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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 3, 2021

_________________________

NOVO NORDISK A/S
(Exact name of Registrant as specified in its charter)
_________________________
Novo Allé
DK-2880 Bagsværd
Denmark
(Adress 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 o


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 o No x


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



Novo Nordisk Annual Report 2020



NVO-20201231_G1.JPG

Team Novo Nordisk, the world's first all-diabetes professional cycling team, are racing with 100 on their jersey to celebrate the 100-year anniversary of the discovery of insulin.
Novo Nordisk A/S - Novo All 1, 2880 Bagsværd, Denmark - CVR no. 24256790



Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information Novo Nordisk Annual Report 2020 /
2

Contents

NVO-20201231_G2.JPG







Management review
Introducing Novo Nordisk
Letter from the Chair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Letter from the CEO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Novo Nordisk at a glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Business model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Performance highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Strategic aspirations
Purpose and sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Innovation and therapeutic focus . . . . . . . . . . . . . . . . . . . . . . 20
Commercial execution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Financials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Corporate governance
Risk management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Shares and capital structure . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Corporate governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Governance practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Board of Directors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Executive Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45


Consolidated statements
Consolidated financial statements
Income statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Cash flow statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Balance sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Equity statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Notes to the consolidated financial statements . . . . . . . . . . 51
Consolidated ESG statement (supplementary information)
Statement of ESG performance . . . . . . . . . . . . . . . . . . . . . . . 81
Notes to the consolidated ESG statement . . . . . . . . . . . . . . 82
Statements and Auditor's Reports
Statement by Board of Directors and
Executive Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
88
Independent Auditor's Reports . . . . . . . . . . . . . . . . . . . . . . . . 89
Independent Assurance Report on the ESG statement . . . 91
Additional information
More information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Product overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93




Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
3


NVO-20201231_G3.JPG
Letter from the Chair
Rising to the
challenge









The devastating impact of COVID-19 on societies and economies in 2020 intensified existing challenges such as inequality and poverty. However, in times of crisis, businesses play a critical role in mobilising resources and providing solutions. Novo Nordisk has worked hard to respond to the challenges, helping people with serious chronic diseases while also supporting society on a broader scale.

Novo Nordisk’s highest priority in 2020 was to ensure the safety of our employees and the uninterrupted supply of our life-saving medicines for patients. We achieved this, while also supporting society's response to the pandemic, most notably in Denmark, where our headquarter presence meant we were able to assist the government in the rapid scale-up of coronavirus testing. At the same time, our scientists continued to make significant progress in discovering new therapies of the future, while our

global commercial organisation embraced an increasingly digital new reality.

The world has been through one of the most difficult years in recent human history. Despite the pandemic and the turbulent business environment, Novo Nordisk took important steps towards delivering on our purpose of driving change to defeat diabetes and other serious chronic diseases – a goal we are confident will translate into sustainable and profitable growth.



Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
4

This does not mean that the road ahead is going to be easy. The pandemic has exacted an immense economic, as well as human, cost on societies and it is inevitable that public finances will remain fragile for many years. Those fiscal constraints will put pressure on businesses that work closely with governments, including the pharmaceutical industry, and we will have to find new ways to ensure that our products are accessible to all those who need them.

Beyond COVID-19, two consistent priorities were high on the Board’s agenda in 2020, namely scientific innovation and sustainability – both of which are vital to ensure the future of the company. It is therefore satisfying to see a healthy product pipeline, including the pioneering science that we consider to be the biggest contribution we can make to society.

Our research is now more broadly focused as we look to deliver treatments within therapy areas adjacent to our core competencies. Specifically, this means looking beyond semaglutide, the GLP-1 molecule found in our new oral diabetes treatment Rybelsus® and the once-weekly injectable Ozempic®. We are exploring novel ways to treat a range of conditions beyond diabetes, including cardiovascular disease – the world’s leading cause of death1 – obesity and most recently also as a potential treatment for Alzheimer’s disease. In tandem with this push into new areas, we are also establishing more external alliances and partnerships to complement our in-house expertise.
NVO-20201231_G4.JPG
Employees from the Novo Nordisk research department volunteered to contribute to the fight against COVID-19 and, together with staff from the Danish health service, they helped to increase the testing capacity in Denmark.
"Above all, 2020 underscored the need for strong corporate values and a shared sense of purpose. We are fortunate that both are well-established across our organisation, empowering our employees to keep delivering for both patients and investors, despite the unprecedented disruptions caused by COVID-19."




1.WHO, The top 10 causes of death (2020)
It is increasingly clear that society expects more from businesses as the world grapples with climate change and environmental degradation, as well as the need for greater equity in healthcare. Indeed, the pandemic has turbocharged many of these issues, with an effective alliance emerging between young people and investors that is prompting companies to pay far more attention to sustainability.

At Novo Nordisk, we have been focused on sustainability for many years – but we are determined to continue to raise our game. In the past year we launched a new social responsibility strategy, Defeat Diabetes, and initiated programmes within renewable power and recycling as part of our Circular for Zero environmental strategy.
Above all, 2020 underscored the need for strong corporate values and a shared sense of purpose. We are fortunate that both are well-established across our organisation, empowering our employees to keep delivering for both patients and investors, despite the unprecedented disruptions caused by COVID-19.


On behalf of the Board of Directors I would like to offer my thanks to all Novo Nordisk’s employees for their hard work and commitment during the exceptional challenges of 2020; to Lars Fruergaard Jørgensen and his team for leading the company through a turbulent year in such a thoughtful and positive manner; and to our shareholders for their continued support.


Helge Lund
Chair of the Board of Directors



Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
5


Letter from the CEO
The power of purpose






The COVID-19 pandemic has taken a terrible toll around the world – but the pain has not been shared equally. People with underlying conditions have been hit disproportionately hard by the virus, a fact that makes Novo Nordisk’s purpose of driving change to defeat diabetes and other serious chronic diseases more meaningful than ever.

Today, one in 11 people in the world has diabetes and if action is not taken to bend the curve, that figure is projected to rise to one in nine by 20451. The risk posed by COVID-19 to people living with diabetes and obesity is a clear wake-up call: we must continue to do more to tackle these diseases or risk vast future damage to millions of lives, as well as to broader societies and economies.

We measure our contribution to the fight against diabetes and other serious chronic diseases in our strategic aspirations for 2025. Appropriately, after a year as unparalleled as 2020, and as the world acknowledges the hundredth anniversary of the















discovery of insulin, the first of these is 'Purpose and sustainability'. Over the past year we have stepped up our commitment to our purpose by launching a new Defeat Diabetes social responsibility strategy. This sets out our ambition to accelerate the prevention of type 2 diabetes, provide access to affordable care for vulnerable patients in every country and innovate to improve lives.

Beyond defeating serious chronic diseases, we also aspire to have zero environmental impact.In 2020, we took an important step by achieving our target of using 100% renewable power across global production – a key milestone on the road to our target of zero CO2 emissions from all operations and transport by 2030.






1. IDF Diabetes Atlas, 9th edition, 2019




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We now also ask that by the end of the decade, our direct suppliers use only renewable power when supplying us. It has been great to see some of our largest suppliers step up and meet this target already.

Despite this encouraging progress, we can only fulfil our purpose and be respected for adding value to society if we deliver on our core contribution of scientific innovation. Thanks to a strategy of targeted investment, our scientists are currently pursuing higher levels of innovation across more therapy areas than at any point in the company’s history. Consequently, I believe we are now well-positioned for success in the short, medium and long term.

Within diabetes, we are further raising the innovation bar with the roll-out of the world’s first once-daily GLP-1 tablet, Rybelsus®, while at the same time working on novel insulins, 100 years after the discovery of the molecule. Our Research & Development (R&D) colleagues are also pursuing greater weight loss in obesity, and in 2020 they demonstrated the potential of semaglutide 2.4 mg in the STEP phase 3 clinical trial programme.

Crucially, we also broadened our technology platforms and expanded our research into adjacent disease areas in 2020 including cardiovascular disease, non-alcoholic steatohepatitis (NASH) and Alzheimer’s disease – areas of huge unmet medical need and a great burden for patients, families and society alike.

Our continued focus on external innovation led to the significant acquisitions of Corvidia Therapeutics and Emisphere Technologies, strengthening our positions in cutting-edge
areas of cardiovascular medicine and drug delivery respectively.

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Commercially, 2020 was a challenging year as lockdowns reduced the time doctors spent with their patients, leading to fewer initiations of new treatments. Despite this, we expanded our leadership position in the diabetes market in terms of value, keeping us on track to reach a share of more than one third by 2025. Diabetes sales were driven by sales of GLP-1 products (Victoza®, Ozempic® and Rybelsus®), which offset mixed market conditions for insulins. We continued to help more people living with obesity, while making progress with our ambition to secure sustained growth within our Biopharm division thanks to strong demand for our growth hormone and new haemophilia products.

I believe that our ability to meet the needs of our millions of patients during the pandemic in 2020 comes as a consequence of our crystal-clear purpose and long-established company values. We are far from done and have many more millions of patients for whom treatment is not accessible
today. So now is the time to continue to invest in our people and in our organisation, creating an inclusive, diverse and safe working environment in which colleagues have equal opportunities to thrive and fulfil their potential.

Looking to the future, I am confident that our clear corporate strategy will make us a valued partner to society as the world continues on the long road to recovery from the pandemic.

In closing, I would like to thank my colleagues around the world for their agility and commitment during this most challenging of years. Special thanks must go to our partners and collaborators, without whom we could not succeed. A sincere thank you goes to our Board of Directors for their continued support and constructive challenging of the organisation. Finally, I would like to send a thank you to our shareholders for their continuous support.


Lars Fruergaard Jørgensen
President & Chief Executive Officer


“Over the past year we have stepped up our commitment to our purpose by launching a new Defeat Diabetes social responsibility strategy. This sets out our ambition to accelerate the prevention of type 2 diabetes, provide access to affordable care for vulnerable patients in every country and innovate to improve lives."






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Novo Nordisk at a glance
Novo Nordisk is a global healthcare company, headquartered in Denmark. Our key contribution is to discover and develop innovative bio- logical medicines and make them accessible to patients throughout the world. We aim to lead in all disease areas in which we are active. Our corporate strategy has four distinct focus areas in which we operate. It is built on our purpose, the Novo Nordisk Way and our ambition to be a sustainable business. We aim to strengthen our leadership and treatment options in Diabetes and Obesity care, secure leading positions within Biopharm and establish a strong presence in other serious chronic diseases such as NASH, cardiovascular disease and Alzheimer’s disease. Succeeding in this will drive sustainable growth for Novo Nordisk.
126,946
NVO-20201231_G7.JPG
463
DKK million in net sales
million people live with diabetes1
54,126 650
DKK million in operating profit
million people live with obesity2
28,565 450
DKK million in free cash flow
thousand people live with haemophilia3
45,323
employees worldwide
169
countries with marketed products

80
countries with affiliates
5 1. IDF Diabetes Atlas, 9th edition, 2019
2. WHO, Obesity and overweight, fact sheet, 2020
3. World Federation of Hemophilia, Annual Survey, 2018
countries with R&D facilities



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Our business model


Our business is built around our purpose: Driving change to defeat diabetes and other serious chronic diseases. Our key contribution is to discover and develop innovative biological medicines and make them accessible to patients throughout the world.

We strive to be a sustainable business, creating value to society and to our future business. We do business in a financially, environmentally and socially responsible manner and we do this the Novo Nordisk Way. By succeeding in this, we will create long-term value to patients, employees, partners, shareholders and society.
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Resources
Resources going into our business model at different stages:
Insights from healthcare experts, patients and partners
Expertise from public and private institutions
Diverse talent
Raw materials
Financial resources


Value
Value created from our business:
32.8 million people using our Diabetes care products
43,500 patients participating in our clinical trials
45,323 employees, of whom 5,446 were new hires in 2020
60,000 direct suppliers
26,376 DKK million total tax contribution
36,976 DKK million to shareholders as dividends and share repurchases




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Performance highlights
Strategic aspirations 2025



To reflect the broad aspects of Novo Nordisk across therapy areas and geographies, Novo Nordisk introduced in 2019 a comprehensive approach describing the future growth aspirations of the company under the headline Strategic Aspirations 2025. The strategic aspirations are objectives that Novo Nordisk intends to work towards and are not a projection of Novo Nordisk's financial outlook or expected growth.










1.CER: Constant Exchange Rate
2.IO: International Operations
3.NAO: North America Operations
NVO-20201231_G9.JPG Purpose and sustainability
NVO-20201231_G10.JPG Innovation and therapeutic focus
2025 strategic aspirations 2020 highlights 2025 strategic aspirations 2020 highlights
Being respected for adding value to society
Progress towards zero environmental impact
Ensure distinct core capabilities and evolve culture
Adding value to society:
Launch of new social responsibility strategy, Defeat Diabetes
Expansion of US affordability offerings
Societal contributions during COVID-19
Lowered ceiling price of human insulin in 76 countries
Environment:
100% renewable power across all production sites
Launch of supplier target aiming at 100% renewable power by 2030
Ensure distinct capabilities and evolve culture
Progress on diversity and inclusion agenda, acceleration of agility mindset and digitalisation capabilities
Further raise the innovation bar for diabetes treatment
Develop a leading portfolio of superior treatment solutions for obesity
Strengthen and progress the Biopharm pipeline
Establish presence in other serious chronic diseases focusing on cardiovascular disease (CVD), NASH and chronic kidney disease (CKD)
Diabetes:
Semaglutide 2.0 mg phase 3b trial successfully completed
Once-weekly insulin icodec phase 3 trial programme initiated
Rybelsus® approved in the EU, the UK and Japan
Obesity:
Applications for semaglutide 2.4 mg submitted to FDA and EMA
AM833 + semaglutide 2.4 mg phase 1 trial successfully completed
Biopharm:
Mim8 phase 1/2 trial initiated
Concizumab phase 3 trial reinitiated
Other serious chronic disease:
Successful completion of phase 2 trials for ziltivekimab and semaglutide in NASH
NVO-20201231_G11.JPG Commercial execution
NVO-20201231_G12.JPG Financials
2025 strategic aspirations 2020 highlights 2025 strategic aspirations 2020 highlights
Strengthen diabetes leadership – aim at global value market share of more than 1/3
Strengthen obesity leadership and double 2019 reported sales
Secure a sustained growth outlook for Biopharm
Diabetes sales increased by 8% at CER1
Value market share leadership expanded by 0.7 percentage points to 29.3%
Obesity sales increased by 3% at CER to DKK 5.6 billion
Biopharm sales increased by 1% at CER
Deliver solid sales and operating profit growth:
Deliver 6–10% sales growth in IO2
Transform 70% of sales in the US (from 2015 to 2022)
Drive operational efficiencies across the value chain to enable investments in future growth assets
Deliver free cash flow to enable attractive capital allocation to shareholders
Operating profit increased by 7%
at CER to DKK 54.1 billion
Sales increased by 7% at CER, to DKK 126.9 billion
10% sales growth at CER in IO
3% sales growth at CER in NAO3, with 48% of US sales transformed to products launched since 2015
Free cash flow of DKK 28.6 billion and DKK 37 billion returned to shareholders






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Performance highlights
Financial highlights


