For the last century, our company has been consistent in its overall mission to drive change to defeat diabetes and other serious chronic diseases. Today, the tools at our disposal are broader and more powerful than they were 100 years ago, when insulin had just been discovered. Yet the need for further innovation to realise our goal has never been greater, not least given the rise of obesity as one of the world’s foremost healthcare challenges.

At a time of societal debate about purpose versus profit, Novo Nordisk shows how the two can go hand-in-hand. The development of our life-changing treatments creates financial rewards that are reinvested in further research and development, a model that we will continue to apply as we build a sustainable business for the decades to come. 

Over the past year, we have seen continued strong growth across both North America and International Operations and therapy areas. This was driven by exceptional demand for our market-leading GLP-1 therapies. In turn, this increase in demand led to further market share expansion for key products in both diabetes and obesity.

At the same time, however, we have experienced pressures and challenges from an increasingly difficult macroeconomic and geopolitical environment, including the impact of war in Ukraine, rising tensions in global trade and the continuing fallout from COVID-19.

Combined with higher than expected demand, temporary capacity limitations at some of our manufacturing sites have resulted in shortages of certain products, including Wegovy^®  for obesity and Ozempic^® for type 2 diabetes.

Meeting patient demand is a top priority and we have invested around DKK 12.7 billion in 2022 alone to expand capacity while operating our global manufacturing facilities 24 hours a day, seven days a week. Like many other large companies, we are restructuring our supply chains to increase resilience in a volatile world.

It is clear that economic challenges and the growing burden of chronic, non-communicable diseases will place increasing pressure on healthcare systems in the years ahead, requiring us to remain laser-focused on our purpose and strategy.

Progress on pipeline projects such as our once-weekly insulin icodec and the novel combination drug candidate CagriSema, for both obesity and diabetes, reflects our determination to break new ground. We are also addressing broader areas of unmet medical need by expanding our commitment to rare blood and endocrine disease and researching novel technology platforms.

This will involve continued investment in our company’s deep in-house expertise, coupled with sourcing the best science from outside, through partnerships and business development. The acquisition of Forma Therapeutics in 2022, a specialist in rare blood disorders, is a good example of this targeted approach.

Our teams are also increasingly applying novel technologies to improve the delivery of products, including the use of smart devices and digital tools to guide and optimise therapy.

Innovation is equally central in addressing the environmental and social challenges that rightly feature so highly in modern society’s expectations of businesses. The challenge we face is significant since Novo Nordisk has an unusually high growth rate for a company of its size, necessitating increased manufacturing and higher product shipments.

However, in 2020, we were able to switch our global production network to sourcing 100% renewable power and we will continue to challenge ourselves in order to achieve net-zero emissions across our entire value chain by 2045. We will also continue to innovate to minimise the use of plastic derived from fossil fuels in our pen devices, whether through recycling or the use of novel materials.

Globally, we are serving a record of almost 40 million patients. However, there are still many people who struggle to access our life-changing products, even though more than 5 million are reached through our access and affordability initiatives. Innovation has a role to play here as well. Our heat-stable insulins, for example, will help to improve access in low- and middle-income countries since they can be kept outside refrigeration for up to four weeks.

Our priority for the next 10 years is to advance scientific understanding and treatment options in our core therapy areas, while diversifying our pipeline into adjacent fields such as cardiovascular disease, non-alcoholic steatohepatitis (NASH) and rare blood disorders. This means looking beyond the success of products based on our leading GLP-1 molecule semaglutide and adopting new technologies.

Innovation itself depends on the creativity of our colleagues, which we will continue to nurture by making Novo Nordisk a truly inclusive and diverse workplace. This will empower employees to use all their capabilities while attracting the best talent to come and work with us. 

Diversity is just as important in the boardroom as in our wider organisation, so we will continue to focus on having a Board of Directors with the right expertise and perspective to guide us through a period of rapid change. We are delighted by the election of Christina Law, whose deep experience in leadership positions in consumer-driven companies across Asia and beyond is and will be invaluable.

