Operator
Good day, and thank you for standing by. Welcome to the Q1 2026 Novo Nordisk Earnings Conference Call.
[Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Michael Novod, Head of Investor Relations.
Please go ahead.
Operator
Michael Novod
Thank you very much, operator. Welcome to this Novo Nordisk earnings call for the first 3 months of 2026.
My name is Michael Novod, I'm the Head of Investor Relations at Novo Nordisk. With me today, I have CEO Mike Doustdar, EVP U.S.
Operations Jamey Millar, EVP International Operations Emil Kongshoej Larsen, EVP Research and Development and Chief Scientific Officer Martin Holst Lange, and Chief Financial Officer Karsten Knudsen. All speakers will be available for the Q&A session.
Please note that all sales and operating profit growth statements will be at CER unless otherwise specified. Over to you, Mike.
Michael Novod
Maziar Doustdar
Thank you, Michael. In 2026, Novo Nordisk is focused on driving competitiveness, progressing our pipeline and making focused investments towards growth opportunities while delivering returns.
Today, Novo Nordisk is serving more than 45 million people living with obesity and diabetes. Of those, more than 4 million people are using our obesity treatments, which means we are now treating over 50% more people living with obesity compared to just a year ago.
We are excited to continue bringing new Wegovy options to patients, including the Wegovy pill in the U.S. and Wegovy HD, the 7.2 milligram high-dose, now approved in the U.S., U.K., European Union and Brazil.
Since launching the Wegovy pill some 16 weeks ago, we have seen over 1 million people using Wegovy pill. As the global momentum behind peptide-based therapies accelerates, Wegovy pill is defining a novel category as the only oral peptide for the treatment of obesity, setting a new benchmark for what patients and physicians can expect.
We are very proud of this, and it highlights our strong innovation and launch capabilities. Within R&D, we have had 6 regulatory approvals and more than 10 clinical trial initiations in Q1.
We have invested about DKK 22 billion in R&D and commercial initiatives in the first quarter, and on top of that, returned nearly DKK 38 billion to shareholders through dividends and share buybacks. We have raised our 2026 guidance, which Karsten will discuss later.
In the first 3 months of 2026, adjusted sales decreased by 4%, driven by lower realized prices, partly offset by GLP-1 volume growth and market expansion. U.S.
operations decreased 11%, partially offset by international operations which grew 6%. Our GLP-1 sales in Diabetes decreased by 11%, mainly driven by U.S.
operations. Obesity care sales increased 22%, driven by both operating units — International Operations grew by 44% and U.S.
Operations grew by 9%. With that, handing it to Jamey.
Maziar Doustdar
Jamey Millar
Thank you, Mike. Earlier this year, Novo Nordisk launched the Wegovy pill in the United States.
Wegovy pill delivers weight loss efficacy on par with that of injectable Wegovy in a once-daily oral tablet. In addition to the weight loss indication, Wegovy pill is the only oral GLP-1 product approved for the reduction of major adverse cardiovascular events — specifically cardiovascular death, heart attack and stroke.
It is also supported by semaglutide's long-standing safety and tolerability profile with around 50 million patient years of real-world experience and does not have drug-to-drug interaction restrictions in its label. Since launch, we have been focused on use, users and usage.
First quarter TRxs were 1.3 million in total, and since launch, we have generated more than 2 million TRxs, translating into more than 1 million people treated. For the week ending on April 17, total weekly prescriptions were 207,000.
In terms of users, close to 80% of Wegovy pill users are GLP-1 treatment-naive patients, and we also see patients coming to Wegovy pill from competitor products with limited cannibalization from injectable Wegovy. In terms of usage, we are tracking titration, refills and stay time — while it is early, we are encouraged by what we see, consistent with our expectations.
By the end of Q1, all 3 of the largest PBMs added Wegovy pill at parity with injection on their standard template formularies, which will have an impact on the balance between reimbursed and self-pay volume over time. As expected, the early volume is largely in the self-pay segment.
Wegovy High-Dose was launched in the U.S. in April in a single-dose device, giving patients and providers the opportunity to experience greater weight loss.