DKK million 2016 2017 2018 2019 2020 2019–2020
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Financial performance Change
Net sales 111,780 111,696 111,831 122,021 126,946 %
Sales growth as reported 3.6  % (0.1  %) 0.1  % 9.1  % 4.0  %
Sales growth in constant exchange rates (CER)1
5.5  % 2.3  % 4.6  % 5.6  % 6.7  %
Operating profit 48,432 48,967 47,248 52,483 54,126 %
Operating profit growth as reported (2.0  %) 1.1  % (3.5  %) 11.1  % 3.1  %
Operating profit growth in constant exchange rates (CER)1
0,2% 4.8  % 2.8  % 5.6  % 6.8  %
Depreciation, amortisation and impairment losses 3,193 3,182 3,925 5,661 5,753
Net financials (634) (287) 367 (3,930) (996)
Profit before income taxes 47,798 48,680 47,615 48,553 53,130 %
Effective tax rate2
20.7  % 21.7  % 18.9  % 19.8  % 20.7  %
Net profit 37,925 38,130 38,628 38,951 42,138 %
Purchase of intangible assets2
1,199 1,022 2,774 2,299 16,256 607  %
Purchase of property, plant and equipment2
7,068 7,626 9,636 8,932 5,825 (35  %)
Free cash flow1
39,991 32,588 32,536 34,451 28,565 (17  %)
Total assets 97,539 102,355 110,769 125,612 144,922 15  %
Equity 45,269 49,815 51,839 57,593 63,325 10  %
Financial ratios
Gross margin2
84.6  % 84.2  % 84.2  % 83.5  % 83.5  %
NVO-20201231_G14.JPG
Sales and distribution costs in percentage of sales 25.4  % 25.4  % 26.3  % 26.1  % 25.9  %
Research and development costs in percentage of sales 13.0  % 12.5  % 13.2  % 11.7  % 12.2  %
Operating margin2
43.3  % 43.8  % 42.2  % 43.0  % 42.6  %
Net profit margin2
33.9  % 34.1  % 34.5  % 31.9  % 33.2  %
Cash to earnings1
105.4  % 85.5  % 84.2  % 88.4  % 67.8  %
Operating profit after tax to net operating assets1
150,2% 143,2% 116,7% 98,0% 82.8  %
Dividend payout ratio2
50.2  % 50.4  % 50.6  % 50.5  % 50.0  %
Share performance
Basic earnings per share/ADR in DKK2
14.99 15.42 15.96 16.41 18.05 10  %
Diluted earnings per share/ADR in DKK2
14.96 15.39 15.93 16.38 18.01 10  %
Total number of shares (million), 31 December 2,550 2,500 2,450 2,400 2,350 (2  %)
Dividend per share in DKK 7.60 7.85 8.15 8.35 9.10
3
%
Total dividend (DKK million) 19,048 19,206 19,547 19,651 21,066
3
%
Share repurchases (DKK million) 15,057 16,845 15,567 15,334 16,855 10  %
Closing share price (DKK) 255 335 298 387 427 10  %
1. See 'Non-IFRS financial measures' 2. See 'Financial definitions'. 3. Total dividend for the year including interim dividend of DKK 3.25 per share, corresponding to DKK 7,570 million, which was paid in August 2020. The remaining DKK 5.85 per share, corresponding to DKK 13,496 million, will be paid subject to approval at the Annual General Meeting.






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Purpose and sustainability
Adding value to society
and to our future
business





Demands on companies are changing fast as the world is faced with extraordinary challenges. Threats like the COVID-19 pandemic and climate change mean that 'business as usual' is no longer an option. The stakes are high and we are determined to be a sustainable business by adding value to society and to our future business.
Responding to COVID-19
During 2020, COVID-19 led to a cascade of critical needs around the world and we used our expertise, resources and global reach to contribute to the response. Our highest priority was to ensure the safety of our employees and the uninterrupted supply of life-saving medicines for our patients. In addition, we focused our resources on donations towards global relief efforts and activated our research and development organisation to perform COVID-19 testing following a request for support from the Danish government.

Leading a sustainable business
Our purpose is to drive change to defeat diabetes and other serious chronic diseases. To maximise our positive impact, we must offer solutions beyond providing medicines to help tackle the global societal challenges of growth in non-communicable diseases, lack of access to affordable care and the impacts of climate change.

We are committed to being a sustainable business. To us, this means that we add value to society and to our future business. To achieve this ambition, we do business in a financially, environmentally and socially responsible way, as reflected in our Articles of Association and the Novo Nordisk Way. This approach is integrated into every aspect of our decision-making, in strategies and actions, always keeping in mind what is best in the long term for the patients we serve, our shareholders, our employees, the communities in which we are present and the global society we are part of.
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2025 strategic aspiration
  NVO-20201231_G16.JPG Purpose and sustainability

Being respected for adding value to society
Progress towards zero environmental impact
Ensure distinct core capabilities and evolve culture
The rapid outbreak of COVID-19 during 2020 put the potential vulnerability of people living with diseases, including diabetes and obesity, firmly in the spotlight. At the same time, climate change remains an urgent challenge. These challenges call for corporations to step up and take a leading role in delivering and adopting solutions.

In 2020 we addressed these challenges by increasing access to our medicines across the world, pursuing zero environmental impact, and taking steps towards creating a more sustainable and inclusive workplace.
With that, we lead towards our strategic aspirations within purpose and sustainability.

This is what ESG – Environmental, Social and Governance – means to us.

Read more about ESG in the following sections
and in the consolidated ESG statement.




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Purpose and sustainability
Our environmental responsibility



Each year, billions of Novo Nordisk tablets, vials and injection pens are distributed to patients and demand for them is growing.
This puts us in the front line of some of the most challenging environmental issues including climate change, water and resource scarcity, pollution and plastic waste. Our ambition is bold and simple: to have zero environmental impact.


To get there, we are adopting a circular mindset, designing products that can be re-used or recycled, reshaping our business practice to minimise consumption and eliminate waste, and working with suppliers who share our ambition. We call our environmental strategy Circular for Zero and we measure our progress based on use of resources, emissions and waste. The Circular for Zero strategy incorporates our entire value chain and is based on three pillars: circular supply, circular company and circular products.
Circular supply
As part of our ambition to switch to circular sourcing and procurement, we collaborate with suppliers to encourage them to shift to sustainably sourced materials, thus reducing our environmental impact. In 2020 we set an ambitious target that all our direct suppliers should source 100% renewable power by 2030 when supplying us. To achieve this, we will work with our suppliers to help them in this transition to renewable power. Successful conversion among our 60,000 suppliers would result in around 300,000 tonnes of CO2 being eliminated from our direct suppliers each year.

Circular company
We work to reduce our environmental impact across all areas of our operations and transportation. In 2020, total CO2 emissions across our operations and transportation were 170,000 tonnes of CO2, representing a 44% decrease from 2019, due primarily to the implementation of renewable energy projects and impacts on travel from COVID-19.

CO2 emissions from operations includes all production facilities, global office buildings and laboratories. In 2020, CO2 emissions from production were 37,000 tonnes CO2, a reduction of 57% versus 2019, primarily due to the implementation of various renewable energy initiatives. These projects include implementation of renewable heat and steam in Kalundborg, wind power in France, Algeria and Russia, and solar power in the USA. CO2 emissions from office buildings and laboratories were 8,000 tonnes CO2, a decrease of 38% versus 2019, due primarily to energy-saving projects and COVID-19 shut-downs.
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NVO-20201231_G18.JPG

Due to COVID-19, CO2 emissions from business flights were reduced to 19,000 tonnes CO2, a reduction of 71% compared with 2019. During 2021, we will focus on ensuring that emissions from business travel are minimised through the promotion of virtual collaboration with both colleagues and stakeholders. CO2 emissions from our company cars in 2020 were 45,000 tonnes CO2, 27% lower than in 2019, primarily due to fewer in-person meetings and less travel as a result of COVID-19. Novo Nordisk is a member of EV100 and has committed to transitioning to 100% electric company cars by 2030. In 2020, CO2 emissions from product distribution were 61,000 tonnes CO2, a decrease of 24% compared with 2019, due to optimisation projects to move products shipped from air to sea freight.

At the beginning of the year, we achieved our ambition of sourcing 100% renewable power in our global production when a new solar facility went online powering our entire US operations. In the process, we became the first pharmaceutical company in the renewable power initiative, RE100, to do this.



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NVO-20201231_G19.JPG
In 2020, the energy consumption for our operations was 3,191,000 GJ, an increase of 7% compared with 2019, primarily due to a new production site in North Carolina. Energy-saving projects implemented in 2020 within production sites are expected to result in annual savings of 94,000 GJ.

Water consumption at production sites was
3,368,000 cubic meters, an increase of 7% compared with 2019 due to the new production site in North Carolina. Four production sites including China and Brazil are in areas subject to water stress or high seasonal variations. These sites accounted for 11% of the total water consumption in 2020, and water consumption at these sites decreased by 15% in 2020, despite adding new production sites. We will continue to focus on reducing water consumption across these sites.

We are committed to reducing waste and have a target of sending zero production waste to landfill by 2030. In 2020, production sites had a total of 141,000 tonnes of waste, an increase of 14% compared with 2019. This increase was due to increased production in Kalundborg.

93% of waste arising from our production was recycled, converted to biogas or incinerated in waste-to-energy plants. During 2020 less than 1% (1,000 tonnes) of our waste was sent to landfill.
Circular products
We are working to ensure existing and new products are fit for circularity and have developed a circular design guideline within R&D to reduce the environmental footprint of our devices.

As part of Circular for Zero, we are seeking to address the end-of-life challenges associated with many of our medical devices. In late 2020, we initiated a pilot take-back scheme for medical devices in Denmark with the aim of scaling globally in the future. Through recycling our production waste, we have been able to successfully recycle insulin pens, providing materials for the manufacture of lamps and office furniture. We are pursuing greater re-use and recycling of our devices and aspire to achieve this in coming years.


“The Danish Association of Pharmacies is very excited to be part of this important take-back project aiming to reduce the environmental impact from used insulin pens, which consist of valuable materials suitable for recycling. By recycling we avoid the negative climate impact from burning the material as normal waste.”

Birthe Søndergaard, Danish Association of Pharmacies


Read more about our environmental performance in the consolidated ESG statement in this report and on novonordisk.com.
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Purpose and sustainability
Our social responsibility

At Novo Nordisk, it is our ambition to be respected for adding value to society. We aim to achieve this by adding value to the communities we are part of, delivering innovative solutions to patients, and by offering an inclusive, diverse, safe and ethical workplace.

Today, one in every 11 people in the world is living with diabetes, a figure that is projected to rise to one in nine by 2045 if action is not taken1. Diabetes places a great burden on health systems, and we are committed to working with health authorities and other partners to prevent and treat the disease. In 2020 we launched a long-term social responsibility strategy, Defeat Diabetes, to help society rise to one of its biggest challenges. We recognise that we cannot defeat diabetes alone, but we can accelerate our actions to find solutions.

Innovation
Our key contribution is to discover and develop innovative biological medicines and make them accessible to patients throughout the world. In 2020, we reached an estimated total of 32.8 million patients with our Diabetes care products, up 9% from 2019.
NVO-20201231_G21.JPG







1.IDF Diabetes Atlas, 9th edition, 2019
  NVO-20201231_G22.JPG Read more in the section on innovation and therapeutic focus.

Access and affordability
We recognise that affordability of medicines can be a challenge and we know that some people in the US living with diabetes are increasingly finding it hard to pay for their healthcare, including our diabetes medicines. Ensuring access and affordability is a responsibility we share with all involved in healthcare. During 2020, we continued our efforts to help patients in the US struggling to afford their Novo Nordisk insulins through a range of options, including:

Follow-on brands: Unbranded biologic versions of fast-acting (Novolog®) and premix insulin (Novolog® Mix) at a 50% list price discount versus branded versions
My$99Insulin: 30-day supply of a combination of Novo Nordisk insulin products (up to three vials or two packs of pens) for 99 USD for eligible patients
Patient Assistance Program: Free diabetes medication to people in need who meet certain eligibility criteria, including annual household income at or below 400% of government-defined poverty level. Programme expanded during COVID-19
Human insulin: For about 25 USD per vial at national pharmacies, including Walmart and CVS
Immediate Supply Program: A free, one-time, immediate supply of Novo Nordisk insulin (up to 3 vials or 2 packs of pens) to eligible patients at risk of rationing
Co-pay Savings Cards: To help defray high out-of-pocket costs for commercially insured patients.

During 2020, we reached more than one million people through affordability offerings in the US.

We also recognise that there are vulnerable patients in every country and to identify these groups we will initiate vulnerability assessments where we operate, excluding the US where we have already expanded our affordability offerings. We do this to identify how we can improve access to affordable care and capacity building. Based on 21 country assessments made in 2020, we have developed affordability plans in 19 countries.

Vulnerable patient groups include people impacted by humanitarian crises, people living in remote areas or in poorer parts of the world with inefficient healthcare systems and vulnerable population groups, such as children and the elderly.

In 2020, we strengthened our Access to Insulin Commitment by lowering the ceiling price (the maximum price within the commitment) from USD 4 to USD 3 per human insulin vial in 76 countries. This covers Least Developed Countries as defined by the UN, other low-income countries as defined by the World Bank, and middle-income countries in which large low-income populations lack sufficient health coverage, as well as selected humanitarian organisations.






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An estimated 3.2 million people were treated with insulin under this commitment in 2020. In 2020, the average price of insulin sold under this commitment was 2.9 USD per vial, corresponding to 11.6 cents per patient per day. Beyond this commitment, we sold human insulin at or below the ceiling price in other countries, reaching an estimated another 3.1 million people during 2020. Our Access to Insulin Commitment is only one element and it cannot stand alone. Supply chain improvements and capacity building are also important in our efforts to provide access to affordable care to vulnerable patients.

Read more about our Access to Insulin Commitment on novonordisk.com.

To further improve capacity building we extended our Partnering for Change partnership with the International Committee of the Red Cross (ICRC) and the Danish Red Cross (DRC), aimed at improving care for people living with chronic diseases in humanitarian crises and we launched an ambition that no child should die from type 1 diabetes. To achieve this, we expanded our Changing Diabetes in Children programme with the aim of reaching 100,000 children by 2030. In 2020, we enrolled 2,601 additional children. In total, 469 healthcare professionals have been trained, 222 clinics established and 28,296 children across 14 countries have received care as part of the programme since 2009.
Prevention
In addition to the impact on patient lives, diabetes also constitutes one of the biggest societal challenges. To help society rise to this challenge, we focus our efforts within diabetes and obesity prevention where our expertise has the biggest impact. Our aim is to find, pilot and scale effective interventions to prevent diabetes and obesity, starting with early interventions and health inequalities in cities.

Within early interventions, our collaboration with UNICEF to prevent childhood overweight and obesity in Mexico and Colombia is progressing despite COVID-19, and global advocacy on childhood malnutrition continues.

Within health inequality in cities, we have a public-private partnership, Cities Changing Diabetes, which aims to address diabetes prevention and treatment amongst vulnerable populations in urban settings. In 2020, Cities Changing Diabetes reached 36 cities, up from 25 in 2019, spanning five continents and more than a hundred local partners across the public and private sectors.

Donations and other contributions
During 2020 we increased our donations, partly to respond to COVID-19. Selected donations include:
– 165 DKK million to the Antimicrobial Resistance Research (AMR) Action Fund, the largest collective fund ever established to
NVO-20201231_G23.JPG


1. Categorised as an equity investment and therefore not expensed in the income statement
support vital research into antimicrobial resistance research and development1
– 138 DKK million to the World Diabetes Foundation (WDF), including a special one-off contribution of 50 DKK million in 2020
– 20 DKK million to the Novo Nordisk Haemophilia Foundation

Helping society respond to COVID-19
Since the outbreak of COVID-19, additional efforts have been focused on helping society.

In Denmark, where we are headquartered, we supported the Danish healthcare system in increasing national testing capacity and developed a COVID-19 antibody test which is being used by the University of Copenhagen to study the virus.

We offered free insulin for six months to the humanitarian organisations that we normally supply, including UNRWA and the Red Cross Organisations, to support relief efforts in humanitarian settings in low- and middle-income countries.

Employees
We aim to be an attractive employer that offers an inclusive, diverse, safe and ethical working environment in which all employees have equal opportunities to realise their potential.

At the end of 2020, the total number of people employed in Novo Nordisk was 45,323,




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corresponding to 44,723 full-time positions, which is a 5% increase compared with 2019. The growth was mainly driven by International Operations.

Diversity and inclusion
To deliver on our strategic aspirations it is crucial to have an inclusive and diverse organisation at all levels including our Board of Directors. We fundamentally believe that diversity of people and inclusive leadership drive value for Novo Nordisk.

