Novo Nordisk Annual Report 6-K Prepared by Imprima

 

UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549


FORM 6-K


REPORT OF FOREIGN PRIVATE ISSUER
Pursuant to Rule 13a-16 or 15d-16
of the Securities Exchange Act of 1934

FEBRUARY 5, 2014


        NOVO NORDISK A/S       
(Exact name of Registrant as specified in its charter)

Novo Allé
DK- 2880, Bagsvaerd
Denmark

(Address of principal executive offices)


Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F

Form 20-F [X]     
     Form 40-F [  ]

Indicate by check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934.

Yes [  ]     
      No [X]

If “Yes” is marked, indicate below the file number assigned to the registrant in connection with Rule 12g-32(b):82-_____________________

 


 

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novo nordisk annual report 2013 The one rule we have to break – the Rule of Halves       Is obesity a disease? – without doubt it is a growing threat to global health       One size doesn’t fit all – when it comes to diabetes treatment If Novo Nordisk’s business strategy were to be described in one word, it would have to be ‘focus’


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4 NOVO NORDISK AT A GLANCE 6 2013 performance and 2014 outlook 22 The one rule we have to break 6 Business strategy: ‘Our focus is our strength’ Risks to be aware of 42 24 One size dosen't fit all 1 Novo Nordisk's five regions

 

Contents

Accomplishments
and results 2013

 
 
 
 
 
     
     
Our business

 
 
 
 
 
 
 
 
 
 
 
 
 
Governance, leadership and shares

 
 
 
 
 
     
     
Financial, social and
environmental statements

 
 
 
     
     
Additional information

 
 

The Management review, as defined by the Danish Financial
Statements Act (FSA), is found on pp 1–54 and 94.

This Annual Report is published in both a Danish and an English
version. In the event of any discrepancies, the Danish version
shall prevail.



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1

 
Letter from
the
Chairman
 
 
 

 

Last year, at Novo Nordisk’s Annual General Meeting in March, I was named Chairman of the Board of Directors of which I have been a member since 2005. I feel honoured by and proud of this appointment, and will do my best to live up to the responsibilities that come with it.

As a board member I’ve followed Novo Nordisk’s development during a very difficult period for the pharmaceutical industry. It has been an exciting journey: in terms of both financial value creation for our shareholders and positive impact on people with diabetes, Novo Nordisk has delivered outstanding results.

I and the other members of Novo Nordisk’s Board are confident that Novo Nordisk will continue to do very well despite having been through a year that, frankly, will be remembered for a number of negative events: a Warning Letter from the US Food and Drug Administration (FDA), a delay for Tresiba® (insulin degludec) in the US, a safety scare around the class of products to which Victoza® belongs, and a major product recall.

Our Chief Executive Officer, Lars Rebien Sørensen, will give you more details and share his reflections on these events on the following pages. What’s important for me to say is that the Board has followed up meticulously on each and every one of these events to ensure that management has responded appropriately to them to minimise the negative effects and the risk of reoccurrence. And we firmly believe that it has.

Chairman of the Board of
Directors Göran Ando at
the Novo Nordisk R&D
Summit in November 2013.

 

The Board has also reviewed the company’s long-term strategy and outlook as we do every year. Is it realistic? Is it ambitious? Does the company have the skills and resources to execute it? And if so, does it provide Novo Nordisk with the competitive advantages needed to be successful in a very competitive industry? We believe it does.

We’ve also evaluated the strength of the company’s executive leadership and senior management and reviewed the succession preparedness for key positions. Together with the executive team we’ve assessed the company’s organisational strengths and weaknesses. Whenever we’ve identified issues that could become a significant obstacle to meeting the company’s long-term goals, we’ve agreed on a plan of action.

We’re confident that in Lars Rebien Sørensen and his Executive Management team we have the leadership needed to execute Novo Nordisk’s strategy and execute it well. It has been a pleasure to see how two new members of Executive Management have been smoothly integrated into the team, and how the company’s bench of senior vice presidents has been expanded with new members, several of them from our large and very successful affiliate in the US.

The Board is also pleased to announce the promotion of Chief Operating Officer Kåre Schultz to president. This is a reflection of the importance and complexity of his organisation and his successful management hereof. In this role, Kåre will work closely with Lars on planning Executive Management meetings and board meetings, and assume a more outward-facing role.

Despite the challenges Novo Nordisk faced in 2013, it met the sales and profit targets we communicated at the beginning of the year. Sales grew by 12% and operating profit by 15%, both measured in local currencies. Furthermore, we made significant progress on the key development projects, which bodes well for future growth and for the company’s ability to achieve its long-term targets.

Against this background, at the Annual General Meeting on 20 March 2014 the Board of Directors will propose a 25% increase in dividend to 4.50 Danish kroner per share of 0.20 krone. The Board of Directors has furthermore decided to initiate a new share repurchase programme of up to 15 billion kroner.

I’d also like to highlight two important decisions that the Board has made regarding corporate governance. We established a Nomination Committee to enhance the process for nominating members to the Board, and set new targets for the diversity of the Board as regards gender and nationality. For more information on this, please see p 47.

On behalf of the Board of Directors, I’d like to express my appreciation for the leadership shown by Lars Rebien Sørensen and his management team, and the hard work and dedication of the entire Novo Nordisk organisation.

Göran Ando
Chairman of the Board of Directors

 


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Letter from
the
CEO
 
 
 

 

2013 was both a good year and a tough year for Novo Nordisk.

Let me start with the tough part. As I mentioned in my letter in last year’s Annual Report, we began the year with the unsettling fact of having received a Warning Letter from the US Food and Drug Administration (FDA), following an inspection of one of our insulin-filling plants in Denmark.

Unrelated to this, in February we received a Complete Response Letter from the FDA in which the agency requested additional cardiovascular safety data before it could complete its review of the New Drug Application for Tresiba® (insulin degludec). Tresiba® is our new-generation basal insulin with an ultra-long duration of action of more than 42 hours.

President and Chief Executive Officer Lars Rebien Sørensen at the Novo Nordisk Capital Markets Day in December 2013.

 

 

To make matters worse, a debate emerged in March in which some scientists questioned whether the incretin class of diabetes medications – the class to which our very successful product Victoza® belongs – had an increased risk of side effects in the pancreas. Although the authorities later concluded that the data currently available don’t confirm the concerns, the debate did create anxiety among some patients using these products.

In October, we had to recall a number of batches of NovoMix® insulin in some European countries as our analysis had shown that a small percentage of the products in these batches didn’t meet the specifications for insulin strength.

Not the kind of events we’d hoped for in our 90th anniversary year – or in any other year for that matter. For Novo Nordisk’s employees, who take immense pride in the safety and efficacy of our products, such events are downright painful.

They are, however, also a good opportunity for learning and reflection, and we have learned from these events and are still learning. To mention just two examples: we’re improving our measures to ensure compliance with the latest and ever-evolving standards for good manufacturing practice, and we’re collecting more data than ever regarding cardiovascular safety to rule out that our products are associated with unacceptable risks.

I wish I could say that events such as the ones I’ve described will never happen again, but I’m not naive. Bad things happen, even to good companies; however, I firmly believe we’re coming out of these events wiser and stronger.

Allow me to turn to the brighter part of my account of 2013. I’m glad to report that our strategic products are doing well in the market. Tresiba® was launched in Japan as the first country in February 2013 and by the end of the year had claimed 8.6%

 


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3

of the segment for long-acting insulin (basal insulin) measured in value. Several other countries launched Tresiba® during the year and in all countries where the product is competing on an equal footing with other insulin products, it’s gaining significant market shares.

Our established key products did well, too: sales of our modern insulins grew 14%, Victoza® 27%, NovoSeven® 8% and Norditropin® 16%, all measured in local currencies. I think it’s fair to say that this is a solid performance in a global pharmaceutical market characterised by all forms of cost-containment measures. To me it shows that there’s a large and growing need for our products.

From a regional perspective, North America was again the main contributor to our growth, followed by International Operations and Region China. It’s also in these regions we expect to see most of the growth in the coming years. Our sales growth, combined with continuous focus on the efficiency of our operations, resulted in operating profit growth of 7% reported and 15% in local currencies. Growth in net profit was 18% and measured on an earnings per share basis, the increase was 20% – all in all a very robust financial performance in 2013.

Several products in our development pipeline passed important milestones in 2013:

The cardiovascular outcomes trial for Tresiba ® designed to provide the data requested by the FDA was initiated in October.
IDegLira, a fixed combination of liraglutide and insulin degludec for the treatment of type 2 diabetes, was filed for regulatory review in the EU.
We started the phase 3a programme for the faster-acting formulation of insulin aspart.
A 3 mg dose of liraglutide, the active substance in Victoza ®, was filed for regulatory review in both the US and the EU as a potential new obesity treatment.
Semaglutide, a once-weekly GLP-1 analogue, started phase 3 trials.
FDA approved our insulin injection pens FlexTouch ® and NovoPen Echo® for use with certain insulin products.
Within haemophilia, turoctocog alfa, our new factor VIII product for people with haemophilia A, was approved in the US, the EU and Japan. Turoctocog alfa will be marketed under the brand name NovoEight® in most countries.

You’ll find more information about these and other significant product development milestones in the research and development section on p 10 and in articles in this Annual Report.

In 2014, we’ll maintain a high level of investment in research and development and in our growth markets and strategic products. We’ll have special focus on:

The continued roll-out of Tresiba ®
The first launches of Ryzodeg ® – a combination of Tresiba® and our fast-acting insulin NovoRapid® – and NovoEight®
The regulatory reviews of IDegLira and liraglutide 3 mg
Further strengthening our systems and processes for ensuring compliance with all relevant regulatory standards
 

Implementing our strategy for global access to diabetes care targeted at people who currently don’t have access to the necessary medical treatment and care.

As you’ll see from the article on the diabetes pandemic later in this Annual Report, the number of people with diabetes is growing at an alarming rate. The latest estimates are that by 2035 close to 600 million people will have diabetes and at some point most of them will require medical treatment. You can read more about this on pp 22–23.

At Novo Nordisk we have a critical role to play and are committed to playing our part in the fight against diabetes. We’ve set ourselves the target that 40 million people will be using our products by 2020. We are, however, keenly aware that our products alone will not address all the challenges. That’s why we’re working with partners all over the world to identify and implement local solutions for improving diabetes care. You’ll find some examples of this in the article on p 26.

In the coming years we’ll have special focus on how to address the diabetes challenge in the world’s big cities. All over the world, people are migrating to big cities and, unfortunately, urbanisation and type 2 diabetes go hand in hand. Not much is known about how to change the situation, but we’re determined to work with partners to find out.

In the face of the challenges that 2013 brought for Novo Nordisk, I’ve taken great pleasure from the collaboration I’ve had with my Executive Management team, our Senior Management Board and the Board of Directors, and from dealing with the challenges we have encountered. I look forward to an even closer collaboration with Kåre Schultz in his new role as president. I have worked with Kåre for almost 20 years and have enjoyed following his development as leader of increasingly larger and more complex organisations. His promotion is well-deserved recognition of his accomplishments and leadership potential.

I’d like to thank everyone in the Novo Nordisk organisation for their contributions to our results in 2013, the people who use our products for their confidence in us, our stakeholders and partners for their collaboration, and our shareholders for their continued support.

Lars Rebien Sørensen
President and chief executive officer

PS: Please tell us what you think about our Annual Report. Does it meet your information needs? Is it comprehensible? You can help improve our reporting by answering six questions at novonordisk.com/annualreport/feedback.



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Novo Nordisk at a glance

PRODUCTS ESTABLISHED IN MARKETED IN DENMARK 180 IN 1923 EMPLOYEES IN 75 COUNTRIES COUNTRIES Novo Nordisk Way

Novo Nordisk Way

In 1923, our Danish founders began a journey to change diabetes.

Today, we are thousands of employees across the world with the passion, the skills and the commitment to continue this journey to prevent, treat and ultimately cure diabetes.

Our ambition is to strengthen our leadership in diabetes.
   
We aspire to change possibilities in haemophilia and other serious chronic conditions where we can make a difference.
   
Our key contribution is to discover and develop innovative biological medicines and make them accessible to patients throughout the world.
   
Growing our business and delivering competitive financial results is what allows us to help patients live better lives, offer an attractive return to our shareholders and contribute to our communities.
   
We never compromise on quality and business ethics.
   
Our business philosophy is one of balancing financial, social and environmental considerations – we call it the Triple Bottom Line.
   
We are open and honest, ambitious and accountable, and treat everyone with respect.
   

We offer opportunities for our people to realise their potential.

Every day we must make difficult choices, always keeping in mind what is best for patients, our employees and our shareholders in the long run.

It’s the Novo Nordisk Way.

 

The Triple Bottom Line

 

83.6 DKK BILLION IN SALES (+7%) 25.2 DKK BILLION IN NET PROFIT (+18%) Financially responsible Patients Socially responsible Environmentally responsible 24.3 MILLION PATIENTS USE OUR DIABETES CARE PRODUCTS (+7%) 125 THOUSAND TONS CO2 EMISSIONS (+2%) 38,436 EMPLOYEES WORLDWIDE (+11%) 2,685 THOUSAND M3 WATER CONSUMPTION (+8%)

 



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5

2013 progress on strategic focus areas

Expand leadership in diabetes care 30% GLOBAL VALUE MARKET SHARE (+2%) Establish presence in inflammation
• Five compounds in clinical trials with three in phase 2. Expand leadership in growth disorders
• Liraglutide 3 mg for obesity completed phase 3a and was submitted in the EU and the US. Pursue leadership in haemophilia
• NovoEight® was approved in the US, the EU and Japan.
• N9-GP successfully completed first phase 3a trial.
• NovoThirteen® was approved in the US.
Establish presence in obesity NovoSeven® sales DKK BILLION Norditropin® sales DKK BILLION 2012 2013 2012 2013 8.9 9.3 5.7 6.1 (+4%) (+7%) 65.5
DKK BILLION IN SALES (+8%) 2.6 (+2%) 2.2 (–19%) 38.2 10.9 (+10%) (–4%) 11.6 (+23%) 27% GLOBAL VALUE MARKET SHARE (+1%)
• Tresiba® was launched in eight countries.
• DEVOTE, a cardiovascular outcomes trial designed to provide the data for Tresiba® requested by the FDA, was initiated.
• IDegLira was filed for regulatory review in the EU.
• Semaglutide, a once-weekly GLP-1 analogue, started phase 3a trials. Protein-related products Oral antidiabetic products Modern insulins Human insulins Victoza® 5


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6     ACCOMPLISHMENTS AND RESULTS 2013

 

2013 performance
and 2014 outlook

2013 was a year of mixed fortunes for Novo Nordisk marked by steady progression towards long-term financial, social and environmental targets, whereas the Complete Response Letter for Tresiba® in the US was a disappointment.

 

Financial performance
The results for 2013 are higher than expected in the outlook for the year in the Annual Report 2012 and in line with the latest guidance provided in connection with the quarterly announcement in October 2013.*
 

Sales development
Sales increased by 12% measured in local currencies and by 7% in Danish kroner. North America was the main contributor with 66% share of growth measured in local currencies, followed by International Operations and Region China contributing 20% and 9% respectively. Sales growth was realised within both diabetes care and biopharmaceuticals, with the majority of growth originating from the modern insulins and Victoza®.
     In the following sections, unless otherwise noted, market data are based on moving annual total (MAT) from November 2013 and November 2012 provided by the independent data provider IMS Health.

 

 



*   Please refer to the company announcement of 30 January 2014 for explanation of results compared with the latest expectations.

 

 

 

Diabetes care
sales development

Sales of diabetes care products increased by 12% measured in local currencies and by 8% in Danish kroner to DKK 65,456 million. Novo Nordisk is the world leader in diabetes care and now holds a global value market share of 27% compared with 26% at the same time the previous year.

Insulins and protein-
related products

Sales of insulins and protein-related products increased by 11% in local currencies and by 6% in Danish kroner to DKK 51,577 million. Measured in local currencies, sales growth was driven by North America, International Operations and Region China. Novo Nordisk is the global leader with 48% of the total insulin market and 46% of the market for modern insulins and new-generation insulins, both measured in volume.
     The roll-out of Tresiba® (insulin degludec), the once-daily new-generation insulin with an ultra-long duration of action, continues to progress. Launch activities are proceeding as planned and feedback from patients and prescribers is encouraging. Tresiba® has been launched in eight countries with 20 more countries expected to launch during 2014. In the countries where Tresiba® is reimbursed on a similar level to insulin glargine, it has steadily grown its share of the basal insulin market. In these countries, Tresiba® now represents around 10% of the basal insulin

 

 

market measured in monthly value market share. In the markets where Tresiba® has been launched with restricted market access compared with insulin glargine, market penetration remains modest.
     Sales of modern insulins increased by 14% in local currencies and by 10% in Danish kroner to DKK 38,153 million. North America accounted for two-thirds of the growth, followed by International Operations and Region China. Sales of modern insulins now constitute 78% of Novo Nordisk’s sales of insulin.

Victoza®
(GLP-1 therapy for type 2 diabetes)
Victoza® sales increased by 27% in local currencies and by 23% in Danish kroner to DKK 11,633 million, reflecting robust sales performance driven by North America, Europe and International Operations. Victoza® holds the global market share leadership in the GLP-1 segment with a 71% value market share compared with 68% in 2012. The GLP-1 segment’s value share of the total diabetes care market has increased to 6.9% compared with 5.9% in 2012.

NovoNorm®/Prandin®/PrandiMet®
(oral antidiabetic products)

Sales of oral antidiabetic products decreased by 16% in local currencies and by 19% in Danish kroner to DKK 2,246 million. The negative sales development reflects an impact from generic competition in the US and Europe as well as a changed inventory set-up in China.

 


 

 

 

NOVO NORDISK ANNUAL REPORT 2013


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ACCOMPLISHMENTS AND RESULTS 2013    
7

 

Biopharmaceuticals
sales development

Sales of biopharmaceutical products increased by 12% measured in local currencies and by 6% in Danish kroner to DKK 18,116 million. Sales growth was primarily driven by North America and International Operations.

NovoSeven®
(bleeding disorders therapy)
Sales of NovoSeven® increased by 8% in local currencies and by 4% in Danish kroner to DKK 9,256 million. The market for NovoSeven® remains volatile, and sales growth is primarily driven by North America and International Operations.

Norditropin®
(growth hormone therapy)
Sales of Norditropin® increased by 16% in local currencies and by 7% in Danish kroner to DKK 6,114 million. The sales growth is primarily driven by contractual wins, the support programmes that Novo Nordisk offers healthcare professionals and patients as well as the penetration of the prefilled FlexPro® device in North America and furthermore by growth in International Operations. Novo Nordisk is the leading company in the global growth hormone market with a 28% market share measured in volume.

Other biopharmaceuticals
Sales of other products within biopharmaceuticals, which predominantly consist of hormone replacement therapy-related (HRT) products, increased by 15% in local currencies and by 9% in Danish kroner to DKK 2,746 million. Sales growth is driven by North America and reflects a positive impact of pricing and non-recurring adjustments to the provisions for rebates.

 

 

Development in costs
and operating profit

The cost of goods sold grew 5% to DKK 14,140 million, resulting in a gross margin of 83.1% compared with 82.7% in 2012. This development primarily reflects an underlying improvement driven by favourable price development in North America and a positive net impact from product mix due to increased sales of modern insulins and Victoza®. The gross margin was negatively impacted by around 0.3 percentage point due to the depreciation of key invoicing currencies versus the Danish krone compared with prevailing exchange rates in 2012.
     Total non-production-related costs increased by 11% in local currencies and by 8% in Danish kroner to DKK 38,621 million.
     Sales and distribution costs increased by 13% in local currencies and by 9% in Danish kroner to DKK 23,380 million. The growth in costs is driven by the expansions of the sales forces and sales and marketing investments in the US, China and selected countries in International Operations as well as costs related to the launch of Tresiba®. The growth percentage for costs has also been impacted by changes to legal provisions in 2012 and 2013.
     Research and development costs increased by 9% in local currencies and by 8% in Danish kroner to DKK 11,733 million. Within diabetes care, costs are primarily driven by development costs related to the initiation of the Tresiba® cardiovascular outcomes trial, and the ongoing phase 3a trials for both faster-acting insulin aspart and semaglutide, the once-weekly GLP-1 analogue. Within biopharmaceuticals, costs are primarily related to the continued progress of the portfolio of development projects within haemophilia and the phase 2 trial for anti-IL-20, a recombinant human monoclonal antibody, in rheumatoid arthritis.

 

 

 

     Administrative costs increased by 9% in local currencies and by 6% in Danish kroner to DKK 3,508 million. The increase in costs is primarily driven by back-office infrastructure costs to support the expansions of the sales organisations in North America, China and selected countries in International Operations, non-recurring costs related to new offices in Denmark and the US as well as an impact from a cost refund in 2012 of a previously expensed fine related to an import licence for a major market in International Operations.
     Licence income and other operating income constituted DKK 682 million compared with DKK 666 million in 2012.
     Operating profit increased by 7% in Danish kroner to DKK 31,493 million. In local currencies, the growth was 15%.

Net financials and tax
Net financials showed a net income of DKK 1,046 million compared with a net expense of DKK 1,663 million in 2012. As of 31 December 2013, foreign exchange hedging gains of around DKK 1,200 million have been deferred for recognition in the income statement in 2014.
     In line with Novo Nordisk’s treasury policy, the most significant foreign exchange risks for the Group have been hedged, primarily through foreign exchange forward contracts. The foreign exchange result was a net income of DKK 1,146 million compared with a net expense of DKK 1,529 million in 2012. This net income reflects gains on foreign exchange hedging involving especially the Japanese yen and the US dollar due to their depreciation versus the Danish krone compared with the prevailing exchange rates in 2012, which has been partly offset by losses on commercial balances, primarily related to non-hedged currencies.
     The effective tax rate for 2013 was 22.6%.

CONTINUED


 

 

 

NOVO NORDISK ANNUAL REPORT 2013


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8     ACCOMPLISHMENTS AND RESULTS 2013

 

Capital expenditure
and free cash flow

Net capital expenditure for property, plant and equipment was DKK 3.2 billion compared with DKK 3.3 billion in 2012. Net capital expenditure was primarily related to new offices in Denmark, filling capacity in Denmark and Russia, additional GLP-1 manufacturing capacity, new diabetes research facilities in Denmark as well as device production facilities in the US and Denmark.
     Free cash flow was DKK 22.4 billion compared with DKK 18.6 billion in 2012. The increase of 20% compared with 2012 reflects the growth in net profit of 18% and a lower impact from tax payments in 2013 compared with 2012 related to ongoing transfer pricing disputes, which was partly offset by earlier payment of rebate liabilities in the US.

 

 

Outlook 2014

The current expectations for 2014 are summarised in the table below:

Expectations are as reported,
if not otherwise stated
Expectations
30 January 2014


Sales growth  
   in local currencies
8–11%
   as reported Around 3.5 percentage points lower
   
Operating profit growth  
   in local currencies Around 10%
   as reported Around 5.5 percentage points lower
   
Net financials Income of around DKK 750 million
   
Effective tax rate Around 22%
   
Capital expenditure Around DKK 4.0 billion
   
Depreciation, amortisation and impairment losses Around DKK 2.9 billion
   
Free cash flow Around DKK 26 billion


Sales growth for 2014 is expected to be 8–11% measured in local currencies. This reflects expectations of continued robust performance for the portfolio of modern insulins and Victoza® as well as a modest sales contribution from Tresiba®. These sales drivers are expected to be partly countered by an impact from a more challenging contract environment in the US, generic competition for Prandin® in the US during the first half of 2014, intensifying competition within both diabetes and biopharmaceuticals as well as the macroeconomic conditions in a number of markets in International Operations. Given the current level of exchange rates versus the Danish krone, the reported sales growth is now expected to be around 3.5 percentage points lower than growth measured in local currencies.
     For 2014, operating profit growth is expected to be around 10% measured in local currencies. This reflects a significant increase in costs related to the continued progress of key development projects within diabetes and biopharmaceuticals. In addition, significant costs are expected in relation to sales force expansions and sales and marketing investments in the portfolio of modern insulins and Victoza® in the US, China and selected markets in International Operations as well as the launch of Tresiba® outside the US. Given the current level of exchange rates versus the Danish krone, the reported operating profit growth is now expected to be around 5.5 percentage points lower than growth measured in local currencies.
     For 2014, Novo Nordisk expects a net financial income of around DKK 750 million. The current expectation primarily reflects gains associated with foreign exchange hedging contracts following the depreciation of the Japanese yen and the US dollar versus the Danish krone compared with the average prevailing exchange rates in 2013.
     The effective tax rate for 2014 is expected to be around 22%.
     Capital expenditure is expected to be around DKK 4.0 billion in 2014, primarily related to investments in additional GLP-1 manufacturing capacity, expansion of filling capacity, prefilled device production facilities, construction of new laboratory facilities as well as expansion of protein capacity within the CMC (Chemistry, Manufacturing and Control) organisation. Depreciation, amortisation and impairment losses are expected to be around DKK 2.9 billion. Free cash flow is expected to be around DKK 26 billion.
     All of the above expectations are based on the assumption that the global economic environment will not significantly change business conditions for Novo Nordisk during 2014, and that currency exchange rates, especially the US dollar, will remain at the current level versus the Danish krone.
     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 the table below:

Key invoicing
currencies
Annual impact on Novo Nordisk’s operating
profit of a 5% movement in currency
Hedging period
(months)
 
 



 
USD
DKK 1,300 million
12  
CNY
DKK 220 million
12 *
JPY
DKK 145 million
14  
GBP
DKK 85 million
12  
CAD
DKK 60 million
10  



 
* USD used as proxy when hedging Novo Nordisk’s CNY currency exposure.  

The financial impact from foreign exchange hedging is included in ‘Net financials’.


 

NOVO NORDISK ANNUAL REPORT 2013


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ACCOMPLISHMENTS AND RESULTS 2013    
9

 

Long-term financial targets

Novo Nordisk introduced four long-term financial targets in 1996 to balance short- and long-term considerations, thereby ensuring a focus on shareholder value creation. The targets have subsequently been revised and updated on several occasions, most recently in connection with the release of the financial statement for 2012. The targets have been selected to ensure focus on growth, profitability, efficient use of capital and cash flow generation.
     The targets are based on an assumption of a continuation of the current business environment. Significant changes to the business environment, including the structure of the US healthcare system, regulatory requirements, pricing and contracting environment, competitive environment, healthcare reforms and exchange rates, may significantly impact the time horizon for achieving the long-term targets or require them to be revised.

Long-term financial target
Result
2013
 
Target
 




 
Operating profit growth 7%   15%  
Operating margin 38%   40%  
Operating profit after tax to net operating assets 97%   125%  
Cash to earnings 89%      
Cash to earnings (three-year average) 94%   90%  




 

Forward-looking statements
Novo Nordisk’s reports filed with or furnished to the US Securities and Exchange Commission (SEC), including this document as well as the company’s Form 20-F, both expected to be filed with the SEC in February 2014, 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
statements regarding the assumptions underlying or relating to such statements.

In this document, examples of forward-looking statements can be found under the heading ‘2013 performance and 2014 outlook’ 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 document, 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, including 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, product recall, unexpected contract breaches or terminations, governmentmandated or market-driven price decreases for Novo Nordisk’s products, introduction of competing products, reliance on information technology, 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, failure to recruit and retain the right employees, and failure to maintain a culture of compliance.
     Please also refer to the overview of risk factors in ‘Risks to be aware of’ on pp 42–43.
     Unless required by law, Novo Nordisk is under no duty and undertakes no obligation to update or revise any forward-looking statement after the distribution of this document, whether as a result of new information, future events or otherwise.

 

 

NOVO NORDISK ANNUAL REPORT 2013

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10     ACCOMPLISHMENTS AND RESULTS 2013

 

Research and
development

 

Diabetes
In 2013, Novo Nordisk made important advances in the pipeline of diabetes care products.

Insulin
In response to the Complete Response Letter on Tresiba® from the US Food and Drug Administration (FDA), Novo Nordisk initiated a cardiovascular outcomes trial (DEVOTE) in October. It is double-blind, uses insulin glargine as comparator and will include 7,500 type 2 diabetes patients who have existing or high risk of cardiovascular diseases. Novo Nordisk expects to have sufficient data to support an interim analysis within two to three years and to complete the study within four to six years from initiation. The data will also be used to support the resubmission of Ryzodeg®, the combination of Tresiba® and insulin aspart.
     Mid-2013, Novo Nordisk filed IDegLira for regulatory review in the EU. IDegLira is a fixed combination of insulin degludec and liraglutide and Novo Nordisk is the first company to submit a product in this new class. The filing of IDegLira in the US is pending the outcome of the interim analysis planned for the DEVOTE trial.
     In the prandial insulin segment Novo Nordisk began the phase 3a programme named onset® for the faster-acting formulation of insulin aspart. The improved formulation is intended to enable a faster onset of appearance of insulin in the bloodstream, thereby mimicking the insulin secretion of a healthy individual more closely than NovoRapid®.