Based on the step-up trial results, the 7.2 milligram dose of semaglutide delivered 20.7% mean weight loss in people with obesity when patients adhered to treatment, with approximately 1 in 3 people experiencing 25% or greater weight loss. The rate of discontinuation due to adverse events is similar to that observed with the 2.4 milligram dose.
Wegovy High-Dose has been launched nationwide across all channels, with the 3 largest PBMs having added it to their standard formularies as a line extension. We are already seeing users titrate to the 7.2 milligram dose.
Our recent commercial efforts have driven a notable shift in new-to-brand prescription dynamics — the Wegovy franchise is now leading on NBRx market share with a share of around 65%. With that, over to Emil.
Jamey Millar
Emil Larsen
Thank you, Jamey. In the first 3 months of 2026, obesity care sales in international operations grew by 44% to DKK 9.2 billion.
This was driven by strong volume growth and market expansion, partly offset by lower prices, particularly in China following price reductions after the NRDL listing of a competitor product. Novo Nordisk continues to be volume market leader in international operations with around 55% weekly injectable GLP-1 volume market share.
While our market share has been declining over recent quarters, we are starting to see our share growth stabilizing, indicating we are gradually seeing the benefit of our efforts to drive competitiveness. As examples, we are expanding our telehealth partnerships — in some of our largest markets, around 20% of Wegovy sales is coming from telehealth channels.
We are also differentiating our GLP-1 portfolio with the U.K. approval of Wegovy 7.2 milligram in a single-dose device and the launches of Ozempic 2.0 milligram.
In addition, Novo Nordisk is expecting to launch Wegovy in select markets in H2 2026, pending regulatory decision. With that, over to Karsten.
Emil Larsen
Karsten Knudsen
Thank you, Emil. In the first 3 months of 2026, our reported sales increased by 32%, reaching DKK 96.8 billion.
However, as part of our 2025 full year results, we introduced adjusted metrics to exclude certain exceptional and nonrecurring effects, primarily of noncash nature, including the provision reversal of USD 4.2 billion related to the 340B drug pricing program in the U.S. That means our adjusted sales declined by 4%, driven by lower realized prices, partly offset by GLP-1 volume growth and market expansion.
The adjusted gross margin decreased to 80.6% compared to 83.5% in 2025, reflecting lower realized prices, onetime costs and a negative currency impact, partially offset by positive product mix from increased GLP-1 sales. Adjusted operating profit decreased by 6% at CER, reflecting the lower sales and gross profit combined with continued investments in R&D and commercial activities including ongoing launches.
We are on track to deliver the DKK 8 billion of savings from the company-wide transformation announced in Q3 2025, which are being reinvested into growth opportunities. At the end of Q1, the number of full-time employees was around 68,000, a decrease of almost 10,000 employees compared to 12 months ago.
For 2026, adjusted sales growth is now expected to be between minus 4% and minus 12% at CER. The improvement in outlook is mainly driven by increased expectations for GLP-1 product sales.
In International Operations, the outlook is based on current growth trends including continued volume penetration from GLP-1 treatments and market expansion, mainly within obesity, and negative impacts from the compound patent expiry of semaglutide molecule in certain markets. In U.S.
operations, the outlook is based on current prescription trends for the injectable GLP-1 portfolio, intensifying competition, and negative impact from reduced obesity medication coverage in Medicaid. Further lower realized prices linked to investments in market access amplified by the Most-Favored-Nations agreement with the U.S.
administration is assumed. Uptake related to the Wegovy pill is reflected in the outlook based on a range of assumptions including market penetration, potential negative impact on the growth of the injectable obesity medication category, and channel mix.
Adjusted operating profit growth is now expected to be minus 4% to minus 12% at CER. We continue our targeted investment in growth opportunities within R&D and commercial, partly funded by reinvestment of savings from the company-wide transformation and further optimization initiatives.
Over to you, Martin.
Karsten Knudsen
Martin Lange
Thank you, Karsten. The first quarter was eventful with numerous readouts and regulatory milestones.