One element of our diversity and inclusion aspiration is to achieve a balanced gender representation at all managerial levels. While several initiatives have been launched to accelerate diversity and inclusion and drive gender balance, there has only been gradual change and we still have room for improvement. The gender distribution amongst managers in 2020 was 59% men and 41% women, compared with 40% women in 2019. In Senior Management1 76% were men and 24% were women in 2020, compared with 18% women in 2019. In our Board of Directors 62% were men and 38% women.

To accelerate diversity and inclusion and ensure accountability for driving progress, all levels throughout the organisation have implemented local action plans during 2020. In addition, in 2020 diversity and inclusion has been anchored in both short- and long-term incentive programmes. The strong stance on diversity and inclusion will continue in 2021 with a focus on realising continuous progress from the local action plans.
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1. Defined as Executive Vice Presidents and Senior Vice Presidents
Human rights and labour
We are committed to fulfilling our responsibility to respect human rights, including labour rights across all our activities and business relationships as a minimum standard of business conduct.

Read more about our Human Rights Commitment on novonordisk.com.

Since 2014, we have been a part of the living wage programme with an external global non-profit business network and consultancy. The objective is to ensure that all our employees are paid a living wage, i.e. adequate to purchase basic goods and services necessary to achieve a basic standard of living, based on calculations of living wages in the countries we operate in. In 2020 we analysed data for 74 countries compared with 12 countries in 2019, and as a result of this analysis an action plan has been implemented.

Read more about our Global Labour Code of Conduct for labour rights on novonordisk.com.

Progress was made in regard to management of salient human rights issues beyond those already addressed by existing global standards and programmes.In 2020, manager and employee human rights training strengthened awareness of these issues, while the training scope covered all human rights and all company operations. In 2020, for patient safety and the right to health, we strove to increase the share of In 2020, for patient safety and the right to health,
we strove to increase the share of affiliates providing safety reporting on local websites to more than 96%. For availability and affordability aspects of the right to health, see progress above.

To mitigate risks of exploitation of human biosamples used in pre-clinical research and ensure respect for donors’ rights to free and informed consent, we implemented a strengthened risk-based due diligence process.

For local manufacturing projects, we implemented enhanced human rights due diligence requirements for all new high-risk business partners. For supply chains, we strengthened the human rights focus of our supplier audits, by updating the auditor toolbox and conducting training with an external expert organisation.

Read more about our due diligence on modern slavery risks on novonordisk.com.

Health and safety and accident reporting
Safety behaviour is part of our company values. In 2020, the average frequency rate of occupational accidents involving absence was 1.3 per million working hours, compared with 2.2 in 2019. In 2020, as in 2019, we had one work-related fatality. We work with a zero-injury mindset and remain committed to continuously improving safety performance.

Read more about our social performance in the consolidated ESG statement in this report and on novonordisk.com




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Purpose and sustainability
Governing
sustainable
business



In Novo Nordisk, sustainability considerations are integrated into our business, decision-making and governance structures. We strive to conduct our business in a responsible manner, in accordance with the Novo Nordisk Way – a set of guiding principles which underpins every decision we make.


Novo Nordisk Way
The Novo Nordisk Way is a set of guiding principles which underpins every decision we make. We use a unique, systematic approach known as facilitation to ensure that everyone lives up to the Novo Nordisk Way. In 2020, 26 facilitations were conducted, down from 32 in 2019 due to COVID-19 travel restrictions. Any issues are addressed locally, and consolidated insights are shared with Executive Management and the Board of Directors. The Novo Nordisk Way also underpins our performance management and incentive programmes.
The Novo Nordisk Way states that we treat everyone with respect, meaning there is no acceptance of discrimination nor harassment. We have processes in place to encourage the reporting of any discrimination, harassment or retaliation, including an anonymous reporting hotline. We encourage all managers and employees to have an open dialogue on the matter.

Company trust
The level of trust in Novo Nordisk among key stakeholders – people with diabetes, general practitioners and diabetes specialists – is an indicator of the extent to which we are living up to stakeholders’ expectations.

Our trust score, measured on a scale of 0-100, increased to 80.6 in 2020 from 78.2 in 2019. The increase was the most significant improvement in a trust score in the pharmaceutical industry in 2020.

Business ethics
Our approach to business ethics is about acting with integrity and in compliance with the Novo Nordisk Way, our Business Ethics Code of Conduct and international and local standards for responsible business conduct. Business ethics covers anti-bribery and anti-corruption, data protection and human rights with the aim of minimising any potential risks to our business, people and society.

Annual training in business ethics is mandatory for all employees, including all new hires. In 2020, 99% of employees completed and documented
Novo Nordisk Essentials, part of the Novo Nordisk Way


1 We create value by having a patient centred business approach.

2 We set ambitious goals and strive for excellence.

3 We are accountable for our financial, environmental and social performance.

4 We provide innovation to the benefit of our stakeholders.

5 We build and maintain good relations with our key stakeholders.

5 We treat everyone with respect.

6 We focus on personal performance and development.

7 We have a healthy and engaging working environment.

8 We strive for agility and simplicity in everything we do.

9 We never compromise on quality and business ethics.
their training, with the remaining 1% missing mainly due to employees being on leave. In 2020, 32 business ethics reviews were completed with 107 findings, compared with 34 reviews with 87 findings in 2019. Consolidated findings are reported to our Executive Management and the Audit Committee.

During COVID-19, all audits outside Denmark were conducted virtually. Despite the changed approach for 2020, Group Internal Audit assesses that the level of business ethics compliance is sound. Management action plans and closure of findings progressed as planned, and there were no overdue management actions or findings at the end of the year.

In 2020, we started developing data ethics principles and will implement these principles to ensure responsible and sustainable use of data. Furthermore, data protection and human rights risks were integrated into the global business ethics risk reporting process in 2020.

Product quality and supplier audits
In 2020, as in 2019, there were no failed inspections among those resolved at year-end. During the year, 77 inspections were conducted, compared with 66 in 2019. At year-end, 59 inspections were passed and 18 were unresolved, as final inspection reports had not been received or the final authority acceptance was pending. Follow-up on unresolved inspections continues in 2021.




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In 2020, a total of 177 supplier audits were conducted to assess compliance levels with our supplier standards. One critical finding was issued related to quality audits regarding handling of controlled waste. A follow-up audit has since been conducted, where the finding was found to have been closed satisfactorily.

In 2020, we had no product recalls from the market, compared with four in 2019.

Corporate governance
As a foundation-owned company, being a sustainable business is integrated into our ownership structure. Our foundation ownership supports the overarching imperative to be both commercially successful and responsive to the wider needs of society. The fact that we have a combination of foundation ownerships and stock listing enables us to embark on long-term strategies while maintaining short-term transparency on performance.

The objective of the Novo Nordisk Foundation is to provide a stable basis for the commercial and research activities of Novo Nordisk and support broader scientific, humanitarian and social purposes.

In addition to managing our business, our governing bodies set direction and ensure that sustainability is implemented in
business decisions. In line with that, two consistent priorities were high on the Board’s agenda in 2020, namely scientific innovation and sustainability – both of which are vital to the future of the company.
NVO-20201231_G22.JPG Read more about our corporate governance in the corporate governance section of this report.

Remuneration
The variable remuneration of executives is designed to promote performance in line with the company’s strategy, purpose and ambition to be a sustainable business.
NVO-20201231_G22.JPG Read more about the remuneration of our executives in the corporate governance section of this report.

Sustainable tax approach
Our overall guiding principle within tax is to have a sustainable tax approach (tax policy), emphasising our commercial approach to managing the impact of taxes while remaining true to our values of operating our business in a responsible and transparent manner. This means that we pay tax where value is generated and are always respecting international and domestic tax rules.

As a global business, we conduct cross-border trading, which is subject to transfer
NVO-20201231_G25.JPG
pricing regulations. We apply a 'Principal structure' in line with OECD principles, meaning all legal entities perform their functions on contract on behalf of the principals and are allocated an activity-based profit according to a benchmarked profit margin. The tax outcome of this operational model is reflected in the overview below, which shows our corporate income taxes by region. To ensure alignment between taxing authorities about the allocation of profit between our entities, we have Advance Pricing Agreements in place for geographies representing more than 65% of our revenue worldwide.

Our sustainable tax approach has been approved by the Board of Directors. Read more about our sustainable tax approach on novonordisk.com.

In addition to corporate income taxes, we also pay other taxes. Please refer to 'total tax contribution' in the ESG statement.
Corporate income taxes by region - three year average
NVO-20201231_G26.JPG Share of category
Region
Intellectual property rights1
Production2
Sales3
Corporate income taxes (DKK billion)
International Operations
NVO-20201231_G27.JPG
NVO-20201231_G28.JPG
NVO-20201231_G29.JPG
8.4
– Denmark
NVO-20201231_G30.JPG
NVO-20201231_G31.JPG
NVO-20201231_G32.JPG
7.2
– EMEA (excluding Denmark)
NVO-20201231_G33.JPG
NVO-20201231_G34.JPG
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0.9
– China
NVO-20201231_G35.JPG
NVO-20201231_G36.JPG
NVO-20201231_G37.JPG
0.2
– Rest of World
NVO-20201231_G35.JPG
NVO-20201231_G38.JPG
NVO-20201231_G37.JPG
0.1
North America Operations
NVO-20201231_G35.JPG
NVO-20201231_G39.JPG
NVO-20201231_G40.JPG
1.5
– Of which the US
NVO-20201231_G35.JPG
NVO-20201231_G39.JPG
NVO-20201231_G41.JPG
1.4
Total 9.9
1. Intellectual property rights based on sales from where intellectual property rights are located
2. Production based on production employees in the region
3. Sales based on the location of the customer



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Financial and ESG assurance
Our financial reporting and the internal controls of financial reporting processes are audited by an independent audit firm elected at the Annual General Meeting. As part of our ESG responsibility, we voluntarily include an assurance report from an independent external auditor for ESG reporting in the annual report. The assurance provider reviews whether the ESG performance information covers aspects that are deemed to be material and verifies the internal control processes for the information reported.

Our internal audit function provides independent and objective assurance, primarily within internal control of financial processes, IT security and business ethics. To ensure that the internal financial audit function operates independently of Executive Management, its charter, audit plan and budget are approved by the Audit Committee. The Audit Committee must approve the appointment, remuneration and dismissal of the head of the internal audit function.
NVO-20201231_G22.JPG Read more about our corporate governance in the corporate governance section of this report.

Materiality
We have a robust materiality process in place where material issues are determined and reassessed on an annual basis by management.

The three most material risk factors that can impact our ability to create value over time are defined by management as:
– Product quality and patient safety

NVO-20201231_G42.JPG
Product quality and patient safety
Progress in the R&D pipeline and regulatory approval
Pricing and market access environment
NVO-20201231_G22.JPG Read more in the risk management section of this report.

Sustainability standards and performance
We strive to report on our ESG performance in accordance with relevant disclosure standards.
One of these is the Taskforce on Climate-related Financial Disclosures (TCFD). Here we take a stepwise approach to incorporate material climate-related disclosures into our annual report. A summary of how we address the risks related to climate change can be found at our website and in our CDP disclosure report. As recommended by TCFD, we are integrating climate change scenarios of 2⁰C scenario, consistent with meeting the Paris Agreement Goal (Representative Concentration Pathway ‘RCP 2.6’) and 4⁰C scenario as an alternative high emission scenario (RCP 8.5) RCP to identify short-, medium- and long-term risks within our production and supply chain to ensure a steady supply of medicine to patients.

We strive to adhere to the disclosures of the Social Accountability Standards Board (SASB) which apply to our industry. We do this to demonstrate our commitment to being transparent and accountable for how we operate. We are fully or partially aligned to 20 of 25 metrics. In 2021 we will further assess our adherence and disclosure.
We adhere to international standards, commitments and recommendations, including those outlined below:

– Access to Medicines Index
– CDP
– Sustainability Accounting Standards Board
– Task Force on Climate-Related Financial Disclosures
– UK Bribery Act
– UK Modern Slavery Act
– UN Global Compact Ten Principles
– Guiding Principles on Business and Human Rights
– UN Political Declaration on Universal Health Coverage
– UN Sustainable Development Goals
– US Foreign Corrupt Practices Act
NVO-20201231_G43.JPG For more information, see
      novonordisk.com.
For the United Nations Sustainable Development Goals (SDGs), we focus our efforts on Goal 3, 'health' and Goal 12, 'responsible consumption and production', as this is where we believe we can maximise our positive impact on the SDGs.

Read more about our sustainability governance in the consolidated ESG statement in this report and on novonordisk.com.



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Innovation and therapeutic focus
Prioritising a pipeline of hope for serious chronic diseases


2025 strategic aspirations
      NVO-20201231_G44.JPG Innovation and
                therapeutic focus

– Further raise the innovation bar for diabetes treatment
– Develop a leading portfolio of superior treatment solutions for obesity
– Strengthen and progress the Biopharm pipeline
– Establish presence in other serious chronic diseases focusing on cardiovascular disease, NASH and chronic kidney disease






















For almost a century, Novo Nordisk has pioneered scientific breakthroughs within serious chronic diseases. To ensure that we continue to deliver value to society, we are pursuing even higher levels of innovation, across more therapy areas and technology platforms and with more patients and partners than at any point in our history.

Discovering ways to treat serious chronic diseases has never been more important. The COVID-19 pandemic has highlighted the vulnerability of hundreds of millions of people with diabetes, obesity and other serious
chronic diseases, underlining the urgency of addressing their unmet medical needs.

We are rising to the challenge by building on a successful track record in diabetes to pursue innovative approaches to fighting obesity and other serious chronic diseases, as well as expanding our therapy area focus. These approaches will rely not only on our cutting-edge protein and peptide engineering, but on novel technology platforms including oral delivery of biologics, stem cells, RNA interference (RNAi) and gene editing to further advance our innovative pipeline for long-term success.

Shifting gears for future growth
Our Research & Development (R&D) strategy is driven by targeted investment in novel products and technology platforms, resulting in higher levels of innovation across more therapy areas and with more external partners than at any point in our near 100-year history. In an increasingly competitive biopharmaceutical industry, this gear-shift is imperative to ensure that we retain a leading scientific position in the disruptive innovations that are set to transform medicine in the 21st century.

Over the past decade, on average we have developed one novel product each year and our business has grown strongly. To secure future growth platforms, we expect to increase our R&D investments in near- and mid-term opportunities. By building on our
NVO-20201231_G45.JPG
core capabilities including our clinical trial expertise, large scale protein manufacturing base and commercial excellence, we strive to enable more products to be launched in future years.

In 2020 we had more than 43,500 patients participating in our clinical phase one to four trials – more than at any point in our history. And, despite the disruption caused to society and healthcare systems by COVID-19, we safely maintained continuity of key clinical trials through remote monitoring of patients and by distributing trial products directly to them rather than via study sites where possible.

Significant regulatory milestones in the past year included European and Japanese approvals for Rybelsus® – the first



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commercially available GLP-1 based medicine in a tablet – strengthening our leadership position in diabetes. The once-daily treatment represents a major technological advance for people living with type 2 diabetes and is now available in nine markets.

Raising the bar in diabetes research
With the number of people living with diabetes projected to increase from 463 million today to 700 million in 20451, there remains an urgent need to find innovative and more convenient treatments. This includes novel forms of insulin, a molecule discovered 100 years ago in 1921. One such candidate is insulin icodec, which during 2020 was seen to be effective and well-tolerated in phase 2 trials. This once-weekly insulin might one day offer patients far fewer injections than the current option of once- or twice-daily basal insulins.

Within GLP-1s we are building on our legacy by developing mono- and combination therapies that deliver higher efficacy and improved outcomes by demonstrating benefits on diabetes comorbidities.