Devices
In the US, the FDA approved FlexTouch® for delivery of NovoLog® (NovoRapid®) and Levemir®. FlexTouch® is a prefilled pen featuring a spring-loaded dosing action that allows users to administer insulin at the touch of a button – regardless of dosage size. The pen has been launched in the EU and Japan.
     Also for administering NovoLog®, the FDA approved NovoPen Echo®, a reusable pen, especially designed to meet the needs of children with diabetes. The pen has been launched in the EU.

GLP-1 (Glucagon-Like Peptide-1)
In the GLP-1 category, Novo Nordisk initiated phase 3a trials investigating the efficacy and safety of liraglutide as an adjunct therapy to insulin in people with

 

 

type 1 diabetes. This programme, named ADJUNCT, is expected to include 3,000 people with type 1 diabetes.
     Novo Nordisk’s once-weekly analogue semaglutide has now started three of six global phase 3a trials, one of which will collect cardiovascular outcomes and other long-term diabetes-related endpoints. In total, the SUSTAIN programme is expected to include more than 8,000 people with type 2 diabetes.
     Novo Nordisk also brought a tablet formulation of semaglutide, OG217SC, into phase 2 development. Pioneering the effort within oral diabetes proteins, Novo Nordisk now has seven oral formulations of insulin and GLP-1 analogues in the early pipeline (phase 1 and 2).

Obesity
Novo Nordisk successfully completed the SCALE phase 3a programme, which confirmed the efficacy and safety of liraglutide 3 mg for the treatment of obesity. Liraglutide 3 mg was filed for regulatory review in the US and the EU in December.

Haemophilia
Novo Nordisk continued its strong progress in the development of treatments for people with haemophilia and other rare bleeding disorders.
     Turoctocog alfa, a recombinant coagulation factor VIII, was approved in the US, the EU and Japan. The product, which is now being marketed under the trade name NovoEight®, is indicated for use in adults and children with haemophilia A for control and prevention of bleeding, perioperative treatment as well as routine prevention of bleeding episodes. In January 2014, Germany was the first country to launch the product.
     Also for people with haemophilia A, a long-acting coagulation factor, glycoPEGylated rFVIII, N8-GP, is being studied in phase 3a. In March a trial was started in children, which is a regulatory requirement.
     Strong results were reported in phase 3a for N9-GP, a long-acting recombinant factor IX molecule for people with haemophilia B, with a safe and well-tolerated profile, no inhibitor development and improved quality of life. Also, during major surgical procedures a single preoperative dose of N9-GP prevented bleeding in all participants with a 100% success rate. The compound continues development in clinical trials in

 

 

children and during surgical procedures.
     In December, the FDA approved recombinant coagulation factor XIII as Tretten® for use in routine prophylaxis of bleeding in patients with congenital FXIII A-subunit deficiency (approved as NovoThirteen® in the EU).

Inflammation
Novo Nordisk aspires to improve the lives of people with autoimmune and chronic inflammatory diseases by developing anti-inflammatory compounds with new modes of action for rheumatoid arthritis, systemic lupus erythematosus (SLE), inflammatory bowel disease and psoriatic arthritis. In March, Novo Nordisk initiated a phase 2a trial with anti-IL-21 for severely active Crohn’s disease.
     Finally, anti-NKG2D was approved for further phase 2 development for Crohn’s disease.

Growth hormone
Novo Nordisk completed its phase 1 trials for the once-weekly growth hormone NN8640 in healthy volunteers and adults with growth hormone deficiency. In the trial, NN8640 appeared to have a safe and well-tolerated profile and no safety concerns were identified. The trial confirmed the data from a similar trial in healthy adults and supports the suitability of NN8640 for once-weekly dosing in adults with growth hormone deficiency.


 

NOVO NORDISK ANNUAL REPORT 2013

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ACCOMPLISHMENTS AND RESULTS 2013    
11

 

Social
performance

 

Social performance has three dimensions: improving access to medical treatment and quality of care for patients, offering a healthy and engaging working environment for employees, and providing assurance that responsible business practices are in place, with the aim of contributing to the communities in which the company operates.

Patients
Novo Nordisk estimates that the company provides medical treatments for approximately 24.3 million people with diabetes worldwide, showing a 7% increase compared with 2012. The number is calculated based on the WHO’s recommended daily doses for diabetes medicines. This growth is driven by sales of insulin and Victoza®.
     Of the 382 million people living with diabetes it is estimated that just over half of them are diagnosed and many of those diagnosed do not receive medical treatment. Novo Nordisk’s global access to diabetes care strategy aims to provide better care for those who need it and currently do not have access to proper diabetes care. The long-term goal is to reach 40 million people in 2020 with diabetes care products and thereby enable more people with diabetes to live better lives.
     In 2013, Novo Nordisk sold human insulin according to the company’s differential pricing policy in 35 of the 49 Least Developed Countries (LDC), as defined by the UN. According to this policy, the price should not exceed 20% of the average prices in the western world. While the number of countries buying insulin in accordance with this policy has been stable for some years, the volume sold increased by 7%. In 2013 the LDC ceiling price for insulin treatment per patient per day was USD 0.22, while the average price of insulins that Novo Nordisk sold under this programme was USD 0.17. In other low- and middle-income countries, Novo Nordisk sells large volumes of insulin at equally low tender prices through government health programmes. In 2013, an estimated 5.2 million patients worldwide have been treated with insulin at or for less than the LDC ceiling price.
     Donations through the World Diabetes Foundation amounted to DKK 64 million in 2013. The World Diabetes Foundation

 

 

is an independent non-profit organisation established in 2002 by Novo Nordisk to help expand access to diabetes care. The foundation invests in sustainable initiatives to build healthcare capacity with the aim of improving prevention and treatment of diabetes in developing countries. Read more on worlddiabetesfoundation.org.
     Novo Nordisk also provides financial support to improve global access to haemophilia care. In 2013, the company donated DKK 19 million to the Novo Nordisk Haemophilia Foundation, established in 2005. The foundation supports projects and fellowships in developing and emerging economies. Initiatives focus on capacity-building, awareness, diagnosis and registries. Read more on nnhf.org.

Employees
At the end of 2013, the total number of employees was 38,436, corresponding to 37,978 full-time positions, which is an 11% increase compared with 2012. This growth is driven by expansion of the sales and marketing organisation in the regions North America and International Operations as well as significant expansion in Denmark in the research and development organisation and in production.
     Employee turnover decreased from 9.1% in 2012 to 8.1%, reflecting a continued positive trend. The average number covers some geographical variation.
     The consolidated score in the annual employee engagement survey, eVoice, was 4.4, measured on a scale of 1 to 5, with 5 being the best score. The survey measures the extent to which the organisation is working in accordance with the Novo Nordisk Way. The 2013 result is an improvement on the score of 4.3 in 2012, and indicates that despite continued growth, there is a strong culture and commitment to the company’s values. Read more about the long-term target on p 12.
     In terms of diversity, by the end of 2013 a total of 70% of the 33 senior management teams were composed of a diverse group, with members of both genders and different nationalities. This represents a continued and steady positive trend towards the ambition that by the end of 2014 all senior management teams must meet these diversity criteria or explain why this has not yet been achievable.

 

 

     In 2013, the average frequency rate of occupational injuries was 3.5 per million working hours, compared with 3.6 in 2012. Uniform occupational health and safety management procedures are being rolled out in the global organisation.

Assurance
Mandatory training in business ethics is a high priority. In 2013, 97% of all relevant employees completed and documented their training and passed the related tests. This is a slight decrease from 99% in 2012, which can be explained by a higher number of employees in scope of training and the introduction of tests with an explicit requirement that documentation of training must be provided in addition to passing the tests. Annual business ethics training is required for all employees, including new hires. Business ethics training is a key element in all onboarding programmes.
     Adherence to the company’s global standards for ethical behaviour must be observed and is monitored. Internal business ethics audits are conducted by means of on-site interviews and documentation reviews to assess compliance with legal requirements and internal procedures. During 2013, 45 business ethics reviews were conducted, compared with 48 in 2012.
     During the year, the global facilitator team conducted 75 audits of units’ adherence to the Novo Nordisk Way, so-called facilitations, covering approximately 11,500 employees, ie around one-third of the entire workforce. A facilitation consists of document review and interviews with local management, employees and stakeholders to determine the level of adherence to corporate values and behaviours spelled out in the Novo Nordisk Way. A conclusive report, presented to the Board of Directors, identifies best practices that are shared internally, while findings of non-compliance are reported to local management, which must subsequently implement corrective actions. Timely closure, measured as an average over a three-year period during which the entire organisation is covered, is consistently high. By the end of 2013, 96% of actions were closed on time, and the conclusion is that there is a high level of compliance with the Novo Nordisk Way across the organisation.

 


CONTINUED ►

NOVO NORDISK ANNUAL REPORT 2013


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12     ACCOMPLISHMENTS AND RESULTS 2013

 

     A total of 221 supplier audits were conducted to assess the level of compliance with Novo Nordisk’s standards for suppliers. These relate to quality as well as environment, labour, human rights and business ethics, in line with Novo Nordisk’s responsible sourcing standards.
     These audits are undertaken by Novo Nordisk’s corporate quality organisation. The level of audit activity was on par with 2012. Of these, 25 audits in 2013 were focused on responsible sourcing criteria, compared with 45 in 2012. Only high-risk

 

suppliers, identified through a robust risk assessment, are selected for responsible sourcing audits. In 2013, one critical finding was identified regarding excessive overtime. This finding is being addressed.
     Following the receipt in December 2012 of a Warning Letter from the US Food and Drug Administration (FDA), a re-inspection was carried out in August 2013. In January 2014 Novo Nordisk received confirmation from the agency that the violations had been addressed satisfactorily.
     In 2013, Novo Nordisk had six instances

 

of product recalls from the market, which is the same level as the previous year. Among one of these, an internal quality control found that a small percentage (0.14%) of certain batches of the company’s prefilled insulin product NovoMix® 30 did not meet the specifications for insulin strength. As a result 3 million products were recalled from wholesalers, pharmacies and patients in several European markets. The root cause was found to be a production error and has been resolved.



Long-term social targets

2013 performance against
long-term social targets

Novo Nordisk has chosen three long-term social targets to support long-term financial performance, balancing responsibility with profitability, with the aim of creating sustainable value for shareholders and other stakeholders. The social targets reflect aspirations expressed in the Novo Nordisk Way: helping people live better lives, working the Novo Nordisk Way and nurturing a diverse working environment. In 2013, progress was made against all three targets.  
   
   
   

 

 

 

 


 

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ACCOMPLISHMENTS AND RESULTS 2013    
13

 

Environmental
performance

Novo Nordisk’s environmental performance is measured on three strategic dimensions: consumption of water, consumption of energy and CO2 emissions from energy consumption.

Water and energy
In 2013, 2,572,000 GJ energy and 2,685,000 m3 water were consumed at production sites around the world. This equals an increase of 6% and 8% respectively, which is linked to the increased production volume output and new production capacity.
     Around half of the water and 30% of the energy consumed at the company’s 13 production sites is consumed at the production site in Kalundborg, Denmark. Optimisations achieved at this site therefore have a significant impact on the company’s total resource consumption.

 

 

CO2 emissions
In 2013, CO2 emissions from production amounted to a total of 125,000 tons. This equals a 2% increase compared with 2012, which is directly linked to the increased consumption of energy. The increase in CO2 emissions is less than the increase in energy consumption, because part of the increase in energy consumption happened at sites where the energy consumed is less CO2-intensive. At the same time, consumption decreased at sites with coal-based energy supply.
     The company’s target of a 10% absolute reduction in 10 years is expected to be met in 2014. Since 2005, 685 energy-saving projects have led to a total reduction in CO2 emissions of 44,000 tons annually. Production sites that rely on coal-based energy supply will be in focus for further reductions. These sites are Kalundborg in Denmark and Tianjin in China.

 

 

Waste
In 2013, Novo Nordisk generated 91,712 tons of waste, which is an increase of 11% compared with 2012. Of this, 81% is non-hazardous organic production waste in diabetes care.
     The objective is to reduce environmental impact from waste. As a consequence, instead of setting traditional reduction targets measured by quantity, those areas where environmental impacts from waste can be reduced the most have been singled out for focused attention.
     Since October 2011, the company’s organic production waste has been used for energy recovery in biogas plants, whereas previously it was used for animal feed. As a consequence, organic production waste is now reported as waste, included in the total waste volume. Organic waste production is the type of waste that increases the most in line with growing production. The total waste volume excluding organic production waste is stable.

 



 

Long-term environmental targets

2013 performance against
long-term environmental targets

Novo Nordisk has chosen three long-term environmental targets to support long-term financial performance, balancing responsibility with profitability, with the aim of creating sustainable value for shareholders and other stakeholders. The environmental targets for consumption of energy and water and CO2 emissions contribute to optimising production efficiency and reducing environmental impacts.
     The consumption of energy and water for production is increasing due to continued growth in sales and, as a consequence, emissions of CO2 are increasing too.
     Performance against the targets is as projected and the targets are expected to be met.

 

 

Long-term environmental targets update

The long-term environmental targets for consumption of energy and water were revised and updated in 2013 to ensure that they were aligned with new business priorities in response to the need for expansions of production capacity and an increased product portfolio.
     The new targets remain ambitious and reflect the aspiration of continuous decoupling of environmental impacts from business growth, measured as increase in sales in local currencies. The targets have been set as a maximum 50% increase in energy and water consumption compared with business growth, measured as a three-year average. This will be particularly challenging in years of production expansion and running-in of new plants or production lines.

 


 

 

 

 


 

 

NOVO NORDISK ANNUAL REPORT 2013


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14     ACCOMPLISHMENTS AND RESULTS 2013

Performance highlights

DKK million
2009
 
2010
 
2011
 
2012
 
2013
 
2012–2013
 












 
Financial performance                     Change  
Net sales 51,078   60,776   66,346   78,026   83,572   7%  












 
Underlying sales growth in local currencies 11%   13%   11%   12%   12%      
Currency effect (local currency impact) 1%   6%   (2% ) 6%   (5% )    












 
Net sales growth as reported 12%   19%   9%   18%   7%      












 
                         
Depreciation, amortisation and impairment losses 2,551   2,467   2,737   2,693   2,799   4%  
Operating profit 14,933   18,891   22,374   29,474   31,493   7%  
Net financials (945 ) (605 ) (449 ) (1,663 ) 1,046   N/A  
Profit before income taxes 13,988   18,286   21,925   27,811   32,539   17%  
Net profit for the year 10,768   14,403   17,097   21,432   25,184   18%  












 
Total assets 54,742   61,402   64,698   65,669   70,337   7%  
Equity 35,734   36,965   37,448   40,632   42,569   5%  












 
Capital expenditure, net 2,631   3,308   3,003   3,319   3,207   (3% )
Free cash flow1 12,332   17,013   18,112   18,645   22,358   20%  












 
                         
Financial ratios                        
Percentage of sales                        
   Sales outside Denmark 99.2%   99.4%   99.3%   99.4%   99.4%      
   Sales and distribution costs 30.2%   29.9%   28.6%   27.6%   28.0%      
   Research and development costs 15.4%   15.8%   14.5%   14.0%   14.0%      
   Administrative costs 5.4%   5.0%   4.9%   4.2%   4.2%      












 
Gross margin1 79.6%   80.8%   81.0%   82.7%   83.1%      
Net profit margin1 21.1%   23.7%   25.8%   27.5%   30.1%      
Effective tax rate1 23.0%   21.2%   22.0%   22.9%   22.6%      
Equity ratio1 65.3%   60.2%   57.9%   61.9%   60.5%      
Return on equity (ROE)1 31.3%   39.6%   46.0%   54.9%   60.5%      
Cash to earnings1 114.5%   118.1%   105.9%   87.0%   88.8%      
Payout ratio1 40.9%   39.6%   45.3%   45.3%   47.1%      












 
                         
Long-term financial targets                     Targets  
Operating margin1 29.2%   31.1%   33.7%   37.8%   37.7%   40%  
Operating profit growth 20.7%   26.5%   18.4%   31.7%   6.9%   15%  
Operating profit after tax to net operating assets1 47.3%   63.6%   77.9%   99.0%   97.2%   125%  
Cash to earnings, (three-year average) 111.5%   115.6%   112.8%   103.7%   93.9%   90%  












 

NOVO NORDISK ANNUAL REPORT 2013

Diabetes care sales
.. Oral antidiabetic products (OAD)
.. Protein-related products
.. Victoza®
.. Human insulins
.. Modern insulins (insulin analogues)
Biopharmaceuticals sales ... Other products ... Norditropin(R) ... NovoSeven(R)
Sales by geographic region ... Japan & Korea ... Region China ... International Operations ... Europe ... North America


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ACCOMPLISHMENTS AND RESULTS 2013    
15

 
2009
 
2010
 
2011
 
2012
 
2013
 
2012–2013
 












 
Social performance                     Change  
Least developed countries where Novo Nordisk sells insulin according to the differential pricing policy 36   33   36   35   35    
Donations (DKK million)2 83   84   81   84   83   (1% )
New patent families (first filings) 55   62   80   65   77   18%  
                         
Employees (total) 29,329   30,483   32,632   34,731   38,436   11%  
Employee turnover 8.3%   9.1%   9.8%   9.1%   8.1%      
                         
Relevant employees trained in business ethics
N/A
  98%   99%   99%   97%      
Product recalls
2
  5   5   6   6    
Warning Letters and re-inspections
0
  0   0   1   1    
Company reputation with external key stakeholders (scale 1–7)
N/A
 
N/A
  5.6   5.7   5.8      












 
                         
Long-term social targets                     Targets  
Patients reached with Novo Nordisk diabetes care products in millions (estimate)
N/A
 
N/A
  20.9   22.8   24.3   40 by 2020  
Working the Novo Nordisk Way (scale 1– 5)
N/A
 
N/A
  4.3   4.3   4.4   4.0  
Diverse senior management teams
50%
  54%   62%   66%   70%   100% by 2014 3












 
                         
Environmental performance                     Change  
Energy consumption (1,000 GJ)
2,246
  2,234   2,187   2,433   2,572   6%  
Water consumption (1,000 m3)
2,149
  2,047   2,136   2,475   2,685   8%  
                         
CO2 emissions from energy consumption (1,000 tons)
166
  95   94   122   125   2%  
Wastewater (1,000 m3)
2,062
  1,935   2,036   2,272   2,457   8%  
Waste (tons)
26,362
  25,627   41,376   82,802   91,712   11%  












 
                         
Long-term environmental targets                     Targets  
Energy consumption (vs prior year)
(11%
) (1% ) (2% ) 11%   6%   6% 4
Water consumption (vs prior year)
(20%
) (5% ) 4%   16%   8%   6% 4
CO2 emissions from energy consumption (vs 2004 baseline)
(24%
) (56% ) (57% ) (44% ) (42% ) by 2014  












 
                         
Share performance                     Change  
Basic earnings per share/ADR in DKK1,5
3.59
  4.96   6.05   7.82   9.40   20%  
Diluted earnings per share/ADR in DKK1, 5
3.56
  4.92   6.00   7.77   9.35   20%  
Total number of shares (millions) 31 December5
3,100
  3,000   2,900   2,800   2,750   (2% )
Net asset value per share, (Group) in DKK5
11.53
  12.32   12.91   14.51   15.48   7%  
Dividend per share in DKK5
1.50
  2.00   2.80   3.60   4.50   25%  
Total dividend (DKK million)
4,400
  5,700   7,742   9,715   11,866 6 22%  












 

1. For definitions, please refer to p 93. 2. Donations to the World Diabetes Foundation and the Novo Nordisk Haemophilia Foundation, which are working to increase healthcare capacity in developing countries. 3. By the end of 2014 all senior management teams must comply with the target to be diverse in terms of both gender and nationality or explain why this has not yet been achievable. 4. The 6% equals 50% of the business growth measured as the increase in sales in local currencies. For detailed target definition, please refer to p 13. 5. As at 2 January 2014 a stock split of the company’s trading unit was conducted. Comparative figures have been restated to reflect the change in trading unit from DKK 1 to DKK 0.20. 6. Proposed dividend for the year (not yet declared).

NOVO NORDISK ANNUAL REPORT 2013

 

Employees (total) ... Japan & Korea ... Region China ... International Operations ... Europe* ... North America
Includes headquarter functions and Research and Development in Denmark.
... Waste* ... Waste excl organic production waste for biogas
* Before 2011, most of the non-hazardous organic production waste was used for animal feed and classified as a by-product. Since October 2011, all this waste has been sent for energy recovery in biogas plants and is therefore reported as waste.
Net cash distribution to shareholders ... Dividends ... Share repurchases


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Business strategy:
‘Our focus is our strength’

If Novo Nordisk’s business strategy were to be
described in one word, it would have to be ‘focus’.

Each year, a team of people from different parts of Novo Nordisk’s global organisation is tasked by senior management to explore the business environment, analyse trends and come back and challenge Novo Nordisk’s strategy based on the findings.
     Novo Nordisk’s corporate strategy is the result of this process, which ends when the Board of Directors approves the updated strategy in June. In the following months, it is anchored in the annual business and organisation plans, balanced scorecards and performance targets.
     The direction and the core elements of the strategy do not change fundamentally from year to year, but are adjusted whenever signals of change occur in Novo Nordisk’s business environment. The adjustments ensure that Novo Nordisk is capable of meeting current and emerging challenges and opportunities.
     The current business environment has plenty of both. It is characterised by slow economic growth and austerity measures in some parts of the world, and rapid economic growth and urbanisation with alarming implications for public health in others. In high-income countries with ageing populations, governments and private payers are reluctant to pay a premium for new, innovative therapies. Low- and middle-income countries fight a double burden of poverty and poor health, and access to care is inadequate and unevenly distributed. Many countries with largely publicly funded healthcare systems are putting in place market restrictions for new medications and in the US, pharmaceutical companies, including Novo Nordisk, are facing increasingly tough pricing negotiations with managed care organisations and pharmacy benefit managers.
     Many pharmaceutical companies are seeing major products going off patent and are unable to bring out innovative products that can make up for the lost revenue. Some have chosen to cut research and development budgets and lay off thousands of employees. Some have added generic and over-the-counter medicines to their offering, while others have created a broader service offering around their core products. And all have realised that new products will only have a chance in the market if they address unmet medical needs and are accompanied by convincing data about their health-economic benefits.
     Novo Nordisk has decided to continue making large investments in research and development, strategic products and growth markets. The decision is based on a firm belief that huge unmet medical needs remain to be addressed, not least within diabetes, a disease that is growing at an alarming rate all over the world. Read more on pp 22–23.
     To meet the increasing demands for data about its products’ health-economic benefits, capabilities are being further strengthened within the company’s market access functions. Moreover, Novo Nordisk is expanding its field force in countries where there are significant opportunities for market expansion. It is also exploring new ways of reaching people with unmet health needs. For example, pilot programmes in low-income countries such as Kenya and Bangladesh have helped improve access to products in rural areas.

 



A focused strategy

The three core elements of Novo Nordisk’s strategy have remained unchanged for years:

First, Novo Nordisk has a sharp focus on a few diseases and conditions where it can make a significant difference. As a result of this focus, the company has built strong positions within diabetes care, haemophilia and growth disorders, while creating a platform for entering into treatments for obesity and autoimmune inflammatory diseases.

Second, activities are leveraging the company’s five core capabilities:
Engineering, formulating, developing and delivering protein-based treatments
Deep disease understanding
Efficient large-scale production of proteins
Planning and executing global launches of new products
Building and maintaining a leading position in emerging markets.


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17

Third, Novo Nordisk has a values-based management system formalised in the Novo Nordisk Way. Read more on p 4. A key element of the Novo Nordisk Way is the Triple Bottom Line business principle, which was written into the company’s Articles of Association at the Annual General Meeting in 2004. It states that Novo Nordisk “strives to conduct its activities in a financially, environmentally and socially responsible way”.
     This is the company that 24.3 million patients rely on for their daily medication, where more than 38,000 employees work and in which more than 130,000 investors have bought shares.

The five strategic focus areas

1. Expand leadership in diabetes

382 million people worldwide are living with diabetes and it is predicted that by 2035 close to 600 million people worldwide will have diabetes. Read more about the diabetes pandemic on pp 22–23.
     The global market for diabetes care products amounts to approximately 238 billion Danish kroner, of which Novo Nordisk products account for about 27%. The market has been growing by around 11% annually in the last decade and is expected to experience continued solid growth driven by an increased prevalence of diabetes and the need for better treatments. Of this global market, insulin accounts for 52%, oral diabetes products for 41% and GLP-1 products for 7%.
     In 1923 the first patients were treated with insulin from the company that is now Novo Nordisk, and diabetes care remains its largest and fastest-growing business area.

Diabetes care accounts for close to 78% of Novo Nordisk’s total sales, most of which comes from insulin and GLP-1 products. In both areas Novo Nordisk is the global market leader in terms of volume.
     Novo Nordisk is well positioned to address the unmet medical needs in diabetes.

The insulin portfolio
The insulin portfolio includes:
Tresiba ® (insulin degludec), a once-daily new-generation basal insulin analogue with an ultra-long duration of action and a flat and stable action profile that reduces the rate of low blood sugar (hypoglycaemia). Read more about Tresiba® on pp 24–25.
Ryzodeg ® (insulin degludec/insulin aspart), a soluble insulin combination of Tresiba® and NovoRapid® (insulin aspart) providing both basal and mealtime glucose control.
NovoRapid ® (marketed as NovoLog® in the US), the world’s most widely used rapid-acting insulin for use at mealtimes.
NovoMix ® 70/50/30 (NovoLog® Mix 70/30 in the US), dual-release modern insulins that cover both mealtime and basal requirements. These insulins can be used either to initiate or intensify insulin therapy.
Levemir ® (insulin detemir), a soluble, long-acting modern insulin for once-daily use. It provides glucose control with a favourable weight profile.

The primary goal of Novo Nordisk’s diabetes research is to discover new therapies that lower blood glucose while reducing the risk of low blood sugar. A recent result of this research is IDegLira, a fixed combination of insulin degludec and liraglutide (the active ingredient in Victoza®). IDegLira is under regulatory review in the EU. Read more about IDegLira on pp 24–25.

 

     Novo Nordisk is also developing a new faster-acting formulation of insulin aspart to be taken at mealtimes and recently initiated an extensive phase 3a programme.
     In addition to new and improved injectable insulins, Novo Nordisk is also developing formulations of insulin that can be taken as tablets.

GLP-1 (Glucagon-Like Peptide-1)
With the launch of Victoza® in 2009, Novo Nordisk entered the GLP-1 therapy segment. Victoza® is a human GLP-1 analogue with 97% similarity to the natural gut hormone. Victoza® is taken once daily and, like natural GLP-1, works by stimulating the beta cells in the pancreas to release insulin only when blood sugar levels are high.
     GLP-1 therapy is a significant advance in the treatment of type 2 diabetes because it lowers glucose with only a very low risk of triggering low blood sugar.
     Victoza® is approved for adults with type 2 diabetes who are unable to achieve blood glucose goals with lifestyle changes and tablet-based treatment (metformin, the most widely used tablet for type 2 diabetes). In less than two years, Victoza® became the leading GLP-1 treatment globally and has steadily expanded the market for GLP-1 treatment. The market is currently valued at around 16.4 billion kroner, of which Victoza® accounts for approximately 70%. Available in more than 80 markets, Victoza® is now used by approximately 800,000 people worldwide according to company estimates.
     Based on the expertise Novo Nordisk has gained through the development of Victoza®, the company is now building a GLP-1 portfolio with the intention of providing an even broader range

CONTINUED ►


 

 


  Novo Nordisk’s strategy
  Strategic focus areas
  Core capabilities  
                                 
  Expand leadership in DIABETES  
Engineering,
formulating,
developing
and
delivering
proteinbased
treatments
 
Deep
disease
under-
standing
 
Efficient
large-scale
production
of proteins
 
Planning and
executing
global
launches of
new
products
 
Building and
maintaining
a leading
position in
emerging
markets
 
                                 
  Establish presence in OBESITY            
                                 
  Pursue leadership in HAEMOPHILIA            
                                 
  Expand leadership in GROWTH DISORDERS            
                                 
  Establish presence in INFLAMMATION            
             
Novo Nordisk Way and the Triple Bottom Line business principle
 
                                 

 


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of treatment options. Key projects include a once-weekly GLP-1 analogue, semaglutide, which in 2013 entered phase 3a development. Novo Nordisk is also developing formulations of GLP-1 that can be taken as tablets.

