordisk Finance (Netherlands) B.V. related to issuance
of Eurobonds.
Novo Nordisk A/S and its Danish subsidiaries are jointly taxed with the Danish
companies in Novo Holdings A/S. The joint taxation also covers withholding taxes in
the form of dividend tax, royalty tax and interest tax. The Danish companies are jointly
and severally liable for the joint taxation. Any subsequent adjustments to income taxes
and withholding taxes may lead to a larger liability. The tax for the individual
companies is allocated in full on the basis of the expected taxable income.
For information on pending litigation and other contingencies, refer to notes 3.5 and
5.2 to the consolidated financial statements.
Financial statements of the parent companyNovo Nordisk Annual Report 2023 111