However, our efforts within diabetes research do not stop there. In late 2020, we initiated a phase 1 trial to establish the safety of a glucose-sensitive insulin candidate. We hope that such a treatment might one day mimic the body’s own, naturally occurring insulin by sensing and responding to blood sugar levels in the body. Furthermore, together with
Massachusetts Institute of Technology, we are continuing to progress the development of systems enabling the oral delivery of macromolecules, including the tortoise shell-inspired, self-orienting oral device 'SOMA', with the ultimate ambition of one day delivering insulin in a tablet.

Shaping the future of obesity treatment
We are also playing a leading role in discovering new treatments for obesity, which is still not universally recognised as a serious chronic and progressive disease. This is despite the fact that people with obesity face a range of other health risks, from cancer, type 2 diabetes and heart disease to severe illness or complications from COVID-19. Among significant progress made in the past year was the phase 3 clinical trial programme STEP (Semaglutide Treatment Effect in People with obesity), in which our GLP-1 once weekly injectable semaglutide 2.4 mg demonstrated average weight loss of 17%-18% over 68 weeks in subjects with obesity without diabetes, when using a trial product estimand (15%-17% weight loss reported when using a treatment policy estimand). By leveraging GLP-1 semaglutide treatment we hope to maximise the ability of people with obesity to achieve and maintain substantial weight loss. Our aspiration is to close the gap between current pharmacological treatment options and bariatric surgery by using combination therapies based on our peptide innovation.

NVO-20201231_G46.JPG

1. IDF Diabetes Atlas, 9th edition, 2019


Semaglutide – also the active ingredient in Rybelsus® and Ozempic® – exemplifies an important trend in medicine in the form of a more holistic approach to cardiometabolic diseases. The close association between type 2 diabetes, obesity, cardiovascular disease, chronic kidney disease and non-alcoholic steatohepatitis (NASH) means that the classical siloed approach to treating disease symptoms one by one is breaking down and that a molecule like semaglutide can potentially target a number of different therapeutic areas.

Other serious chronic diseases
As a result, semaglutide is becoming a pipeline of opportunities within a single molecule. In addition to the results seen with semaglutide in diabetes and obesity, a recent phase 2 trial involving patients with NASH showed that treatment with semaglutide resulted in a significantly higher percentage of patients achieving NASH resolution compared to placebo and could potentially play a key role in preventing disease progression. Furthermore, early-stage research supports investigating semaglutide as treatment for early Alzheimer's disease. A pivotal phase 3 programme with oral semaglutide will be initiated in the first half of 2021. But, while such a molecule is every scientist's dream, our long-term innovation for the benefit of patients must go beyond semaglutide.




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It is with this ambition that we are branching into areas of medicine that build upon our core capabilities. In cardiovascular therapy, this includes several approaches, including an anti-IL6 monoclonal antibody and a PCSK9 peptide-based inhibitor, the latter of which would provide an alternative to existing forms of powerful cholesterol-lowering therapy. This molecule has just completed phase 1 studies.

Harnessing external innovation
The acquisition in 2020 of US-based biotech company Corvidia Therapeutics further strengthens our pipeline by introducing the anti-IL-6 monoclonal antibody, ziltivekimab, which has shown encouraging results in phase 2 on inflammatory biomarkers in patients with atherosclerotic cardiovascular disease and chronic kidney disease.

Strategic investments of this nature reflect our ambition to establish a leading presence in new adjacent therapy areas – just as we do within diabetes, obesity, haemophilia and growth disorders. During 2020, we also acquired Emisphere Technologies, and with it proprietary technologies that enable the oral formulation of therapeutics – including the Eligen® SNAC technology found in Rybelsus®.

By continuing to work with a growing number of external partners and investing in novel technology platforms – including stem cell research, RNA-interfering (RNAi) therapeutics and gene editing – we aim to deliver innovation across a broader range of serious chronic diseases than ever before. These technologies are revolutionising what is possible in medicine and they will power the disruptive innovations of the future.

Progressing the Biopharm pipeline
External innovation is also playing an important role in the evolution of our Biopharm business, a speciality care unit that encompasses treatments for rare blood and rare endocrine disorders, where unmet need remains high. Our pipeline includes Mim8 – a next generation treatment for haemophilia A, concizumab for the treatment of haemophilia A or B and once-weekly somapacitan for growth-related disorders. However, we are also collaborating with bluebird bio, which is pioneering the development of next-generation in vivo genome editing treatments for genetic diseases, including haemophilia.

Looking to the future
Our investment in stem cell-based, regenerative therapies lays the foundation for additional expansion into new areas such as Parkinson’s disease, dry age-related macular degeneration and chronic heart failure. Not to mention stem cell-based therapies potentially offering a path to curing type 1 diabetes – an aspiration at the heart of our purpose to defeat diabetes and other serious chronic diseases.

One thing common to our entire innovation strategy is a drive to maximise the potential of data and digital technology – spaces that we invested in throughout 2020 via recruitment and external collaboration. It is increasingly clear that excellence in digital science, just as much as expertise in biology, will be vital for success in biopharmaceutical R&D in the 21st century, as advances in analytics and real-world evidence move data-driven discovery to centre-stage in the hunt for new medicines.
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Innovation and therapeutic focus
Research and development
Diabetes

Regulatory events
– The oral glucagon-like peptide 1 (GLP-1) analogue in a tablet, Rybelsus®, was granted market authorisation in the EU and Japan for treatment of adults with type 2 diabetes (T2D).
– In China, a label expansion for Victoza® was approved to include a cardiovascular (CV) indication based on LEADER. Furthermore, new drug applications (NDAs) were submitted to China’s National Medicinal Products Administration for semaglutide and the insulin degludec/liraglutide combination.

Clinical progress
– The phase 3b trial, SUSTAIN FORTE, completed successfully, demonstrating superior reduction in HbA1c for 2.0 mg semaglutide compared with 1.0 mg semaglutide when administered once-weekly subcutaneously (sc) in people with T2D in need of treatment intensification1.
– A phase 3b trial was initiated, investigating the effects of sc semaglutide in people with T2D and peripheral artery disease.
– A phase 3b trial was initiated with high dose oral sema- glutide, 25 and 50 mg, in people with T2D in H1 2021.
– Phase 2 trials with the once-weekly basal insulin ana- logue, insulin icodec, were successfully completed and the phase 3a trial programme, ONWARDS, was initiated.
– Phase 1 trials for icosema and insulin 965 were successfully completed.
– The first human dose trials were initiated for glucose- sensitive insulin, once-weekly combination sema-GIP and a DNA immunotherapy for T1D.
Obesity

Regulatory events
– An NDA for once-weekly sc semaglutide 2.4 mg for weight management in adults with obesity was filed with the FDA utilising a priority review voucher. A marketing authorisation application for semaglutide 2.4 mg obesity was submitted to the European Medicines Agency
– The submissions are based on the results from the STEP phase 3a clinical trial programme, which included more than 4,500 adults with obesity or overweight. Across the STEP programme, people with obesity treated with once-weekly semaglutide 2.4 mg achieved a statistically significant and greater reduction in body weight compared to placebo. Across the trials in people without diabetes, STEP 1, 3 and 4, a weight loss of 17%-18% was reported for people treated with semaglutide 2.4 mg, when using a trial product estimand (15%-17% weight loss reported when using a treatment policy estimand).
– Saxenda® was granted a label expansion to include the use in adolescents (aged 12 to <18 years) with obesity or overweight in the US.

Clinical progress
– Novo Nordisk announced successful headline results from two clinical trials with the once-weekly sc amylin analogue (AM833). Encouraging results were obtained in a phase 2 AM833 monotherapy trial and a phase 1b combination trial of AM833 and once- weekly semaglutide 2.4 mg.
Biopharm

Regulatory events
– The once-weekly growth hormone derivative, somapacitan, was approved under the brand name Sogroya® for treatment of adult growth hormone deficiency (AGHD) in the US and Japan. Positive Committee for Medicinal Products for Human Use (CHMP) opinion for Sogroya® for AGHD was granted in Europe.

Clinical progress
– The phase 2 proof-of-concept study (Explorer 4) with concizumab in haemophilia patients with inhibitors completed successfully. The halted phase 3 programme (Explorer 6, 7 and 8) was reinitiated,completed successfully. The halted phase 3 programme (Explorer 6, 7 and 8) was reinitiated,investigating sc concizumab prophylaxis treatment in haemophilia A and B patients regardless of inhibitor status
– The combined phase 1/2 trial was initiated for Mim8, a next-generation factor VIII mimetic bispecific antibody for sc prophylaxis in haemophilia A patients regardless of inhibitor status . After successful single-dose administration (phase 1), Mim8 entered multiple-dose administration (phase 2).
– A phase 1 trial for EPI-01 in sickle cell disease completed successfully.
Other serious chronic diseases

Clinical progress

– The phase 2 trial investigating daily, sc semaglutide in non-alcoholic steatohepatitis (NASH) was completed successfully and semaglutide was granted break- through therapy designation in the US. Phase 3a initiation of semaglutide in NASH will be initiated in 2021.
– Novo Nordisk and Gilead Sciences presented results from a phase 2 proof-of-concept trial in NASH . The five-arm trial evaluated combinations of semaglutide with Gilead’s FXR agonist, cilofexor, and/or ACC inhibitor, firsocostat in people with NASH.
– Novo Nordisk acquired Corvidia Therapeutics Inc., with the lead compound ziltivekimab in late-stage clinical development. Ziltivekimab is a fully human monoclonal antibody directed against interleukin-6 (IL-6). Following the acquisition, the phase 2b trial with ziltivekimab was successfully completed. Ziltivekimab showed reduction in markers of inflammation compared to placebo in a chronic kidney disease patient population with atherosclerotic CV disease and inflammation. A phase 3 CV outcomes trial is expected to be initiated in 2021.
– Positive phase 1 results were reported for the PCSK9i mimetic peptide showing long-lasting LDL-cholesterol lowering effect.
1.As add-on to metformin and/or sulfonylureas
Note: Details on clinical trials can be found in company announcements and press releases published by Novo Nordisk during 2020, available at novonordisk.com



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Innovation and therapeutic focus
Pipeline overview


Diabetes care Biopharm
Project Indication Description Phase Project Indication Description Phase
Semaglutide 2.0 mg
NN9535
Type 2 diabetes A long-acting GLP-1 analogue for once-weekly treatment.
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Sogroya®
NN8640
Adult GHD1
A long-acting HGH2 derivative intended for
once-weekly subcutaneous administration in adults.
NVO-20201231_G49.JPG
Oral semaglutide HD NN9924
Type 2 diabetes A long-acting oral GLP-1 analogue, 25 and 50 mg, intended for once-daily oral treatment.
NVO-20201231_G50.JPG
Somapacitan
NN8640
GHD1
A long-acting HGH2 analogue intended for once-weekly subcutaneous administration in children.
NVO-20201231_G51.JPG
Icodec
NN1436
Type 1 and 2 diabetes A long-acting basal insulin analogue intended for once-weekly treatment.
NVO-20201231_G50.JPG
Concizumab
NN7415
Haemophilia A and B w/wo inhibitors A monoclonal antibody against tissue factor pathway inhibitor intended for subcutaneous prophylaxis treatment.
NVO-20201231_G51.JPG
Insulin 965
NN1965
Type 1 and
2 diabetes
A novel basal insulin analogue intended for once-daily treatment.
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Macrilen™
EX2020
GHD1
An oral diagnostic agent used for the diagnosis of
GHD in adolescents and children.
NVO-20201231_G53.JPG
Icosema
NN1535
Type 2 diabetes A combination of GLP-1 analogue semaglutide
and insulin icodec intended for once-weekly treatment.
NVO-20201231_G52.JPG
Mim8
NN7769
Haemophilia A with or without inhibitors A next generation FVIII mimetic bispecific antibody
for subcutaneous prophylaxis of haemophilia A regardless of inhibitor status.
NVO-20201231_G53.JPG
FDC Sema – OW GIP
NN9389
Type 2 diabetes A combination of semaglutide and novel GIP
intended for once-weekly treatment.
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Eclipse
NN7533
Sickle cell disease An oral combination treatment of sickle cell disease
and beta thalassaemia. Project is developed in collaboration with EpiDestiny.
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Glucose-sensitive insulin
NN1845
Type 1 and
2 diabetes
A glucose-sensitive insulin analogue intended for once-daily treatment.
NVO-20201231_G52.JPG
Other serious chronic diseases
Ideal Pump Insulin
NN1471
Type 1 diabetes A novel insulin analogue ideal for use in a closed loop pump device as delivery.
NVO-20201231_G52.JPG
Semaglutide
NN9931
NASH3
A long-acting GLP-1 analogue for once-weekly treatment of NASH3
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DNA Immunotherapy
NN9041
Type 1 diabetes A novel plasmid encoding pre- and pro-insulin intended for preservation of beta cell function.
NVO-20201231_G52.JPG
Ziltivekimab
NN6018
CVD4
A novel once-monthly monoclonal antibody intended for inhibition of IL-6 activity.
NVO-20201231_G55.JPG
Obesity care
PCSK9i peptide
NN6434
CVD4
A long-acting PCSK9 inhibitor for subcutaneous treatment.
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Semaglutide 2.4 mg
NN9536
Obesity A long-acting GLP-1 analogue intended for once-weekly treatment.
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Anti-ApoC3
NN5058
CVD4
A novel monoclonal antibody intended for
inhibition of ApoCIII activity. Project is developed in collaboration with STATEN.
NVO-20201231_G56.JPG
AM833
NN9838
Obesity A novel long-acting amylin analogue intended for once-weekly treatment.
NVO-20201231_G58.JPG
1.GHD: Growth hormone deficiency 2. HGH: Human growth hormone 3. NASH: Non-alcoholic steatohepatitis
4.CVD: Cardiovascular disease
AM833 + semaglutide
NN9838
Obesity A combination of amylin analogue and GLP-1 analogue semaglutide intended for once-weekly treatment.
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LA-GDF15
NN9215
Obesity A long-acting GDF15 analogue intended for appetite regulation leading to weight loss.
NVO-20201231_G59.JPG
PYY1875
NN9775
Obesity A novel analogue of the appetite-regulating hormone, PYY, intended for once-weekly treatment.
NVO-20201231_G59.JPG

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Innovation and therapeutic focus
Patent status for marketed products




The patent expiry dates for the products are shown in the table on the right. The dates provided are for expiry in the US, China, Japan and Germany of patents on the active ingredient, unless otherwise indicated, and include extensions of patent term, when applicable. For several products, in addition to the active ingredient patent, Novo Nordisk holds other patents on manufacturing processes, formulations or uses that may be relevant for exclusivity beyond the expiration of the active ingredient patent. Furthermore, regulatory data protection and/or orphan exclusivity may apply.
Diabetes:
Key marketed products in main markets (active ingredients) US China Japan Germany
Human insulin Expired Expired Expired Expired
NovoRapid® (NovoLog®)
Expired Expired Expired Expired
NovoMix® 30 (NovoLog® Mix 70/30)
Expired Expired Expired Expired
NovoNorm® (Prandin®)
Expired Expired Expired Expired
Levemir®
Expired Expired Expired Expired
Victoza®
2023 Expired 2022 2023
Tresiba®
2029 2024 2027 2028
Ryzodeg®
2029 2024
20242
2028
Xultophy®
2029 2024
20242
2028
Fiasp®
(2030)3
(2030)3
(2030)3
(2030)3
Ozempic®
20321
2026
20311
2031
Rybelsus®
20321,7
20267
20311,7
2031
Obesity:
Saxenda®
2023 Expired Expired 2023
Biopharm:
Norditropin® (Norditropin® SimpleXx®)
Expired Expired Expired Expired
Sogroya®
20341
2031
20361
20351
MacrilenTM
20278
N/A N/A N/A
NovoSeven®
Expired4
Expired4
Expired4
Expired4
NovoEight®
N/A N/A N/A N/A
NovoThirteen® (TRETTEN®)
2021 N/A Expired Expired
Refixia® (REBINYN®)
20281
2022
20271
20271
Esperoct®
20321
2029
20341
2034 1
Vagifem® 10 mcg
20225,6
N/A
20215
N/A
1. Current estimate. 2. Patent term extension until 2027 may apply. 3. Formulation patent; active ingredient patent has expired. 4. Room temperature-stable formulation patent until 2023 in China, Japan and Germany and until 2025 in the US. 5. Patent covers low-dose treatment regimen. 6. Licensed to several generic manufacturers from October 2016. 7. Tablet formulation and once-daily treatment regimen are protected by additional patents expiring in 2031-2034. 8. Protects method of use and kits of parts.