Within obesity, we obtained FDA approval for high-dose semaglutide at 7.2 milligram in the U.S. We have also initiated the 2 pivotal Phase III trials in the zenagamtide development program, AMAZE, plus Phase III trials investigating zenagamtide in people with obesity and sleep apnea, in people with obesity and knee osteoarthritis, and to investigate weight loss maintenance.
Within diabetes, we completed the pivotal Phase III trial REIMAGINE 1 for CagriSema in people with type 2 diabetes inadequately controlled by diet and exercise. CagriSema demonstrated a superior HbA1c reduction of up to 1.8 percentage points and a superior weight loss of up to 13.8% at 40 weeks.
Detailed results from REIMAGINE 1, 2 and 3 will be presented at the American Diabetes Association Conference in 2026. A weekly insulin received FDA approval as the first and only once-weekly long-acting basal insulin for people living with type 2 diabetes, with launch expected in the FlexTouch device in the U.S.
in H2 2026. Recently, we announced top line results from the Phase III HIBISCUS study evaluating Etavopivat in sickle cell disease in addition to standard of care.
Sickle cell disease affects approximately 8 million individuals worldwide — treatment options remain limited and the unmet need is significant. Etavopivat is a novel once-daily oral small molecule designed to improve red blood cell health via pyruvate kinase-R activation.
HIBISCUS was a randomized, double-blinded 52-week trial investigating Etavopivat versus placebo in 385 people aged 12 years or older. The co-primary endpoints were annualized VOC rate reduction and hemoglobin response.
Etavopivat successfully met both co-primary endpoints, making it the first of its class to do so — substantially reducing VOC events and improving hemoglobin response. In the trial, Etavopivat demonstrated a superior reduction in annualized VOC rates by 27% compared to placebo.
Time to first VOC event was delayed by around 4 months compared to placebo. For the hemoglobin endpoint, Etavopivat demonstrated a superior increase in the proportion of people achieving a hemoglobin response greater than 1 gram per deciliter at week 24 — 48.7% compared to 7.2% with placebo.
As an exploratory analysis, Etavopivat also significantly reduced the risk of blood transfusion. The top line safety profile was in line with previous Etavopivat trials.
Based on HIBISCUS results, Novo Nordisk plans to submit the first regulatory approval of Etavopivat in Q4 2026. Earlier this year, Novo Nordisk and United Laboratories announced top line results for UBT251, a long-acting synthetic peptide triple agonist targeting GLP-1, GIP and glucagon receptors, in 2 Chinese Phase II trials — one in obesity and one in diabetes.
In the obesity Phase II trial, the highest mean weight loss observed was 19.7% after 24 weeks. In the type 2 diabetes trial, the largest mean A1c reduction was 2.16 percentage points at 24 weeks and the highest mean weight loss observed was 9.8%.
Safety and tolerability appeared consistent with tri-agonist-based therapies. Novo Nordisk has initiated a global Phase Ib/IIa trial in obesity with results expected in 2027, and expects to start a global Phase II trial with UBT251 in type 2 diabetes in Q2 2026.
Looking ahead for the rest of 2026 — within obesity, we still expect a decision in the U.S. for CagriSema at the end of 2026 with a potential launch in 2027 around the same time of the REDEFINE 11 top line results.
We expect to initiate a Phase IIIb trial with CagriSema high dose in Q2 2026. We also expect to initiate the AMAZE 9 trial for oral zenagamtide in Q3 and a Phase III trial with cagrilintide high dose in Q4 2026.
In the U.S., we anticipate the decision regarding Wegovy FlexTouch resubmitted in Q1. In the EU, we expect a decision on Wegovy pill and the single-dose device for injectable Wegovy 7.2 milligram.
Within obesity-related comorbidities, we expect Phase III results for efruxifermin in the SYNCHRONY real-world trial in MASH. Within diabetes, we have initiated the Phase II trial for our GLP-1/GIP/amylin tri-agonist and expect to initiate the zenagamtide Phase III program AMBITION in Q4 2026.