Injection devices
Novo Nordisk invented the market for insulin injection devices with the launch of the world’s first insulin pen in 1985. Today, Novo Nordisk offers the world’s most widely used durable and disposable devices for insulin and GLP-1, NovoPen® 4 and FlexPen®, and is currently introducing its latest innovations, NovoPen® 5 and FlexTouch®, in many markets. The development of injection devices is based on extensive studies of how patients experience their daily injections and what they want from their device. It is an area where Novo Nordisk can make a difference by developing devices that are simple, safe and user-friendly. Read more about devices on p 10.

2. Establish a
presence in obesity

According to the World Health Organization (WHO), obesity has reached pandemic proportions, with up to 1.4 billion adults (over 20 years old) being overweight. Of these, more than 200 million men and nearly 300 million women are clinically obese (ie BMI ≥ 30). Obesity is known to be a major risk factor in developing serious diseases such as type 2 diabetes and cardiovascular diseases.
     Despite the growing prevalence of obesity globally, there are only a few pharmaceutical treatment options currently available and reimbursement for these medications is limited. The market for obesity products currently amounts to 2–3 billion kroner.
     Novo Nordisk has been investigating the use of liraglutide in a 3 mg dose as a new once-daily treatment for some people with obesity, namely those with obesity-related medical conditions such as prediabetes, sleep apnoea, high blood pressure and lipid disorders. Liraglutide 3 mg is under regulatory review in the EU and the US. Read more about obesity on pp 28–29.

3. Pursue leadership
in haemophilia

Haemophilia is an inherited or acquired bleeding disorder that prevents blood from clotting. An estimated 420,000 people worldwide are living with severe or moderate haemophilia. The global haemophilia drug market is estimated at 53 billion kroner and has grown by more than 4% annually in recent years.
     Novo Nordisk entered the haemophilia market in 1996 when it introduced NovoSeven® for the treatment of haemophilia patients who form antibodies against traditional treatments. The

company’s ambition is to move from this niche into the main segments of the haemophilia A and B market and achieve a leadership position by developing improved treatment options for all patients. Read more about haemophilia on p 30.

4. Expand leadership
in growth disorders

Novo Nordisk has been active in the treatment of growth hormone deficiency for almost four decades. Growth hormone therapy is most frequently used in developed countries. Globally it is estimated that more than 2 million people are eligible for growth hormone therapy.
     The market for growth disorder treatments is estimated at 16.4 billion kroner and has grown by more than 4% annually since 2009. Novo Nordisk is the leading provider of human growth hormone with a global market share of 30% measured by value.
     Novo Nordisk’s strategy in growth hormone therapy is to expand leadership by providing innovative and convenient products and devices. Norditropin® (somatropin) is the only liquid growth hormone product with room temperature stability after first use that is available in a prefilled pen device. Novo Nordisk’s newest injection device for growth hormone is Norditropin® FlexPro®, which has an easy-touch dosing mechanism.
     Novo Nordisk is also developing a long-acting growth hormone formulation, currently in phase 1 trials.

5. Establish presence
in inflammation

Autoimmune inflammatory diseases, such as rheumatoid arthritis and Crohn’s disease, result from the immune system attacking the body’s own tissues and creating a chronic state of inflammation. Many people with autoimmune inflammatory diseases do not respond adequately to current treatments.
     Novo Nordisk is using its expertise in designing therapeutic proteins and within chronic disease management care to develop new treatments, particularly for patients who are unresponsive to current treatments. Novo Nordisk has built a portfolio of first-in-class compounds with three projects being investigated in phase 2 clinical studies.

The core capabilities
Engineering, formulating, developing
and delivering protein-based treatments

Novo Nordisk has dedicated research and development facilities in Denmark, China, the US and India. More than 7,000 employees are involved in research and development activities throughout the company, working in partnerships with external biotech and academic researchers.

 

Novo Nordisk’s researchers have many years’ experience with formulation technology, protein engineering, expression and delivery, enabling the company to continuously improve the properties of therapeutic proteins such as insulin and GLP-1. Furthermore, since 1985, when Novo Nordisk launched the world’s first insulin injection device – NovoPen® – the company has developed world-class expertise in designing and producing simple and convenient devices for injecting protein therapeutics.

Deep disease understanding
Novo Nordisk has a deep understanding of the unmet medical needs associated with chronic conditions. This, together with strong relationships and numerous collaborations with external researchers and clinicians, provides a solid foundation for the company’s research, development and marketing activities. One example is DAWN2 (Diabetes Attitudes, Wishes and Needs), a study conducted in 17 countries and including more than 15,000 people with diabetes, their family members and healthcare professionals. DAWN2 highlights opportunities for improving diabetes care, education and community support.


Efficient large-scale
production of proteins
A high-quality, cost-effective global manufacturing infrastructure is a prerequisite for competing successfully in an increasingly competitive pharmaceutical market. It also enables Novo Nordisk to make treatments available at very low prices in developing countries. Novo Nordisk has a global production set-up with facilities strategically located in five countries across four continents:
The production of active pharmaceutical ingredients is a highly specialised process and mainly takes place in Denmark, where Novo Nordisk has nine plants, including the largest insulin factory in the world.
The production of diabetes finished products takes place in five countries: Denmark, France, the US, Brazil and China, which all have the approval and ability to export to other markets.
In addition, Novo Nordisk has a number of smaller manufacturing plants that support local demand in selected countries.
All production facilities operate under one global quality management system with centrally deployed standard operating procedures (SOPs) for all involved employees. This ensures a uniform and high quality standard for all products.

All manufacturing sites are held accountable for meeting ambitious targets for minimising their impact on the environment. Performance measures include energy and water consumption, CO2 emissions and the amount of waste



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19

 

generated during production processes. Read more about production on pp 36–37.

Planning and executing global launches of new products
Due to the high and increasing costs associated with developing, obtaining approval for and marketing a new medicine, most pharmaceuticals must be launched globally to optimise the return on investment. And, importantly, such launches must happen over a relatively short time so there is a reasonable period left before the product’s patents expire. Through the launches of Victoza® in multiple markets over the past years, Novo Nordisk has refined this capability, which is now being utilised in connection with the launch of, for example, Tresiba®.

Building and maintaining a leading position in emerging markets
Many years of experience have helped Novo Nordisk understand the needs of new markets and forge partnerships with local stakeholders. The company’s strategy has always been to establish a local organisation early – as soon as there are signs of a market developing – and to grow organically as the market develops. This has enabled Novo Nordisk to build long-term relations and a sustainable market presence, and is a key reason behind Novo Nordisk’s success in rapidly developing markets such as China. Read more about Novo Nordisk’s five regions on pp 31–35.

The Triple Bottom Line business principle
Novo Nordisk’s strategy is underpinned by the Triple Bottom Line business principle, which ensures that financial, social and environmental impacts are considered when decisions are made. This requires systematic and respectful engagements with key stakeholders to stay attuned to their interests and expectations.
     The aim is to ensure long-term profitability by mitigating risks and minimising negative impacts from business activities, and to enhance the positive contributions to society from the company’s global operations.

Financially responsible:
profitable for the long term

Doing business in a profitable and responsible way is the basis for the long-term viability of the company. Novo Nordisk uses four long-term financial targets to steer the business towards long-term sustainable growth. These targets help Executive Management balance growth in the short term with investments in longer-term growth such as new production facilities and research and development activities.

Socially responsible: promote healthy living – and a healthy and engaging workplace
It is Novo Nordisk’s mission to help people with diabetes, haemophilia and other chronic diseases live better lives. This is encapsulated in the company’s corporate commitments of Changing Diabetes® and Changing Possibilities in Haemophilia®. As a research-based healthcare company, Novo Nordisk’s main contribution is to discover and develop innovative biological medicines and make them accessible to patients throughout the world.
     With its deep disease understanding and patient focus, Novo Nordisk plays an active part in the fight against diabetes. The company is engaged in the prevention of diabetes through the promotion of healthy living, and is working to improve awareness, diagnosis and treatment of diabetes. Through these efforts, Novo Nordisk aims to reduce the human and financial burden of diabetes. Read more about Changing Diabetes® on pp 26–27.
     Social responsibility is also about ensuring a healthy and engaging workplace for Novo Nordisk’s employees. A healthy, inclusive and engaging working environment helps attract, motivate and retain the right people, and this is critical to sustain global growth and make positive contributions to society. Diversity of backgrounds and experience enriches the working environment. A diversity aspiration has been set for senior management teams. It drives strategic efforts to encourage recruitment and promotion of women and people from different nationalities

 

throughout the organisation. The people strategy offers global standards for equal opportunities, respect for the individual and a safe working environment. As a particular focus, the company promotes healthy lifestyles at work through its NovoHealth programme.

Environmentally responsible:
preserve nature’s resources

Producing more with less is not just sound household management; it is a way to help preserve scarce natural resources and proactively address sustainability challenges throughout the value chain. As its business grows, Novo Nordisk seeks to reduce the consumption of natural resources and manufactured inputs across the value chain. In addition, there is also a focus on minimising outputs in the form of emissions such as CO2 and waste. Read more about production on pp 36–37.

Maximising the value
of the Triple Bottom Line
The Triple Bottom Line business principle creates value for Novo Nordisk in three ways as it:
1. makes the company more adaptive to changes in its business environment. This, in turn, mitigates risks and builds trust. Novo Nordisk proactively engages with stakeholders to address global and systemic challenges that could affect the company’s success in the long term. One example is an active engagement in the development of a new set of global sustainable development goals under the auspices of the United Nations.
2. strengthens competitiveness. Changing Diabetes® is an example of how demonstrating social responsibility and systematic stakeholder engagements can effectively complement market strategies to drive revenue growth. Novo Nordisk has developed a method to demonstrate the business case, called the Blueprint for Change programme. Through a series of case studies, the programme documents how the company’s approach to doing business in ways that are responsible and profitable creates shared value, ie benefits for both stakeholders and the business.
3. is an engine for innovation in collaboration with partners. One example is from the recent Blueprint for Change case study in Indonesia, one of the company’s selected growth markets. The study showed how Novo Nordisk, by working with partners, can develop its business by reaching out more effectively to people with diabetes who currently do not have access to insulin treatment. The study has informed the strategy in Indonesia. Read more at novonordisk.com/sustainability.

 


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20     OUR BUSINESS

Pipeline overview

Diabetes care

 Compound  
 Indication
 
 Description
  Phase 1   Phase 2   Phase 3   Filed/
regulatory
approval
Diabetes

Tresiba®
(insulin
degludec)
NN1250
  Type 1 and 2 diabetes   A new-generation basal insulin with an ultra-long duration of action of more than 42 hours. Approved to offer patients reduced risk of hypoglycaemia and the possibility of adjusting the time of injection, when needed. Approved and launched in the EU, Japan and other markets. Additional data required by the US FDA are being generated for the planned resubmission.  

Ryzodeg®
(insulin
degludec and
insulin aspart)
NN5401
  Type 1 and 2 diabetes   A soluble co-formulation of Tresiba®, the new-generation basal insulin analogue with an ultra-long duration of action, and NovoRapid® (insulin aspart, marketed as NovoLog® in the US), a rapid-acting mealtime insulin. Approved to offer patients reduced risk of hypoglycaemia. Approved in the EU, Japan and other markets. Additional data required by the US FDA are being generated for the planned resubmission.  

IDegLira
(a fixed combination of insulin degludec and liraglutide)
NN9068
  Type 2
diabetes
  A combination of insulin degludec and liraglutide intended to offer the benefits of the two components in a single preparation. Under regulatory review in the EU. Regulatory filing in the US is awaiting the additional data required by the FDA for Tresiba®.  

Faster-acting
insulin aspart
NN1218
  Type 1 and 2 diabetes including pump users   A new formulation of insulin aspart to accelerate onset of action.  

Semaglutide
NN9535
  Type 2 diabetes   A once-weekly GLP-1 analogue intended to offer the clinical benefits of a GLP-1 analogue with less frequent injections.  

LATIN T1D
NN9211
  Type 1 diabetes   Liraglutide, a once-daily human GLP-1 analogue, intended to offer clinical benefits as adjunct therapy to insulin.  

OG217SC
NN9924
  Type 2 diabetes   A long-acting GLP-1 analogue intended to offer the clinical benefits of a GLP-1 analogue in a tablet.  

OG987GT
NN9926
  Type 2 diabetes   A long-acting GLP-1 analogue intended to offer the clinical benefits of a GLP-1 analogue in a tablet.  

OG987SC
NN9927
  Type 2 diabetes   A long-acting GLP-1 analogue intended to offer the clinical benefits of a GLP-1 analogue in a tablet.  

OG217GT
NN9928
  Type 2 diabetes   A long-acting GLP-1 analogue intended to offer the clinical benefits of a GLP-1 analogue in a tablet.  

LAI287
NN1436
  Type 1 and 2 diabetes   A long-acting basal insulin analogue with potential for once-weekly dosing.  

OI338GT
NN1953
  Type 1 and 2 diabetes   A long-acting basal insulin analogue intended to offer the clinical benefits of a basal insulin analogue in a tablet.  

OI362GT
NN1954
  Type 1 and 2 diabetes   A long-acting basal insulin analogue intended to offer the clinical benefits of a basal insulin analogue in a tablet.  

OI287GT
NN1956
  Type 1 and 2 diabetes   A long-acting basal insulin analogue intended to offer the clinical benefits of a basal insulin analogue in a tablet.  

Obesity            

Liraglutide
3 mg

NN8022
Obesity   A once-daily human GLP-1 analogue for use as adjuvant to lifestyle changes intended to offer weight loss for people with severe obesity, including those at particular risk of developing diabetes. Under regulatory review in the US and the EU.  


NOVO NORDISK ANNUAL REPORT 2013

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OUR BUSINESS    
21

Biopharmaceuticals

 Compound  
 Indication
 
 Description
  Phase 1   Phase 2   Phase 3   Filed/
regulatory
approval
Haemophilia                    











N8-GP
NN7088
  Haemophilia A   A long-acting recombinant coagulation factor VIII derivative intended to offer prophylaxis and treatment of bleeds.  

N9-GP
NN7999
  Haemophilia B   A long-acting recombinant coagulation factor IX derivative intended to offer prophylaxis and treatment of bleeds.  

Concizumab
NN7415
  Haemophilia A, B and with inhibitors   A monoclonal antibody against Tissue Factor Pathway Inhibitor (TFPI) intended for bleeding prevention after subcutaneous administration.  

Growth disorders                    

NN8640   Growth disorders   A long-acting human growth hormone intended to offer less than once-daily injections.  

Inflammation                    

Anti-IL-20
NN8226
  Rheumatoid
arthritis
  A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  

Anti-IL-21
NN8828
  Crohn’s
disease
  A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  

Anti-NKG2D
NN8555
  Crohn’s
disease
  A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  

Anti-C5aR
NN8210
  Rheumatoid
arthritis
  A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  

Anti-NKG2A
NN8765
  Rheumatoid
arthritis
  A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  

Anti-IL-21
NN8828
  Systemic lupus erythematosus   A recombinant human monoclonal antibody with a novel mechanism of action. The drug is intended to improve treatment outcomes in patients who do not respond adequately to existing treatments.  


Phase 1  

Studies in a small group (usually 10–100) of healthy volunteers, and sometimes patients, to investigate how the body handles, distributes and eliminates new medication and establish maximum tolerated dose.

 

Phase 2  

Studies of various dose levels in a larger group of patients (usually 100–1,000) to learn about the new medication’s effect on the condition and its side effects. In phase 2, clinical trials are carried out to evaluate efficacy (and safety) in specified populations of patients. The outcome of phase 2 trials is clinical proof of concept and the selection of dose for evaluation in phase 3 trials.

 

Phase 3  

Studies in large groups of patients (more than 8,000) comparing a new medication with a commonly used drug or placebo for both safety and efficacy. Phase 3a covers trials conducted after efficacy is demonstrated and prior to regulatory submission. Phase 3b covers clinical trials completed during and after regulatory submission. In small therapeutic areas such as haemophilia, regulatory guidelines may allow the design of single-arm therapeutic confirmatory trials or trials that compare against eg historical control instead of existing treatment or placebo.


Read more at novonordisk.com/investors and clinicaltrials.gov.

NOVO NORDISK ANNUAL REPORT 2013

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22


 

The one rule
we have to
break

382 million people in the world have diabetes today.
Yet half of these people have not been diagnosed and,
alarmingly, it’s assessed that only 6% of people with
diabetes live a life free from diabetes-related complications.
 


Diabetes is an insidious disease of pandemic proportions. Ban Ki-moon, the Secretary-General of the United Nations, has described diabetes as a tsunami in slow motion. According to the latest figures from the International Diabetes Federation (IDF), 382 million people in the world have diabetes today – a number predicted to grow to close to 600 million by 2035.1* 80% of the total number affected live in low- and middle-income countries, where the pandemic is gathering pace at alarming rates due to the lifestyle changes associated with economic growth and urbanisation.
     Just as worrying is the fact that only about half of these people have been appropriately diagnosed with diabetes. This is where the ‘Rule of Halves’
2 begins. Of those who are diagnosed, only half receive treatment from a qualified healthcare professional and again just half of these people achieve their treatment targets. Unfortunately the Rule of Halves does not end there: only half of this already relatively small group actually achieve the desired outcome and live a life free from diabetes-related complications
     The Rule of Halves estimates a global average. For some countries, eg Vietnam, Kenya and China,
1 diagnosis rates are even lower than 50%. For some, treatment may


* All footnotes can be found on p 112.
 

be almost non-existent, while in other countries a key issue is that even those people who are diagnosed and treated do not reach their treatment targets and therefore have a high risk of developing complications.
     Findings from a landmark study in the UK showed that reducing blood sugar levels by close to 1% may reduce diabetes-related deaths by more than 20% and reduce microvascular complications by nearly 40%.
3 Microvascular complications include diabetic retinopathy, which causes more than 12,000 cases of blindness annually in the US alone.4

Cannot be ignored
In human as well as financial terms, the burden of diabetes is high, being a factor in 5.1 million deaths and accounting for some 548 billion US dollars in health spending (11% of the total spend worldwide) in 2013 according to the IDF.1
     What all countries have in common is that the diabetes pandemic cannot be ignored. And what’s important from both the human and economic perspective is that countries have a plan for how to address the Rule of Halves with a view to minimising both the personal strains and the financial burdens of diabetes. Novo Nordisk is working with governments and non-governmental organisations in many countries to help address these challenges. Read more about Changing Diabetes® on pp 26–27.

 

382 MILLION PEOPLE LIVE WITH DIABETES WORLDWIDE BY 2035 592 MILLION PEOPLE WILL LIVE WITH DIABETES

NOVO NORDISK ANNUAL REPORT 2013


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The International Diabetes
Federation (IDF) estimates that
there are currently 35 million
people with diabetes living in
the Middle East and North
Africa. With a population of
9 million, Cairo is the largest city
in this region and as in all other
big cities, the number of people
with diabetes is increasing.

 
 

 

 

 

 

The Rule of Halves According to the Rule of Halves*, only around 6% of people with diabetes live a life free from diabetes-related complications.
Of the estimated 382 million people with diabetes
About 50% are diagnosed**
Of whom about 50% receive care** Achieve treatment targets Of whom about 50% achieve treatment targets** Achieve desired outcomes Of whom about 50% achieve desired outcomes**
* Hart J.T., Rule of Halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care, Br J Gen Pract 1992, March; 42(356):116-119, and W.C.S. Smith, A.J. Lee, I.K. Coombie, H. Tunstall-Pedoe, Control of blood pressure in Scotland: The rule of halves, BMJ, 300 (1990): 981-983. ** Actual rates of diagnosis, treatment, targets and outcomes vary in different countries.


Potential complications
of uncontrolled diabetes

 

What is diabetes?

Diabetes affects the way the body uses food for growth and energy. There are two main forms of diabetes: type 1 and type 2. Type 1 diabetes is a lifelong autoimmune disease that develops when the body produces an immune response against its own cells, destroying beta cells in the pancreas. As a result, the pancreas stops producing insulin, often – but not always – at a young age.
     At least 90% of people with diabetes have type 2, which is caused by a combination of lifestyle and genetic factors. People with type 2 diabetes may still produce their own insulin, but the amount is insufficient and the insulin is not used effectively by the body.
     Most of the long-term health complications associated with diabetes are due to persistently high blood glucose levels, which can cause damage to the kidneys, neurological system, cardiovascular system, retina or to the feet and legs through effects on both large and small blood vessels.

 

How is diabetes treated?

People with type 1 diabetes need to start taking insulin as soon as they are diagnosed and must continue to do so for the rest of their lives.
     People with type 2 diabetes need different treatments as the disease progresses. Initially, lifestyle changes, including diet and exercise, and an oral medicine such as metformin may be suffi cient. If treatment goals are not met, GLP-1 therapy or a basal insulin (long-acting insulin) may be added. If treatment targets are still not achieved, intensive insulin treatment may be necessary. This may include adding a rapid-acting insulin at mealtimes, in addition to a basal insulin. For insulin initiation, premixed insulin with dual release to cover both mealtime and basal requirements may be used.
     In total, approximately 45–50 million people worldwide are using insulin.
     A significant challenge in managing diabetes with insulin is to maintain appro priate blood glucose levels, adjusting insulin dosing as necessary to balance the impact of food and exercise to avoid either high blood glucose levels (hyperglycaemia), which can lead to long-term complications such as blindness and amputations, or low blood glucose levels (hypoglycaemia), which can lead to seizures, unconsciousness or, in rare cases, death.

Stroke Strokes are up to four times as likely
Blindness Diabetes is a leading cause of blindness
Heart attack Heart attack is three times as likely and heart disease is up to four times as likely
Total kidney failure Total kidney failure is three times as likely
Amputation Diabetes is a leading cause of non-traumatic lower-limb amputations.

 

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OTHER BUSINESS    
25

   

has been designed with this need in mind.
     Establishing a routine for when to take insulin is important, but with a duration of action that lasts beyond 42 hours, once-daily Tresiba® provides flexibility when needed. “To be able to change the time you inject from day to day, if the situation requires, gives a remarkable sense of freedom for patients,” points out Dr Alan Moses, global chief medical officer. “And with the significantly lower risk of hypoglycaemia during the night, Tresiba® is a good example of how, even after 90 years, we can still engineer better insulin treatments.”

Greater than the sum of its parts
Not all people can control their diabetes with a basal insulin alone. As type 2 diabetes progresses, it may become necessary to add treatment(s) to tackle the spike in the blood sugar level that occurs

 

 

    Image of the insulin degludec molecule based
on X-ray crystallography data. Insulin degludec is
the active compound in Tresiba
®.

 

 

 

 

The fear of low blood sugar  (hypoglycaemia) means that many people with type 2 diabetes are not treating their condition intensively enough to reduce blood sugar to the recommended level. Adding to this problem is the inflexibility of when injections must be taken, which can lead many people to not take insulin as prescribed. These factors can result in people with diabetes being at risk of developing severe long-term complications.

When long is not long enough
A long-acting insulin is often the first step into insulin treatment for a person with type 2 diabetes – the idea is that such a ‘basal insulin’ should only need to be taken once a day, so it’s a ‘manageable’ introduction to insulin injections. One challenge, however, is that the speed at which the insulin is absorbed in the body can vary significantly from day to day in the same person. This increases the risk of hypoglycaemia, particularly at night. Another challenge is that most basal insulins do not provide an adequate level of insulin in the blood for full 24-hour coverage.1
     “From speaking with many doctors and people with diabetes, we knew there was a need for a basal insulin with an ultra-long duration of action,” says Jakob Riis, executive vice president of Marketing & Medical Affairs. Tresiba® (insulin degludec)

   

after meals too. For these people, Novo Nordisk has developed IDegLira, a combination of Tresiba® and Victoza® (liraglutide), delivered in a single daily dose. Victoza®, a human GLP-1 analogue, stimulates insulin secretion and inhibits glucagon secretion in a blood glucose-dependent manner and has also been shown to reduce body weight.
     In clinical trials, when IDegLira was administered once daily independently of meals, it provided improved overall glycaemic control compared with Tresiba® or Victoza® alone, with no weight change and a low rate of hypoglycaemia compared with Tresiba®. “If people aren’t getting good control on a basal insulin, IDegLira may provide the opportunity of continuing on a single daily injection of a long-acting insulin, but with the addition of Victoza®. During clinical trials, this co-formulation has been shown to work better than Tresiba® or Victoza® separately,” says Alan Moses.
     Jakob Riis agrees: “IDegLira may provide a new opportunity for people with type 2 diabetes who are not adequately controlling their blood sugar levels. We believe this product will improve convenience for patients, but the development programme has also supported that the two active ingredients actually complement each other.”
     In May 2013, Novo Nordisk submitted the regulatory filing for IDegLira in the EU.

 


Making Tresiba® available for patients

Tresiba® was approved in the EU in January 2013 and by the end of the year it had been launched in eight countries. In countries with broad market access, Tresiba® has quickly gained a significant share of the market for long-acting insulins.
     In February 2013, Novo Nordisk received a Complete Response Letter from the US Food and Drug Administration (FDA) in which the agency requested additional cardiovascular safety data from a dedicated cardiovascular outcomes trial before the review of the New Drug Application can be completed. While Novo Nordisk remains confident about the cardiovascular safety of Tresiba® based on both its own interpretation of the data derived from the clinical development programme and reviews by the European and Japanese regulatory authorities, the company also recognises the importance of reassuring the FDA about the cardiovascular safety. Hence, in October 2013, a dedicated clinical trial, named DEVOTE, was initiated to rule out any excess cardiovascular risk.
     DEVOTE is a double-blind trial, using insulin glargine as comparator, and is expected to include around 7,500 type 2 diabetes patients who have existing or high risk of cardiovascular disease. Novo Nordisk expects to have sufficient data to support a prespecified interim analysis within two to three years and to complete the study within four to six years from initiation. Thereby Novo Nordisk passed a significant milestone in the process of making Tresiba® available for people with diabetes in the US.

 

Tresiba® study results

Translating the results from clinical trial programmes into real advances in clinical practice can be challenging, especially since new medicines are often utilised in patients who are not responding well to available therapies. However, recent findings from Marc Evans, a clinician investigator in the UK, provide some important insights into how much value Tresiba® can bring to patients who are experiencing challenges with other insulins. Dr Evans studied 25 consecutive patients who were experiencing poor glucose control and frequent low blood sugar with either insulin glargine or Levemir® (insulin detemir). He found that when switched to Tresiba®, these patients improved their glucose control (in both type 1 and type 2 diabetes) and substantially reduced the frequency of low blood sugar episodes.2

 

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26     OUR BUSINESS

 

 

Changing
diabetes
where it matters most


It has been almost a decade since Novo Nordisk launched
Changing Diabetes
®, its promise to people with
diabetes to help them live a better life. Much has been
achieved in this time, but a lot still needs to be done.


Novo Nordisk’s core responsibility to people with diabetes and to society is to deliver innovative, high-quality products. We have a very diverse insulin portfolio, from human insulins to modern insulin analogues,” says Jakob Riis, executive vice president of Marketing & Medical Affairs. “Our core focus is to drive innovation and develop even better products to help people achieve the best possible outcome of their treatment.”
     As a world leader in diabetes care, Novo Nordisk not only produces insulin, but also works to ensure that it reaches the hands of those who need treatment and care worldwide. “We strive to make insulin accessible for more people living at the base of the economic pyramid, and we’ll continue to offer human insulin at very low prices in developing countries,” explains Jakob Riis.
     While delivering products will always remain Novo Nordisk’s number one priority, the efforts to change diabetes go beyond medicine. “Our goal is to make a difference to patients, and we know that we can only get part of the way with our products. This is why our Changing Diabetes® activities are important,” points out Jakob Riis.
     “Access to health is a human right, and Changing Diabetes® is Novo Nordisk’s response to the global diabetes challenge. A key element is our strategy for global access to diabetes care, which we renewed in 2013. It is global in scope and part of our business model. Basically, we will stop diabetes ruining people’s lives,” explains Charlotte Ersbøll, corporate vice president of Corporate Stakeholder Engagement. “We would like to see a world where everyone with diabetes is diagnosed, everyone who is diagnosed gets treated and everyone treated can live their life to the full,” she adds.
     That is why Novo Nordisk is working around the world together with its partners to break the diabetes ’Rule of Halves’. Read more on pp 22–23.