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Commercial execution
Delivering innovation to patients in the face of a pandemic


Around the world, the number of people living with diabetes and other serious chronic diseases is growing fast and the need to supply improved treatments is critical. But ensuring that life-saving medicines reach all those who require them – from Stockholm to Shanghai and New York to Nigeria – has demanded new ways of doing business in 2020 as the COVID-19 pandemic has disrupted societies and economies.

Despite the challenging backdrop provided by the COVID-19 pandemic, our commercial teams around the world have remained committed to delivering innovation to patients. By harnessing the power of digital technologies, they have shown it is possible to continue to grow market share and execute on key new product launches, while meeting the needs of our patients and customers. This includes the successful roll- out of Rybelsus®, our GLP-1 based medicine in a tablet. As a result, we remain on track to reach our goal of a global diabetes value market share of more than one third by 2025, after expanding our value market share by 0.7 percentage points to 29.3% in 2020. Obesity treatment sales were impacted by the COVID-19
pandemic in 2020 but are also on course to double from 2019 to 2025, while the Biopharm division is building a platform for sustainable growth.

A victory for agility
Our ability to maintain effective commercial operations during these exceptional times reflects our willingness to pursue new, simpler, agile ways of working. Even before the pandemic hit, we were already adopting strategies to address the opportunity presented by the rise of digitisation in healthcare and the challenge of ensuring the affordability of our medicines. The effect of COVID-19 has been to push the 'fast-forward' button on all these key activities, inspiring colleagues to adapt and evolve business practices faster than ever in 2020.

The crisis underscores the importance of increasing our efforts in prevention and disease management for people with diabetes and obesity, as they are subject to an increased risk of severe symptoms and outcomes from COVID-19. With millions of patients depending on us, failing to meet their needs is simply not an option.

Embracing virtual interactions
Across the pharmaceutical industry the pandemic has created an unprecedented commercial environment in which traditional ways of delivering medical innovations could no longer continue. Face-to-face contacts – whether between patients and doctors or companies and customers – became almost impossible in many countries for significant periods of 2020. This challenged some parts of our business, especially in the dynamic section of the market as fewer patients could be initiated onto new treatments in the face of widespread lockdowns and follow-up clinic visits were delayed.

But we quickly adapted to the new ways of communicating, by transitioning to virtual interactions with healthcare professionals and customers. As well as a far greater degree of virtual interactions, this involved making the majority of our commercial materials digital and shifting group presentations into a virtual setting – a particularly popular approach in China. We also moved our line-up of expert educational events to digital platforms, running a significant proportion of these virtually in 2020.

This line-up of changes dovetailed with a dramatic rise in the use of telemedicine across primary and some secondary care in key markets including the USA and the UK, as well as the transition of international medical congresses from physical to virtual platforms. Fortunately, the inability to run physical congresses allowed many more healthcare professionals who would not normally attend in person to participate remotely and learn about the latest developments in their field.

2025 strategic aspiration

     NVO-20201231_G61.JPG Commercial execution

– Strengthen diabetes leadership – aim at a
global value market share of 1/3
– Strengthen obesity leadership and double 2019 reported sales
– Secure a sustained growth outlook for Biopharm



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the Medicare Part D Coverage Gap legislation. Measured by volume, we continue to be the world’s leading provider of insulin.

Around the globe, the insulin market is becoming increasingly competitive, and we are adapting our commercial approach according to the needs of different markets. Despite the challenges, one of our core strengths is a broad portfolio of products at different price points – from human insulin in glass vials to the newer insulins, such as Tresiba® and Ryzodeg®, offered in FlexTouch® pre-filled pens. We are also adapting packaging to the needs of different markets, for example by offering smaller pack sizes in out-of-pocket markets such as in India, where some customers struggle to afford monthly or quarterly purchases of their medicines.

We also know some people are struggling to afford their insulin in the US as well, and offer patients a range of options to help. We invested in raising awareness of Novocare®, which provides patient affordability and access support, to ensure that during a period of financial hardship and increased unemployment, patients are aware of the options available – including our Patient Assistance Program, which offered a free 90-day supply of insulin for eligible patients who lost healthcare coverage due to COVID-19.
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Source IQVIA data
A leading portfolio of diabetes medicines
In diabetes, 2020 was a breakthrough year for our latest GLP-1 products, with Ozempic®, our once weekly injectable, now launched in 52 countries around the world and Rybelsus®, our semaglutide-based oral medicine, now launched in nine countries around the world. Overall sales of GLP-1 products for type 2 diabetes (Victoza®, Ozempic® and Rybelsus®) increased by 25.9% in Danish kroner and by 28.7% in constant exchange rates.

GLP-1 therapies are now helping millions of people to manage their disease, and the segment’s value share of the total diabetes market has grown to 50.4% compared with 47.5% a year ago. The GLP-1 story shows how we are continuing to deliver meaningful advances for patients, despite having been in diabetes for nearly a century.

Insulin sales across global markets were mixed, with growth across International Operations being offset by declining sales in the USA due to lower realised prices following higher rebates, launches of affordability programmes and changes in
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1. WHO, Obesity and overweight, fact sheet, 2020
2. Lancet, Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults (2017)
3. Population covers people with a BMI at or above 35 and with cardiovascular risk

Leading the way in obesity
Obesity is a serious chronic disease that is closely linked to type 2 diabetes and which also poses a range of other health risks – from cancer and heart disease to severe outcomes from COVID-19. Our ambition is to ensure that it is widely recognised as such and to offer medical treatment to help effective management of the disease. It has been encouraging to see more governments – including Italy, Germany, the UK and Switzerland – taking steps during 2020 to recognise and address obesity as a chronic disease. But there is still more to be done to raise awareness and to fight the stigma and bias associated with obesity.

Sales of Saxenda® increased by 3.3% in constant exchange rates, while declining by 1.3% in Danish kroner in 2020. Sales growth was negatively impacted by COVID-19 as fewer patients initiated treatment. In October 2020 the United Kingdom’s National Institute for Health and Care Excellence (NICE) recommended Saxenda® for certain people with obesity3; however, it is often not reimbursed and is paid for out of pocket by patients. In countries such as Brazil, Saudi Arabia and South Korea, fewer Saxenda® prescriptions were filled due to patients cutting personal spending as the COVID-19 pandemic took hold. In the US, meanwhile, growth was negatively impacted by a significant drop in doctor visits and fewer patients initiating treatment.
Nonetheless, we remain confident in the difference we can make for people with obesity and we are well-placed to serve a growing demand as we aspire to transition from a single-product obesity offering to a portfolio of therapies in the future. In the near term, this is expected to be driven by semaglutide, 2.4 mg, which has proven effective in clinical trials, demonstrating weight loss of 17%-18% in subject with obesity without diabetes, when using a trial product estimand (15%-17% weight loss reported when using a treatment policy estimand), and thus showing potential as a transformative treatment for obesity.



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Building in Biopharm
Sales of Biopharm products increased by 0.7% in constant exchange rates and declined 1.3% in Danish kroner. The growth as measured in constant exchange rates is following increasing demand for our growth hormone Norditropin®, due in part to supply challenges for competing products in some countries. Our haemophilia medicine NovoSeven®, however, experienced weaker sales, partly as a result of reduced elective surgeries and bleeds during COVID-19 lockdowns. This was offset to some extent by the successful roll-out of the new haemophilia treatments Esperoct® and Refixia®.



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Financials
2020 performance and 2021 outlook

Financial performance
Sales increased by 4% measured in Danish kroner and by 7% at CER to DKK 126,946 million in 2020. Sales growth was negatively impacted by COVID-19, driven by fewer patients initiating treatment. Novo Nordisk’s 2020 sales and operating profit performance measured at constant exchange rates (CER) were within the ranges provided in October 2020. The effective tax rate, capital expenditure as well depreciation, amortisiation and impairment loses were all broadly in line with the guidance. The free cash flow subceeded the range provided in October 2020 reflecting the acquisitions of Emisphere Technologies Inc. in the fourth quarter of 2020.

Geographic sales development
Sales in International Operations increased by 7% measured in Danish kroner and by 10% at CER. Sales growth was driven by all geographical areas. Sales in EMEA increased by 6% measured in Danish kroner and by 9% at CER. Sales in Region China increased by 10% measured in Danish kroner and by 11% at CER. Sales in Rest of World increased by 6% measured in Danish kroner and by 12% at CER.

Sales in North America Operations increased by 1% measured in Danish kroner and by 3% at CER. In 2020, 48% of US sales came from products launched after 2015, with the aspiration to reach 70% by 2022.

Sales development across therapeutic areas
Diabetes care sales growth of 8% (CER), Obesity care sales growth of 3% (CER) and Biopharm sales growth of 1% (CER).

Diabetes and Obesity care
Diabetes care, sales development
Sales in Diabetes care increased by 5% measured in Danish kroner and by 8% at CER to DKK 102,412 million driven by GLP-1 growth. Novo Nordisk has improved the global diabetes value market share over the last 12 months from 28.6% to 29.3%, driven by market share gains in both International Operations and North America Operations.

In the following sections, unless otherwise noted, market data are based on moving annual total (MAT) from November 2020 and November 2019 provided by the independent data provider IQVIA.

Insulin
Sales of insulin decreased by 5% measured in Danish kroner and by 3% at CER to DKK 56,550 million. The sales decrease was driven by declining sales in the US, partly offset by increased sales in International Operations.

Sales of long-acting insulin decreased by 11% measured in Danish kroner and by 9% at CER to DKK 18,439 million. Novo Nordisk has increased its global volume market share in the long-acting insulin segment from 32.4% to 32.8% in the last 12 months. The sales decline measured at CER was driven by declining Levemir® and Tresiba® sales, partially offset by increased sales of Xultophy®. Tresiba® has been launched in 91 countries, while Xultophy® has been launched in 42 countries.

Sales of premix insulin increased by 3% measured in Danish kroner and by 6% at CER to DKK 10,925 million. Novo Nordisk is the market leader in the premix insulin segment with a global volume market share of 65.2% compared to 64.2% 12 months ago. The sales increase was driven by increased sales
of both Ryzodeg® and NovoMix®. Ryzodeg® has now been launched in 37 countries.

Sales of fast-acting insulin decreased by 5% measured in Danish kroner and by 3% at CER to DKK 18,313 million. Novo Nordisk is the market leader in the fast-acting insulin segment and has increased its global volume market share to 51.7% from 50.7% in the last 12 months. The sales decrease was driven by NovoRapid®, partly offset by increased Fiasp® sales. Fiasp® has now been launched in 41 countries.

Sales of human insulin decreased by 2% measured in Danish kroner and increased by 2% at CER to DKK 8,873 million.

GLP-1 therapy for type 2 diabetes
Sales of GLP-1 products for type 2 diabetes (Ozempic®, Victoza® and Rybelsus®) increased by 26% measured in Danish kroner and by 29% at CER to DKK 41,831 million. Ozempic® has now been launched in 52 countries with sales of DKK 21,211 million, and Rybelsus® has been launched in nine countries with sales of DKK 1,873 million. The GLP-1 segment’s value share of the total diabetes market has increased to 22.0% compared with 18.0% 12 months ago. Novo Nordisk continues to be the global market leader in the GLP-1 segment with a 50.4% value market share, an increase of 2.9 percentage points compared to 12 months ago. Sales growth was negatively impacted by COVID-19.

Obesity care, sales development
Sales of Saxenda® decreased by 1% measured in Danish kroner and increased by 3% at CER to DKK 5,608 million. Saxenda® sales growth at CER was driven by International Operations, partially offset by North America Operations. Sales growth was negatively impacted by COVID-19 as fewer patients initiated treatment. Saxenda® has now been launched


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in 55 countries. Novo Nordisk currently has a value market share of 64.7% of the global obesity prescription drug market.

Biopharm
Biopharm, sales development
Sales of biopharm products decreased by 1% measured in Danish kroner and increased by 1% at CER to DKK 18,926 million. The sales growth at CER was driven by International Operations. Sales growth was driven by Growth Disorders and the launches of new haemophilia products, offset by declining sales of NovoSeven®. Sales growth was negatively impacted by lower demand due to COVID-19.

Haemophilia
Sales of haemophilia products decreased by 6% measured in Danish kroner and by 4% at CER to DKK 9,662 million. The decreasing sales were driven by declining NovoSeven® sales, while the haemophilia A and B franchises grew driven by the continued global roll-out of Esperoct® and Refixia®.

Sales of NovoSeven® decreased by 11% measured in Danish kroner and by 9% at CER to DKK 7,203 million. The sales development was driven by declining sales in North America Operations, Rest of World and EMEA, partially offset by increasing sales in Region China, reflecting timing of shipments. The declining sales partly reflect reduced elective surgeries and bleedings due to COVID-19.

Sales of NovoEight® decreased by 4% measured in Danish kroner and by 1% at CER to DKK 1,462 million. The decreasing sales were driven by declining sales in EMEA and the US, partly offset by increased sales in Rest of World. The NovoEight® sales decrease was offset by Esperoct®, the long-acting haemophilia A treatment, which has now been launched in 19 countries.

Sales of Refixia® increased to DKK 518 million. Sales growth was driven by continued uptake in Rest of World and EMEA as well as continued uptake in North America Operations. Refixia® has been launched in 25 countries.

Growth disorders (Norditropin®)
Sales of Norditropin® increased by 6% measured in Danish kroner and by 8% at CER to DKK 7,704 million. The sales increase was driven by International Operations increasing by 16%, partially offset by North America Operations declining by 4% at CER. Novo Nordisk is the leading company in the global human growth disorder market with a value market share of 36.0% compared to 33.0% a year ago, driven by new indications and the global roll-out of the next-generation device. Sales growth was positively impacted by additional demand, following supply challenges for competing products in select countries.

Development in costs and operating profit
The cost of goods sold increased by 4% measured in Danish kroner and by 5% at CER to DKK 20,932 million, resulting in an unchanged gross margin of 83.5% measured in Danish kroner compared to 2019. The unchanged gross margin reflects productivity improvements and a positive product mix driven by increased GLP-1 sales. This is countered by a negative impact from lower realised prices in the US and a negative currency impact of 0.3 percentage point.

Sales and distribution costs increased by 3% measured in Danish kroner and by 6% at CER to DKK 32,928 million. The increase in costs is driven by North America Operations reflecting launch activities for Rybelsus® and continued promotional activities for Ozempic®, partly offset by lower promotional spend related to insulin. In International Operations, promotional spend is related to launch activities for Ozempic® and Rybelsus® as well as the continued roll-out
of Saxenda®. COVID-19 resulted in a reduction of the activity level and delay of promotional activities.

Research and development costs increased by 9% measured in Danish kroner and by 10% at CER to DKK 15,462 million. The cost increase is driven by the amortisation of the priority review voucher for semaglutide 2.4 mg in obesity in the third quarter of 2020. Increased activities within Other serious chronic diseases are driving the cost increase following progression of the early pipeline within cardiovascular disease and stem cell projects as well as patient recruitment to the ongoing cardiovascular outcomes trials, SOUL and SELECT.

Administration costs decreased by 1% measured in Danish kroner and increased by 1% at CER to DKK 3,958 million, reflecting broadly unchanged spend across administrative areas.

Other operating income (net) was DKK 460 million compared with DKK 600 million in 2019 following reduced royalty income.

Operating profit increased by 3% measured in Danish kroner and by 7% at CER to DKK 54,126 million.

Financial items (net) and tax
Financial items (net) showed a net loss of DKK 996 million compared with a net loss of DKK 3,930 million in 2019.