Within diabetes-associated comorbidities, the first readout of Ziltivekimab from the ZEUS Phase III trial is anticipated in Q3 2026. Lastly, we are awaiting regulatory decisions in the U.S.
and EU for denecimig, previously known as Mim8, for people living with hemophilia A. Over to you, Michael.
Martin Lange
Michael Novod
Thank you, Martin. With that, we're now ready for the Q&A.
Michael Novod
Operator
Your first question today comes from the line of Richard Vosser from JPMorgan.
Operator
Richard Vosser
Two questions on oral Wegovy. There seems to be a drop-off in patients going between the 4mg and 9mg doses in titration.
Is that the jump in price, tolerability, or weight loss results? And how will that impact stay time and growth going forward?
And on supply of oral Wegovy — how many international markets do you think you can sustain?
Richard Vosser
Michael Novod
First to Jamey and then to Karsten on supply.
Michael Novod
Jamey Millar
Overall, titration is happening as expected and comparable to what we see with injectable Wegovy — we're pleased with the progress. It's early in the evaluative period of usage, but we see continued uptake on a week-over-week basis towards the 9 and 25 milligram doses.
Jamey Millar
Karsten Knudsen
Richard, on supply — while we do not have unlimited supply for the Wegovy pill due to product design, despite setting a new record for product uptake in the U.S., we are still able to announce launches in the first markets ex U.S. already this year.
This speaks to scaling of supply and the inventories we've put in place, and we play it gradually from here in terms of the pace of international rollout.
Karsten Knudsen
Operator
Your next question comes from the line of Sachin Jain from Bank of America.
Operator
Sachin Jain
First, on SG&A — it's the lowest absolute number for a number of quarters, which seems odd into a product launch. Should we think of this as a new commercial model with telehealth as the base, or think about the cadence of SG&A through the year?
Second, a broad question on price — you've mentioned no intention to lower prices and oral price in the sweet spot. Is there no intention to lower at the 150 or 149 lower oral dose holding?
And if oral price is the sweet spot, how do we think about price mix across the business shifting to this lower price bracket?
Sachin Jain
Michael Novod
First question to Karsten and then second goes to Mike.
Michael Novod
Karsten Knudsen
On SG&A — first, it's important to note we have a one-off favorable adjustment of a legal provision, a notch more than $100 million that favorably impacts the quarter. One should adjust for that.
We have gone pretty much all in on the Wegovy pill launch and its resourcing. The model we're deploying together with telehealth partners yields a different scalability in terms of promotional presence between paid versus earned media, yielding a very high share of voice in Q1.
Through the coming quarters, expect us to be disciplined around our spending. We have fewer employees, which helps on SG&A, but we are truly investing in the growth drivers — Wegovy HD, the launch products coming up, and the Wegovy tablets.
The SG&A ratio for the full year is in the low 20s.
Karsten Knudsen
Maziar Doustdar
Price is dynamic and a function of volume uptake. Looking at our volume uptake, we believe we are at the sweet spot.
At the current prices, we have had 2 million scripts after 16 weeks, more than 200,000 scripts per week despite competitors launching, with more than 1 million patients on our product. We have priced this product correctly.
Of course, it's dynamic because if you look at this in a longer spectrum, getting to hundreds of millions of patients will require very different pricing. But for now, this is the right price.
Maziar Doustdar
Operator
Your next question comes from the line of Simon Baker, Rothschild & Co.
Operator
Simon Baker
First, on oral Wegovy — you're getting a better handle on the price volume dynamic, so what's the feedback on why patients are choosing the pill? Is it convenience, efficacy, or cost because it's the cheapest option?
Second for Karsten — not only was SG&A low after the legal adjustment, R&D was as well. Can you give us an idea of the phasing of R&D through the rest of the year?
Simon Baker
Michael Novod
First question for Jamey and then second for Karsten.
Michael Novod
Jamey Millar
The volume uptake and receptivity in the market suggest we've found the sweet spot. In terms of oral attractiveness, the key decision criteria remains the magnitude of weight loss — the Wegovy pill demonstrated 17% weight loss.