The challenge is global, the solutions local
“The challenges of living with diabetes are different from country to country and person to person, so we partner with governments

 



and local stakeholders to identify the most pressing health needs and ways in which we can achieve the biggest impact,” explains Charlotte Ersbøll.
     For countries where improving understanding of diabetes and its prevention is of the utmost importance, Novo Nordisk works to raise awareness, for example through activities on World Diabetes Day and by organising high-level national and international diabetes leadership forums with policymakers.
     More urgent in some countries is the need to increase diagnosis of diabetes and improve access to healthcare. In these areas Novo Nordisk is working with local partners to develop screening programmes, build capacity by training healthcare professionals, and establish clinics and networks to strengthen the existing healthcare infrastructure.

Ambitious long-term target
“Ten years ago diabetes was not recognised as having a direct impact on development,” says Charlotte Ersbøll. “The world knew diabetes was increasing in high-income countries such as the US, but didn’t understand the implications of the rising prevalence of diabetes in developing countries. Today non-communicable diseases, including diabetes, are recognised as the biggest killer globally and therefore increasingly important on the global health agenda.”
     Novo Nordisk has set a long-term global target of providing quality diabetes care products to 40 million people by 2020. It builds on the belief that the way in which the company addresses a global health issue must be linked to its commercial offering; otherwise it is not sustainable in the long term. Today, Novo Nordisk provides diabetes care products to more than 24 million people.
     “With our ‘40by20’ long-term target we hope to make a significant contribution to the World Health Organization’s target of decreasing mortality from non-communicable diseases such as diabetes by 25% by 2025,” adds Charlotte Ersbøll.

 

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Team Novo Nordisk has raced more than
9,500 km in 55 races since its launch
in December 2012.
 

Inspire people with diabetes
through Team Novo Nordisk
“Ultimately, diabetes shouldn’t restrict the lives of children or adults no matter where they live,” says Jakob Riis. “This is why we support Team Novo Nordisk, the world’s first all-diabetes pro-cycling team. The team’s mission is to educate, empower and inspire those affected by diabetes. We want people to say ‘I manage my diabetes, it doesn’t manage me’.” In total, Team Novo Nordisk consists of more than 80 cyclists, triathletes and runners who all have diabetes.

 

Eliodoro Gonzales lives in Bolivia.
He has type 1 diabetes and lost his
legs due to diabetes complication.

The World Diabetes Foundation
The World Diabetes Foundation was established by Novo Nordisk in 2002 as an independent trust with the vision of being a catalyst for change in developing countries. Since 2002, Novo Nordisk has donated around 1.1 billion Danish kroner to the Foundation. The largest share (37%) is spent on strengthening healthcare systems and building healthcare capacity. As of October 2013, 7,138 clinics had been established or strengthened, 4.6 million patients had been treated and 221,935 healthcare professionals trained.
     
Training apprentices
in China.
  In most of Africa there
is a lack of knowledge about diabetes.

 
Building healthcare capacity
Healthcare professionals who are capable of detecting and treating diabetes are needed to catch up with the accelerating growth in the prevalence of diabetes. In China, Novo Nordisk, the government and local partners collaborate to increase quality diabetes care. As of October 2013, 2,076 apprentices have been trained and people across 830 counties have benefited from improved diagnosis and treatment. Another example is the new REACH programme in which Novo Nordisk-owned Steno Diabetes Center is scaling up its efforts by establishing an education centre in various countries in Asia. Once fully rolled out, the programme, which is funded by the Novo Nordisk Foundation, is expected to train more than 9,200 healthcare professionals globally each year.
 


Reaching the base of the pyramid
People who earn 1,500–3,000 US dollars per year constitute more than 1 billion people. With some disposable income, but difficulties in accessing healthcare services, they belong to the base of the global economic pyramid. Novo Nordisk has launched projects in Kenya, India and Nigeria to bring diabetes care to these people. Through public–private partnerships, integrated solutions are pursued to supply insulin and diagnosis as well as quality treatment and care. One example is the establishment of ‘One-Stop-Shops’ in Nigeria, where people with diabetes are offered guidance on how to manage their diabetes, blood glucose testing and easy and fast access to insulin.

     
Patsy Left Hand
Bull is a tribal
elder of the
Lakota Sioux
tribe in the
Rosebud
Reservation.
 
Ranjith is enrolled in the
Changing Diabetes
® in
Children programme
in India.

Supporting vulnerable populations
People living in vulnerable communities are often overlooked if they live in high-income countries, but they experience disproportionately high levels of diabetes compared with the rest of the population. Novo Nordisk recently helped the Rosebud Sioux tribe of South Dakota in the US improve diabetes care. The project includes a mobile health unit for travelling to remote areas of the reservation, a wellness centre and a programme to certify diabetes educators.

  Changing Diabetes® in Children
In some developing countries, the life expectancy for children with type 1 diabetes is less than one year. In 2010, Novo Nordisk committed 75 million Danish kroner over five years to provide free insulin and care to children as part of its Changing Diabetes® in Children programme. The programme is a collaboration with local partners including ministries of health and the World Diabetes Foundation. Since 2010, 93 clinics have been established and over 4,150 local healthcare professionals have received the proper training and education to treat children. More than 11,700 children in nine countries across Africa and Southeast Asia have been enrolled in the programme.

 

 


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28     OUR BUSINESS

Is
obesity

a disease?

The increasing prevalence of obesity is no longer just an issue for high-income countries; the number of people who are overweight or obese is rising to record-breaking levels in low- and middle-income countries too. Without doubt, obesity is a growing threat to global health as it has many potentially life-threatening complications, not least type 2 diabetes. With liraglutide 3 mg, Novo Nordisk hopes to be able to offer a new treatment option for some people with obesity.

According to the World Health Organization, being overweight or obese is the fifth leading risk for deaths worldwide, and is linked to more deaths globally than being underweight. In the US, where more than 35% of adults, or some 100 million people, are obese,1 the American Medical Association recently recognised obesity as a disease. In 2011, a US congress committee urged the US Food and Drug Administration (FDA) to take steps to support the development of new treatments for obesity. The US isn’t the only country sounding the alarm over the obesity epidemic. Worldwide there appears to be a new willingness to address obesity.
     The problem isn’t necessarily obesity itself, it’s that obesity can have many serious – even life-threatening – health consequences. Known co-morbidities including heart disease, hypertension, type 2 diabetes, sleep apnoea and some types of cancer2–5 reduce life expectancy for people with obesity by 5–10 years. With increased BMI6,7 (see box on p 29) the risk of these complications increases and, as a consequence, obesity has a huge cost implication for healthcare systems.8
     Yet, many people with obesity are unaware how it might affect their health. “Some people who are overweight or obese may never experience any health issues,” explains Mads Krogsgaard Thomsen, executive vice president and chief science officer. “For these people, obesity may be less of a health concern. What we’re concerned about are the people who have a BMI of 35 or more and a significantly elevated risk of complications such as diabetes, prediabetes or sleep apnoea, or indeed may already have these co-morbidities. It’s our vision to offer a medical treatment to help these people specifically.”

Moderate weight loss has significant health benefits
Lifestyle interventions, including a healthy diet and increased physical activity, should always be part of the treatment for people with obesity. It’s recognised that a moderate weight loss of 5–10% has

 

significant health benefits.9–15 However, with most people not managing to achieve and maintain this level of weight loss with diet and exercise alone, other treatment options are necessary. “In the past, when medicines with an acceptable efficacy and safety profile were lacking and after diet and exercise had failed, doctors may have been reluctant to engage in dialogue with patients about obesity,” says Heather Millage, corporate vice president and responsible for bringing liraglutide 3 mg to the market. “We hope obesity care will improve when more tools – in particular liraglutide 3 mg – are available for the treatment of this disease.” Liraglutide 3 mg, Novo Nordisk’s once-daily GLP-1 therapy, has recently completed the fourth phase 3a trial as part of SCALE, the clinical development programme for obesity treatment.
      “Liraglutide is a fascinating molecule,” points out Mads Krogsgaard Thomsen. “Back in 1997, our research scientists suggested it could be efficacious for the treatment of type 2 diabetes, as well as obesity. We’ve therefore been investigating this molecule for the last 15 years. If approved, it’ll be the first and only product to treat obesity based on physiological regulation of appetite.”

A natural hormone
Liraglutide 3 mg is 97% similar to human GLP-1, a gut hormone that produces the sensation of fullness and decreases hunger signals when eating. Thereby it reduces appetite and food intake. In addition, liraglutide 3 mg stimulates the release of insulin in response to glucose to maintain the right levels of glucose in the blood.
     “GLP-1 is a natural hormone in the body, so with liraglutide 3 mg we’re using one of the body’s own mechanisms to tackle obesity,” says Mads Krogsgaard Thomsen. “In clinical trials, four out of 10 patients who took

 

liraglutide 3 mg during one year lost 10% of their body weight. And the majority of patients who had prediabetes at the beginning of the trial and who took liraglutide 3 mg reverted to a normal glucose level.” In fact, the majority of people with obesity treated with liraglutide 3 mg in the largest trial in the development programme achieved a clinically relevant weight loss of 5%. In one of the trials that extended for 104 weeks, weight loss achieved after one year was maintained for two years.
     Safety has been a key issue for obesity treatments, with several drugs being withdrawn due to safety concerns. However, a lot is already known about the safety profile of liraglutide. Under the brand name Victoza®, liraglutide has been on the market since 2009 in 1.2 mg and 1.8 mg doses for the treatment of type 2 diabetes.

Stigmatisation of people with obesity
While liraglutide 3 mg looks promising for the treatment of obesity, and with early research ongoing into other approaches to treating obesity, there are still challenges ahead. One is that many doctors, based on past experience, are reluctant to prescribe antiobesity medications due to concerns that the benefits don’t outweigh the risks of treatment. Another is that obesity medications aren’t widely reimbursed. The latter is to a large extent the result of a false assumption that all people with obesity can effectively lose weight just by changing their lifestyle – exercise more and eat less. For most this has proven exceedingly difficult, if not impossible, despite many attempts. It is this group – often stigmatised due to their weight and suffering from the complications of obesity – that may benefit from treatment with an obesity medication in combination with lifestyle changes and diet.
     “There are many myths and a lot of stigmas when it comes to the science of obesity and its treatment. We need to remove the stigma and raise awareness that safe and effective treatment options can improve lives. This is what Novo Nordisk has been doing successfully with type 2 diabetes and we think we can do it with obesity too,” says Heather Millage.

 

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Maria Lopez is one of the
100 million obese people
in the US. Her BMI is 33.

         
     
29
 
         
 

 

 
         
    Definition of obesity
Obesity is defined as abnormal or excessive fat accumulation that may impair health for people with a BMI over 30. BMI provides the most convenient population-level measure of overweight and obesity currently available.16 BMI itself, however, does not define health risk.

The role of hormones in obesity
The understanding of the biological factors contributing to weight gain and obesity is rapidly evolving. There is increased focus on the role of hormones and new research clearly indicates that much more is involved in the progression from normal body weight to obesity than just a person’s lifestyle and eating habits.17
     The regulation of appetite and food intake is a complex process involving multiple hormones that transmit signals between the organs that receive the food (the intestines or gut) and the brain. After a meal, the gut responds to food by producing several hormones that tell the brain to increase the feeling of fullness while reducing feelings of hunger. One of these hormones is GLP-1, which has been found to play an important role in regulating appetite.18
     As a GLP-1 analogue, liraglutide directly addresses some of the underlying biological mechanisms of obesity. Novo Nordisk is committed to research into and further exploration of the role of hormones in obesity and weight management, and the development of liraglutide is a first step in this process.

   
         
         
           

The number of adults with obesity has doubled since 1980
500 million
1980 2008
Worldwide rates of obesity have doubled since 1980, with more than 500 million adults classified as obese in 2008 – more than 10% of the world’s adult population (World Health Organization’s global estimates from 2008).


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30     OUR BUSINESS

An important
factor
of life
Image of the turoctocog
alfa molecule based on
X-ray crystallography
data. Turoctocog alfa
is the active compound
in NovoEight
®.
For people living with haemophilia A or B, there hasn’t always been a great deal of choice when it comes to treatment. With NovoSeven®, Novo Nordisk helps about 5% of these people – but with the launch of NovoEight®, the company will be able to help many more.

Novo Nordisk addressed a huge unmet medical need in 1996 when it launched the first ever recombinant treatment for people with haemophilia with inhibitors. Today NovoSeven® is still an important treatment option for the small part of the haemophilia community who have inhibitors.
     Now, Novo Nordisk is offering another product for people in the haemophilia community by launching a recombinant factor VIII product (turoctocog alfa) for people with haemophilia A. “While there are already similar products available for this group of people, NovoEight
® should not be underestimated,” says Stephanie Seremetis, chief medical officer, Haemophilia.

     “We’ve tried to improve on what is available and I think we’ve achieved this. NovoEight® is technically a different product from our competitors’. We’ve established a production process focusing on providing a new, highly purified and well-defined molecule and I believe this is important for both safety and efficacy. Of all licensed factor VIII products, NovoEight® has undergone the largest pre-approval programme ever carried out, which also includes a paediatric study. We therefore have a lot of data to document the safety and efficacy of our product.”

 

Building on confidence
In the phase 3 trial, NovoEight® demonstrated good efficacy in preventing and treating bleeds and had no confirmed inhibitor development. NovoEight® has now been approved in the US, the EU and Japan for the treatment and prophylaxis of bleeding in patients with haemophilia A. In January 2014 Germany was the first country to launch NovoEight®, and Novo Nordisk expects to launch the product in more European countries and in Japan during the year. Launch in the US is expected after April 2015, awaiting the expiration of existing patents.
     “NovoEight
® is very important for us as a company as we want to be a true partner for people with haemophilia and take a leadership role in this market – and we can’t do that without a treatment option for people with haemophilia A,” explains Paul Huggins, corporate vice president and responsible for bringing NovoEight® to the market. “Patients and doctors have grown to know and have confidence in NovoSeven®. We want to build on that confidence by providing another option for physicians that’s based on advanced purification technology.”

A paradigm shift in treatment
Novo Nordisk is also developing a long-acting recombinant factor VIII (N8-GP) and factor IX (N9-GP). The latter holds the promise of changing treatment

 

options for people with haemophilia B. “Our strong clinical trial results have shown that prophylactic treatment with N9-GP reduces the number of bleeding episodes per year to a very large extent,” says Stephanie Seremetis.
     Unfortunately, the expansion of manufacturing capacity for N9-GP didn’t progress as fast as planned, and Novo Nordisk therefore had to shorten the duration of one of the clinical trials. This, understandably, caused much frustration among both patients in the trial and their doctors
     In addition to developing products for the wider haemophilia community, Novo Nordisk remains committed to smaller patient groups – as illustrated by the development and approval in major markets of NovoThirteen® for the treatment of a rare bleeding disorder caused by congenital factor XIII deficiency, which around 1,000 people suffer from worldwide.

         
         

             
  Haemophilia
Haemophilia is an inherited or acquired bleeding disorder that prevents blood from clotting. People with haemophilia lack, either partially or completely, an essential clotting factor needed to form stable blood clots. Internal bleeding into the joints, muscles and other tissues can cause severe pain, joint damage and disability. The treatment for haemophilia involves intravenous administration of replacement clotting factors. Treatment may be administered when bleeding occurs or, increasingly, on a preventive basis (prophylactic treatment).
     People with haemophilia A may have either a decreased ability or total inability to produce clotting factor VIII. Approximately 350,000 people have haemophilia A globally. However, the disease is severely under-diagnosed in developing countries.
     People with haemophilia B have deficiencies in producing clotting factor IX. Haemophilia B is inherited in the same way as haemophilia A, but is five times less common (70,000 people worldwide).
     Around 3,500–4,500 people with haemophilia worldwide have high-titre inhibitors.
      Living with haemophilia
HERO (Haemophilia Experiences, Results and Opportunities) is an international study that aims to build an understanding of life with haemophilia, seen from the perspective of people with haemophilia, their families and their healthcare providers. Read more about the study, which is supported by Novo Nordisk’s programme Changing Possibilities in Haemophilia®, at novonordisk.com/ hero.
 
             

 

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Novo Nordisk’s
FIVE REGIONS

North America .. Europe .. International Operations .. Region China .. Japan & Korea

Novo Nordisk markets its products in more than 180 countries. Despite the differences in terms of economic development, political systems and healthcare infrastructure between these countries, Novo Nordisk’s business model is fundamentally the same all over the world.

Novo Nordisk has employees in 75 countries. They share the common ambition to be the country’s leading pharmaceutical company within the selected disease areas, both in commercial terms and when it comes to making a positive change for patients. Key to achieving this ambition are biological pharmaceuticals with new, distinct properties that Novo Nordisk’s researchers have invented and developed. These products, for example NovoRapid®/ NovoLog®, Levemir® and Victoza®, are what make up the bulk of Novo Nordisk’s revenues in all of its five business regions.
     In addition, Novo Nordisk offers – and is committed to continue offering – lower-priced products in the form of traditional human insulin in countries where there’s still a significant demand for such products.

Creating value for customers
Novo Nordisk markets its products the same way globally by sharing clinical knowledge about the products with doctors, so that they can make an informed choice about whether these products are right for their patients. At the same time, payers and administrators – typically public health systems and private health plans – are presented with evidence about the cost efficiency of the products, in order to make informed decisions about pricing and reimbursement.
     Moreover, Novo Nordisk organises and supports education of healthcare professionals in managing diabetes, and engages in activities aimed at improving awareness, prevention and diagnosis of the disease.

Organisation
Novo Nordisk is a firm believer in having wholly owned affiliates and expanding them organically as the market develops. While

 

other pharmaceutical companies may build a presence through the acquisition of local companies, joint ventures or rented sales forces, Novo Nordisk prefers to hire its own people and train them to become the best. This is also seen as the best way to convey and preserve a strong company culture.

Competitors
In its all-important insulin market, Novo Nordisk’s main competitors are the same all over the world: Eli Lilly and Sanofi. In addition, there are local competitors in some countries such as China and India. However, they are not innovation-based and primarily offer human insulin. So far, these companies haven’t been able to gain significant market shares. In the biopharmaceuticals business, Novo Nordisk faces competition from a broader number of pharmaceutical companies, in some markets including producers of biosimilar medicines (products that are similar but not identical to an original medicine). So far, biosimilar competition hasn’t had a dramatic impact on the business, which has continued to grow at a global level.

Regional differences
What almost all countries have in common is that the incidence of diabetes is increasing and that they’re battling with how to tackle the situation most effectively. The countries differ, however, when it comes to the level of spending on diabetes care and in their ability and willingness to fund further investments in improving care, including the use of the latest advances in medical treatment. The following pages provide a review of Novo Nordisk’s business in the five regions.

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32  

 

         

  North America

The North American region consists of the US and Canada and is Novo Nordisk’s largest in terms of sales, which isn’t surprising given that the US is the world’s largest pharmaceutical market. In 2012, total pharmaceutical sales in the US amounted to 327 billion US dollars, of which 6% was spent on products for treating diabetes.
     Novo Nordisk has experienced tremendous growth in the US in recent years. Since 2008, sales have more than doubled from 14 billion Danish kroner (3 billion dollars) to 37 billion kroner (7 billion dollars) in 2013. In the same period Novo Nordisk’s organisation in the US, including research and development and production, has grown from around 3,700 employees to more than 6,100. The main drivers of sales have been – and continue to be – the portfolio of modern insulins and Victoza®.
     In 2013, sales of diabetes care products increased by 18% in local currencies in North America. This reflects continued market penetration by the modern insulins, especially

 

Levemir®, modest growth of human insulin and a 31% growth in sales of Victoza®, measured in local currencies.
     Sales of biopharmaceuticals – NovoSeven® and Norditropin® being the main products – grew by 16% in 2013, measured in local currencies. Norditropin® in particular did very well in 2013, which is due to both the very positive reception of the FlexPro® injection device and the very comprehensive support programmes that Novo Nordisk offers both healthcare professionals and patients.

A complex healthcare system
The US healthcare system is complex as it involves multiple payers and intermediaries with complex interactions. Roughly half of all Americans are insured by their employers and one-third by the government through programmes such as Medicare and Medicaid, while around 15% are uninsured.
The government figure is expected to increase significantly while the number of uninsured is expected to drop significantly in the coming years as a result of the Affordable Care Act, which is currently being implemented.
     To manage the purchase and delivery of healthcare, employers and the government contract with intermediaries such as health plans and pharmacy benefit managers (PBMs). These are often referred to as ‘payers’, but are in most cases managers of healthcare costs on behalf of payers.
     Health plans contract with

 

providers such as physician, hospital and pharmacy networks to provide the required service. They provide different levels of coverage based on the payers’ willingness to pay for selected services for their employees. A PBM is an intermediary that contracts with payers and health plans to manage the pharmacy benefit for a specific population. Typical services include claims processing, managing enrolee eligibility, contracting pharmacy networks and managing rebate contracts with pharmaceutical companies.
     The health plans use various methods for managing the use and cost of pharmaceuticals. Among the most widely used interventions are generic substitution, quantity limits, prior authorisation (which means that a medication will only be covered under certain conditions and subject to individual approval by the health plan) and tightly controlled Preferred Drug Lists.

Growing pressures
Competitive pressures are growing in the managed healthcare industry, driving both consolidation through mergers and acquisitions and increasingly tough rebate negotiations with pharmaceutical companies. Novo Nordisk experienced the effects of the latter in the second half of 2013 when it lost coverage for NovoLog
® and Victoza® for 2014 with Express Scripts National Preferred Formulary covering 45 million people in the US. Despite such pressures and increasing competition from other pharmaceutical companies, Novo

         


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In Philadelphia, 65% of the adult inhabitants
are estimated to be overweight, making it
one of the most obese cities in the US. More
than 10% of the inhabitants have diabetes.
         

Nordisk maintains a competitive presence on the US market. The company’s key diabetes care products have broad market access and are capturing market shares. In fact, in 2013 Novo Nordisk’s three modern insulins were the only products with a growing volume market share in the US in the modern insulin category.

Growing market for diabetes products
Novo Nordisk holds around 29% of the total US market for diabetes care medications and 37% of the insulin market, measured in value. The insulin market is expected to continue growing in volume in the coming years due to the increasing number of people with diabetes, many of whom will require insulin treatment. Moreover, in the US, only around 41% of insulin volume is delivered in a pen system such as Novo Nordisk’s FlexPen®, while it is more than 95% in Europe. This means there is still significant potential to upgrade treatment in the US. In 2014, Novo Nordisk expects to introduce its newest pen system, FlexTouch®, with certain insulin products.
     Novo Nordisk is the market leader within GLP-1-based therapies in the US, where Victoza
® has a value market share of around 67%. The market itself experienced decelerating growth in 2013 due to questions being raised about potential pancreatic side effects. Read more on pp 38–41. Victoza®, however, continues to expand its share of the GLP-1 market and has further consolidated this position with the support of a new nationwide TV campaign.

     It’s Novo Nordisk’s ambition to sustain the strong performance, despite the dynamic business environment, by consolidating the diabetes market leadership position through the modern insulins and Victoza®.

 

      To further strengthen the presence in the US, Novo Nordisk’s US affiliate has expanded its field force several times in recent years. The latest expansion was announced in 2013 with the addition of more than 350 new representatives, who after an intensive period of training will be in the field by April 2014.

Preparing for a new market
The US affiliate is preparing to enter a new market for the medical treatment of obesity with liraglutide 3 mg, which was filed for regulatory review with the US Food and Drug Administration (FDA) in December 2013. Read more about obesity on pp 28–29.

Developments to look out for
In February 2013, the FDA requested more data on the cardiovascular safety profile of Tresiba® (insulin degludec) before it could complete its review of Novo Nordisk’s application. In response, Novo Nordisk

 

initiated a cardiovascular outcomes trial involving 7,500 patients. Read more on pp 24–25.
     Another event that may have an impact on the insulin market is Sanofi’s basal insulin product, insulin glargine, which will lose US patent protection in 2015. Eli Lilly has submitted a biosimilar version of insulin glargine for regulatory approval, and Sanofi itself is developing a stronger formulation of insulin glargine. How, and to what extent, such events will change the market dynamics is not possible to predict at this point in time.
     In the GLP-1 area, several new products are likely to enter the market in the coming years.

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Sales in North America


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  Europe

Europe is Novo Nordisk’s second largest region in terms of sales. Sales growth has been modest in recent years – in the low single-digit range. To a large extent, this is a result of the depressed economy in many European countries in the wake of the financial crisis. This has led governments to implement cost-cutting measures, both through price cuts on medicines and by limiting access to new medicines. Tresiba® has been affected by such measures in countries such as the UK and Denmark.
     In 2013, Novo Nordisk’s sales of diabetes care products in Europe increased by 3% in local currencies. Sales of insulin and protein-related products were unchanged, reflecting the fact that declining human insulin sales were offset by the continued progress of Levemir® and NovoRapid®. Furthermore, sales were impacted by low volume growth of the insulin market, around 3%. However, the use of devices for insulin injections is very high, with 96% of Novo Nordisk’s insulin volume being used in devices, primarily NovoPen® and FlexPen®.
     Sales of Victoza® increased by 20% in local currencies. Sales growth was primarily driven by France, the UK, Spain and Italy. In Europe, the GLP-1 class’s share of the total diabetes care market in value increased to 8% compared with 7% in 2012. Victoza® is the GLP-1 market leader with a value market share of 78%.

Tresiba® is important for future growth
There are no signs of a return to significantly higher sales rates in the coming years, with government cost-cutting measures expected to continue. Moreover, the diabetes market is well developed, diagnosis rates are high, birth rates low and Novo Nordisk already has an insulin market share of 49% measured by volume. This means there are limits as to how much Novo Nordisk can grow in Europe.
     The key growth driver in the coming years is expected to be Tresiba® as it becomes available to patients in more European countries. Moreover, Novo Nordisk will be launching NovoEight® for treating haemophilia A in the first European countries in 2014.

 

  International Operations

With sales of 12 billion Danish kroner in 2013 and average annual sales growth of around 15% since 2009, International Operations is Novo Nordisk’s main contributor to growth after North America. Thinking of International Operations as one business region requires a stretch of the imagination, though. It encompasses 149 countries all over the world with more than 4.4 billion people – Latin America, Africa, the Middle East, the Gulf, most of Asia, and Australia. A region of extraordinary diversity, it covers some of the world’s poorest countries and some of the richest.
     This means that Novo Nordisk must be able to meet demand for both standard therapy in the form of human insulin in vials at very low prices and advanced modern insulin products in sophisticated pen systems, which are sold at prices similar to those seen in Europe and the US. Within many of the countries in International Operations, there is both a public and a private market. In most cases the public market only reimburses use of human insulin vials, while the private market is primarily modern insulin paid for by people who either have private insurance or can pay out of their own pockets.
     What these countries have in common is that the incidence of diabetes is increasing, and many of them are enjoying economic growth above what is being seen in the Western world. This means they can afford to extend the reach and quality of their healthcare systems.
     In 2013, Novo Nordisk’s sales of diabetes care products in International Operations increased by 16% in local currencies, driven by all three modern insulins. Currently, 59% of Novo Nordisk’s insulin volume in the major private markets is used in devices. Novo Nordisk’s insulin volume market share is around 56%.
     Victoza® is becoming an increasingly important product in International Operations. Sales grew by 31% measured in local currencies in 2013 and the product was marketed in 43 countries by the end of 2013.

 

Future growth
Growth in International Operations will continue to be driven by the increasing number of people with diabetes in the region and the fact that more of them will have access to medical treatment as economies develop. Novo Nordisk’s key priorities are to increase the modern insulin penetration, launch Tresiba® in more countries (Mexico and India already launched this product in 2013), continue the roll-out of Victoza® and ensure that more people are treated with insulin sooner than is the case today.
     To support growth, Novo Nordisk is expanding its organisation in many of the key growth markets and making significant investments in building healthcare capacity within diabetes.