In line with Novo Nordisk’s treasury policy, the most significant foreign exchange risks for Novo Nordisk have been hedged, primarily through foreign exchange forward contracts. The foreign exchange result was a net loss of DKK 747 million compared with a net loss of DKK 3,212 million in 2019. This reflects losses on non-hedged currencies driven by significant depreciations of several emerging market currencies, partially offset by gains on hedged currencies.


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As per the end of December 2020, a positive market value of financial contracts of approximately DKK 1.8 billion has been deferred for recognition in 2021. For more information see note 4.3 in the financial statement.

The effective tax rate is 20.7% in 2020 compared with an effective tax rate of 19.8% in 2019. In 2019, a tax reform was passed in Switzerland which had positive impact on the effective tax rate, driven by a non-recurring increase to deferred tax assets.

Cash flow and capital allocation
Capital expenditure for property, plant and equipment was DKK 5.8 billion compared with DKK 8.9 billion in 2019. The lower capital expenditure was mainly related to lower investments in the new production facility for diabetes active pharmaceutical ingredients in Clayton, North Carolina, US, which is now in the final stages of construction.

Free cash flow of DKK 28.6 billion compared with DKK 34.5 billion in 2019. The decrease is reflecting purchase of intangible assets of DKK 16.3 billion, primarily related to the acquisitions of Corvidia Therapeutics Inc. and Emisphere Technologies Inc.

Novo Nordisk’s financial reserves were DKK 28.8 billion by end of December 2020 comprising cash at bank and undrawn credit facilities less overdrafts and loans repayable within 12 months.

2021 outlook
The current expectations for 2021 are summarised in the table named 'Outlook 2021' on this page.

For 2021, sales growth is expected to be 5% to 9% at CER. The guidance reflects expectations for continued sales growth in International Operations in line with the strategic aspiration of 6-10% growth as well as growth in North America Operations. The guidance reflects expectations for sales growth within Diabetes care, mainly driven by the GLP-1 products Ozempic® and Rybelsus®, as well as growth within Obesity care. Intensifying competition within both Diabetes care and Biopharm is also reflected in the guidance. Furthermore, continued pricing pressure within Diabetes care, especially in the US, is expected to negatively impact sales development. Given the current exchange rates versus the Danish krone, growth reported in DKK is expected to be around 4 percentage points lower than at CER.

Operating profit growth is expected to be 4% to 8% at CER. The expectation for operating profit growth primarily reflects the sales growth outlook and continued investments in current and future growth drivers across the operating units, including the continued roll-out of Ozempic® and Rybelsus® as well as global investments in building an anti-obesity market and the expected launch of semaglutide 2.4 mg in the US. Furthermore, resources are allocated to both early and late-stage pipeline activities, including expected initiations of several phase 3a clinical trial programmes in 2021. Given the current exchange rates versus the Danish krone, growth reported in DKK is now expected to be around 6 percentage points lower than at CER, mainly driven by the spot rate of the USD being 615 versus an average of 654 in 2020.

The current COVID-19 pandemic causes uncertainty to the outlook regarding the number of patients initiating treatment and societal impacts such as the unemployment rate in the US, which is impacting healthcare insurance coverage. The outlook is based on a number of assumptions related to the severity
and duration of impacts from COVID-19. Consequently, volatility in quarterly results should be expected.

For 2021, Novo Nordisk expects financial items (net) to amount to a gain of around DKK 0.7 billion, reflecting the expected hedging gains of DKK 1.1 billion mainly related to the US dollar with a hedging period of 11 months and associated hedging costs.

The effective tax rate for 2021 is expected to be in the range of 20-22%.

Capital expenditure is expected to be around DKK 8.0 billion in 2021, primarily relating to investments in additional capacity for active pharmaceutical ingredient (API) production at existing manufacturing sites within Diabetes care. The expected increase in capital expenditure reflects progress of R&D projects based on the oral technology platform.

Depreciation, amortisation and impairment losses are expected to be around DKK 6.0 billion. The increase in depreciation, amortisation and impairment losses in 2021 reflects depreciation of the new production facility for diabetes active pharmaceutical ingredients in Clayton, North Carolina, US. The free cash flow is expected to be DKK 36-41 billion. The increase in free cash flow compared to 2020 reflects the impact from the acquisitions in 2020.

All of the above expectations are based on assumptions that the global or regional macroeconomic and political environment will not significantly change business conditions for Novo Nordisk during 2021, including the potential implications from major healthcare reforms, and that the currency exchange rates, especially the US dollar, will remain at the current level versus the Danish krone. Neither does the guidance include the financial implications of significant


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business development transactions during the remainder of 2021.

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 operating profit as outlined in note 4.2 in the financial statements.

Forward-looking statements
Novo Nordisk’s reports filed with or furnished to the US Securities and Exchange Commission (SEC), including this statutory Annual Report 2020 and Form 20-F, which are both expected to be filed with the SEC in February 2021 in continuation of the publication of this Annual Report 2020, and written information released, or oral statements made, to the public in the future by or on behalf of Novo Nordisk, may contain forward-looking statements.

Words such as ‘believe’, ‘expect, ‘may’, ‘will’, ‘plan’, ‘strategy’, ‘prospect’, ‘foresee’, ‘estimate’, ‘project’, ‘anticipate’, ‘can’, ‘intend’, ‘target’ and other words and terms of similar meaning in connection with any discussion of future operating or financial performance identify forward-looking statements. Examples of such forward-looking statements include, but are not limited to:
– Statements of targets, plans, objectives or goals for future operations, including those related to Novo Nordisk’s products, product research, product development, product introductions and product approvals as well as cooperation in relation thereto,
– Statements containing projections of or targets for revenues, costs, income (or loss), earnings per share, capital expenditures, dividends, capital structure, net financials and other financial measures,
– Statements regarding future economic performance, future actions and outcome of contingencies such as legal proceedings, and
– Statements regarding the assumptions underlying or relating to such statements.

In this Annual Report 2020, examples of forward-looking statements can be found under the section related to our ‘strategic aspirations’ and elsewhere.

These statements are based on current plans, estimates and projections. By their very nature, forward-looking statements involve inherent risks and uncertainties, both general and specific. Novo Nordisk cautions that a number of important factors, including those described in this Annual Report 2020, 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 recalls, unexpected contract breaches or terminations, government-mandated or market-driven price decreases for Novo Nordisk’s products, introduction of competing products, reliance on information technology, 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, failure to maintain a culture of compliance and epidemics, pandemics or other public health crises.

For an overview of some, but not all, of the risks that could adversely affect Novo Nordisk’s results or the accuracy of forward-looking statements in this Annual Report 2020, reference is made to the overview of risk factors in ‘Risk management’ of this Annual Report 2020.
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 Annual Report 2020, whether as a result of new information, future events, or otherwise.

Outlook 2021
The current expectations for 2021 are summarised in the table below:
Expectations are as reported, if not otherwise stated Expectations 3 February 2021
Sales growth
at CER 5% to 9%
as reported Around 4 percentage points lower than at CER
Operating profit growth
at CER 4% to 8%
as reported Around 6 percentage points lower than at CER
Financial items (net) Gain of around DKK 0.7 billion
Effective tax rate 20% to 22%
Capital expenditure (PP&E) Around DKK 8.0 billion
Depreciation, amortisation and impairment losses Around DKK 6 billion
Free cash flow DKK 36-41 billion



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Risk management



In order for us to become a sustainable business, we must anticipate and adapt to our surrounding environment to create new strategic opportunities. Managing risks rigorously and systematically is key in order for us to create and protect value over the short, medium and long.



Addressing risks in our strategic planning:
Scenario and risk-thinking exercises are part of our strategic planning process. They include analyses of market dynamics as well as socioeconomic and political developments that present risks or opportunities for our business.

Access and affordability
In the short and medium term, access to affordable care and innovative treatments is a key challenge for patients in many parts of the world. Access to affordable care is a global issue as healthcare systems struggle to provide quality care at a sustainable cost, while the burden of chronic diseases keeps rising. Ensuring access and affordability is a responsibility Novo Nordisk shares with all involved in healthcare. We recognise that we
cannot defeat diabetes alone, but we can accelerate our actions to find solutions in collaboration with relevant stakeholders.

Digital disruption
New digital technologies in healthcare are offering more personalised treatment and better management of diseases. This is an opportunity for us to deliver more value to our stakeholders and help patients live a life free from the limitations of their disease. New digital health solutions, including our own, bring new risks particularly around data regulation and data privacy, as well as potential quality and reliability risks. We strive to develop digital health solutions in collaboration with relevant partners. We also believe in the value of open innovation and sharing our knowledge and experience.

Environmental risks
We are preparing for the risks and opportunities which will arise from climate change. As recommended by the Task Force on Climate-related Financial Disclosures (TCFD), we are integrating climate change scenarios into our risk management processes to identify short, medium and long-term risks.

Human rights and labour risks
We take a proactive approach to integrating risk management of human and labour rights into our risk management process, while recognising that modern slavery, including human trafficking, forced labour, bonded labour, child slavery and hazardous
 child labour, can occur in every industry and sector. We respect human rights as per the UN Guiding Principles on Business and Human Rights.

Risk management process
A rigorous approach to enterprise risk management helps the company protect and enhance the value of our assets. We are continually exposed to risks throughout our value chain – from early discovery of new, promising molecules to the production and delivery of medicines to patients. Some risks are inherent in the pharmaceutical industry, such as delays or failures of potential new medicines in the R&D pipeline. Other risks, such as supply disruptions and competitive threats, are well-known to any manufacturing company with global production. We will never compromise on product quality, patient safety and business ethics: these are front and centre of our enterprise-wide risk management set-up. We apply a two-way lens and assess risks to potential financial loss and reputational damage.

Executive Management and the Board of Directors review a 'heat map' of our biggest risks every six months. This map is based on insights from management teams in the organisation and includes risks that could cause significant disruptions to the business over a three-year horizon. The following overview provides more details of our key risks.

For more information, see our Corporate Governance report available on www.novonordisk.com/
about/corporate-governance/recommendations-
and-practices.html
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Risk area Description Impact Mitigating actions
1 Research and Development
Risks
Findings in pre-clinical and clinical activities, regulatory processes or commercial product planning leading to delays or failure of products in the pipeline.
Patients would not benefit from innovative treatments
Could have adverse impact on sales, profits and market position
Insight into patients' unmet needs informs the selection of new product candidates
Pre-clinical and clinical activities to demonstrate safely and efficacy
Scientific and commercial viability assessments determine progress
Consultations with regulators to review pre-clinical and clinical findings and obtain guidance on development path
2 Product Supply, Quality and Safety Risks Disruption of product supply or quality failures may compromise the health of patients.
Product shortages could have potential implications for patients
Could put patients' health and lives at risk and jeopardise Novo Nordisk's reputation and license to operate if regulatory compliance is not ensured
Could have an adverse impact on sales, profits and market position
Global production with multiple facilities and safety stock reduces supply risk
Regular quality audits of internal units and suppliers and annual inspections by authorities document GMP compliance
Identification and correction of root causes when issues are identified. If necessary, products are recalled
3 Commercialisation Risks Market dynamics and geopolitical, macroeconomic or healthcare crises (e.g. pandemics) leading to reduced payer ability and willingness to pay.
Market dynamics could impact price levels and patient access
Could have an adverse impact on sales, profits and market position
Innovation of novel products, clinical trial data and real-world evidence demonstrate added value of new products
Payer negotiations to ensure improved patients' access
Increased and new access and affordability initiatives
4 IT Security Risks Disruption to IT systems, such as cyber attacks or infrastructure failure resulting in business disruption or breach of data confidentiality.
Could limit our ability to produce and safeguard product quality
Could compromise patients' or other individuals' privacy
Could limit our ability to maintain operations
Could limit future business opportunities if proprietary information is lost
Protection mechanisms in IT systems and business processes
Company-wide information security awareness activities
Continuity plans for non-availability of IT systems
Company-wide internal audit of IT security controls
5 Financial Risks Exchange rate fluctuations, disputes with tax authorities and changes to tax legislation and interpretation. Our foreign exchange risk is most significant in USD, CNY, and JPY.
Could negatively impact cash flow, statement of comprehensive income and balance sheet
Could lead to significant tax adjustments, fines and higher-than-expected tax level
Hedging for selected currencies
Integrated treasury management
Applicable taxes paid in jurisdictions where business activity generates profits
Multi-year Advance Pricing Agreements with tax authorities for more than 65% of sales
6 Legal and Compliance Risks Breach of legislation, industry codes or company policies. Competitors asserting patents against Novo Nordisk or challenging patents critical for protection of commercial product and pipeline candidates.
Could expose Novo Nordisk to investigations, criminal and civil sanctions and other penalties
Could compromise our reputation and the rights and integrity of individuals involved
Unexpected loss of exclusivity for or injunctions against existing and pipeline products could have an adverse impact on future sales
Legal review of key activities
Business Ethics Code of Conduct and compliance hotline in place
Internal Audit of compliance with business ethics standards.
Internal controls minimise vulnerability to patent infringement and invalidity actions




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Shares and capital structure

Through open and proactive communication, Novo Nordisk aims to provide the basis for fair and efficient pricing of our shares.

Share capital and ownership
Novo Nordisk’s share capital of DKK 470,000,000 is divided into A and B share capital. The A and B shares are calculated in units of DKK 0.20, amounting to 2.35 billion shares. The A share capital, consisting of 537 million shares, has a nominal value of DKK 107,487,200 and the B share capital, consisting of 1,813 million shares, has a nominal value of DKK 362,512,800. Each A share carries 200 votes and each B share carries 20 votes. Novo Nordisk's B shares are listed on Nasdaq Copenhagen and on the New York Stock Exchange (NYSE) as American Depository Receipts (ADRs).

The company’s A shares are not listed and are held by Novo Holdings A/S1, a Danish public limited liability company wholly-owned by the Novo Nordisk Foundation. The Foundation has a dual objective: to provide a stable basis for the commercial and research activities conducted by the companies within the Novo Group (of which Novo Nordisk A/S 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. Special rights attached to A shares include pre-emptive subscription rights in the event of an increase in the A share capital and pre-emptive purchase rights in the event of a sale of A shares, while B shares take priority for liquidation proceedings. A shares take priority for dividends
below 0.5%, and B shares take priority for dividends between 0.5 and 5%. However, in practice, A and B shares receive the same amount of dividend per share.

As of 31 December 2020, Novo Holdings A/S also held a B share capital of nominally DKK 24,347,800. Together with the A shares, Novo Holdings A/S's total ownership amounted to nominally DKK 131,835,000. Novo Holdings A/S's ownership is reflected in the 'Ownership structure' chart.

There is no complete record of all shareholders; however, based on available sources of information, as of 31 December 2020 it is estimated that shares were geographically distributed as shown in the 'Geographical split of shareholders’ chart. As of 31 December 2020, the free float of listed B shares was 91.2% (of which approximately 10.0% are listed as ADRs), excluding Novo Holdings A/S's holding and Novo Nordisk’s holding of treasury shares. As of 31 December 2020, Novo Holdings A/S and Novo Nordisk B shares equalled 159,277,660 shares and had a nominal value of DKK 31,855,532. For details about the share capital, see note 4.1 to the consolidated financial statements.

Capital structure
Novo Nordisk’s Board of Directors and Executive Management consider that the current capital and share structure of Novo Nordisk serve the interests of the shareholders and the company well. Novo Nordisk’s capital structure strategy offers a balance between long-term shareholder value creation and competitive shareholder return in the short term.

The capital structure has been adjusted as a consequence of Novo Nordisk’s debt-financed, USD 1.8 billion acquisition of Emisphere Technologies Inc., which was finalised on 8 December 2020.
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1. Novo Holdings A/S's registered address is Tuborg Havnevej 19, DK-2900 Hellerup, Denmark.
2. Using shareholder registered home countries.
3. Treasury shares are included, however, voting rights of treasury shares cannot be exercised.