In addition, the attractiveness of the limited time offer pricing for the initial starting dose brings people to the product as well.
Jamey Millar
Karsten Knudsen
Thanks, Simon. As Martin mentioned, there's a lot going in R&D, and it's a strategic priority to expand our pipeline for growth not only medium term but long term.
The R&D ratio in Q1 is a notch on the low side compared to what we expect for the full year, so expect us to lean in on R&D investment in the coming quarters.
Karsten Knudsen
Operator
Your next question comes from the line of Peter Verdult from BNP Paribas.
Operator
Peter Verdult
Martin — on your next-gen GLP-1, is it fair to assume this will be differentiated on dosing frequency, or do you still believe there is scope within the GLP-1 class to differentiate on efficacy or safety? And Jamey — you're new to the management team and bring an outsider perspective.
Can you give a flavor of what you found when you arrived and some of the biggest changes you've made since taking the role?
Peter Verdult
Michael Novod
First question to Martin and then to Jamey.
Michael Novod
Martin Lange
When we talk about differentiation, we look at efficacy, tolerability, dosing frequency, and scalability. Let's assume this one has one or more of these potential traits, but I won't go further into detail — attend the CMD to learn more.
Martin Lange
Jamey Millar
Firstly, a lot of opportunity. The Q1 milestones — approvals, clinical data readouts — have produced a great environment to change the trajectory of the business, especially Wegovy pill and Wegovy high-dose 7.2 milligram, which really allows us to level the playing field from an efficacy standpoint.
Secondly, the opportunity to integrate our thinking across market access, sales, marketing, medical and regulatory in a differentiated way.
Jamey Millar
Operator
Your next question comes from the line of Michael Leuchten from Jefferies.
Operator
Michael Leuchten
First, Ozempic had a pretty strong Q1. Can you talk to the price erosion you saw in the U.S.
in Q1, and how that might look once the Medicare bridge program kicks in? Would there be collateral damage for Ozempic in diabetes in H2?
Second on guidance — Karsten, you haven't changed the lower end of the range when Q1 came in quite robustly. What are the variables that don't allow you to lift that lower end from a double-digit decline?
Michael Leuchten
Michael Novod
Two questions for Karsten.
Michael Novod
Karsten Knudsen
On Ozempic pricing in the U.S. — what we've seen in Q1 is a continuation of what we saw toward the end of last year, both on volume trending and on pricing, in the range of minus 10% to up to minus 15% price erosion.
Same guidance this year as last year and even the year before on Ozempic U.S. price.
On guidance — now 3 months down the road, we've seen several items play our way: oral script trends, the Wegovy high-dose approval, our decision to launch Wegovy tablet ex U.S. in a few select markets, and more information on competition and LOE approvals in IO.
Based on that, we're more confident in our outlook, and as a consequence, we parallel shifted both sales and OP ranges by 1 percentage point. You should take it as a signal of confidence that we lifted the range by 1 percentage point.
Karsten Knudsen
Operator
Your next question comes from the line of Mike Nedelcovych from TD Cowen.
Operator
Michael Nedelcovych
First, on Ziltivekimab — between ZEUS, HERMES, ARTEMIS and ATHENA, which trial do you view as having the largest opportunity? Second, on Wegovy IP in the U.S.
— does Novo plan to defend the later-dated patents for Wegovy pill and Wegovy injection, given there's almost a decade difference between the drug substance patent and the latest dated patents?
Michael Nedelcovych
Michael Novod
One question for Martin and one for Karsten.
Michael Novod
Martin Lange
From an indication and potential perspective, ZEUS, HERMES and ARTEMIS are the only ones that will lead to potential indications — respectively in ASCVD, heart failure with preserved ejection fraction, and post-myocardial infarction. We have a high level of confidence in the biology with potential to improve outcomes in all 3 categories.
We still flag the high risk — this is first-in-class, and we need to establish not only efficacy but also the safety and tolerability of an anti-IL-6. Very high potential across all 3 indications, but also high risk until we've seen the first readout.