  Region China

With sales of 7.2 billion Danish kroner in 2013 and average annual sales growth of around 19% since 2009, China has been a major contributor to Novo Nordisk’s growth in recent years. This is predicted to be the case in the coming years too, partly due to the rapidly increasing number of people with diabetes in China. According to the latest estimates from the International Diabetes Federation, more than 99 million people in China have diabetes today.
     With China’s economic growth comes urbanisation, with urbanisation come sedentary lifestyles – and diabetes follows. This is the same pattern seen in other rapidly developing countries, but on a much larger scale in a country with an ageing population of 1.35 billion. On top of this, there is another challenge. Twenty years ago, very few doctors in China knew how to treat diabetes, and outside the bigger cities this is often still the case. Novo Nordisk established its own affiliate in China in 1994 and, to this day, the company’s main focus has therefore been to educate doctors and patients in proper diabetes care, including how to use insulin effectively and safely. While these initiatives primarily took place in the biggest cities at first, today they’re being rolled out to smaller cities and rural areas.
     In 2013, Novo Nordisk’s sales of diabetes care products in Region China increased by

         
 
 

Sales in Europe
Sales in International Operations
Sales in Region China


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13% in local currencies. The sales growth was driven by all three modern insulins, while sales of human insulins only grew modestly. Currently, 97% of Novo Nordisk’s insulin volume in China is used in devices, primarily the durable device NovoPen®. GLP-1 products are currently not reimbursed in China and this class of products is therefore relatively small. However, its share of the total diabetes care market in value expanded to 0.6% compared with 0.5% in 2012. Victoza® holds a GLP-1 value market share of 74%.

Reforms to widen healthcare coverage
The Chinese government is implementing widespread reforms of the healthcare system with a view to extending both its reach and quality and, as in many other countries, several measures are being taken to limit spending on pharmaceuticals. One way to do this is by creating lists of essential pharmaceuticals that are purchased from potential companies in large quantities at low prices. Pharmaceuticals on this list are primarily older products that have gone off patent, such as human insulin.
     However, there’s also a growing market for newer and higher priced pharmaceuticals in China as both the health awareness and the purchasing power of many Chinese families are growing. They’re willing to pay for – or have private health insurance that covers – newer and more innovative treatments.
     Novo Nordisk’s growth in the coming years is expected to primarily come from the portfolio of modern insulins, in part driven by the continuing expansion of the company’s reach into an increasing number of county hospitals, and from Victoza®.

Japan & Korea

With a 52% market share measured in volume, Novo Nordisk is the clear insulin market leader in Japan. The use of devices remains high in Japan, with 98% of Novo Nordisk’s insulin volume being used in devices, primarily FlexPen®.

 

     In 2013, Novo Nordisk’s sales of diabetes care products in Japan & Korea decreased by 4% in local currencies. This sales development reflects a stagnant Japanese insulin volume market and the negative impact from a challenging competitive environment. A shift in recent years from the use of premixed insulin products, where Novo Nordisk is the clear leader with NovoMix®, to basal insulin products, where Novo Nordisk is in fierce competition with Sanofi, has led to a loss of market share.
     In 2013, there have been signs that this development is changing with the launch of Tresiba®. Japan was the first country to launch Tresiba® in 2013 with broad market access. Since its launch in March, Tresiba® has steadily expanded its share of the basal insulin market and now represents 8.6% of this market measured in monthly value market share.
     In 2014, the focus in Japan & Korea will be on the further penetration of Tresiba®, the launch of Ryzodeg® (insulin degludec/insulin aspart) and the launch of NovoEight® (turoctocog alfa) for treating haemophilia A. However, growth rates are expected to remain modest due to price reductions and the overall low growth of the total insulin market.

 

Sales in Japan & Korea
Diabetes care Value market share by geographic region ... North America ... Europe ... International Operations ... Region China ... Japan & Korea
Modern insulins Global value market share by brand in its respective insulin segment* ... NovoMix(r) ... NovoRapid(r) ... Levemir(r)
* Levemir(r) in the long-acting segment, NovoRapid(r) in the rapid-acting segment and NovoMix(r) in the dual-release segment.


Key regional facts North
America
  Europe   International
Operations
  Region China4   Japan &
Korea
 










 
Population (million)1
349
 
538
 
4.408
 
1.351
 
178
 










 
GDP per capita (USD)1
51,796
 
33,242
 
4,499
 
6,091
 
39,925
 










 
Healthcare spend per capita (USD)1
8,310
 
3,575
 
292
 
278
 
3,566
 










 
Physicians per 1,000 people1
2.4
 
3.3
 
1.1
 
1.8
 
2.1
 










 
Number of people with diabetes (million)2
27
 
34
 
203
 
99
 
11
 










 
Diagnosis rate2
78%
 
64%
 
55%
 
46%
 
51%
 










 
Diabetes national prevalence2
11%
 
9%
 
8%
 
10%
 
8%
 










 
Novo Nordisk total sales (DKK billion)
39.0
 
20.1
 
12.0
 
7.2
 
5.3
 










 
Insulin value market share3
38%
 
47%
 
49%
 
57%
 
52%
 










 
Insulin volume market share3
41%
 
49%
 
56%
 
59%
 
49%
 










 

1. The World Bank. 2. The 2013 data are based on the IDF Diabetes Atlas, 6th edition, 2013. Prevalence rates have been estimated lower in a number of countries compared with the 5th edition used in the Novo Nordisk Annual Report 2012. This reduction is due to changes in methodology and sources used by IDF for a given country and not to an improvement in diabetes prevalence. All studies from the same country show an increase in diabetes prevalence over a longer time period. 3. IMS Health, IMS MIDAS Customized Insights, November 2013. 4. Data from IMS Health, IDF and The World Bank include China only.


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The complexity of insulin production

More than 24 million people globally rely on Novo Nordisk’s products to treat their diabetes. Around 10,000 employees are responsible for manufacturing high-quality products – with low environmental impact.

Insulin production at Novo Nordisk starts in Kalundborg, a town of about 16,000 inhabitants 100 kilometres west of Copenhagen, Denmark. It is here that the company makes insulin crystals, the active ingredient in its insulin products, through the processes of fermentation, recovery and purification. Site Kalundborg is Novo Nordisk’s largest production site at 1,350,000 m2 – equivalent to 270 football pitches. In fact, it’s the largest production site for insulin in the world, making around half of the world’s insulin crystals.

A complex production process
Insulin is a protein and thus a large and complex molecule. Manufacturing insulin is very different from manufacturing most other pharmaceuticals, which are based on small molecules. It requires large investments in biotechnology, sterile production facilities and an understanding of working with living cells – in this case yeast – to produce a uniform and pure product.
     “In Kalundborg we’ve developed large-scale production expertise over many years,” says Henrik Wulff, senior vice president and head of Product Supply. “Centralised insulin crystal production is an important part of

 

our manufacturing strategy, and our unique capabilities enable us to produce large volumes of insulin at a competitive cost.”
     While most other large-molecule pharmaceuticals are produced in relatively small quantities, production of insulin is a high-volume undertaking. It is estimated that an entire Olympic-sized swimming pool could be filled with Novo Nordisk’s insulin every year. Every second, every day, 21 Penfill® insulin cartridges are filled. And enough FlexPen® injection devices are produced each year to stretch more than once around the globe.

Final production close to patients
While the production of insulin crystals is centralised in Denmark, the next steps in the manufacturing process are closer to the patients and major markets that need the company’s products.
     The largest production sites outside Denmark are in the US, Brazil, France, China and Japan. Working according to the same, global quality management system, these plants turn the insulin crystals into finished products. In the formulation process, freeze-dried insulin crystals are blended with other ingredients and water

 

to create the different types of Novo Nordisk insulin, for example Levemir® (insulin detemir) or Tresiba® (insulin degludec). In the filling process, glass Penfill® cartridges and vials are filled on high-speed lines. Once filled and inspected, some cartridges are mounted into injection devices, such as FlexPen® and FlexTouch®. Finally, the products are packed to fulfil customer orders and shipped to their destination after final quality control.
     “We place the production of finished products close to where the patients are,” explains Henrik Wulff. “This allows us to react fast to local changes and lowers any supply risk; our obligation to patients is to supply safe, high-quality products in compliance with regulatory requirements, in volumes that meet demand. To live up to this obligation, we have one quality management system that defines the global standards for compliance and product quality.”

Continuous improvement
Novo Nordisk’s highly efficient production system is based on years of experience and learning from better practices. The company has continuously developed its

 

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One global quality system

Novo Nordisk uses one global approach to ensure the quality of its products no matter where in the world they are produced. The company’s quality management system has been designed to ensure that all manufacturing processes follow its standard operating procedures (SOPs) and are in compliance with international standards such as Good Manufacturing Practice and ISO 9001. In total, Product Supply, the company’s production division, has more than 15,000 SOPs.
     All employees working in Product Supply receive training to ensure compliance with the quality management system, including how to document that all production lines consistently meet the predetermined criteria, how to identify and address systemic quality problems, and how to handle deviations from the standards.
     Furthermore, Novo Nordisk has two functions charged with ensuring manufacturing quality. Quality Control independently validates that products are manufactured in compliance with all procedures, while Quality Assurance monitors that processes are conducted in accordance with the company’s SOPs. This is the final control before batches of medicine are released to the markets.

 

Ephrem Rudahunga works at site Kalundborg, the largest insulin production site in the world.


production through technology upgrades, skill-building and process optimisation. “The introduction and in-house development of cLEAN®, our version of the lean manufacturing principles, has had a very positive impact on the quality and performance of our processes and hence the production cost,” Henrik Wulff says. In fact, the company’s ambition to improve production performance has produced remarkable results, with cost of goods sold as a percentage of sales falling from 28% to 17% from 2003 to 2013.

Energy savings
Optimising process performance has also helped reduce Novo Nordisk’s environmental impact significantly. The

 

long-term aspiration is to continuously decouple environmental impacts from business growth. Since 2004, Novo Nordisk has reduced the emissions of CO2 by 42%. In response to the need for expansions of production capacity and an increased product portfolio, the long-term environmental targets for consumption of energy and water were revised and updated in 2013.
     Energy-saving projects have resulted in savings of up to 144 million kWh, equivalent to the annual energy usage of more than 7,000 Danish households, and reductions in CO2 emissions of 44,000 tons annually. “In the beginning, we could realise large improvements in our environmental impact, but now it has

 

become more difficult to optimise our absolute footprint as we’ve become so efficient. However, we remain committed to ensuring that our environmental impact grows more slowly than the company grows its sales,” explains Henrik Wulff.
     “Looking ahead, I’m confident that we’re well prepared to continue our strong performance within production. We’ll expand our production facilities to increase output in line with market demands and continue supplying high-quality products that meet regulatory requirements. At the same time, we’ll keep our focus on improving our existing processes so that we continue to live up to our financial, environmental and social commitments,” he concludes.



             
 

A Warning Letter with important learnings

In December 2012, Novo Nordisk received a Warning Letter from the US Food and Drug Administration (FDA) following an inspection of a production plant in Denmark. In the Warning Letter, the FDA cited two specific violations of its compliance standards. Novo Nordisk immediately took action to address the issues. A re-inspection was carried out in August 2013 and in January 2014, Novo Nordisk received confirmation from the agency that the violations had been addressed satisfactorily. The learnings from this case are being applied throughout the global Product Supply organisation and serve as a reminder of the importance of keeping up with ever-evolving compliance standards.

     

An error that shouldn’t have happened

In October 2013, Novo Nordisk recalled certain batches of its prefilled insulin product NovoMix® 30 in several European countries. A quality control conducted by Novo Nordisk had shown that a small percentage (0.14%) of the 3 million products in these batches did not meet the specifications for insulin strength. This could lead to the patient’s blood sugar level becoming higher or lower than expected. To protect patient safety Novo Nordisk recalled all products in the affected batches from wholesalers, pharmacies and patients. The root cause, a production error at one of Novo Nordisk’s production facilities, has been identified and resolved.

 
             

 

NOVO NORDISK ANNUAL REPORT 2013


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38     OUR BUSINESS

 

A question of trust

As a business with shareholders to satisfy, the pharmaceutical industry must have a strong focus on financial performance. But the industry’s greater purpose is to improve human health. At first glance these ambitions may appear conflicting – is it therefore any wonder that the issue of trust is so often raised?   and redacted to protect patient and site confidentiality – as they are the complete descriptions of the trials presented in a standardised format and the actual material used for submission to regulatory authorities. “In this way, we hope to further reassure healthcare professionals and patients that what we communicate is an accurate reflection of what we have observed and thereby strengthen public confidence in the approved medical treatments,” adds Peter Kristensen.
     He stresses that Novo Nordisk will publish the CSRs after regulatory approval in the EU and in the US, so that the
         

The pharmaceutical industry is no stranger to critical media attention. Headlines often call into question the ethics and transparency of business practices that must balance financial and social responsibilities. It is easy to find people who don’t trust pharmaceutical companies to put the interests of patients above profits.
     Calling into question the transparency of clinical trial results, some critics are suggesting that negative data, or data that don’t support the hypothesis being tested, have been buried. They have called for the disclosure of further data. Authorities have also recently reviewed guidelines on the interaction between the pharmaceutical industry and healthcare professionals in order to address concerns about this relationship. The dilemma is obvious: On the one hand, doctors have expert knowledge based on their clinical experience, without which pharmaceutical companies can’t develop new medical treatments. On the other hand, some may see payments made to healthcare professionals for this knowledge as an illegitimate means of encouraging them to prescribe certain medicines. So can patients be sure that doctors are making treatment decisions in the patients’ best interests?

Data transparency
Novo Nordisk has a strong track record on clinical trial data transparency. For almost a decade, the company has systematically shared and published results and related data – irrespective of trial outcome. “For the success of future clinical trials, and for our long-term business, it is imperative that we build good and trustful relationships with doctors and patients. We rely on our collaboration with them, and take the concerns they may have very seriously. This is why today, we already go beyond regulatory requirements by making our

 

clinical trial results of approved products public,” explains Peter Kristensen, senior vice president of Global Development.
     It is Novo Nordisk’s policy that the results of all clinical studies are published, preferably in scientific journals and at scientific meetings. Tabulated data from Novo Nordisk’s clinical trials of products approved in the US are available today on the website clinicaltrials.gov. This is a registry and results database of publicly and privately supported clinical trials conducted around the world and is run by the U.S. National Institutes of Health. Since 2005, Novo Nordisk has published a synopsis of results from the company’s clinical trials of approved marketed products, whether positive or negative. Today this information is publicly available at novonordisk-trials.com including information from discontinued trial programmes.
     From 1 March 2014, novonordisk-trials.com will also provide access to Clinical Study Reports (CSRs) for all Novo Nordisk trials after 2006 – regardless of study outcome – involving product indications that are approved in the EU and the US. The company has chosen to publish CSRs – without appendices

 

 

 

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OUR BUSINESS    
39

 

 

decision-making process of the regulatory authorities is not made even more complex by a parallel public debate. In addition, prior to approval, Novo Nordisk regards the design of its trials, as well as the results obtained, as confidential information. “We have to protect competitive information. Otherwise investments in future treatments will be lost, which would be bad for patients and the industry alike,” points out Peter Kristensen.

Access to patient-level data
Taking transparency to a new level, public access to individual patient

A selection of books
published in recent years
with a critical perspective on
the pharmaceutical industry.

 

research data from clinical trials has recently been proposed by the European Medicines Agency (EMA). Novo Nordisk agrees that there is value in making these data available: “We have a responsibility to patients to ensure that the data they contribute to clinical trials are leveraged as much as possible to advance scientific understanding. We believe that by sharing detailed clinical trial data with the research community, new knowledge may be created that could contribute to the development of new and improved treatments,” Peter Kristensen highlights. “However, we have to be careful that patient confidentiality is not compromised and that competitive business information is not divulged.”
     Therefore, Novo Nordisk will make patient-level data for approved products from trials completed after 2001 available to researchers upon request. To ensure that the data are handled in a responsible way, the company will establish an independent governing body. This will include experts skilled in evaluating clinical data and will assess researchers’ requests for data and make decisions based on an accountable and transparent process.

Integrity and transparency are the foundation for building trust
A company such as Novo Nordisk can’t develop new medicines without the guidance, knowledge and expertise of doctors, who understand the medical needs of the patients they see in their clinics. It is therefore reasonable that they are fairly compensated for the services they provide in this respect. However, relationships with doctors can create the potential for conflicts of interest as the doctors have a direct impact on a company’s sales via their prescribing decisions. The issue of trust raises its head again.

 

     “Our business ethics strategy is there to safeguard the integrity of our relationships with all our stakeholders and we want to make sure our actions are transparent,” comments Lise Kingo, executive vice president and chief of staffs. She is also the chair of the Business Ethics Board, which is responsible for implementing the company’s business ethics strategy. “We have focused on business ethics for a long time and we’re always looking for ways we can make improvements in this area.” By way of example, Lise Kingo mentions that all relevant employees are trained in – and then tested on – the company’s standard operating procedures for interactions with and payments to healthcare professionals.

Global reporting, global transparency
This past year national regulations for disclosure of payments and other transfers of value to healthcare professionals have come into force in the US and France. There is now, for example, a requirement to report any individual payments exceeding 10 US dollars or 10 euros in the US and France respectively. Furthermore, the European pharmaceutical industry trade organisation EFPIA has recently revised its codes of conduct for interactions between the pharmaceutical industry and healthcare professionals and patient organisations. The revised codes ban all gifts to healthcare professionals, enable each country to set a threshold for any hospitality provided to doctors and, as in the US and France, call for individual disclosure of any transfers of value.
     Novo Nordisk fully supports the new regulations and codes of conduct, and has developed a system for reporting payments to individual healthcare professionals. “Ultimately, we want to have one system for all our affiliates to ensure the same reporting standard, not only in the US and

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Europe, but throughout the world. We are therefore ready to roll out this system in each country once specific national requirements have been announced and taken into account,” explains Lise Kingo. “We hope that these new regulations and revised codes of conduct will enhance transparency and reassure external stakeholders of our commitment to ethical behaviour.”

Reaffirming results to build confidence
For good reason, product safety is one of the greatest concerns for patients and healthcare professionals and is an issue that Novo Nordisk takes very seriously, particularly as the company makes potentially life-

  saving treatments for people who are, by nature of their medical condition, vulnerable. The company therefore continuously and actively monitors the safety profile of its products. Stringent protocols and systems are in place to ensure product safety, both during the development phases and after a product has been launched. Read more in the box on p 41.
     However, new pharmaceuticals often come under the spotlight, particularly if they represent a new class of drug. A recent example is GLP-1-based diabetes therapies, a drug class to which Novo Nordisk’s Victoza® belongs. The safety of this drug class was challenged early in 2013, when a study (which did not include
  Victoza®) suggested an increased risk of side effects on the pancreas. The FDA and EMA reacted by reviewing data on GLP-1-based therapies to see if a link between them and an increase in pancreatic side effects could be determined.
     In July, the EMA concluded that currently available data did not confirm the concerns over an increased risk of pancreatic adverse events with these medicines. The FDA has not officially announced the conclusion of its review. However, in response to questions from the media, a spokesperson said that the FDA was in agreement with the EMA’s conclusions.
     Mads Krogsgaard Thomsen, executive vice president and chief science officer,


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Continuous safety
surveillance process

All Novo Nordisk products – whether in development or on the market – have a dedicated cross-organisational safety committee, with experts anchored in Global Safety, which oversees the safety of the product. Preclinical data, clinical studies, post-marketing reports, publications, competitor information and databases are continuously reviewed to detect any safety concerns.
     The benefit–risk profiles of Novo Nordisk-marketed products are described in the product label, as agreed with health authorities. New data are shared with authorities, either as an ongoing process via individual case safety reports or at regular intervals via periodic safety update reports. If necessary, product labels are updated based on new data. Furthermore, when possible, analysis of safety data is published in peer-reviewed journals in collaboration with experts.

 

 

 

 

 

 

 




Senior Clinical Research Associate
Sowmya Muralidhar from India
discusses a clinical trial with
a doctor involved in the trial.

 
       

welcomed the EMA’s conclusion: “Novo Nordisk is committed to patient safety and continuously monitors for adverse events related to all of its medicines. Victoza® has more than 1.9 million patient years of use and a strong body of evidence to support its safety and efficacy based on both clinical trial and real-world practice data.”
     Karsten Lollike, corporate vice president and head of Global Product Safety, adds that Novo Nordisk continues to conduct studies to assess the effects of long-term use of Victoza® on the pancreas. This includes a review of databases and the cardiovascular outcomes trial LEADER®, to be completed in 2016, and other post-marketing studies.
 

     “Ensuring the safety of our products remains our top priority. I believe our history – and how we have handled safety issues and concerns in the past – proves our commitment is more than just words,” explains Karsten Lollike. “I’m really pleased that in a recent survey1 Novo Nordisk was ranked number one in the industry by patients for having a good record in ensuring patient safety. I believe this shows that patients trust us.”

An ongoing issue requires a long-term perspective
While it can be expected that the issue of trust and the pharmaceutical industry will continue to be discussed for many

  years to come, Lise Kingo hopes that Novo Nordisk’s approach to business ethics will demonstrate the company’s commitment to building trust with all its stakeholders: “We have clear priorities and the needs of patients come first – this has been the case ever since the company was founded. We have a Triple Bottom Line approach that ensures all business decisions live up to our financial, social and environmental responsibilities. This long-term perspective is absolutely fundamental to the way we work and how we run our business, and I believe this is our firm foundation for being a credible and trustworthy company,” she concludes.

 

 

 

 


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RISKS
to be aware of

Several developments in 2013 were reminders that there are, and always will be, risks associated with Novo Nordisk’s business – risks that all investors should be aware of.

           

8 February 2013: The US Food and Drug Administration (FDA) informs Novo Nordisk that it cannot approve the New Drug Applications for Tresiba® (insulin degludec) and Ryzodeg® (insulin degludec/ insulin aspart) in their current form. This unexpected development meant that these two insulin products could not be launched in the US in 2013 as originally planned. Read more on pp 24–25.

22 March 2013: A study is published suggesting that GLP-1-based drugs for treating type 2 diabetes have an increased risk of pancreatic side effects. Although the authorities later concluded that currently available data did not confirm the concerns, the growth of this market segment was affected in some countries. Read more on pp 38–41.

23 October 2013: Novo Nordisk announces a recall of 3 million NovoMix® insulin products in several European countries due to a production error. Situations leading to product recalls may pose a risk to patient safety, lead to disruption of supplies in the affected countries and tarnish Novo Nordisk’s reputation. Read more on pp 36–37.

Three examples of three different types of risk that come with being a pharmaceutical company and investor in one. And there are more. This article covers the main types of risk that Novo Nordisk faces. For some specific risks, reference is made to articles elsewhere in the Annual Report and notes to the consolidated statements.

  Market risks
The principal market risks Novo Nordisk experiences are:
 

     In addition to these global risks, in some countries in the International Operations region political instability or war may pose a risk to Novo Nordisk’s business for varying lengths of time.

Delays or failure of pipeline products
Development of a new pharmaceutical product is an expensive undertaking that can take more than 10 years. It includes extensive non-clinical tests and clinical trials as well as an elaborate regulatory approval process, including approval of the production facilities. During the process, various hurdles may delay the development of a potential product candidate and add substantial expense. In some cases, significant obstacles could lead to the company eventually deciding to abandon the development of the potential product candidate.
     In Novo Nordisk’s experience, there is a less than 35% chance of a diabetes product candidate in phase 1 clinical trials ultimately being approved for marketing, while the chance of success is around 40% for products in phase 2 trials and rises to around 70% for products in phase 3 trials. However, there is significant uncertainty regarding the timing and success of the

price pressure and reimbursement restrictions by payers
the launch of new products by established competitors
increased competition from producers of biosimilar medicines in key markets.

Europe, China and the US are all main markets for Novo Nordisk where payers – both governments and private payers – take measures to limit spending on medicines, typically by driving down prices, demanding higher rebates and/or restricting access to and reimbursement of products. This is unlikely to change in the foreseeable future. For Novo Nordisk, reimbursement restrictions pose a significant risk when launching a new product such as Tresiba
®, the new-generation basal insulin with ultra-long duration of action. Despite the patient benefits and data supporting the health-economic benefits of the product, it is not always possible to obtain market access on what Novo Nordisk considers reasonable conditions. In some countries, the company may therefore not launch Tresiba® under the current conditions.
     The launch of new products by established competitors is an inherent market risk. As mentioned on p 33 in the article about Novo Nordisk’s five regions, new products are under way in both the insulin and GLP-1 segments, including a biosimilar version of the best-selling modern insulin product. How and to what extent such events will change the market dynamics is not possible to predict at present.
           



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43
 
               

regulatory approval process, as illustrated by the aforementioned decision by the FDA regarding Tresiba® and Ryzodeg®.

Supply disruptions
Failure or breakdown in one of Novo Nordisk’s or the company’s key suppliers’ vital production facilities could adversely affect operations and potentially cause employee injuries or infrastructure damage. Fire prevention design, alarms and fire instructions, annual inspections, back-up facilities and safety inventories all aim to mitigate this risk. To spread this risk geographically and optimise costs and supply logistics, Novo Nordisk has established production sites in several countries. Read more on pp 36–37.

Quality and product safety issues
Quality and product safety issues may arise if, for example, a production facility is not continuously in compliance, a product is not within specifications or if side effects that were not detected in clinical trials become apparent when a product is used for long periods of time. Novo Nordisk proactively manages such risks through its quality management system, a key priority of which is to safeguard product quality and minimise risks to patient safety and secure product quality. The quality management system aims to ensure that the company is in compliance with all regulatory requirements and it includes standard operating procedures, quality controls and release, quality audits, quality improvement plans and systematic senior management reviews. For information on Novo Nordisk’s product safety monitoring, authority inspection status and product recalls, read more on pp 36–37 and 38–41 and in note 4.2 on p 100.

Financial risks
Novo Nordisk’s main financial risks relate to exchange rates and tax disputes.
     Novo Nordisk’s reporting currency and the functional currency of corporate operations is the Danish krone, which is closely linked to the European euro in a narrow range of ±2.25%. However, the majority of the company’s sales are in US dollars, European euros, Chinese yuan, Japanese yen and British pounds. Exchange rate risk is therefore the company’s biggest financial risk and the risk has grown in importance as the size of international markets and the share of sales in different currencies have increased. To manage this risk, the company

 

hedges expected future cash flows for selected key currencies. Read more about how Novo Nordisk manages this risk in notes 4.2 and 4.3 on pp 79–83.
     In the course of conducting business globally, transfer pricing disputes with tax authorities may occur. Novo Nordisk’s policy is to pursue a competitive tax level, meaning at or below the average for the company’s peer group, in a responsible way. This means paying relevant tax in jurisdictions where business activity generates profits. As a general rule, Novo Nordisk’s affiliates pay corporate taxes in the countries in which they operate.
     To manage uncertainties regarding tax, Novo Nordisk has negotiated multi-year transfer pricing agreements with tax authorities in key markets. Read more about taxes paid by Novo Nordisk in 2013, in note 2.4 on pp 68–70.

Information technology risks
Well-functioning IT systems are critical for Novo Nordisk’s ability to operate effectively. Furthermore, they hold confidential information that if disclosed could have a severe impact on Novo Nordisk’s competitive situation. An information security strategy is in place to mitigate the risk of intruders causing damage to systems and gaining access to critical data. Specific measures include awareness campaigns, access controls, and intrusion detection and prevention systems.

Business ethics and legal risks
Business ethics violations and patent and contract disputes are the main risks in this area.
     The pharmaceutical industry is tightly regulated in many respects, including which promotional claims it can make about its products and how it can interact with doctors and other healthcare professionals.
     In June 2013, news broke in China of a government investigation into the business practices of an international pharmaceutical company. At the same time the Chinese government announced industry-wide measures to crack down on illegal business activities. Subsequently, several companies, including Novo Nordisk, were visited by the authorities. In August, Novo Nordisk’s facilities in Tianjin were visited by the local Administration for Industry and Commerce (AIC) and asked to provide information regarding the company’s operations in Tianjin City. The investigation has been closed by the

    AIC with a few observations, which have no material impact on Novo Nordisk’s business in China.
     This example underlines the potential business ethics risks associated with being a pharmaceutical company. To minimise the risk of violating national and international regulations, over the past decade Novo Nordisk has strengthened its global and regional business ethics compliance programmes. Global governance, a business ethics policy and global business ethics procedures, together with elaborate training programmes and tests for employees, close monitoring of performance, reporting requirements and audits, all aim to mitigate business ethics risks.
     In June 2011, Novo Nordisk settled two civil cases with the US Department of Justice regarding alleged improper marketing of NovoSeven®. As part of the settlement, Novo Nordisk’s US affiliate entered into a five-year Corporate Integrity Agreement with the Office of the Inspector General of the US Department of Health and Human Services. Under that agreement, the US affiliate has added additional reporting and other procedures to its already robust compliance programme.
     Also in the US, Novo Nordisk is a defendant in product liability lawsuits related to hormone therapy products and Victoza®. Read more about these and other pending litigations against Novo Nordisk and investigations involving the company, in note 3.6 on pp 74–76.
     Protection of intellectual property through patents is very important for promoting innovation and stimulating long-term economic growth and job creation. Novo Nordisk’s business model is based on developing new, innovative products, and when the company makes significant new inventions it will typically seek to patent them. Intellectual property risks occur if, for example, a government does not recognise the validity of patents or is unable to uphold patent rights, or if a competitor infringes a Novo Nordisk patent or challenges its validity.