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Dividend policy
The company’s dividend policy applies a pharmaceutical industry benchmark to ensure a competitive payout ratio for dividend payments, which are complemented by share repurchase programmes. The final dividend for 2019 paid in March 2020 was equal to DKK 5.35 per A and B share of DKK 0.20 as well as for ADRs. The total dividend for 2019 was DKK 8.35 per A and B share of DKK 0.20, corresponding to a payout ratio of 50.5%, which was in line with the 2019 pharma peer group average of 53.5%.

In August 2020, an interim dividend was paid equalling DKK 3.25 per A and B share of DKK 0.20 as well as for ADRs. For 2020, the Board of Directors will propose a final dividend of DKK 5.85 to be paid in March 2021, equivalent to a total dividend for 2020 of DKK 9.10 and a payout ratio of 50.0%. The company expects to distribute an interim dividend in August 2021. Further information regarding this interim dividend will be announced in connection with the financial report for the first six months of 2021. Dividends are paid from distributable reserves. Novo Nordisk does not pay a dividend on its holding of treasury shares.

Share repurchase programme for 2020/2021
During the twelve-month period beginning 1 February 2020, Novo Nordisk repurchased shares worth DKK 17 billion. The share repurchase programme has primarily been conducted in accordance with the safe harbour rules in the EU Market Abuse Regulation (MAR). For the next 12 months, Novo Nordisk has decided to implement a new share repurchase programme. The expected total repurchase value of B shares amounts to a cash value of up to DKK 17 billion. The total programme may be reduced in size if significant business development opportunities arise during 2021. Novo Nordisk expects to conduct the majority of the new share repurchase programme according to the safe harbour rules in MAR. At the
Annual General Meeting in March 2021, the Board of Directors will propose a further reduction in the company’s B share capital, corresponding to approximately 1.7% of the total share capital, by cancelling 40,000,000 treasury shares.

Share price development
Novo Nordisk’s share price increased by 10.3% between its 2019 close of DKK 386.65 and the 31 December 2020 close of DKK 426.65. For comparison purposes, the Danish OMXC25 stock index increased by 33.7% and the pharma peer group decreased by 2.4% during 2020. The total market value of Novo Nordisk’s B shares, excluding treasury shares and Novo Holdings A/S shares, was DKK 705,374,617,388 as of 31 December 2020.











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Corporate governance
Shareholders
Key responsibilities The shareholders of Novo Nordisk have ultimate authority over the company and exercise their right to make decisions at general meetings. 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. Resolutions can generally be passed by a simple majority.
However, resolutions to amend the Articles of Association require two thirds of the votes cast and capital represented, unless other adoption requirements are imposed by the Danish Companies Act.

Novo Holdings A/S holds the majority of votes at general meetings. However, all strategic and operational matters are decided solely by the Board of Directors and Executive Management.
Board of Directors
Key responsibilities

Board committees:
– Chairmanship
– Audit Committee
– Nomination Committee
– Remuneration Committee
– R&D Committee
Novo Nordisk has a two-tier management structure consisting of a Board of Directors and Executive Management. The two bodies are separate and no one serves as a member of both.

The Board of Directors
– Develops the company as a focused, sustainable, global pharmaceutical company
– Supervises Executive Management
– Appoints members of Executive Management and determines their remuneration
– Determines the company’s overall strategy and oversees the implementation of the strategy and the performance of the company
– Ensures adequate management and organisation
– May distribute extraordinary dividends and issue new shares in accordance with the Articles of Association
– May repurchase shares in accordance with authorisations granted by the shareholders at the Annual General Meeting in 2020 and recorded in the meeting minutes available at novonordisk.com
Composition and independence
As of 31 December 2020, the Board of Directors consisted of 13 members. Nine were elected by shareholders and four by Danish-based employees. Board members must retire at the first Annual General Meeting after they reach the age of 70.

Shareholder-elected Board members serve for a one-year term and may be re-elected, which was the case for all nine members at the Annual General Meeting in 2020. Two shareholder-elected Board members are not independent, as they are related to the main shareholder, Novo Holdings A/S, and may be regarded as representing Novo Holdings A/S’s 1 interests, while the remaining seven members are independent. For independence2, see table on page 44.

Danish-based employees may elect a number of Board members equalling half of the shareholder- elected members. Employee-elected members serve for a statutory four-year term, with the next election in 2022, and have the same rights, duties and responsibilities as shareholder-elected members.
Executive Management
Key responsibilities Executive Management is responsible for overall day-to-day management, the organisation of the company, 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.

To ensure the organisational implementation of our strategy, Executive Management has established a Management Board consisting of the Chief Executive Officer, Executive Vice Presidents and Senior Vice Presidents.
Composition and meetings
As of 31 December 2020, Executive Management consisted of nine members including the Chief Executive Officer. No changes were made in the composition of Executive Management in 2020. Executive Management meets at least once a month and due to COVID-19 a significant number of their meetings and other activities were conducted virtually. The three executives who are based outside Denmark and who have responsibility for Biopharm, International Operations and North America Operations, respectively, are not registered as executives with the Danish Business Authority.
1. Related as a member of either the Board of Directors or Executive Management of Novo Holdings A/S. 2. Independence as defined by the Danish Corporate Governance Recommendations.



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Board committees1

Chairmanship Audit Committee Nomination Committee Remuneration Committee Research & Development Committee
Key responsibilities

Assists the Board of Directors with:
Planning of Board meetings
Employment, incentive remuneration and performance evaluation of Executive Management
Represents the Board externally
The external auditors
The internal audit function
Handling complaints reported through the Compliance Hotline
Financial, social and environmental reporting (ESG reporting)
Internal controls over financial and ESG reporting
Business ethics compliance
IT security and insurance coverage

The competence profile and composition of the Board
Nomination of Board members and Board committee members
Annual evaluation of the Board
Corporate governance of the company
The Remuneration Policy
The actual remuneration of Board members, Board committees and Executive Management
The research and development strategy
The pipeline
The R&D organisation
Members (appointed by the Board)

For independence and competencies see table on page 44.
Consists of the chair and the vice chair, both of whom are elected directly by the shareholders at the general meetings.

At the Annual General Meeting in 2020, Helge Lund was re-elected as chair and Jeppe Christiansen was re- elected as vice chair of the Board.
Liz Hewitt (chair)
Laurence Debroux
Andreas Fibig
Sylvie Grégoire
Stig Strøbæk

Helge Lund (chair)
Sylvie Grégoire
Kasim Kutay
Mette Bøjer Jensen
Jeppe Christiansen (chair)
Brian Daniels
Liz Hewitt
Anne Marie Kverneland
Martin Mackay (chair)
Brian Daniels
Sylvie Grégoire
Kasim Kutay
Thomas Rantzau
2020 key activities In 2020, the Chairmanship focussed particularly on strategy execution within the therapy areas and in different markets, digitalisation, partnering and acquisitions to access external innovation, talent and leadership development as well as succession preparedness, core capabilities and development of the company culture and impact of the COVID-19 pandemic. In 2020, the Audit Committee focused on work performed by internal
and external auditors and held focus sessions on risks and internal controls . The Audit Committee also discussed key accounting matters,
including provisions for sales rebates, indirect production costs, ongoing tax and legal cases and impairment. The Audit Committee also reviewed Information Security, Business Ethics Compliance and Compliance Hotline cases . Finally, the Audit Committee recommended Deloitte to be elected as external auditor in 2021.
In 2020, the Nomination Committee focused particularly on reviewing the composition of the Board, identifying and interviewing candidates and considering long-term succession planning. It also reviewed the desired competences to be represented on the Board. In 2020, the Remuneration Committee focused particularly on executive remuneration in light of the COVID-19 pandemic, on assessing the design and structure of the short-term as well as the long- term incentive programme for the Executive Management in 2021 and on enhancing the transparency in remuneration reporting even further. In 2020, the Research & Development Committee focused particularly on reviewing the results of clinical trials and discussed potential additional research and development activities to further explore opportunities within subcutaneous and oral GLP-1 as well as competitor initiatives. In addition, the committee discussed the potential opportunities for addressing unmet needs in mild cognitive impairment and mild dementia . It also reviewed potential external research collaborations as well as acquisitions.
1. For a more detailed description of the Board committees, details on members and full reports on the Board committees’ activities in 2020, please refer to the Corporate Governance Report 2020 available at: https:// www.novonordisk.com/about/corporate-governance/recommendations-and-practices.html





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Governance practices
Evaluation
The Board conducts an annual evaluation. The evaluation includes all Board members and executives. The chair has overall responsibility for the evaluation in collaboration with the Nomination Committee . Every third year, the evaluation is facilitated by external consultants, who interview all Board members and executives. For the subsequent two years, the evaluation is facilitated by the secretary of the Nomination Committee based on written questionnaires.
The evaluation includes topics such as Board performance, effectiveness, composition and succession, performance of the Chairmanship and the Board Committees as well as the collaboration in the Board and between the Board and Executive Management. Each Board member and executive also receives feedback from all other Board members and executives on their individual performance.

In 2020, the Board evaluation was facilitated externally by a consultant working exclusively with Board effectiveness reviews. Overall, the evaluation revealed good performance by the Board and good collaboration between the Board and Executive Management. The evaluation resulted in continued focus on Board culture, evolving the induction for new Board members, Board documentation and presentations, Board competency profile and informal time between the Board members, which had been affected by COVID-19.
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Nomination
The Nomination Committee presents proposals for election or re-election of shareholder-elected Board members to the Board of Directors . When recommending candidates to be nominated by the Board, the Nomination Committee considers factors such as the balance between renewal and continuity, the desired competences and experience, the performance of the individual
Board members, the ambition for diversity as well as independence consideration.

The Board of Directors has determined a competence profile for the shareholder-elected Board members . Board members should possess integrity, accountability, fairness, financial literacy, commitment and desire for innovation . Additionally, the following competences and experience should be represented: Global business management, strategic operations and governance. Healthcare industry and market access. Research and development, technology and digitalisation. M&A and external innovation sourcing. People leadership and change management. Finance and accounting.

Please refer to the overview on page 44 for com- petence profiles for shareholder-elected Board members. The Competence Profile is available at our website.
Board diversity
In 2016, the Board of Directors adjusted its diversity ambition and set new targets for diversity among shareholder-elected Board members. By 2020, it was the aim that at least two members were of Nordic nationality and two of non-Nordic nationality. The aim was also to have at least three shareholder-elected Board members of each gender.

As of 31 December 2020, our shareholder- elected Board members consisted of two Nordic members and seven non-Nordic members . Of these, three members were female and six were male. Thus, the Board of Directors fulfilled its 2016 gender and nationality ambition. The Board of Directors finds that being diverse in gender and nationality is of continued importance, and consequently in 2020 the Board of Directors prolonged its gender and nationality ambition
to 2024. When including the employee-elected Board members, six members were Nordic and seven were non-Nordic. Of these, five were female and eight were male.

In accordance with sections 99b and 107d of the Danish Financial Statements Act, Novo Nordisk discloses current performance on diversity in the social responsibility section. Novo Nordisk’s diversity policy is available in that section.



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Remuneration
In 2020, a new Remuneration Policy was adopted by the Annual General Meeting describing Board and Executive remuneration. The policy replaces Novo Nordisk’s Remuneration Principles and was introduced to comply with changed EU leg- islation. The new policy is applicable to Board remuneration as of 2020, while it is applicable to Executive remuneration as of 2021. Consequently, the Remuneration Principles applied to Board remuneration relating to the period up to and including 2019 and to Executive remuneration for the period up to and including 2020. The Remuneration Policy and the Remuneration Principles are available at: https://www.novonordisk.com/about/ corporate-governance/remuneration.html

Novo Nordisk has prepared a separate Remuneration Report describing the remuner- ation awarded or due during 2020 to the Board members and Executives as registered with the Danish Business Authority. The Remuneration Report will be submitted to the Annual General Meeting for an advisory vote . The Remuneration Report is available at: https://www.novonordisk.com/about/
corporate-governance/remuneration.html

Compliance with corporate governance codes Novo Nordisk’s B shares are listed on Nasdaq Copenhagen and on the New York Stock Exchange (NYSE) as American Dipository Receipts (ADRs).

Today, Novo Nordisk adheres to all Danish Corporate Governance Recommendations (2017) designated by Nasdaq Copenhagen except the five recommendations outlined under the heading 'Danish Corporate Governance Recommendations not being fulfilled'.

In addition, Novo Nordisk complies with the Corporate Governance Standards of the NYSE applicable to foreign private issuers. A summary of the significant ways in which Novo Nordisk’s corporate governance practices differ from the NYSE Corporate Governance Standards can be found in Novo Nordisk’s Corporate Governance Report 2020.

Novo Nordisk's compliance with and explanations about the applicable corporate governance codes designated by Nasdaq Copenhagen and the New York Stock Exchange is available at www.novonordisk.com/about/
corporate-governance/recommendations-and- practices.html in accordance with section 107b of the Danish Financial Statements Act.


Danish Corporate
Governance Recommendations not being fulfilled
3.3.2
Disclosure of additional information about the Board members: Information on matters such as numbers of shares owned and changes during the year is disclosed in the Remuneration Report for 2020 and not in the management commentary.

3.4.2
Independence of Board committees: The majority of the members of the Nomination Committee and the Remuneration Committee are not independent.

3.4.6
Tasks of the Nomination Committee: Responsibility for succession manage- ment and recommending candidates for the Executive Management resides with the Chairmanship and not with the Nomination Committee.

3.4.7
Tasks of the Remuneration Committee: Responsibility for the remuneration pol- icy applicable to employees in general resides with Executive Management and not with the Remuneration Committee.

4.1.5
Termination payments: One executive employment contract entered into before 2008 allows for severance payments of more than 24 months’ fixed base salary plus pension contribution, and thus the total value of the remuneration relating to the notice period and of the severance payment exceeds two years of remuneration.



Disclosure regarding change of control
The EU Takeover Bids Directive, as partially imple- mented by the Danish Financial Statements Act, requires listed companies to disclose information that may be of interest to the market and poten- tial take-over bidders, in particular in relation to disclosure of change-of-control provisions in material contracts .

Novo Nordisk discloses that the Group has one significant agreement with a US payer which takes effect, alters or terminates upon a change of control of the Group. If effected, a takeover could – at the discretion of the relevant counter- party – lead to the termination of such agree- ment. Given the ownership structure of Novo Nordisk, the risk is considered to be remote.

In relation to Executive Management, the current employment contracts allow
for severance payments of up to 36 months' fixed base salary plus pension contributions in the event of a merger, acquisition or takeover of Novo Nordisk.

For information about the ownership structure of Novo Nordisk, see 'Shares and capital structure'.



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Board of Directors
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Helge Lund — Chair
Chair of the Board of Novo Nordisk A/S since 2018 (member for one year in 2014-2015 and again in 2017) and chair of the Nomination Committee since 2018 (member since 2017).

Positions and management duties: Operating advisor to Clayton Dubilier & Rice, US. Chair of the boards of BP p.l .c . UK and Inkerman Holding AS, Norway. Member of the boards of P/F Tjaldur, Faroe Islands and Belron SA, Luxembourg.
Member of the board of Trustees of the International Crisis Group.

Special competences:
Extensive executive and board experience in large multinational companies and significant financial knowledge.

Education:
MBA from INSEAD, France (1991) and MA in Economics from the Norwegian School of Economics & Business Administration (NHH), Norway (1987).
Jeppe Christiansen — Vice Chair
Vice chair and member of the Board of Novo Nordisk A/S since 2013. Chair of the Remuneration Committee since 2017 (member since 2015).

Positions and management duties:
Chief Executive Officer of Maj Invest Holding A/S as well as board mem- ber and/or executive director of two wholly owned subsidiaries of this company, both in Denmark . Chair of Haldor Topsøe A/S, Emlika Holding ApS, and two wholly owned subsid- iaries of the latter company, and chair of JEKC Holding ApS . Board member of Novo Holdings A/S and KIRKBI A/S, Pluto Naturfonden and Randers Regnskov, all in Denmark . Member of the board of BellaBeat Inc ., US . Member of the board of Governors of Det Kgl . Vajsenhus, Denmark . Adjunct Professor, De- partment of Finance, Copenhagen Business School, Denmark.