Martin Lange
Karsten Knudsen
On IP — this industry works by taking very significant risks in early R&D investments with fairly low probability of early success. In return, we get patent protection for a certain period of time.
When granted, of course, we intend to defend all our patents in court should they be challenged by generics.
Karsten Knudsen
Operator
Your next question comes from the line of James Gordon from Barclays.
Operator
James Gordon
First, on long-term semaglutide obesity pricing — in India, there are at least 8 generics approved at very low prices. Do you still think with synthesis generics, your manufacturing technique gives you a long-term price advantage?
Or do you think there will be an order of magnitude price drop once patents go in the West, making it tougher for next-generation obesity therapies? Second on SG&A — you achieved a 47% adjusted EBIT margin; even with the legal one-off, it's still mid-40s.
But the midpoint of the full year guide is more like 40%. Is that because of more R&D, or also lots more sales and marketing for ex-U.S.
oral Wegovy launches?
James Gordon
Michael Novod
Two questions for Karsten.
Michael Novod
Karsten Knudsen
On sema manufacturing — we believe we are hypercompetitive in terms of unit cost and hypercompetitive in terms of scale to produce sema globally. What that leads into in terms of pricing in different healthcare systems remains to be seen.
More of this will be available in care segments with different partners and go-to-market models. Brand recognition and loyalty versus generics, and consequently how much price differentiation next-generation products can achieve, remains to be seen.
India is not a good proxy for other markets. On margins — our point of departure is already a very competitive margin compared to peers.
Strategically, for us it's more important to invest in future growth than short-term margin optimization. We're investing in the short and medium term opportunity with assets in market or coming soon, as well as investing in pipeline.
We could drive for higher margin, but that's not our strategy or intention. We are very disciplined and rational — almost 10,000 fewer FTEs today compared to a year ago, reallocating resources toward our key growth opportunities.
The SG&A ratio for the full year is in the low 20s, reflecting this discipline.
Karsten Knudsen
Operator
Your next question comes from the line of Evan Seigerman from BMO Capital Markets.
Operator
Evan Seigerman
First, on the impact of generic semaglutide in Canada — how are you thinking about that in your guidance? Second, is rare disease an area where you should be leaning in more to complement obesity and diabetes, to give investors the next leg of growth?
Evan Seigerman
Michael Novod
One for Emil on Canada and then one for Mike on rare disease.
Michael Novod
Emil Larsen
We now have 2 approved generics in Canada. We haven't changed our guidance at group level, which assumes low single-digit impact at group level.
We are very ready — the leading tactic in Canada is a savings card that has seen very good uptake for both Ozempic and Wegovy, giving us a lot of maneuverability as this unfolds. After 3 generics, there is a mandated 65% price decline versus our list — we know the game there and are ready to play it.
We have optionality on a second brand as well.
Emil Larsen
Maziar Doustdar
Our strategy is to ensure we drive growth short, medium and long term, both with current products and with our pipeline across all therapy areas. I'm incredibly proud of what we have seen with Etavo, which comes in a family of other best-in-class rare blood and hematology drugs.
All in all, stay tuned — the main aim is to make sure we have multiple legs to stand on so we can drive growth short, medium and long term.
Maziar Doustdar
Operator
Your next question comes from the line of James Quigley from Goldman Sachs.
Operator
James Quigley
First, can you talk to what you're seeing in the early stages of the Foundayo launch? What's the latest feedback from physicians and patients, particularly on managing food and water interactions and awareness of the weight loss differential between the two products?
Are there any patterns in terms of patients going on each drug? Second, for the AMAZE program — you've started 7 Phase III trials.
Can you talk to the dosing protocol? The primary endpoint runs out to week 84, suggesting learnings from CagriSema were incorporated, but how flexible is the dosing, particularly given the unpredictability seen in CagriSema and before seeing REDEFINE 11 results?
James Quigley
Michael Novod
First question for Jamey regarding Foundayo launch and then the second question to Martin on AMAZE.