 
     
  Novo Nordisk’s risk management policy
“In Novo Nordisk we will proactively manage risk to ensure continued growth of our business and to protect our people, assets and reputation. This means that we will:
 
  utilise an effective and integrated risk management system while maintaining business flexibility  
  identify and assess material risks associated with our business  
  monitor, manage and mitigate risks.”  
  For more information on Novo Nordisk’s risk management process, please visit novonordisk.com/about_us.  
       


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44     GOVERNANCE, LEADERSHIP AND SHARES

Shares and capital structure

Novo Nordisk has two classes of shares: A shares and B shares. All A shares are owned by Novo A/S – a wholly owned subsidiary of the Novo Nordisk Foundation. Novo Nordisk’s B shares are listed on NASDAQ OMX Copenhagen, and on the New York Stock Exchange as American Depository Receipts (ADRs). Through open and proactive communication, the company seeks to provide the basis for fair and efficient pricing of its B shares.


Share capital and ownership
Novo Nordisk’s total share capital of DKK 550,000,000 is divided into an A share capital of nominally DKK 107,487,200 and a B share capital of nominally DKK 442,512,800, of which Novo Nordisk A/S and its wholly owned affiliates held nominal DKK 20,570,405 as treasury shares as of 31 December 2013.
     To secure liquidity for both the Novo Nordisk B shares and American Depositary Receipts (ADRs) and bring price levels in line with market practice, especially for the ADRs, a stock split of the Novo Nordisk B shares and ADRs was implemented in January 2014. Following the five for one stock split, Novo Nordisk’s A and B shares are calculated in units of DKK 0.20. The ratio of Novo Nordisk’s B shares to ADRs remains one-to-one.
     The company’s A shares are not listed and are held by Novo A/S, a Danish public limited liability company wholly owned by the Novo Nordisk Foundation. The Novo Nordisk Foundation has a dual objective: to provide a stable basis for commercial and research activities conducted by the companies within the Novo Group (of which Novo Nordisk is the largest), and to support scientific and humanitarian purposes. According to the Articles of Association of the Foundation, the A shares cannot be divested. As of 31 December

 

2013, Novo A/S also held nominal value DKK 32,762,800 of B share capital. Each A share carries 200 votes and each B share carries 20 votes. With 25.5% of the total share capital, Novo A/S controls 74% of the total number of votes, excluding Novo Nordisk’s holding of treasury shares.
     The B shares are issued to the bearer but may, on request, be registered in the holder’s name in Novo Nordisk’s register of shareholders. As Novo Nordisk’s B shares are in bearer form, no complete record of all shareholders exists. Based on available sources of information about the company’s shareholders as of 31 December 2013, it is estimated that shares were distributed as shown in the charts on this page. As of 31 December 2013, the free float of listed B shares was 87.9%, excluding the Novo A/S holding and Novo Nordisk’s holding of treasury shares. For details on share capital, see note 4.1 on pp 78–79.

The capital structure
Novo Nordisk’s Board of Directors and Executive Management consider that the current capital and share structure of Novo Nordisk serves the interests of the shareholders and the company well, as it provides strategic flexibility to pursue Novo Nordisk’s vision and a good balance between long-term shareholder value creation and competitive shareholder

 

return in the short term. Novo Nordisk’s guiding principle is that any excess capital, after the funding of organic growth opportunities and potential acquisitions, is returned to investors. The company applies a pharmaceutical industry payout ratio to dividend payments complemented by share repurchase programmes. As decided at the 2013 Annual General Meeting, a reduction of the company’s B share capital, corresponding to approximately 1.8% of the total share capital, was implemented in April 2013 by cancellation of treasury shares. This enabled Novo Nordisk to continue to buy back shares without exceeding the limit for a holding of treasury shares equivalent to 10% of the total share capital. During the 12-month period since the release of the financial results for 2012, Novo Nordisk repurchased shares worth DKK 14 billion. Since 2008, the share repurchase programme has primarily been conducted in accordance with the provisions of European Commission Regulation No 2273/2003 of 22 December 2003 (also known as the Safe Harbour Regulation). In this programme Novo Nordisk appoints financial institutions as lead managers to execute a part of its share repurchase programme independently and without influence from Novo Nordisk.

Share repurchase programme for 1 February 2014 to 31 January 2015
For the next 12 months, Novo Nordisk has decided to implement a new share repurchase programme with an expected total repurchase value of B shares amounting to a cash value of up to DKK 15 billion. Novo Nordisk expects to implement the majority of the new share repurchase programme according to the Safe Harbour Regulation. At the 2014 Annual General Meeting, the Board of Directors will propose a further reduction of the company’s B share capital, corresponding to approximately 3.6% of the total share capital, by cancellation of 20 million treasury shares. After implementation of the share capital reduction, Novo Nordisk’s share capital will amount to DKK 530,000,000 divided into an A share capital of DKK 107,487,200 and a B share capital of DKK 422,512,800, corresponding to 537,436,000 A shares and 2,112,564,000 B shares of DKK 0.20.

Breakdown of shareholders % of capital (% of votes)Novo A/S, Bagsværd, Denmark Novo Nordisk A/S Other 25.5 (74.0) 3.7 (0.0) 70.8 (26.0)
Geographic distribution of shareholders* % of share capital (2012 % of share capital) Denmark North America UK and Ireland Other * Calculated using shareholders’ registered home country. 41.1 (40.4) 31.9 (34.0) 12.8 (12.9) 14.2 (12.7)


NOVO NORDISK ANNUAL REPORT 2013

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GOVERNANCE, LEADERSHIP AND SHARES    
45

Share price performance
Novo Nordisk’s share price increased by 8.5% from its 2012 close of DKK 916.50 to its 31 December 2013 close of DKK 994.00 for B shares with a nominal value of DKK 1. Following the stock split, the comparable share prices for B shares with a nominal value of DKK 0.20 were DKK 183.30 and DKK 198.80 at the end of 2012 and 2013 respectively. In comparison, the MSCI Europe Health Care and MSCI US Health Care indexes increased by 20% and 36% respectively during 2013. The smaller increase in Novo Nordisk’s share price compared with the two indexes is assumed to reflect a negative impact from the delay in the US regulatory process for Tresiba® (insulin degludec), which has only partly been offset by an expanded leadership position in the growing diabetes care market, coupled with a continued improvement in operating margin and encouraging outlook for the rest of the research and development product portfolio. Read more about financial performance on p 6 and about developments in the pipeline on pp 20–21. The total market value of Novo Nordisk’s B shares, excluding treasury shares, was DKK 419 billion at the end of 2013.

 

Payment of dividends
As illustrated below Novo Nordisk has continuously increased both the payout ratio and the dividend paid over the last five years. The dividend for 2012 recorded in March 2013 was equal to DKK 3.60 per share of DKK 0.20. At the 2014 Annual General Meeting, the Board of Directors will propose a dividend for 2013 of DKK 4.50 per A and B share of DKK 0.20, as well as for ADRs. The dividend for 2013 represents an increase in the dividend per share of 25% (adjusted for stock split). Novo Nordisk does not pay a dividend on its holding of treasury shares. The proposed dividend corresponds to a payout ratio of 47.1%. For 2012, the payout ratio was 45.3%, whereas Novo Nordisk’s peer group of comparable pharmaceuticals companies operated with a payout ratio of 47%. Shareholders’ enquiries concerning dividend payments and shareholder accounts should be addressed to Investor Service. Read more on the back cover.

Communication with shareholders
To keep investors updated on performance and the progress of clinical development programmes, Novo Nordisk

 

hosts conference calls with Executive Management following key events and the release of financial results. Executive Management and Investor Relations also travel extensively to ensure that all investors with a major holding of Novo Nordisk shares can meet with the company on a regular basis and that a number of smaller investors and potential investors also have access to the company’s Management and Investor Relations.

Analyst coverage
Novo Nordisk is currently covered by 34 sell-side analysts, including the major global investment banks that regularly produce research reports on Novo Nordisk. A list of analysts covering Novo Nordisk can be found at novonordisk.com/investors, where company announcements from 1995 onwards, financial, social and environmental results, a calendar of investor-relevant events, investor presentations, background information etc are also available.



Novo Nordisk’s share performance compared with benchmark indexes

Total price development in the period up to 31 December 2013   1 year   3 years   5 years
             
   Novo Nordisk’s B shares on NASDAQ OMX, DKK  
8%
 
58%
 
267%
             
   Novo Nordisk’s ADRs on the New York Stock Exchange, USD  
13%
 
64%
 
260%
             
   NASDAQ OMX Copenhagen 20 Index  
24%
 
35%
 
148%
             
   MSCI Europe Health Care Index  
20%
 
39%
 
48%
             
   MSCI US Health Care Index  
36%
 
92%
 
108%

 
 

Dividend payments and payout ratio Dividend per share for the year1 (left) Payout ratio2 (right) 1. Adjusted for the five for one stock split implemented as of 2 January 2014. 2. Dividend for the year as a percentage of net profit. 3. Proposed dividend for the financial year 2013. DKK
Price development and monthly turnover of Novo Nordisk’s B shares on NASDAQ OMX Copenhagen 2013 Turnover of B shares (left) Novo Nordisk’s B share closing prices (right) DKK billion DKK
Total shareholder return Per cent


NOVO NORDISK ANNUAL REPORT 2013


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Corporate
governance


In 2013, the Board of Directors established a Nomination Committee to enhance
the process for nominating members to the Board of Directors. The Board
of Directors also increased its diversity ambition and set new targets for 2017.

 

 


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GOVERNANCE, LEADERSHIP AND SHARES    
47

 

Governance structure

Shareholders
Shareholders have ultimate authority over the company and exercise their rights to make decisions at general meetings in person, by proxy or by correspondence. Resolutions can generally be passed by a simple majority. However, resolutions to amend the Articles of Association require two-thirds of votes cast and capital represented, unless other adoption requirements are imposed by the Danish Companies Act. Novo Nordisk is not aware of the existence of any agreements with or between shareholders on the exercise of votes or control of the company.
     At the annual general meeting, shareholders approve the annual report and any amendments to the company’s Articles of Association. Shareholders also elect board members and the independent auditor.
     Novo Nordisk’s share capital is divided into A shares and B shares. Special rights attached to A shares include pre-emptive subscription rights in the event of an increase of the A share capital, pre-emptive purchase rights in the event of a sale of A shares and priority dividend if the dividend is below 0.5%. B shares take priority for dividends between 0.5% and 5% and for liquidation proceedings. Read more about shares and capital structure on pp 44–45.

Board of Directors
Novo Nordisk has a two-tier management structure consisting of the Board of Directors and Executive Management. The two bodies are separate and no one serves as a member of both. The Board of Directors determines the company’s overall strategy and follows up on its implementation, supervises the performance, ensures adequate management and organisation, and as such actively contributes to developing the company as a focused, sustainable, global pharmaceutical company. The Board of Directors supervises Executive Management in its decisions and operations. The Board of Directors may also issue new shares or buy back shares in accordance with authorisations granted by the annual general meeting and recorded in the meeting minutes. For minutes from annual general meetings, see novonordisk.com/about_us.
     The Board of Directors has 11 members, seven of whom are elected by shareholders and four by employees in Denmark. Shareholder-elected board members serve a one-year term and may be re-elected. Members must retire at the first annual general meeting after reaching the age of 70. Four of the seven shareholder-elected board members are independent as defined by the Danish Corporate Governance Recommendations. Read more on pp 52–53.
     A proposal for nomination of board members is presented by the newly established Nomination Committee to the Board of Directors, taking into account required competences as defined by the Board of Directors’ competence

 

 

profile and reflecting the result of a self-assessment process facilitated by internal or external consultants. The assessment process is based on written questionnaires and evaluates the Board of Directors’ composition and the skills of its members, including whether each board member and executive participates actively in board discussions and contributes with independent judgement.
     To ensure that discussions include multiple perspectives representing the complex, global pharmaceutical environment, the Board of Directors aspires to be diverse in gender and nationality. Currently, one shareholder-elected board member is female and five of the seven shareholder-elected board members are non-Danes. In 2013, the Board of Directors increased its ambition and set out new targets with the aim that by 2017 it will consist of at least two shareholder-elected board members with Danish nationality and at least two shareholder-elected board members with a nationality other than Danish – and at least two shareholder-elected board members of each gender. In accordance with section 99b of the Danish Financial Statements Act, Novo Nordisk discloses its mandatory diversity report at novonordisk.com/annualreport.
     The self-assessment conducted in 2013 resulted in a continued focus on discussion of the current critical issues and on management development and succession planning. In order to support continued fulfilment of the Novo Nordisk Way, criteria for board members include integrity, accountability, fairness, financial literacy, commitment and desire for innovation. Members are also expected to have experience of managing major companies that develop, manufacture and market products and services globally. The competence profile, which includes the nomination criteria, is available online at novonordisk.com/about_us.
     Under Danish law, Novo Nordisk’s employees in Denmark are entitled to be represented by half of the total number of board members elected at the annual general meeting. In 2010, employees elected four board members from among themselves – three male and one female, all Danes. Board members elected by employees serve a four-year term and have the same rights, duties and responsibilities as shareholder-elected board members.
     Novo Nordisk’s Board of Directors met seven times during 2013.

Chairmanship
The annual general meeting directly elects the chairman and vice chairman of the Board of Directors. The Chairmanship carries out administrative tasks such as planning board meetings to ensure a balance between overall strategy-setting and financial and managerial supervision of the company. Other tasks include reviewing the fixed asset investment portfolio and recommending the remuneration of board members and Executive Management.

 

 


    In practice, the Chairmanship has the role and responsibility of a remuneration committee, as the Board of Directors considers that each board member must have the opportunity to contribute actively to discussions and have access to all relevant information on remuneration.

    In March 2013, the Annual General Meeting elected a new chairman, Göran Ando, and a new vice chairman, Jeppe Christiansen. See novonordisk.com/about_us for a report on the Chairmanship’s activities.

Audit Committee
The three members of the Audit Committee are elected by the Board of Directors among its members. Two members qualify as independent and have been designated as financial experts as defined by the US Securities and Exchange Commission (SEC). Under Danish law, two members qualify as financial experts and as independent. In 2013, an employee representative was elected as a member.
     The Audit Committee assists the Board of Directors with oversight of the external auditors, the internal audit function, the procedure for handling complaints regarding accounting, internal accounting controls, auditing or financial reporting matters and business ethics matters (whistleblowing), financial, social and environmental reporting, business ethics compliance, post-completion reviews and post-investment reviews of investments, long-term incentive programmes, and in 2013 it was agreed that the Audit Committee also assists with oversight of IT security. In 2013, the Board of Directors re-elected Hannu Ryöppönen as chairman and Liz Hewitt as a member of the Audit Committee and, further, elected Stig Strøbæk as a new member. See novonordisk.com/about_us for a report on the Audit Committee’s activities.

Nomination Committee
In 2013, the Board established a Nomination Committee consisting of four members to enhance the process for nominating members to the Board of Directors. Two members qualify as independent, while one member is an employee representative.
     The Nomination Committee assists the Board with oversight of the competence profile and composition of the Board, nomination of members and committees, and other tasks on an ad hoc basis as specifically decided by the Board. In 2013, the Board of Directors elected Göran Ando as chairman and Bruno Angelici, Liz Hewitt and Anne Marie Kverneland as members of the Nomination Committee. See novonordisk.com\about_us for a report on the Nomination Committee’s activities.

Executive Management
The Board of Directors has delegated responsibility for day-to-day management of Novo Nordisk to its Executive


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48     GOVERNANCE, LEADERSHIP AND SHARES

 

Management. In 2013, two new executives were appointed and Executive Management now consists of the president and chief executive officer plus six executives. They are responsible for overall conduct of the business and all operational matters, for organisation of the company as well as allocation of resources, determination and implementation of strategies and policies, direction-setting, and ensuring timely reporting and provision of information to the Board of Directors and Novo Nordisk’s stakeholders. Executive Management meets at least once a month and often more frequently. The Board of Directors appoints members of Executive Management and determines remuneration. The Chairmanship reviews the performance of the executives.

Assurance

External audit
The company’s financial reporting and the internal controls over financial reporting processes are audited by an independent audit firm elected at the annual general meeting. The auditor acts in the interest of shareholders and expresses an audit opinion on the annual report as well as reporting any significant audit findings to the Audit Committee and the Board of Directors. As part of Novo Nordisk’s commitment to its social and environmental responsibility, the company voluntarily includes an assurance report for social and environmental reporting in the annual report. The assurance provider reviews whether the social and environmental performance information covers aspects deemed to be material and verifies the internal control processes for the information reported.

Internal audit
Novo Nordisk’s internal audit function provides independent and objective

 

 

assurance, primarily within internal control of financial processes and business ethics.
     To ensure that the internal financial audit function works independently of Executive Management, its charter, audit plan and budget are approved by the Audit Committee. The Audit Committee reviews the result of the audits and must approve the appointment, remuneration and dismissal of the head of the internal audit function.
     Three other types of assurance activity – quality audits, organisational audits and values audits, called facilitations – help ensure that the company adheres to high-quality standards and operates in accordance with the Novo Nordisk Way.

Compliance
Novo Nordisk’s B shares are listed on NASDAQ OMX Copenhagen and on the New York Stock Exchange (NYSE) as American Depository Receipts (ADRs). The applicable corporate governance codes for each stock exchange and a review of Novo Nordisk’s compliance are available at novonordisk.com/about_us.
     In accordance with section 107b of the Danish Financial Statements Act, Novo Nordisk discloses its mandatory corporate governance report at novonordisk. com/about_us/corporate_governance/ compliance.asp.
     In 2013, new Danish corporate governance recommendations were introduced, and Novo Nordisk adheres to all but the following:

The Board of Directors has not established a remuneration committee (but in practice the Chairmanship has such role).
Current employment contracts for Executive Management allow in some instances for severance payments of more than 24 months’ fixed base salary plus pension contribution.
 

The majority of the Nomination Committee’s members are not independent. It consists of two members who are not independent, including the Chairman, and two members who are independent.

The reasons for deviating from the first two recommendations are given on pp 47 and 50. The reason for deviating from the third recommendation is that the Board of Directors finds that this composition of the Nomination Committee allows for both a representative of the majority shareholder as well as an employee representative to be on the Nomination Committee, while keeping it small.
     Novo Nordisk complies with the corporate governance standards of NYSE applicable to foreign listed private issuers.
     As a controlled company, Novo Nordisk is not obliged to comply with all standards established by NYSE. Furthermore, Novo Nordisk as a foreign private issuer is permitted to follow home country practice, which is the case in relation to independence requirements, audit committee, equity compensation plans, code of business conduct and ethics, and CEO certification.
     The Novo Nordisk Way outlines the company’s ambitions and the values that characterise the way Novo Nordisk does business and interacts with its stakeholders. Furthermore, it sets the direction for and applies to all employees in Novo Nordisk. Read more about the Novo Nordisk Way on p 4.
     Novo Nordisk is part of the Novo Group and adheres to the Charter for Companies in the Novo Group, which is available online at novo.dk. However, all strategic and operational matters are solely decided by the Board of Directors and Executive Management of Novo Nordisk. Read more about the Novo Group on p 44.

 


 

 

Corporate governance codes and practices

* The Chairmanship is directly elected by the annual general meeting.

Compliance Governance structure Assurance
Danish and foreign laws and regulations Corporate governance standards Novo Nordisk Way Audit of financial data and review of social and environmental data (internal and external)Facilitation and organisational audit (internal)
Quality audit and inspections (internal and external) Board of Directors Shareholders Executive Management Organisation Chairmanship* Nomination Committee Audit Committee


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GOVERNANCE, LEADERSHIP AND SHARES    
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Remuneration

 

At the Annual General Meeting in 2013, Novo Nordisk’s shareholders approved that the maximum allocation for both the short- and long term incentive programmes for Executive Management was increased to 12 months’ base salary plus pension contribution. This was done to ensure flexibility for the Board of Directors in executive remuneration, as the benchmark had shown that elements of the executive remuneration were below market levels.

Remuneration of the Board of Directors and Executive Management is assessed on an annual basis against a benchmark of Nordic companies as well as European pharmaceutical companies that are similar to Novo Nordisk in size, complexity and market capitalisation. The results are presented to the Board of Directors by the chairman at its October meeting. The company strives for simplicity when composing the remuneration package, and its remuneration principles provide guidance for remuneration of the Board of Directors and Executive Management. These principles are available at novonordisk.com/about_us/corporate_ governance/remuneration.asp.

Board of Directors’ remuneration
The remuneration of Novo Nordisk’s Board of Directors comprises a fixed base fee, a multiplier of the fixed base fee for the Chairmanship and members of the company’s Audit Committee and

 

 

Nomination Committee, fees for ad hoc tasks and a travel allowance.
     At the December meeting, the Board of Directors agrees on recommendations for remuneration levels for the next financial year. In connection with the approval of the annual report, the Board of Directors endorses the actual remuneration for the past financial year and the recommendation on remuneration levels for the current financial year. These are then presented to the annual general meeting for approval.

Travel and other expenses
All board members who reside outside Denmark are paid a fixed travel allowance: 3,000 euros for Europe-based board members and 6,000 euros for board members based outside Europe. Otherwise, no travel allowance is paid to board members when attending board meetings outside Denmark. Expenses such as travel and accommodation in relation to board meetings as well as relevant continuing education are reimbursed. Novo Nordisk also pays social security taxes imposed by foreign authorities and bank transfer fees.

Variable remuneration
Board members are not offered stock options, warrants, restricted stock or participation in other incentive schemes.

Executive Management’s remuneration
The remuneration of Novo Nordisk’s Executive Management is proposed by the Chairmanship and approved by the Board

 

 

of Directors. Remuneration packages for executives comprise a fixed base salary, a cash-based incentive, a share-based incentive, a pension contribution and other benefits. The split between fixed and variable remuneration is intended to result in a reasonable part of the salary being linked to performance, while promoting sound, long-term business decisions to achieve the company’s objectives. All incentives are subject to claw-back if it is subsequently determined that payment was based on information that was manifestly misstated.

Fixed base salary
The fixed base salary is intended to attract and retain executives with the professional and personal competences required to drive the company’s performance.

Cash-based incentive
The cash-based incentive is designed to incentivise individual performance and achievement of a number of predefined short-term functional and individual business targets linked to goals in the company’s Balanced Scorecard. Short-term targets for the chief executive officer are fixed by the chairman of the Board of Directors, while the targets for the other members of Executive Management are fixed by the chief executive officer. The Chairmanship evaluates the degree of achievement for each member of Executive Management based on input from the chief executive officer.


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Board of Directors

In 2013, the base fee for members of the Board of Directors was DKK 500,000 (DKK 500,000 in 2012)

     
2013
             
2012
         
 






 






 
DKK million
Fixed
base fee
 
Fee for
ad hoc tasks and
committee work
 
Travel
allowance
 
Total
 
Fixed
base fee
 
Fee for
ad hoc tasks and
committee work
 
Travel
allowance
 
Total
 
 
 
















 
Göran Ando3, 4 (chairman of the Board and of the Nomination Committee) 1.4     0.1   1.5   1.0     0.1   1.1  
Jeppe Christiansen1 (vice chairman of the Board) 0.8       0.8          
Hannu Ryöppönen (chairman of the Audit Committee) 0.5   0.5   0.1   1.1   0.5   0.4   0.1   1.0  
Liz Hewitt1 (member of the Audit Committee and the Nomination Committee) 0.5   0.3   0.1   0.9   0.4   0.2   0.1   0.7  
Stig Strøbæk (member of the Audit Committee) 0.5   0.2     0.7   0.5       0.5  
Bruno Angelici (member of the Nomination Committee) 0.5   0.1   0.1   0.7   0.5     0.1   0.6  
Henrik Gürtler 0.5       0.5   0.5       0.5  
Ulrik Hjulmand-Lassen 0.5       0.5   0.5       0.5  
Thomas Paul Koestler 0.5     0.3   0.8   0.5     0.3   0.8  
Anne Marie Kverneland (member of the Nomination Committee) 0.5   0.1     0.6   0.5       0.5  
Søren Thuesen Pedersen 0.5       0.5   0.5       0.5  
Steen Scheibye2 0.4       0.4   1.5       1.5  
Kurt Anker Nielsen2 0.1   0.1     0.2   0.5   0.3     0.8  
Jørgen Wedel2         0.1   0.1   0.1   0.3  
















 
Total 7.2   1.3   0.7   9.2 5 7.5   1.0   0.8   9.3 5
















 
1.  Liz Hewitt was first elected at the Annual General Meeting in March 2012, and Jeppe Christiansen was first elected at the Annual General Meeting in March 2013.
2.  Jørgen Wedel resigned as of March 2012. Steen Scheibye and Kurt Anker Nielsen resigned as of March 2013.
3.  Novo Nordisk provides secretarial assistance to the chairman in Denmark and the UK.
4.  As Göran Ando also holds the position of chairman of the Board, he has not received a fee as chairman of the Nomination Committee.
5.  In addition, social security taxes have been paid by Novo Nordisk amounting to less than DKK 1 million (less than DKK 1 million in 2012).

 

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50     GOVERNANCE, LEADERSHIP AND SHARES

 

     In 2013, the Annual General Meeting approved that the maximum allocation per year cannot exceed 12 months’ base salary plus pension contribution, and in March the Board of Directors determined that the 2013 maximum would be up to 10 months.

Share-based incentives
The long-term share-based incentive programme is designed to promote the collective performance of Executive Management and align the interests of executives and shareholders. Share-based incentives are linked to both financial and non-financial targets.
     The long-term incentive programme is based on a calculation of shareholder value creation compared with planned performance. In line with Novo Nordisk’s long-term financial targets, the calculation of shareholder value creation is based on reported operating profit after tax reduced by a weighted average cost of capital-based return requirement on average invested capital. A proportion of the calculated shareholder value creation is allocated to a joint pool for the participants, who include Executive Management and other members of the Senior Management Board.

 

Pension
Pension contributions are paid to enable executives to build up an income for retirement.

Other benefits
Other benefits are added to ensure that overall remuneration is competitive and aligned with local practice. Such benefits are approved by the Board of Directors via delegation of powers to the Chairmanship. In addition, executives may participate in employee benefit programmes such as employee share purchase programmes.

Severance payment
Novo Nordisk may terminate employment by giving executives 12 months’ notice. Executives may terminate their employment by giving Novo Nordisk six months’ notice. In addition to the notice period, executives are entitled to a severance payment.
     Current employment contracts allow severance payments of up to 36 months’

 

fixed base salary plus pension contribution in the event of a merger, acquisition or takeover of Novo Nordisk. If an executive’s employment is terminated by Novo Nordisk for other reasons, the severance payment is three months’ fixed base salary plus pension contribution per year of employment as an executive, taking into account previous employment history. In no event will the severance payment be less than 12 months’ or more than 36 months’ fixed base salary plus pension contribution.
   The existing employment contracts will not be changed. For the two executives who joined Executive Management in 2013 and for all future employment contracts for executives, the severance payment will be no more than 24 months’ fixed base salary plus pension contribution, which will bring Novo Nordisk into alignment with the Danish Corporate Governance Recommendations in the long term.

 


     Non-financial targets are determined on the basis of an assessment of the objectives regarded as particularly important to the fulfilment of the company’s long-term performance. These are typically related to reaching specific milestones within research and development, such as execution of trials, product approvals and product launches, or milestones within sustainability related to patients, environment, company reputation and development of employees. The total number of non-financial targets varies, but is typically made up of 10–15 targets within five to six categories.
     In 2013, the Annual General Meeting approved that the maximum allocation per year cannot exceed 12 months’ base salary plus pension contribution and in March the Board of Directors determined that the 2013 maximum for Executive Management would be nine months. If the financial target is met for economic profit, and at least 85% performance is reached on non-financial targets, the allocation to the joint pool would correspond to 4½ months’ base salary plus pension contribution for Executive Management.
     This pool is then converted into Novo Nordisk B shares, which in any given year are locked up for three years before they are transferred to the participants. The shares in the joint pool are allocated to the participants prorated according to their base salary as per 1 April in any given year. If a participant resigns during the lock-up period, his or her shares will remain in the joint pool for the benefit of the other participants.
     Further information on Novo Nordisk’s share-based incentives is available online at novonordisk.com/about_us.