The collaboration between the Board of Directors and Executive Management continues to be both trusting and transparent. The relationship grew further during a year in which we were able to increasingly meet each other in person and engage with Novo Nordisk colleagues applying themselves tirelessly to delivering tomorrow’s healthcare innovation.

We would like to thank all our colleagues around the world for their dedication and hard work during a  challenging year, as well as our shareholders for their continued support.

Helge Lund
Chair of the Board of Directors

Lars Fruergaard Jørgensen
President and CEO

Strategic Aspirations 2025

1. Progress towards zero environmental impact

2. Being respected for adding value to society

3. Being recognised as a sustainable employer

2022 Highlights

1. Progress towards zero environmental impact:

• Carbon emissions from operations and transportation decreased by 29% compared to 2019

2. Adding value to society:

• Progress on Defeat Diabetes strategy
• Medical treatment provided to 36.3 million people living with diabetes
• Reaching more than 41,000 children in Changing Diabetes® in Children programme
• Diabetes and haemophilia medications donated to the Ukrainian Ministry of Health
• Positive scientific opinion from EMA on human insulin with more flexible storage without refrigeration

3. Being recognised as a sustainable employer

• Share of women in senior leadership positions has increased to 39% from 36% in 2021

Have a look at our ESG performance for 2022 in our ESG portal

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 other serious chronic diseases focusing on cardiovascular disease (CVD), non-alcoholic steatohepatitis (NASH) and chronic kidney disease (CKD)

2022 Highlights

1. Further raise innovation bar for diabetes treatment:

• Approval of Ozempic® 2.0 mg in the US
• Successful completion of phase 3a trials with once-weekly insulin icodec
• Successful completion of phase 2 trial with CagriSema in people with type 2 diabetes
• Phase 1 trials with Ideal Pump insulin successfully completed
• Phase 1 trial initiated with a once-daily oral GLP-1/GIP agonist and once-weekly oral semaglutide

2. Develop superior treatment solutions for obesity:

• STEP TEENs phase 3 trial successfully completed
• Phase 3a initiation with CagriSema in people with obesity
• Phase 1 initiation of oral amycretin

3. Strengthen and progress Rare Disease pipeline:

• Concizumab phase 3 trials completed in people with haemophilia A and B with inhibitors and in people without inhibitors
• Dosing initiated in phase 3a trial with Mim8
• Phase 2 trial initiated with NDec in sickle cell disease
• Acquisition of Forma Therapeutics to expand pipeline in in sickle cell disease

4. Establish presence in other serious chronic diseases:

• Phase 2 trial initiated with NNC6019 in cardiomyopathy
• Phase 1 trials initiated in NASH utilising the siRNA platform

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

2022 Highlights

1. Strengthen diabetes leadership to more than one-third:

• Diabetes value market share increased by 1.8 percentage points to 31.9% (MAT)

2. More than DKK 25 billion in Obesity sales by 2025:

•  Obesity care sales increased by 84% (CER) to DKK 16.9 billion

3. Secure a sustained growth outlook for Rare Disease:

• Rare Disease sales increased by 1% (CER) to DKK 20.5 billion

Strategic Aspirations 2025

1. Deliver solid sales and operating profit growth:

– Deliver 6-10% sales growth in International Operations

– Transform 70% of sales in the US (from 2015 to 2022)

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

2022 Highlights

1. Deliver solid sales and operating profit growth:

• Sales growth at 16% (CER)
• International Operations sales growth of 13% (CER)
• US sales growth of 19% (CER) with 73% of sales coming from products launched since 2015
• Operating profit growth of 15% (CER)

2. Drive operational efficiencies:

• Continued productivity gains in Product Supply

3. Enable attractive capital allocation to shareholders:

• Free cash flow of DKK 57.4 billion
• DKK 49.4 billion returned to shareholders in 2022