Special competences:
Executive background and extensive 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 from University of Copenhagen, Denmark (1985).
Brian Daniels
Member of the Board of Novo Nordisk A/S since 2016, member of the Remuneration Committee since 2018 and member of the Research & Development Committee since 2017.

Positions and management duties: Partner with 5AM Venture Management, LLC, member of the board at Caballeta Bio Inc., and Artiva Biotherapeutics, all in the US.

Special competences:
Extensive experience in clinical development, medical affairs and corporate strategy across a broad range of therapeutic areas within the pharmaceutical industry, especially in the US.

Education:
MD from Washington University,
St . Louis, US (1987), and MA in Metabolism and Nutritional Biochemistry (1981) and BSc in Life Sciences (1981), both
from Massachusetts Institute of Technology, Cambridge, US.
Laurence Debroux
Member of the Board of Novo Nordisk A/S and member of the Audit Committee since 2019.

Positions and management duties: Group Chief Financial Officer, executive board member of Heineken N .V ., the Netherlands. Member of the board of Exor N.V., the Netherlands, and of HEC Paris Business School, France.

Special competences:
Significant financial and accounting experience, extensive global experience within the pharmaceutical industry and experience from executive positions in major international companies.

Education:
Master's Degree from HEC Paris, Ecoles des Hautes Etudes Commerciales, France (1992).
Andreas Fibig
Member of the Board of Novo Nordisk A/S and member of the Audit Committee since 2018.

Positions and management duties: Chair and Chief Executive Officer of International Flavors & Fragrances Inc ., US, Chair of the board of the German American Chamber of Commerce, and Executive Committee member of the World Business Council for Sustainable Development (WBCSD).

Special competences:
Extensive global experience within biopharmaceutical companies, in-depth knowledge of strategy, sales and marketing and knowledge about how large international companies operate.

Education:
Degree in Marketing from Berlin School of Economics, Germany (1982).
Sylvie Grégoire
Member of the Board of Novo Nordisk A/S and of the Audit Committee since 2015, member of the Research & Development Committee since 2017, and member of the Nomination Committee since 2018.

Positions and management duties:
Executive Chair of the board of EIP Pharma, Inc ., and member of the board of Perkin Elmer Inc ., both in the US.

Special competences:
Deep knowledge of the regulatory environment in both the US and the EU, with experience of all phases of the product life cycle, including discovery, registration, pre-launch and managing the life cycle while on the market . Ms . Grégoire also has financial insight, including into P&L responsibility.

Education:
Pharmacy Doctorate degree from the State University of NY at Buffalo, US (1986), BA in Pharmacy from Laval University, Canada (1984), and Science College degree from Séminaire de Sherbrooke, Canada (1980).





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Liz Hewitt
Member of the Board of
Novo Nordisk A/S since 2012,
chair of the Audit Committee
since 2015 (member since
2012) and member of the Remuneration Committee
since 2018.

Positions and
management duties:
Member (senior independent director) of the board of
Melrose Industries plc, UK,
where she chairs the audit
committee, and member of
the board of National Grid
plc, UK.

Special competences:
Extensive experience within the field of medical devices, significant financial knowledge, including mergers and acquisitions, and knowledge about how
large international companies operate.

Education:
Qualified Chartered Accountant FCA (UK Institute of Chartered Accountants) (1982), and BSc (Econ Hons) from the University College in London, UK (1977).

Mette Bøjer Jensen
Member of the Board of
Novo Nordisk A/S (employee
representative) and member
of the Nomination Committee
since 2018.

Positions and
management duties:
Wash & Sterilisation Specialist
in Product Supply, Novo
Nordisk A/S.

Education:
Graduate Programme (HD)
in Business Administration
(Strategic management and
business development) from Copenhagen Business School,
Denmark (2010), and MSc in Biotechnology, Aalborg University, Denmark (2001).

Kasim Kutay
Member of the Board of Novo
Nordisk A/S and member of
the Nomination Committee
since 2017 and member of
the Research & Development Committee since 2020.

Positions and
management duties:
Chief Executive Officer of
Novo Holdings A/S, Denmark . Member of the board of
Novozymes A/S, Denmark,
of Evotec SE, Germany, and
of the Life Sciences Advisory
board of Gimv NV, Belgium.

Special competences:
Extensive experience as an investor in the life science sector. Mr Kutay manages an investment fund that invests in life science companies at all stages of development including the venture, growth and developed stages. Extensive experience as financial advisor to the pharmaceutical, biotechnology and medical device industries. Mr Kutay has also advised healthcare companies on an international basis including companies based in Europe, the US, Japan and India.

Education:
MSc in Economics (1987), and BSc in Economics (1986), both from the London School of Economics, UK.

Anne Marie Kverneland
Member of the Board of
Novo Nordisk A/S since 2000 (employee representative) and member of the Remuneration
Committee since 2017.

Positions and
management duties:
Laboratory technician and
full-time union representative in Novo Nordisk A/S . Member of the Board of Directors of
the Novo Nordisk Foundation since 2014.

Education:
Degree in medical laboratory technology (laboratory
technologist) from Copenhagen University Hospital, Denmark (1980).

Martin Mackay
Member of the Board of Novo
Nordisk A/S and chair of the
Research & Development
Committee since 2018.

Positions and
management duties:
Co-founded Rallybio LLC, US,
in January 2018 and serves
as chair of the board and
CEO of the company and in an executive leadership
role overseeing all research
and non-research functions.
Member of the board of 5:01
Acquisition Corporation, US. Senior advisor to New Leaf Venture Partners, LLC, US . Member of the board and chairs the Science and Technology Committee of Charles River Laboratories International, Inc., US.

Special competences:
R&D executive with extensive experience in building a pipeline, acquiring products and managing the portfolio of early-stage and late-stage projects in large international pharmaceutical companies.

Education:
Doctorate/PhD from University of Edinburgh, UK (1984), and BSc (First Class Honours) in Microbiology from Heriot-Watt University, Edinburgh, UK (1979).

Thomas Rantzau
Member of the Board of
Novo Nordisk A/S (employee representative) andmember of the Research & Development Committee since 2018.

Positions and
management duties:
Area specialist in Product
Supply, Novo Nordisk A/S.

Education:
Degree in food engineering from DTU, Denmark (2003) and diploma as dairy technician (1992).

Stig Strøbæk
Member of the Board of
Novo Nordisk A/S since 1998
(employee representative)
and member of the Audit
Committee since 2013.

Positions and
management duties:
Electrician and a full-time
union representative in Novo
Nordisk A/S.

Education:
Diploma in further training
for board members from the
Danish Employees’ Capital
Pension Fund (LD) (2003),
and diploma in electrical
engineering (1984).






Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
44

Independence, meeting attendance and competence overview
Meeting attendance in 20201
Name (male/female) First elected Term Nationality Born
Independence2
Board of
Directors
Chairmanship
Audit Committee8
Nomination Committee Remuneration Committee R&D Committee Competencies
Helge Lund (m)
20173
2021 Norwegian Oct. 1962 Independent 9 of 9 7 of 7 4 of 4
Jeppe Christiansen (m) 2013 2021 Danish Nov. 1959
Not independent 4
8 of 9 6 of 7 5 of 5
Laurence Debroux (f) 2019 2021 French Jul. 1969
Independent 9
8 of 9 4 of 5
Brian Daniels (m) 2016 2021 American Feb. 1959 Independent 9 of 9 4 of 5 5 of 5
Andreas Fibig (m) 2018 2021 German Feb. 1962
Independent 5, 6
9 of 9 5 of 5
Sylvie Grégoire (f) 2015 2021 Canadian/American Nov. 1961
Independent 5, 6
9 of 9 5 of 5 4 of 4 5 of 5
Liz Hewitt (f) 2012 2021 British Nov. 1956
Independent 5, 6, 9
9 of 9 5 of 5 5 of 5
Mette Bøjer Jensen (f) 2018 2022 Danish Dec. 1975
Not independent 7
9 of 9 4 of 4 N/A (employee-elected)
Kasim Kutay (m) 2017 2021 British May. 1965
Not independent 4
9 of 9 4 of 4 5 of 5
Anne Marie Kverneland (f) 2000 2022 Danish Jul. 1956
Not independent 7
9 of 9 5 of 5 N/A (employee-elected)
Martin Mackay (m) 2018 2021 American Apr. 1956 Independent 9 of 9 5 of 5
Thomas Rantzau (m) 2018 2022 Danish Mar. 1972
Not independent 7
9 of 9 5 of 5 N/A (employee-elected)
Stig Strøbæk (m) 1998 2022 Danish Jan. 1964
Not independent 5, 7
9 of 9 5 of 5 N/A (employee-elected)
1. Number of meetings attended by each Board member out of the total number of meetings within the member's term. 2. In accordance with recommendation 3.2.1 of the Danish Corporate Governance Recommendations as designated by Nasdaq Copenhagen.
3. In addition, Helge Lund was a member of the Board for one year in 2014-2015 4. Member of the Board of Directors or Executive Management of Novo Holdings A/S.
5. Pursuant to the US Securities Exchange Act, Ms Hewitt, Ms Grégoire, Ms Debroux and Mr Fibig qualify as independent Audit Committee members, while Mr Strøbæk relies on an exemption from the independence requirements. 6. Ms Hewitt, Ms Grégoire, Ms Debroux
and Mr Fibig qualify as independent Audit Committee members as defined under part 8 of the Danish Act on Approved Auditors and Audit Firms. 7. Elected by employees of Novo Nordisk. 8. All members have relevant industry expertise.
9. Designated as financial experts as defined by the US Securities and Exchange Commission (SEC).

Competencies and experiences to be represented among shareholder-elected Board members (see page 40)

Global business management, strategic operations and governance Healthcare industry and market access
Research and development, technology and digitalisation M&A and external innovation sourcing
People leadership and change management Finance and accounting





Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
45

Executive Management
NVO-20201231_G93.JPG
NVO-20201231_G94.JPG
NVO-20201231_G95.JPG
NVO-20201231_G96.JPG
NVO-20201231_G97.JPG

Lars Fruergaard Jørgensen
— President and Chief
Executive Officer (CEO)

Born: November 1966.

Other positions and
management duties:
Vice chair of the supervisory
board and member of the audit
committee and nomination
committee of Carlsberg A/S,
Denmark.

As of 1 January 2021, vice president
elect of the European Federation
of Pharmaceutical Industries and Associations (EFPIA).

Monique Carter
— Executive Vice President,
People & Organisation

Born: December 1973.

Other positions and
management duties:
No other management positions.

Maziar Mike Doustdar1
— Executive Vice President,
International Operations

Born: August 1970.

Other positions and
management duties:
No other management positions.

Ludovic Helfgott1
— Executive Vice President, Biopharm

Born: July 1974.

Other positions and
management duties: President of the Novo Nordisk
Haemophilia Foundation Council.

Karsten Munk Knudsen
— Executive Vice President,
Chief Financial Officer (CFO)

Born: December 1971.

Other positions and
management duties:
Chair of the board of NNE A/S,
Denmark.
NVO-20201231_G98.JPG
NVO-20201231_G99.JPG
NVO-20201231_G100.JPG
NVO-20201231_G101.JPG

Doug Langa1
— Executive Vice President,
North America Operations

Born: October 1966.

Other positions and
management duties:
No other management positions.

Camilla Sylvest
— Executive Vice President, Commercial Strategy & Corporate Affairs

Born: November 1972.

Other positions and
management duties:
Member of the board of Danish
Crown A/S, Denmark and
Vice Chair of the board of the World
Diabetes Foundation, Denmark.

Mads Krogsgaard Thomsen
— Executive Vice President, Chief Science Officer (CSO)

Born: December 1960.

Other positions and
management duties:
Member of the board of BB Biotech
AG, Switzerland. Member of the
editorial boards of international,
peer-reviewed journals.

Adjunct professor at the Faculty
of Health and Medical Sciences of the University of Copenhagen,
Denmark

Henrik Wulff
— Executive Vice President, Product Supply, Quality & IT

Born: November 1970.

Other positions and
management duties:
Member of the board of Ambu A/S,
Denmark and member of the board of Grundfos Holding A/S, Denmark.
1. Not registered as executive with the Danish Business Authority .





Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements / Additional information
Novo Nordisk Annual Report 2020 /
46
Consolidated financial, environmental, social and
governance statements 2020


Consolidated financial statements
Income statement p. 47
Cash flow statement p. 48
Balance sheet p. 49
Equity statement p. 50

Notes to the consolidated financial statements
Section 1
Basis of preparation
1.1
Principal accounting policies and key accounting estimates p. 51
1.2 Changes in accounting policies and disclosures p. 51

Section 2
Results for the year
2.1 Net sales and rebates p. 52
2.2 Segment information p. 53
2.3 Research and development costs p. 55
2.4 Employee costs p. 55
2.5 Other operating income, net p. 56
2.6 Income taxes and deferred income taxes p. 56

Section 3
Operating assets and liabilities
3.1 Intangible assets and property, plant and equipment p. 58
3.2 Leases p. 60
3.3
Inventories p. 61
3.4 Trade receivables p. 61
3.5 Retirement benefit obligations p. 62
3.6 Provisions and contingent liabilities p. 63
3.7 Other liabilities p. 64











Section 4
Capital structure and financial items
4.1
Earnings per share, distributions to shareholders, treasury shares, share capital and other reserves
p. 65
4.2 Financial risks p. 66
4.3 Derivative financial instruments p. 68
4.4 Borrowings p. 69
4.5
Cash and cash equivalents, financial reserves and free cash flow p. 69
4.6 Change in working capital p. 70
4.7 Other non-cash items p. 70
4.8 Financial assets and liabilities p. 71
4.9 Financial income and expenses p. 72

Section 5
Other disclosures
5.1 Share-based payment schemes p. 73
5.2 Commitments p. 75
5.3 Related party transactions p. 76
5.4 Fee to statutory auditors p. 76
5.5 General accounting policies p. 76
5.6 Companies in the Novo Nordisk Group p. 77

'




















Statement of environmental, social and governance (ESG) performance (supplementary information)
Statement of ESG performance p. 81

Notes to the ESG statement
Section 6
Basis of preparation p. 82

Section 7
Environmental performance
7.1
Energy consumption for operations and share of renewable power p. 83
7.2 Water consumption for production sites p. 83
7.3
CO2 emissions from operations and transportation
p. 83
7.4 Waste from production sites p. 84

Section 8
Social performance
8.1
Patients reached with Novo Nordisk's Diabetes care products p. 84
8.2 Donations and other contributions p. 84
8.3 Employees p. 85
8.4 Frequency of occupational accidents p. 85
8.5 Animals purchased for research p. 85
8.6 Gender diversity p. 85

Section 9
Governance performance
9.1 Business ethics p. 86
9.2 Facilitations of the Novo Nordisk Way p. 86
9.3 Supplier audits p. 86
9.4 Product recalls p. 86
9.5 Failed inspections p. 86
9.6 Company trust p. 86
9.7 Total tax contribution p. 87
9.8 Breaches of environmental regulatory limit values p. 87






Introducing Novo Nordisk / Strategic aspirations / Corporate governance / Consolidated statements - Financial statements / Additional information
Novo Nordisk Annual Report 2020 /
47
Income statement

and statement of comprehensive income for the year ended 31 December

DKK million Note 2020 2019 2018
Income statement
Net sales 2.1, 2.2 126,946 122,021 111,831
Cost of goods sold 2.2 20,932 20,088 17,617
Gross profit 106,014 101,933 94,214
Sales and distribution costs 2.2 32,928 31,823 29,397
Research and development costs 2.2, 2.3 15,462 14,220 14,805
Administrative costs 2.2 3,958 4,007 3,916
Other operating income, net 2.2, 2.5 460 600 1,152
Operating profit 54,126 52,483 47,248
Financial income 4.9 1,628 65 2,122
Financial expenses 4.9 2,624 3,995 1,755
Profit before income taxes 53,130 48,553 47,615
Income taxes 2.6