 

 

Remuneration package components





Remuneration Board of
Directors
Executive
Management
Comments relating
to Executive Management




Fixed fee/base salary
Accounts for 30–55% of the total value of the remuneration package*




Fee for committee work
 




Fee for ad hoc tasks
 




Cash bonus
Up to 6–10 months’ fixed base salary + pension contribution per year




Share-based incentive
Up to 9 months’ fixed base salary + pension contribution per year




Pensions
25–30% of fixed base salary and cash-based incentive




Travel and other expenses
 




Benefits
Non-monetary benefits such as company car and phone




Severance payment
Up to 24 months’ fixed base salary + pension. The employment contracts entered into before 2008 exceed the 24-month limit, though will not exceed 36months’ fixed base salary plus pension contribution




* The interval 30–55% states the span between ‘maximum performance’ and ‘on-target performance’.

 



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GOVERNANCE, LEADERSHIP AND SHARES    
51

 

Delayed approval of Tresiba® in the US reduces share allocation in the 2013 incentive programme
While Novo Nordisk exceeded the planned financial performance in 2013, the company did not meet its target of having Tresiba® approved in the US due to the Complete Response Letter from the US Food and Drug Administration (FDA) in February. This event also entailed that the target for the submission of IDegLira for regulatory approval to the FDA could not be met. As a   consequence of these shortcomings, the allocation of shares under the long-term incentive programme was reduced. For 2013, Executive Management was allocated an amount equal to 4.75 months’ fixed base salary plus pension contribution per member compared with a potential maximum allocation of nine months.

Remuneration of the Executive Management and other members
of the Senior Management Board

  2013   2012  
 








 








 
DKK million
Fixed
base
salary
 
Cash
bonus
 
Pension
 
Benefits
 
Share-
based
incentive
 
Total
 
Fixed
base
salary
 
Cash
bonus
 
Pension
 
Benefits
 
Share-
based
incentive
 
Total
 
























 
Executive Management                                                
Lars Rebien Sørensen 10.1   5.1  
3.8
  0.3     19.3   8.4   2.9  
2.8
  0.3     14.4  
Jesper Brandgaard 5.7   2.4  
2.0
  0.3     10.4   4.8   1.6  
1.6
  0.3     8.3  
Lars Fruergaard Jørgensen1 4.1   1.4  
1.4
  0.3     7.2      
       
Lise Kingo 5.1   1.9  
1.8
  0.3     9.1   4.3   1.1  
1.4
  0.3     7.1  
Jakob Riis1 4.1   1.4  
1.4
  0.3     7.2      
       
Kåre Schultz 6.3   2.7  
2.4
  0.3     11.7   5.2   1.4  
1.7
  0.3     8.6  
Mads Krogsgaard Thomsen 5.7   2.4  
2.0
  0.3     10.4   4.8   1.6  
1.6
  0.3     8.3  

























Executive Management in total 41.1   17.3  
14.8
  2.1     75.3   27.5   8.6  
9.1
  1.5     46.7  
























 
Other members of the Senior Management Board in total2 82.7 4 32.3  
25.5
  14.4     154.9   72.1 4 25.0  
22.3
  8.4     127.8  
























 
Share allocation3                 51.5   51.5                   73.1   73.1  
























 
1.   Effective 31 January 2013, Novo Nordisk’s Executive Management was expanded to include two new members, Jakob Riis and Lars Fruergaard Jørgensen.
2.   The total remuneration for 2013 includes remuneration to 33 senior vice presidents (26 in 2012), five of whom have retired or left the company (none in 2012). The 2013 remuneration for the retired senior vice presidents is included in the table above, whereas severance payments of DKK 57.2 million are not included.
3.   The joint pool of shares is locked up for three years before it is transferred to the participants employed at the end of the three-year period. The value is the cash amount of the share bonus granted in the year using the grant-date market value of Novo Nordisk B shares. Based on the split of participants at the establishment of the joint pool, approximately 40% of the pool will be allocated to the members of Executive Management and 60% to other members of the Senior Management Board (2012: 30% and 70%, respectively). In the lock-up period, the joint pool may potentially be reduced in the event of lower-than-planned value creation in subsequent years.
4.   Including social security taxes paid amounting to DKK 2.0 million (DKK 1.5 million in 2012).

Management’s long-term incentive programme

The shares allocated to the joint pool for 2010 (842,880 shares) were released to the individual participants subsequent to the approval of the Annual Report 2013 by the Board of Directors and the announcement on 30 January 2014 of the full-year financial results for 2013. Based on the share price at the end of 2013, the value of the released shares is as follows:

 
Number
 
Market value1
 
Value as at 31 December 2013 of shares released on 30 January 2014
of shares
 
(DKK million)
 




 
Executive Management        
Lars Rebien Sørensen 74,985   14.9  
Jesper Brandgaard 49,990   9.9  
Lars Fruergaard Jørgensen 24,995   5.0  
Lise Kingo 49,990   9.9  
Jakob Riis 24,995   5.0  
Kåre Schultz 49,990   9.9  
Mads Krogsgaard Thomsen 49,990   9.9  




 
Executive Management in total 324,935   64.5  




 
Other members of the Senior Management Board in total2 392,970   78.1  




 
1.   The market value of the shares released in 2014 is based on the Novo Nordisk B share price of DKK 198.80 at the end of 2013.
2.   In addition, 124,975 shares (market value: DKK 24.8 million) were released to retired members of the Senior Management Board.
   
Lars Rebien Sørensen serves as a board member of Danmarks Nationalbank, from which he received remuneration of DKK 22,232 in 2013 (DKK 22,012 in 2012), as a member of the Supervisory Board of Bertelsmann AG, from which he received remuneration of EUR 122,000 in 2013 (EUR 129,000 in 2012) and as a board member of Thermo Fisher Scientific Inc, from which he received remuneration of USD 314,786 in 2013 (USD 219,840 in 2012). Jesper Brandgaard serves as chairman of the Board of Directors of SimCorp A/S, from which he received remuneration of DKK 871,068 in 2013 (DKK 801,846 in 2012). Kåre Schultz serves as a board member of LEGO A/S, from which he received remuneration of DKK 350,000 in 2013 (DKK 300,000 in 2012). Kåre Schultz also serves as chairman of the Board of Directors of Royal Unibrew A/S, from which he received remuneration of DKK 625,000 in 2013 (DKK 625,000 in 2012). Mads Krogsgaard Thomsen serves as a board member of the University of Copenhagen, from which he received remuneration of DKK 40,500 in 2013 (DKK 79,800 in 2012). Lise Kingo serves as a board member of Grieg Star Group AS from April 2013, from which she received remuneration of NOK 225,000. Jakob Riis serves as a board member of ALK-Abelló A/S, from which he received remuneration of DKK 375,000 in 2013.


NOVO NORDISK ANNUAL REPORT 2013


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52     GOVERNANCE, LEADERSHIP AND SHARES

 

Board of Directors

   
Göran Ando (chair)   Jeppe Christiansen (vice chair)   Bruno Angelici

 
 
Formerly CEO of Celltech Group plc, UK (retired). Member of the Board of Novo Nordisk A/S in 2005, vice chair since 2006, chair since 2013 and chair of the Nomination Committee since 2013.
Management duties: Symphogen A/S, Denmark (chair), member of the boards of Novo A/S, Denmark, Molecular Partners AG, Switzerland, Archimedes Pharma Ltd., UK, and RAND Health, US. Senior advisor to Essex Woodlands Health Ventures Ltd., UK.
Special competences: Medical qualifications and extensive executive background within the international pharmaceutical industry.
Education: Specialism in general medicine (1978) and degree in medicine (1973), both from Linköping Medical University, Sweden.
  Chief executive officer of Fondsmæglerselskabet Maj Invest A/S, Denmark. Vice chair of the Board of Novo Nordisk A/S since 2013.
Management duties: Member of the boards of Novo A/S, Haldor Topsøe A/S, KIRKBI A/S and Symphogen A/S, all in Denmark.
Special competences: Extensive background and experience within the financial sector, in particular in relation to financial and capital market issues, as well as insight into the investor perspective.
Education: MSc in Economics (1985) from the University of Copenhagen, Denmark.
  Formerly executive vice president of AstraZeneca (retired). Member of the Board of Novo Nordisk A/S since 2011 and member of the Nomination Committee since 2013.
Management duties: Member of the boards of Smiths Group plc and Vectura Group plc, both in the UK, and Wolters Kluwer, the Netherlands. Member of the Global Advisory Board at Takeda Pharmaceutical Company Limited, Japan.
Special competences: Extensive global experience with two companies in the fields of pharmaceuticals and medical devices, and in-depth knowledge of strategy, sales, marketing and governance of major companies.
Education: AMP (1993) from Harvard Business School and MBA (1978) from Kellogg School of Management at Northwestern University, both in the US. Law degree (1973) from Reims University and BA in Business Administration (1971) from École Supérieure de Commerce de Reims, both in France.

   
Henrik Gürtler   Liz Hewitt   Ulrik Hjulmand-Lassen

 
 

President and CEO of Novo A/S, Denmark, since 2000. Formerly a member of Corporate Management of Novo Nordisk A/S with special responsibility for Corporate Staffs. Member of the Board of Novo Nordisk A/S since 2005.
Management duties:
Novozymes A/S (chair) and Copenhagen Airports A/S (chair), both in Denmark.

Special competences: Knowledge of the Novo Group’s business and its policies, and knowledge of the international biotech industry.
Education: MSc in Chemical Engineering (1976) from the Technical University of Denmark.

  Formerly Group Director Corporate Affairs of Smith & Nephew plc, UK (retired). Member of the Board of Novo Nordisk A/S since 2012, and member of the Audit Committee since 2012 and the Nomination Committee since 2013.
Management duties: Member of the board, audit committee (chair), remuneration committee and nomination committee of Synergy Health plc and member of the board of Melrose Industries plc, both in the UK. External member of the audit committee of the House of Lords, UK.
Special competences: Extensive experience within the field of medical devices, significant financial knowledge and knowledge of how large international companies operate.

Education: BSc (Econ) (Hons) (1977) from University College London, UK, and FCA (UK Institute of Chartered Accountants) (1982).
  Advanced IT quality advisor in the IT QA Office. Member of the Board of Novo Nordisk A/S since 2010.
Education: CISM (2011). Trained as an MCSA/IT Security (2009) and as an ISO 9001 lead auditor (2006). BSc (1985) from the Technical University of Denmark/DIA-E.

 

Name (male/female)
First elected
Term
Nationality
Born
Independence1






Göran Ando (m)
2005
2014
Swedish
March 1949
Not independent2
Jeppe Christiansen (m)
2013
2014
Danish
November 1959
Not independent2
Bruno Angelici (m)
2011
2014
French
April 1947
Independent
Henrik Gürtler (m)
2005
2014
Danish
August 1953
Not independent2
Liz Hewitt (f)
2012
2014
British
November 1956
Independent4,5
Ulrik Hjulmand-Lassen3 (m)
2010
2014
Danish
April 1962
Not independent






1. As designated by NASDAQ OMX Copenhagen in accordance with section 3.2.1 of Recommendations on Corporate Governance (2013). 2. Member of Management or the Board of Novo A/S. 3. Elected by employees of Novo Nordisk.

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GOVERNANCE, LEADERSHIP AND SHARES    
53

 

   
Thomas Paul Koestler   Anne Marie Kverneland   Søren Thuesen Pedersen

 
 
Executive with Vatera Holdings LLC, US. Member of the Board of Novo Nordisk A/S since 2011.
Management duties: Melinta Therapeutics Inc. (chair), US. Member of the boards of Momenta Pharmaceuticals Inc., ImmusanT Inc. and Arisaph Pharmaceuticals Inc., all in the US.
Special competences: Extensive R&D knowledge, both generally and within the field of regulatory affairs. Significant know-how about the pharmaceutical industry in general and how large international corporations operate. Additional knowledge of the US market. Education: PhD in Medicine & Pathology (1982) from the Roswell Park Memorial Institute and BSc in Biology (1975) from Daemen College, both in the US.
  Laboratory technician and full-time shop steward. Member of the Board of Novo Nordisk A/S since 2000 and member of the Nomination Committee since 2013.
Education: Degree in Medical Laboratory Technology (1980) from Copenhagen University Hospital, Denmark.
  External affairs director in Quality Intelligence. Member of the Board of Novo Nordisk A/S since 2006.
Management duties: Member of the board of the Novo Nordisk Foundation since 2002.
Education:
BSc in Chemical Engineering (1988) from the Engineering Academy of Denmark.


     
Hannu Ryöppönen   Stig Strøbæk    

 
   
Formerly CFO and deputy CEO of Stora Enso Oyj, Finland (retired). Member of the Board of Novo Nordisk A/S since 2009 and chair of the Audit Committee since 2012 (member since 2009).
Management duties:
Private equity funds Altor 2003 GP Limited (chair), Altor Fund II GP Limited (chair) and Altor III GP Limited (chair), all in Jersey, Channel Islands. BillerudKorsnäs AB (chair), Sweden. Member of the boards of Amer Sports Oyj, Finland, and the private equity fund Value Creation Investments Limited, Jersey, Channel Islands. Chair of the audit committee of Amer Sports Oyj, Finland.

Special competences: International executive background and thorough understanding of managing finance operations in global organisations, in particular in relation to accounting, financial and capital market issues, but also experience in private equity and mergers & acquisitions (M&A).
Education: BA in Business Administration (1976) from Hanken School of Economics, Helsinki, Finland.
  Electrician and full-time shop steward. Member of the Board of Novo Nordisk A/S since 1998 and member of the Audit Committee since 2013.
Management duties:
Member of the board of the Novo Nordisk Foundation since 1998.
Education:
Diploma as an electrician. Diploma in further training for board members (2003) from the Danish Employees’ Capital Pension Fund (LD).
   

 

Name (male/female)
First elected
Term
Nationality
Born
Independence1






Thomas Paul Koestler (m)
2011
2014
American
June 1951
Independent
Anne Marie Kverneland3 (f)
2000
2014
Danish
July 1956
Not independent
Søren Thuesen Pedersen3 (m)
2006
2014
Danish
December 1964
Not independent
Hannu Ryöppönen (m)
2009
2014
Finnish
March 1952
Independent4,5
Stig Strøbæk3 (m)
1998
2014
Danish
January 1964
Not independent






4. Mr Ryöppönen and Ms Hewitt qualify as independent Audit Committee members as defined by the US Securities and Exchange Commission (SEC). 5. Mr Ryöppönen and Ms Hewitt qualify as independent Audit Committee members as defined under part 8 of the Danish Act on Approved Auditors and Audit Firms.

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54     GOVERNANCE, LEADERSHIP AND SHARES

 

Executive Management

  Lars Rebien Sørensen    
  President and chief executive officer*    
 


  Lars Rebien Sørensen joined Novo Nordisk’s Enzymes Marketing in 1982. Over the years, he has completed several overseas postings, including in the Middle East and the US. He was appointed a member of Corporate Management in May 1994, and in December 1994 was given special responsibility within Corporate Management for   Health Care. He was appointed president and chief executive officer in November 2000.
Other management duties: Member of the boards of Danmarks Nationalbank, Denmark, and Thermo Fisher Scientific Inc., US. Member of the Bertelsmann AG Supervisory Board, Germany.
Born:
October 1954.

 

   
Kåre Schultz   Jesper Brandgaard   Lars Fruergaard Jørgensen
Chief operating officer*   Chief financial officer   Chief information officer

 
 
Kåre Schultz joined Novo Nordisk in 1989 as an economist in Health Care, Economy & Planning. In November 2000, he was appointed executive vice president and chief of staffs. In March 2002, he took over the position of executive vice president and chief operating officer.
Other management duties: Chair of the board of Royal Unibrew A/S and member of the board of LEGO A/S, both in Denmark.
Born: May 1961.
  Jesper Brandgaard joined Novo Nordisk in 1999 as senior vice president of Corporate Finance. He was appointed executive vice president and chief financial officer in November 2000.
Other management duties: Chair of the boards of SimCorp A/S and NNIT A/S, both in Denmark.
Born: October 1963.
  Lars Fruergaard Jørgensen joined Novo Nordisk in 1991 as an economist in Health Care, Economy & Planning and has over the years completed overseas postings in the US and Japan. In 2004, he was appointed senior vice president for IT & Corporate Development. In January 2013, he was appointed executive vice president and chief information officer, assuming responsibility for IT, Quality & Corporate Development.
Other management duties: Vice chair of the board of NNE Pharmaplan A/S and member of the board of NNIT A/S, both in Denmark.
Born:
November 1966.

 

   
Lise Kingo   Jakob Riis   Mads Krogsgaard Thomsen
Chief of staffs   Executive vice president of Marketing & Medical Affairs   Chief science officer

 
 
Lise Kingo joined Novo Industry A/S in 1988 and worked over the years to build up the company’s Triple Bottom Line business principle. In 1999, she was appointed senior vice president, Stakeholder Relations. In 2002, she was appointed executive vice president and chief of staffs, assuming global responsibility for Corporate Relations. She is adjunct professor at the Medical Faculty, Vrije Universiteit, Amsterdam, the Netherlands.
Other management duties: Chair of the board of Steno Diabetes Center A/S, Denmark, and member of the board of Grieg Star Group AS, Norway. Chair of the Danish Council for Corporate Responsibility.
Born: August 1961.
  Jakob Riis joined Novo Nordisk in 1996 as a health economist. From 2001 to 2005, he worked first in the US sales force and then as head of marketing in Japan. In 2005, he was appointed senior vice president for International Marketing. In January 2013, he was appointed executive vice president, assuming responsibility for Marketing & Medical Affairs.
Other management duties: Chair of the board of Copenhagen Institute of Interaction Design and member of the board and audit committee of ALK-Abelló A/S, both in Denmark.
Born: April 1966.
  Mads Krogsgaard Thomsen joined Novo Nordisk in 1991 as head of Growth Hormone Research. He was appointed executive vice president and chief science officer in November 2000. He is a member of the editorial boards of international journals. He has served as president of the National Academy of Technical Sciences (ATV), Denmark. He is adjunct professor of pharmacology at the Royal Veterinary and Agricultural University (now the Faculty of Health and Medical Sciences of the University of Copenhagen), Denmark.
Other management duties: Member of the board of the University of Copenhagen, Denmark.
Born: December 1960.

* Effective 30 January 2014, Kåre Schultz is appointed president and chief operating officer. Lars Rebien Sørensen continues as chief executive officer.

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Consolidated financial,
social and environmental
statements 2013

 
Consolidated financial statements



 
 
 
 
 
 
   
 
   
Consolidated social statement
(supplementary information)



 
 
 
   
 
   
Consolidated environmental statement
(supplementary information)



 
 
     
     
     
     

.

 

     
  As Novo Nordisk’s business continues to develop, the company remains committed to documenting its performance via its integrated reporting. The Consolidated financial, social and environmental statements are structured to increase focus on what drives the company’s performance in accordance with the Triple Bottom Line business principle.

Within each of the financial, social and environmental statements, the notes are grouped into sections based on how Novo Nordisk views its business. Each of the statements includes an overview of the sections and notes, and each of the sections has an introduction explaining the link between how the company does business and how this is reflected in Novo Nordisk’s financial, social and environmental statements. The disclosures in the notes are structured to provide full transparency on the disclosed amounts, describing the relevant accounting policy, key accounting estimates and numerical disclosure for each note

 
     

 

Juan Jenny Li works as a
chemistry professional in Novo
Nordisk’s Research and
Development Centre in Beijing.


 


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56     CONSOLIDATED FINANCIAL STATEMENTS

Income statement
and Statement of comprehensive income for the year ended 31 December

DKK million
Note
2013
2012
2011








Income statement  
   
Net sales 2.1, 2.2   83,572 78,026 66,346
Cost of goods sold 2.2, 2.3   14,140 13,465 12,589








Gross profit   69,432 64,561 53,757
   
Sales and distribution costs 2.2, 2.3   23,380 21,544 19,004
Research and development costs 2.2, 2.3   11,733 10,897 9,628
Administrative costs 2.2, 2.3   3,508 3,312 3,245
Licence income and other operating income, net 2.2, 2.3, 5.6   682 666 494








Operating profit   31,493 29,474 22,374
   
Financial income 4.7   1,702 125 514
Financial expenses 4.7   656 1,788 963








Profit before income taxes   32,539 27,811 21,925
   
Income taxes 2.4   7,355 6,379 4,828








Net profit for the year   25,184 21,432 17,097








   
Earnings per share  
   
Basic earnings per share (DKK)1 4.1   9.40 7.82 6.05
Diluted earnings per share (DKK)1 4.1   9.35 7.77 6.00









DKK million
Note
2013
2012
2011








Statement of comprehensive income
 
 
 
Net profit for the year
  25,184 21,432 17,097
 
 
Other comprehensive income:
 
Items that will not be reclassified subsequently to the Income statement:
 
Remeasurements of defined benefit plans
3.7
  54 (281 )
 
 
Items that will be reclassified subsequently to the Income statement
 
when specific conditions are met:
 
Exchange rate adjustments of investments in subsidiaries
  (435 ) (172 ) (173 )
Cash flow hedges, realisation of previously deferred (gains)/losses
  (809 ) 1,182 658
Cash flow hedges, deferred gains/(losses) incurred during the period
  1,195 849 (1,170 )
Other items
  75 35 (20 )
Tax on other comprehensive income, income/(expense)
2.4
  (211 ) (587 ) 190








Other comprehensive income for the year, net of tax
  (131 ) 1,026 (515 )








 
 
Total comprehensive income for the year
  25,053 22,458 16,582








1. Comparative figures have been restated to reflect the change in trading unit from DKK 1 to DKK 0.20.


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CONSOLIDATED FINANCIAL STATEMENTS    
57

Balance sheet
at 31 December

DKK million
Note
2013
2012






Assets
 
Intangible assets 3.1 1,615 1,495
Property, plant and equipment 3.2 21,882 21,539
Deferred income tax assets 2.4 4,231 2,244
Other financial assets 4.6 551 228






Total non-current assets 28,279 25,506






Inventories 3.3 9,552 9,543
Trade receivables 3.4 10,907 9,639
Tax receivables 3,155 1,240
Other receivables and prepayments 3.5 2,454 2,705
Marketable securities 4.2, 4.6 3,741 4,552
Derivative financial instruments 4.3 1,521 931
Cash at bank and on hand 4.2, 4.4 10,728 11,553






Total current assets 42,058 40,163






Total assets 70,337 65,669






 
Equity and liabilities
 
Share capital 4.1 550 560
Treasury shares 4.1 (21 ) (17 )
Retained earnings 41,137 39,001
Other reserves 903 1,088






Total equity 42,569 40,632






             
Deferred income tax liabilities 2.4 672 732
Retirement benefit obligations 3.7 688 760
Provisions 3.6 2,183 1,907






Total non-current liabilities 3,543 3,399






             
Current debt 4.6 215 500
Trade payables 4.6 4,092 3,859
Tax payables 2,222 593
Other liabilities 3.8 9,386 8,982
Derivative financial instruments 4.3 48
Provisions 3.6 8,310 7,656






Total current liabilities 24,225 21,638






Total liabilities 27,768 25,037






Total equity and liabilities 70,337 65,669






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58     CONSOLIDATED FINANCIAL STATEMENTS

Statement of cash flows
for the year ended 31 December

DKK million
Note
 
2013
2012
2011








Net profit for the year   25,184 21,432 17,097
   
Adjustment for non-cash items 5.3   10,738 11,253 9,117
Change in working capital 4.5   (265 ) 274 434
Interest received   131 207 332
Interest paid   (39 ) (61 ) (215 )
Income taxes paid 2.4   (9,807 ) (10,891 ) (5,391 )








Net cash generated from operating activities   25,942 22,214 21,374








               
Proceeds from sale of other financial assets   29
Purchase of intangible assets and other financial assets 3.1, 4.6   (406 ) (250 ) (259 )
Proceeds from sale of property, plant and equipment   31 53 70
Purchase of property, plant and equipment 3.2   (3,238 ) (3,372 ) (3,073 )
Net sale/(purchase) of marketable securities   811 (501 ) (197 )








Net cash used in investing activities   (2,773 ) (4,070 ) (3,459 )








               
Repayment of loans   (502 ) (507 )
Purchase of treasury shares, net 4.1   (13,924 ) (11,896 ) (10,595 )
Dividends paid 4.1   (9,715 ) (7,742 ) (5,700 )








Net cash used in financing activities   (23,639 ) (20,140 ) (16,802 )








   
Net cash generated from activities   (470 ) (1,996 ) 1,113
   
Cash and cash equivalents at the beginning of the year   11,053 13,057 11,960
Exchange gains/(losses) on cash and cash equivalents   (70 ) (8 ) (16 )








Cash and cash equivalents at the end of the year 4.4   10,513 11,053 13,057








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CONSOLIDATED FINANCIAL STATEMENTS    
59

Statement of changes in equity
at 31 December

Other reserves

DKK million
Share
capital
Treasury
shares
Retained
earnings
Exchange
rate
adjust-

ment
Cash
flow

hedges
Tax and
other

items
Total
other

reserves
Total
















2013
Balance at the beginning of the year 560 (17 ) 39,001 226 847 15 1,088 40,632
 
Net profit for the year 25,184 25,184
Other comprehensive income for the year 54 (435 ) 386 (136 ) (185 ) (131 )
















Total comprehensive income for the year 25,238 (435 ) 386 (136 ) (185 ) 25,053
 
Transactions with owners:
Dividends (note 4.1) (9,715 ) (9,715 )
Share-based payments (note 5.1) 409 409
Tax credit related to share option scheme 114 114
Purchase of treasury shares (note 4.1) (15 ) (13,974 ) (13,989 )
Sale of treasury shares (note 4.1) 1 64 65
Reduction of the B share capital (note 4.1) (10 ) 10
















Balance at the end of the year 550 (21 ) 41,137 (209 ) 1,233 (121 ) 903 42,569
















 
2012
Balance at the beginning of the year 580 (24 ) 37,111 398 (1,184 ) 567 (219 ) 37,448
Net profit for the year 21,432 21,432
Other comprehensive income for the year (281 ) (172 ) 2,031 (552 ) 1,307 1,026
















Total comprehensive income for the year 21,151 (172 ) 2,031 (552 ) 1,307 22,458
Transactions with owners:
Dividends (note 4.1) (7,742 ) (7,742 )
Share-based payments (note 5.1) 308 308
Tax credit related to share option scheme 56 56
Purchase of treasury shares (note 4.1) (15 ) (12,147 ) (12,162 )
Sale of treasury shares (note 4.1) 2 264 266
Reduction of the B share capital (note 4.1) (20 ) 20
















Balance at the end of the year 560 (17 ) 39,001 226 847 15 1,088 40,632
















 
 
2011
Balance at the beginning of the year 600 (28 ) 36,097 571 (672 ) 397 296 36,965
Net profit for the year 17,097 17,097
Other comprehensive income for the year (173 ) (512 ) 170 (515 ) (515 )
















Total comprehensive income for the year 17,097 (173 ) (512 ) 170 (515 ) 16,582
 
Transactions with owners:
Dividends (note 4.1) (5,700 ) (5,700 )
Share-based payments (note 5.1) 319 319
Purchase of treasury shares (note 4.1) (18 ) (10,821 ) (10,839 )
Sale of treasury shares (note 4.1) 2 242 244
Tax on sale of treasury shares (123 ) (123 )
Reduction of the B share capital (note 4.1) (20 ) 20
















Balance at the end of the year 580 (24 ) 37,111 398 (1,184 ) 567 (219 ) 37,448
















 

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60     CONSOLIDATED FINANCIAL STATEMENTS

Notes
Sections in the Consolidated financial statements

Section 1 Basis of preparation
Read this section to get an overview of the financial accounting policies in general and an overview of Management’s key accounting estimates.
 
1.1 Summary of significant accounting policies, p 61
1.2 Summary of key accounting estimates, p 62
1.3 Changes in accounting policies and disclosures, p 62
1.4 General accounting policies, p 62
   
Section 2 Results for the year
Read this section to get more details on the results for the year, including operating segments, taxes and employee costs.
 
2.1 Net sales and sales deductions, p 63
2.2 Segment information, p 65
2.3 Employee costs, p 68
2.4 Income and deferred income taxes, p 68
   
Section 3 Operating assets and liabilities
Read this section to get more details on the assets that form the basis for the activities of Novo Nordisk, and the related liabilities.
   
