If you didn’t read all of my live tweets from
$NVO ’s Capital Markets Day today, here is a summary of the most important things I took away from the presentations:
Mike Doustdar opened the day by acknowledging that Novo needs to convince investors that the company has a bright future.
“We are very convinced that Novo has a bright future. But we also realize that it is not enough that we are convinced.”
Novo wants to become a larger and much more diversified company by 2035, despite semaglutide losing patent protection in Europe in 2031 and the U.S. in 2032.
The new ambitions include launching more than five multi-blockbusters by 2030 and generating more than DKK 150B in annual sales from the current pipeline by 2035. Mike Doustdar said the DKK 150B target is already significantly risk-adjusted and does not include future acquisitions or partnerships.
But the communication around future growth was one of the biggest problems of the day.
Novo initially announced that it aims to grow revenue “in line with industry peers” through 2030.
The problem was that Novo defines its peer group as 14 major pharmaceutical companies, including
$LLY , AstraZeneca, J&J, AbbVie, Novartis, Roche and Pfizer, among others. That left investors guessing what level of growth Novo was actually targeting.
Mike Doustdar was later asked about the lack of clarity and said Novo aims to grow at least in line with its peers.
It was not until several hours later that CFO Karsten Munk Knudsen finally put a number on it: mid-single-digit annual revenue growth through 2030, likely around 4% to 6%.
Personally, I think this was incredibly poor communication. If you introduce a new growth ambition at Capital Markets Day, investors should not have to spend several hours trying to figure out what it actually means.
R&D is getting a major overhaul.
Novo started first-in-human trials for only three new drug candidates last year. Martin Holst Lange called that “not good enough.” The new ambition is to start first-in-human trials for at least 15 new drug candidates every year.
Novo also wants to reduce the time from the first dose in humans to filing for regulatory approval to no more than five years, with AI playing a major role in designing trials and accelerating development.
The obesity pipeline is becoming much broader.
Novo highlighted zenagamtide, UBT251 and its triple agonist, while also revealing that it has five oral obesity drugs in development, including oral amylin.
Novo is also working on several once-monthly obesity treatments and plans to move three to four monthly candidates into development.
And the strategy is no longer simply about achieving the greatest possible weight loss.
Novo wants different treatments for different patients. Some may prioritize maximum weight loss, while others may care more about fewer side effects, preserving muscle and bone, taking a pill or only needing treatment once a month.
Pills were probably one of the biggest themes of the entire day.
Martin Holst Lange said directly that “pills are the future.”
Oral Wegovy has now reached 7 million prescriptions since its U.S. launch in January.
Novo says Oral Wegovy accounts for more than 80% of new-to-brand prescriptions in the U.S. oral obesity market and is running at around 285,000 total weekly prescriptions compared with around 45,000 for Lilly’s Foundayo.
Novo wants to “win the oral market” and increase its oral GLP-1 manufacturing capacity from serving around 1.5 million people with obesity today to around 15 million by 2030.
The international rollout is also accelerating.
Oral Wegovy has sold around 660,000 packs during its first 10 weeks in the UK. Novo says the launch has expanded the UK obesity market by 20% to 25% by volume while increasing Novo’s GLP-1 obesity market share by 12 to 15 percentage points.
Mexico will be the next market, and Novo expects Oral Wegovy to be available in more than 20 markets by the end of 2027.
We also got new CagriSema data.
In REIMAGINE 5, a lower dose of CagriSema delivered 12.4% weight loss compared with 9.1% for a lower dose of Lilly’s tirzepatide in people with diabetes.
Martin Holst Lange reiterated that Novo remains confident in CagriSema despite previous disappointments and believes it can compete.
Karsten Munk Knudsen later made clear how much Novo is relying on CagriSema, calling it “one of the stronger levers” for delivering the company’s growth through 2030.
Novo also believes the obesity market itself has enormous room to grow.
Hong Chow said less than 2% of people living with obesity are currently treated with a GLP-1, while patients remain on treatment for an average of only around nine months.
Novo therefore does not see obesity simply as a fight with Lilly for existing patients. It wants to expand the overall market and bring more people into treatment.
That connects with another major theme throughout the day: consumer behavior.
Jamey Millar said patients are increasingly seeking out obesity treatments themselves.
“Consumers are not just end users, but also budget holders and decision makers.”
Novo wants to meet those patients through direct-to-consumer marketing, telehealth and online access.
Around 85% of Wegovy sales in the UK are now online. In Germany, the figure has increased from around 7% to 30% in a year, while online Wegovy sales in both markets are around 5x higher than last year.
Novo plans to expand this direct-to-consumer approach into more international markets.
Beyond obesity and diabetes, Novo is also diversifying.
A new business area will initially focus on cardiovascular and liver disease, although Mike Doustdar made clear that “there is more to come.”
Novo currently treats around 46 million patients, and many of them also live with cardiovascular or liver conditions.
Novo is even looking at oral insulin again, with Martin Holst Lange saying advances in drug development and manufacturing have made it attractive to pursue once more.
Acquisitions will also play a larger role.
Mike Doustdar said Novo plans to become more active in business development and acquisitions and acknowledged that Novo cannot discover everything itself.
Novo potentially has capacity for acquisitions worth around DKK 300B, but Mike Doustdar said the focus will be on the quality of the opportunity rather than its size.
He also would not rule out acquiring products that are already on the market.
Manufacturing was another major topic.
Novo says it now has the production capacity needed to support its growth ambitions.
Its drug substance factories can deliver around 3x the production capacity they were originally designed for, while partnerships give Novo additional flexibility to rapidly scale pill production depending on demand.
On the financial side, Novo expects its operating margin to remain broadly stable through 2030.
At the same time, R&D spending will increase from around 17% of revenue today as Novo tries to build the much larger pipeline outlined during the day.
Then there is the elephant in the room: the semaglutide patent cliff.
Mike Doustdar acknowledged that prices will fall when semaglutide loses patent protection.
But Novo also believes lower prices will significantly expand the obesity market by bringing many more patients into treatment.
Jamey Millar said Novo wants to build as much volume as possible for its newer medicines before semaglutide loses U.S. patent protection in 2032.
Mike Doustdar compared the situation with Novo’s insulin business, where older products lost patent protection but the company continued introducing newer and better versions.
He believes semaglutide could become a standard treatment by 2035, while Novo moves patients toward newer products with longer patent protection.
His example was CagriSema:
“We have a better semaglutide, CagriSema, which has a much longer patent.”
“And then, of course, we have the pills as well.”
There was also a rather unusual moment during one of the breaks.
Novo apparently forgot to turn off the microphones during the livestream, even though management seemed to think they were speaking privately.
One comment could be heard clearly:
“We are going through a period right now where it is almost impossible to provide guidance.”
I cannot say with certainty who said it.
Novo is also becoming a smaller organization.
Mike Doustdar said another 4,000 employees have left the company on top of the previously announced 9,000 job cuts.
He said the decisions were difficult but necessary as Novo changes how the company operates.
Mike Doustdar ended Capital Markets Day by returning to the long-term ambition:
“We plan to be a bigger company in 2035 despite the very significant patent expiry of semaglutide.”