3.1 Intangible assets, p 71
3.2 Property, plant and equipment, p 72
3.3 Inventories, p 73
3.4 Trade receivables, p 73
3.5 Other receivables and prepayments, p 74
3.6 Provisions and contingent liabilities, p 74
3.7 Retirement benefit obligations, p 76
3.8 Other liabilities, p 77

 

 

 
Section 4 Capital structure and financing items
Read this section to gain an insight into the capital structure, cash flow and financing items.
 
4.1 Share capital, distribution to shareholders and earnings per share, p 78
4.2 Financial risks, p 79
4.3 Derivative financial instruments, p 81
4.4 Cash and cash equivalents, financial resources and free cash flow, p 83
4.5 Change in working capital, p 83
4.6 Financial assets and liabilities, p 84
4.7 Financial income and expenses, p 85
   
Section 5 Other disclosures
Read this section for more details on the statutory notes that have secondary importance from the perspective of Novo Nordisk.
 
5.1 Share-based payment schemes, p 86
5.2 Management’s holdings of Novo Nordisk shares, p 88
5.3 Adjustments for non-cash items, p 89
5.4 Commitments, p 90
5.5 Related party transactions, p 91
5.6 Licence income and other operating income, net, p 91
5.7 Fee to statutory auditors, p 91
5.8 Companies in the Novo Nordisk Group, p 92
5.9 Financial definitions, p 93

 



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CONSOLIDATED FINANCIAL STATEMENTS    
61

Section 1
Basis of preparation of the Consolidated financial statements

     
 

Novo Nordisk presents its Consolidated financial statements on the basis of the latest developments in international financial reporting and strives for early adoption of EU-endorsed IFRS accounting standards.

All entities in the Novo Nordisk Group follow the same Group accounting policies. This section gives a summary of the significant accounting policies, Management’s key accounting estimates, new IFRS requirements and other accounting policies in general. A detailed description of accounting policies and key accounting estimates related to specific reported amounts is presented in each note to the relevant financial items.

 
     

1.1 
Summary of significant accounting
policies

The Consolidated financial statements included in this Annual Report have been prepared in accordance with International Financial Reporting Standards (IFRS) as issued by the International Accounting Standards Board (IASB), in accordance with IFRS as endorsed by the European Union and also in accordance with additional Danish disclosure requirements for annual reports of listed companies.

Measurement basis
The Consolidated financial statements have been prepared on the historical cost basis except for derivative financial instruments, equity investments and marketable securities measured at fair value.

The principal accounting policies set out below have been applied consistently in the preparation of the Consolidated financial statements for all the years presented.

Principal accounting policies
Novo Nordisk’s accounting policies are described in each of the individual notes to the Consolidated financial statements. Considering all the accounting policies applied, Management regards the following as the most significant accounting policies for the recognition and measurement of reported amounts:

Net sales and sales deductions (notes 2.1 and 3.6)
Revenue is only recognised when, in Management’s judgement, the significant risks and rewards of ownership have been transferred and when the Group does not retain managerial involvement in or effective control over the goods sold. To arrive at net sales, rebates and discounts to retail customers, government agencies, wholesalers, health insurance companies and managed healthcare organisations are deducted from gross sales. These deductions include estimates of unsettled obligations, requiring the use of judgement when estimating the effect of these sales deductions on gross sales for a reporting period.

Research and development (note 3.1 and 3.2)
Internal research costs are fully charged to the consolidated income statement in the period in which they are incurred, consistent with industry practice. Novo Nordisk considers that regulatory and other uncertainties inherent in the development of new products preclude the capitalisation of internal development costs as an intangible asset until marketing approval from the regulatory authority in a relevant major market is obtained or highly probable. The same principles are applied to plant and equipment with no alternative use developed as part of a research and development project. However, plant and equipment with alternative use or used for general research and development purposes is capitalised and depreciated over its estimated useful life as research and development costs.

 

 

 


For acquired in-process research and development projects, the probability effect is reflected in the cost of the asset, and the probability recognition criteria are therefore always considered satisfied. As the cost of acquired in-process research and development projects can often be measured reliably, these projects fulfil the capitalisation criteria as intangible assets upon acquisition. However, further internal development costs subsequent to acquisition are treated in the same way as other internal development costs.

Derivative financial instruments (note 4.3)
Novo Nordisk hedges commercial exposures, with foreign exchange risk being the principal financial risk for the Group. The overall objective of foreign exchange risk management is to limit the short-term negative impact on net profit and cash flow from exchange rate fluctuations, thereby increasing the predictability of the financial results. The purpose of hedge accounting is to match the impact of the hedged item and the hedging instrument in the Consolidated income statement. Management has chosen to classify the result of hedging activities as part of financial items. Thus, as the majority of Novo Nordisk’s sales are in EUR, USD, JPY, CNY, GBP and CAD, net sales will be impacted by exchange rate fluctuations whereas the impact of exchange rate fluctuations on Profit before income taxes depends on the results of the hedging activities and the development in non-hedged currencies.

In addition, the following other accounting policies are considered relevant to an understanding of the Consolidated financial statements:

Income taxes (note 2.4)
Property, plant and equipment including impairment (note 3.2)
Inventories (note 3.3)
Trade receivables and allowance for doubtful trade receivables (note 3.4)
Provisions for legal disputes (note 3.6).

Defining materiality
The Consolidated financial statements are a result of processing large numbers of transactions and aggregating those transactions into classes according to their nature or function. When aggregated, the transactions are presented in classes of similar items in the Consolidated financial statements. If a line item is not individually material, it is aggregated with other items of a similar nature in the Consolidated financial statements or in the notes.

There are substantial disclosure requirements throughout IFRS. Management provides specific disclosures required by IFRS unless the information is considered immaterial to the economic decision-making of the users of these financial statements or not applicable.


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62     CONSOLIDATED FINANCIAL STATEMENTS

1.2 
Summary of key accounting
estimates

The use of reasonable estimates is an essential part of the preparation of the Consolidated financial statements. Given the uncertainties inherent in Novo Nordisk’s business activities, Management must make certain estimates and judgements that affect the application of accounting policies and reported amounts of assets, liabilities, sales, costs, cash flows and related disclosures at the date(s) of the Consolidated financial statements.

Management bases its estimates on historical experience and various other assumptions that are held to be reasonable under the circumstances. The estimates and underlying assumptions are reviewed on an ongoing basis and, if necessary, changes are recognised in the period in which the estimate is revised. Management considers the carrying amounts recognised in relation to the key accounting estimates mentioned below to be reasonable and appropriate based on currently available information. However, the actual amounts may differ from the amounts estimated as more detailed information becomes available.

Management regards the following as the key accounting estimates and assumptions used in the preparation of the Consolidated financial statements:

Sales deductions and provisions for sales rebates (notes 2.1 and 3.6)
  Indirect production costs (note 3.3)
Allowance for doubtful trade receivables (note 3.4)
Income taxes (note 2.4)
Provisions for legal disputes (note 3.6).

Please refer to the specific notes for further information on the key accounting estimates and assumptions applied.

1.3 
Changes in accounting policies
and disclosures

Early adoption of new or amended IFRSs
With effect from 1 January 2013, Novo Nordisk has implemented the new standards IFRS 10 ‘Consolidated Financial Statements’, IFRS 11 ‘Joint Arrangements’ and IFRS 12 ‘Disclosure of Interests in Other Entities’. These new standards have no material impact on the Consolidated financial statements in 2013, nor is a significant impact expected on future periods.

Adoption of new or amended IFRSs
IAS 19R ‘Employee benefits’ effective for annual periods beginning on or after 1 July 2012 was early adopted in 2012. As retrospective application of these changes only had an immaterial impact on each previous financial year, Management fully adopted the revised standard in 2012 without restating previous years’ comparative amounts and disclosures. Please refer to note 3.7 for a detailed description of the accounting policy for retirement benefit obligations.

Furthermore, amendment to IAS 1 ‘Presentation of financial statements’, effective for annual periods beginning on or after 1 July 2012, was early adopted in 2012 with no material impact on the Consolidated financial statements. For a further description please refer to the Annual Report 2012.

Based on an assessment of new or amended and revised accounting standards and interpretations (‘IFRSs’) issued by IASB and IFRSs endorsed by the European Union effective on or after 1 January 2013, it has been assessed that the application of these new IFRSs has not had a material impact on the Consolidated financial statements in 2013 and Management does not anticipate any significant impact on future periods from the adoption of these new IFRSs.

New or amended IFRSs that have been issued but have not yet come into effect and have not been early adopted
In addition to the above, IASB has issued a number of new or amended and revised accounting standards and interpretations that have not yet come into effect. The following standards are in general expected to change current accounting regulation most significantly:

 
IASB has issued IFRS 9 ‘Financial Instruments’, which awaits final effective date and EU endorsement. IFRS 9 is part of the IASB’s project to replace IAS 39, and the new standard will substantially change the classification and measurement of financial instruments and hedging requirements. Novo Nordisk has assessed the impact of the standard and determined that it will not have any significant impact on the Consolidated financial statements in its current wording.
   
IASB has issued re-exposure drafts on IAS 17 ‘Leasing’ and IAS 18 ‘Revenue’. The revised IAS 18 is expected to have only immaterial impact on the Consolidated financial statements. Depending on the wording of the final standard, the change in lease accounting is expected to require capitalisation of the majority of the Group’s operational lease contracts, representing less than 10% of total assets, with a minor impact on the Group’s assets, liabilities and financial ratios, and no significant impact on net profit.

Changes in classification
With effect from 1 January 2013, Novo Nordisk has changed the classification of uncertain tax positions. Previously these were presented net as part of deferred tax liabilities. As of 2013 these are presented gross as part of deferred tax assets, tax receivables and tax payables. Refer to note 2.4 for further description.

1.4 
General accounting
policies

Principles of consolidation
The Consolidated financial statements incorporate the financial statements of Novo Nordisk A/S and entities controlled by Novo Nordisk A/S. Control exists when Novo Nordisk own more than 50% of the voting rights or has the power to govern the entity in some other way.

Where necessary, adjustments are made to the financial statements of subsidiaries to bring their accounting policies into line with Novo Nordisk group policies. All intra-Group transactions, balances, income and expenses are eliminated in full when consolidated.

Translation of foreign currencies
Functional and presentation currency
Items included in the financial statements of each of Novo Nordisk’s entities are measured using the currency of the primary economic environment in which the entity operates (functional currency). The Consolidated financial statements are presented in Danish kroner (DKK), which is also the functional and presentation currency of the parent company.

Translation of transactions and balances
Foreign currency transactions are translated into the functional currency using the exchange rates prevailing at the dates of the transactions. Foreign exchange gains and losses resulting from the settlement of such trans actions and from the translation at year-end exchange rates of monetary assets and liabilities denominated in foreign currencies are recognised in the Income statement.

Translation differences on non-monetary items, such as financial assets classified as available for sale including equity investments, are recognised in Other comprehensive income.

Translation of Group companies
Financial statements of foreign subsidiaries are translated into Danish kroner at the exchange rates prevailing at the end of the reporting period for balance sheet items, and at average exchange rates for income statement items.

All effects of exchange rate adjustment are recognised in the Income statement, with the exception of exchange rate adjustments of investments in subsidiaries arising from:

the translation of foreign subsidiaries’ net assets at the beginning of the year at the exchange rates at the end of the reporting period
the translation of foreign subsidiaries’ statement of comprehensive income from average exchange rates to exchange rates at the end of the reporting period
the translation of non-current intra-Group receivables that are considered to be an addition to net investments in subsidiaries.

These specific exchange rate adjustments are recognised in Other comprehensive income.

 

 


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CONSOLIDATED FINANCIAL STATEMENTS    
63

Section 2
Results for the year

     
 

This section comprises notes related to the results for the year, including sales and sales deductions, segment information, employee costs as well as details on income and deferred income taxes. Consequently the section provides additional information related to performance against two of Novo Nordisk’s four long-term financial targets: Operating profit margin and Growth in operating profit.

Continued growth in the number of patients, a global commercial presence and innovative products drive Novo Nordisk’s growth in sales. Over the last five years, growth in operating profit has been higher than sales growth, resulting in an increasing operating margin. The gross margin expansion has primarily been driven by a positive product mix and a favourable pricing development. The operating margin expansion has also been supported by a modest development in administrative costs and economy of scale advantages within sales and marketing, whereas research and development costs have been growing in line with sales. Novo Nordisk continues to invest in innovation while contributing to society by paying corporate taxes in the countries where it operates. The Management review section ‘2013 performance and 2014 outlook’ on p 6 gives a detailed description of the results for the year.

 
     

2.1 
Net sales and
sales deductions

Accounting policies
Revenue from goods sold is recognised when Novo Nordisk has transferred the significant risks and rewards to the buyer, and the amount of revenue can be measured reliably.

Sales are measured at the fair value of the consideration received or receivable. When sales are recognised, Novo Nordisk also records estimates for a variety of sales deductions, including rebates, discounts, refunds,

 


incentives and product returns. Sales deductions are recognised as a reduction of gross sales to arrive at net sales. Where contracts contain customer acceptance provisions, Novo Nordisk recognises sales when the acceptance criteria are satisfied.

Revenue recognition for new product launches is based on specific facts and circumstances relating to those products, including estimated demand and acceptance rates for well-established products with similar market characteristics. Where shipments of new products are made on a sale or return basis, without sufficient historical experience for estimating sales returns, revenue is only recorded when there is evidence of consumption or when the right of return has expired.



Overall sales performance

The sales performance for a five-year period is presented below in respect of business performance and geographical areas:

Financial performance

DKK million
2013
 
2012
 
2011
 
2010
 
2009
 










 
Net sales
 
 
 
 
 
   Modern insulins (insulin analogues)
38,153
 
34,821
 
28,765
 
26,601
 
21,471
 
   Human insulins
10,869
 
11,302
 
10,785
 
11,827
 
11,315
 
   Victoza®
11,633
 
9,495
 
5,991
 
2,317
 
87
 
   Protein-related products
2,555
 
2,511
 
2,309
 
2,214
 
1,977
 
   Oral antidiabetic products (OAD)
2,246
 
2,758
 
2,575
 
2,751
 
2,652
 










 
   Diabetes care total
65,456
 
60,887
 
50,425
 
45,710
 
37,502
 
 
 
 
 
 
 
   NovoSeven®
9,256
 
8,933
 
8,347
 
8,030
 
7,072
 
   Norditropin®
6,114
 
5,698
 
5,047
 
4,803
 
4,401
 
   Other biopharmaceuticals
2,746
 
2,508
 
2,527
 
2,233
 
2,103
 










 
   Biopharmaceuticals total
18,116
 
17,139
 
15,921
 
15,066
 
13,576
 










 
Net sales by business segment
83,572
 
78,026
 
66,346
  60,776   51,078  










 
   North America
39,024
 
34,220
 
26,586
  23,609   18,279  
   Europe
20,063
 
19,707
 
19,168
  18,664   17,540  
   International Operations
12,007
 
11,080
 
9,367
  8,335   6,835  
   Japan & Korea
5,317
 
6,617
 
6,223
  5,660   4,888  
   Region China
7,161
 
6,402
 
5,002
  4,508   3,536  










 
Net sales by geographical segment
83,572
 
78,026
 
66,346
  60,776   51,078  










 

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64     CONSOLIDATED FINANCIAL STATEMENTS

2.1 
Net sales and sales deductions
(continued)

Key accounting estimates – Sales deductions
Sales discounts and sales rebates are predominantly issued in Region North America. In this region, significant sales rebates are paid in connection with US public healthcare insurance programmes, namely Medicare and Medicaid, as well as rebates to managed healthcare plans. The most significant discounts are offered under contracts with institutions, mostly hospitals and government agencies. In addition, political pressure to contain healthcare costs has led several other countries to impose significant price reductions on pharmaceutical products. As such, concerted austerity measures have been implemented by governments in countries in Region Europe, while government-mandated price cuts have been introduced in Region China, Japan and major countries in Region International Operations.

US Medicaid and Medicare rebates
Medicaid and Medicare rebates have been calculated using a combination of historical experience, product and population growth, price increases, the impact of contracting strategies and specific terms in the individual agreements. For Medicaid, the calculation of rebates also involves interpretation of relevant regulations that are subject to changes in interpretative guidance from government authorities. Although accruals are made for Medicaid and Medicare rebates at the time sales are recorded, the actual rebates related to the specific sale will typically be invoiced to Novo Nordisk up to nine months later. Due to the time lag, the rebate adjustments to sales in any particular period may incorporate adjustments of accruals for prior periods.

US managed healthcare rebates
Rebates are offered to a number of managed healthcare plans. These rebate programmes allow the customer to receive a rebate after attaining certain performance parameters relating to formulary status and pre-established market share milestones relative to competitors. Rebates are estimated according to the specific terms in each agreement, historical experience, anticipated channel mix, product growth rates and market share information. Novo Nordisk adjusts the provision periodically to reflect actual sales performance.

 

US wholesaler charge-backs
Wholesaler charge-backs relate to contractual arrangements between Novo Nordisk and indirect customers in the US, whereby products are sold at contract prices lower than the list price originally charged to wholesalers. A wholesaler charge-back represents the difference between the invoice price to the wholesaler and the indirect customer’s contract price. Provisions are calculated for estimated charge-backs using a combination of factors such as historical experience, current wholesaler inventory levels, contract terms and the value of claims received but not yet processed. Wholesaler charge-backs are generally settled within 10 to 30 days of the liability being incurred.

Discounts, sales returns and other rebates
Other discounts are provided to wholesalers, hospitals, pharmacies etc, and are usually linked to sales volume or provided as cash discounts. Sales returns are related to damaged or expired products. Accruals are calculated based on historical data, and recorded as a reduction in gross sales at the time the related sales are recorded.

Arrangements with certain healthcare providers may require Novo Nordisk to make refunds to the healthcare providers if anticipated treatment outcomes do not meet predefined targets.

Gross-to-net sales reconciliation

DKK million
2013
 
2012
 
2011
 






 
Gross sales
115,906
 
103,948
 
84,386
 






 
US Medicaid and Medicare rebates
(9,959
)
(7,519
)
(5,075
)
US managed healthcare rebates
(5,481
)
(4,390
)
(2,551
)
US wholesaler charge-backs
(10,126
)
(8,196
)
(5,894
)
US discounts and sales returns
(2,978
)
(2,620
)
(1,886
)
Non-US rebates, discounts and sales returns
(3,790
)
(3,197
)
(2,634
)






 
Total gross-to-net sales adjustments
(32,334
)
(25,922
)
(18,040
)






 
Net sales
83,572
  78,026   66,346  






 

Provisions for sales rebates are adjusted to actual amounts as rebates and discounts are processed. Please refer to note 3.6 for further information on sales-related provisions.

 

 


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CONSOLIDATED FINANCIAL STATEMENTS    
65

2.2 
Segment
information

Accounting policies
Operating segments are reported in a manner consistent with the internal reporting provided to Management and the Board of Directors.

Business segments

Novo Nordisk operates in two business segments based on therapies: Diabetes care and Biopharmaceuticals.

The Diabetes care business segment includes research, development, manufacturing and marketing of products within the areas of insulin, GLP-1 and related delivery systems, oral antidiabetic products (OAD) and obesity.

The Biopharmaceuticals business segment includes research, development, manufacturing and marketing of products within the areas of haemophilia, growth hormone therapy, hormone replacement therapy, inflammation therapy and other therapy areas.

 

Segment performance is evaluated on the basis of operating profit consistent with the Consolidated financial statements. Financial income and expenses and income taxes are managed at Group level and are not allocated to business segments.

There are no sales or other transactions between the business segments. Costs have been split between business segments according to a specific allocation with the addition of a minor number of corporate overhead costs allocated systematically between the segments. Licence income and other operating income has been allocated to the two segments based on the same principle. Segment assets comprise the assets that are applied directly to the activities of the segment, including intangible assets, property, plant and equipment, other financial assets, inventories, trade receivables, and other receivables and prepayments.

No single customer represents more than 10% of the total sales and no operating segments have been aggregated to form the reported business segments.



Business segments

DKK million
2013
2012
2011
2013
2012
2011
2013
2012
2011






 
Segment sales
Diabetes care
  Biopharmaceuticals  
Total


















 
NovoRapid® / NovoLog®
16,848
15,693
12,804
 
 
NovoMix® / NovoLog® Mix
9,759
9,342
8,278
 
 
Levemir®
11,546
9,786
7,683
 
 
Total modern insulins
38,153
34,821
28,765
 
 
Human insulins
10,869
11,302
10,785
 
 
Victoza®
11,633
9,495
5,991
 
 
Protein-related products
2,555
2,511
2,309
 
 
Oral antidiabetic products (OAD)
2,246
2,758
2,575
 
 


















Diabetes care total sales
65,456
60,887
50,425
 
 


















 
 
 
NovoSeven®
  9,256
8,933
8,347  
Norditropin®
  6,114
5,698
5,047  
Other products
  2,746
2,508
2,527  


















Biopharmaceuticals total sales
  18,116
17,139
15,921  


















 
 
 
Segment key figures
 
 
Total net sales
65,456
60,887
50,425
  18,116
17,139
15,921   83,572 78,026 66,346
Change in DKK (%)
7.5%
20.7%
10.3%
  5.7%
7.7%
5.7%   7.1% 17.6% 9.2%
Change in local currencies (%)
12.0%
14.5%
12.6%
  11.5%
2.4%
7.6%   11.9% 11.6% 11.4%
 
 
 
Cost of goods sold
11,909
11,435
10,762
  2,231
2,030
1,827   14,140 13,465 12,589
Sales and distribution costs
20,584
18,894
16,476
  2,796
2,650
2,528   23,380 21,544 19,004
Research and development costs
7,786
7,322
6,402
  3,947
3,575
3,226   11,733 10,897 9,628
Administrative costs
2,767
2,604
2,485
  741
708
760   3,508 3,312 3,245
Licence income and other operating income, net
510
464
285
  172
202
209   682 666 494
Operating profit
22,920
21,096
14,585
  8,573
8,378
7,789   31,493 29,474 22,374
Operating margin
35.0%
34.6%
28.9%
  47.3%
48.9%
48.9%   37.7% 37.8% 33.7%
 
 
 
Depreciation, amortisation and impairment losses expensed
2,209
2,167
2,051
  590
526
686   2,799 2,693 2,737
Additions to Intangible assets and Property, plant and equipment
2,651
2,800
2,654
  990
770
678   3,641 3,570 3,332
  
 
 
Assets allocated to business segments
36,436
36,030
34,853
  10,525
9,119
8,998   46,961 45,149 43,851
Assets not allocated to business segments1
 
  23,376 20,520 20,847
Total assets
 
  70,337 65,669 64,698



















1. The part of total assets that remains unallocated to either of the two business segments includes Cash at bank and on hand, Marketable securities, Derivative financial instruments deferred tax assets and tax receivables.

NOVO NORDISK ANNUAL REPORT 2013

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66     CONSOLIDATED FINANCIAL STATEMENTS

 

2.2 
Segment information
(continued)

Information about geographical areas

Novo Nordisk operates in five geographical regions:

North America: the US and Canada
  Europe: the EU, EFTA, Albania, Bosnia-Hercegovina, Macedonia, Serbia, Montenegro and Kosovo
Japan & Korea: Japan and Korea
Region China: China, Hong Kong and Taiwan
International Operations: all other countries.
 

Sales are attributed to geographical regions according to the location of the customer. Allocation of property, plant and equipment, trade receivables, allowance for trade receivables and total assets are based on the location of the assets.

The country of domicile is Denmark, which is part of Region Europe. Denmark is immaterial to Novo Nordisk’s activities in terms of geographical size and the operational business segments. More than 99.4% of total sales are realised outside Denmark. Sales to external customers attributed to the US are collectively the most material to the Group. The US is the only country where sales contribute more than 10% of total sales. Sales to the US represent more than 90% of sales in Region North America.

For patent expiry in key markets, please refer to note 2.5 in the social statements, where the various marketed products are listed.


Geographical areas

DKK million
2013
2012
2011
2013
2012
2011












 
North America
 
Europe












Sales by business segment:
 
      NovoRapid® / NovoLog®
9,953
9,033
6,934
 
3,819
3,707
3,464
      NovoMix® / NovoLog® Mix
2,694
2,488
2,088
 
2,450
2,544
2,623
      Levemir®
6,823
5,290
3,711
 
2,909
2,833
2,577
   Modern insulins (insulin analogues)
19,470
16,811
12,733
 
9,178
9,084
8,664
   Human insulins
1,976
1,959
1,762
 
2,427
2,642
3,032
   Victoza®
7,537
5,930
3,716
 
2,896
2,427
1,620
   Other diabetes care
1,590
1,998
1,705
 
885
965
1,210












   Diabetes care total
30,573
26,698
19,916
 
15,386
15,118
14,526
 
 
   NovoSeven®
4,459
4,397
3,951
 
2,294
2,206
2,310
   Norditropin®
2,273
1,721
1,394
 
1,729
1,741
1,705
   Other biopharmaceuticals
1,719
1,404
1,325
 
654
642
627












   Biopharmaceuticals total
8,451
7,522
6,670
 
4,677
4,589
4,642












Total sales by business and geographical segment
39,024
34,220
26,586
 
20,063
19,707
19,168












Underlying sales growth in local currencies1
17.8%
19.2%
17.9%
 
2.5%
2.0%
2.4%
Currency effect (local currency impact)
(3.8%
)
9.5%
(5.3%
)
(0.7%
)
0.8%
0.3%












Total sales growth as reported
14.0%
28.7%
12.6%
 
1.8%
2.8%
2.7%












Property, plant and equipment
1,571
1,500
1,329
 
16,801
16,200
15,681
Trade receivables
3,076
2,278
2,081
 
3,779
3,688
3,652
Allowance for doubtful trade receivables
(20
)
(18
)
(22
)
(245
)
(239
)
(333
)
Total assets
7,057
5,867
5,465
 
51,205
47,663
47,202












1. Additional non-IFRS measure; please refer to p 93 for definition.

NOVO NORDISK ANNUAL REPORT 2013


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CONSOLIDATED FINANCIAL STATEMENTS    
67

2.2 
Segment information
(continued)

Geographical areas

DKK million
2013
2012
2011
2013
2012
2011












 
International Operations  
Japan & Korea












Sales by business segment:
 
      NovoRapid® / NovoLog®
1,639
1,408
1,100
 
951
1,175
1,057
      NovoMix® / NovoLog® Mix
1,875
1,708
1,482
 
789
1,028
970
      Levemir®
1,290
1,106
942
 
288
386
363
   Modern insulins (insulin analogues)
4,804
4,222
3,524
 
2,028
2,589
2,390
   Human insulins
2,954
3,073
2,581
 
490
768
960
   Victoza®
741
613
322
 
331
455
327
   Other diabetes care
692
632
583
 
471
493
430












   Diabetes care total
9,191
8,540
7,010
 
3,320
4,305
4,107
 
 
   NovoSeven®
1,716
1,526
1,485
 
629
646
482
   Norditropin®
853
780
651
 
1,246
1,442
1,285
   Other biopharmaceuticals
247
234
221
 
122
224
349












   Biopharmaceuticals total
2,816
2,540
2,357
 
1,997
2,312
2,116












Total sales by business and geographical segment
12,007
11,080 9,367   5,317 6,617 6,223












                         
Underlying sales growth in local currencies1
17.0% 16.2% 17.1%   (0.1% ) (1.5% ) 5.1%
Currency effect (local currency impact)
(8.6% ) 2.1% (4.7% ) (19.5% ) 7.8% 4.8%












Total sales growth as reported
8.4% 18.3% 12.4%   (19.6% ) 6.3% 9.9%












Property, plant and equipment
1,292 1,508 1,672   140 174 207
Trade receivables
2,196 2,177 2,052   269 335 377
Allowance for doubtful trade receivables
(716 ) (710 ) (535 ) (8 ) (3 ) (2 )
Total assets
5,945 6,660 6,419   1,022 989 1,388












 

DKK million
2013
2012
2011
2013
2012
2011












  Region China   Total sum of the five regions












Sales by business segment:  
      NovoRapid® / NovoLog®
486
370
249
 
16,848
15,693
12,804
      NovoMix® / NovoLog® Mix
1,951
1,574
1,115
 
9,759
9,342
8,278
      Levemir®
236
171
90
 
11,546
9,786
7,683
   Modern insulins (insulin analogues)
2,673
2,115
1,454
 
38,153
34,821
28,765
   Human insulins
3,022
2,860
2,450
 
10,869
11,302
10,785
   Victoza®
128
70
6
 
11,633
9,495
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