Michael Novod
Jamey Millar
It's early days, but what we see is an affirmation of the strength of the Wegovy pill profile. The number one decision criteria is efficacy, and we have unsurpassed efficacy with 17% weight loss.
We also quickly introduced an indirect treatment comparison — a well-respected health economic population approach to comparing Phase III trials based on population adjustment — which showed better efficacy with Wegovy pill than the competitor as well as a lower likelihood of discontinuation due to adverse events, specifically GI events. What we've heard in the market is consistent with the strength of our profile.
Jamey Millar
Martin Lange
We did take a lot of learnings from the REDEFINE program. Regarding patient population, the need and wish to lose a substantial amount of weight is a key imperative — we've implemented that starting with REDEFINE 11, and also in AMAZE.
We have adapted flexible dosing so that we prompt patients more and allow investigators to work more with patients to get them to higher doses while maintaining the flexible nature of trials. We clearly learned from REDEFINE that approximately one-third of patients need flexible dosing to achieve the full weight loss potential, and we need to allow that while guiding patients.
We implemented this in REDEFINE 11 — without going into detail, I can already see a substantial impact in REDEFINE 11 from the titration data. We have employed more or less the same algorithm in the AMAZE program, and we are quite confident we'll help patients achieve the full weight loss potential of zenagamtide.
Martin Lange
Operator
Your next question comes from the line of Graham Parry from Citigroup.
Operator
Graham Parry
First, can you quantify the total inventory impact on Wegovy pill sales in the quarter? Was there further inventory increase through the quarter, and do you expect that to run off or continue building in subsequent quarters?
Second, on the CagriSema co-formulation — why the decision to terminate? Is that a technical or commercial decision?
Graham Parry
Michael Novod
First for Karsten on Wegovy pill inventory and then the second to Martin on co-formulation.
Michael Novod
Karsten Knudsen
For the Wegovy tablet, we reported around DKK 2.3 billion sales in Q1. To the tune of $150 million of those were related to what we call pipeline filling — both the initial inventory build with wholesalers and pharmacies, the customary launch orders, and the customary inventory build in connection with the brand getting bigger very, very fast.
This happens for all products; it's just a question of the pace of the inventory build. Going forward, there will be a certain degree of inventory build as the brand continues to expand, so IQVIA scripts will show additional sales especially in early phases linked to inventory build across the chain — this happens for all products and we've seen it for decades.
Karsten Knudsen
Martin Lange
We've always talked about scaling the dual-chamber device of CagriSema to a full-scale launch, and we are very confident in that. We saw the co-formulation as a flexibility or upside option.
The way we now think about it is that we have front-loaded and sped up the AMAZE program and the type 2 diabetes program as well as the oral program for zenagamtide. With full scalability on the dual-chamber device combined with anything zenagamtide coming more or less the same time or even before as the co-formulation could, it really didn't make sense to progress.
It was not a technical thing — we did see full bioavailability, so it actually worked. There was just no need from a production perspective to progress it.
Martin Lange
Operator
Your next question comes from the line of Florent Cespedes from ODDO BHF.
Operator
Florent Cespedes
First, on the GLP-1 franchise in diabetes — how could you reenergize the business in the coming years across U.S. and ex-U.S.?
Second for Martin — on the two tri-agonists, when should we have more visibility on their profiles, and do you intend to keep both going forward depending on their profiles?
Florent Cespedes
Michael Novod
We'll split the first question — one to Emil on driving Ozempic in IO and one to Jamey on Ozempic in the U.S., and then over to Martin.
Michael Novod
Emil Larsen
We are very much focused on getting back in the game with Ozempic now that we have had full supply for 8 to 9 months, and we're seeing emerging positive trends in terms of share growth, particularly in the U.K. What will further increase momentum is our 2.0 launch — we've had first launches in 3 European markets including Germany and the Netherlands, with very good traction.
In IO, two-thirds of all patients have already gotten to our 1 milligram dose and many would benefit from uptitrating both for weight and A1c. We also just got approval in China for our once-weekly combination of GLP-1 and weekly insulin, launching this summer.
Whether it's insulins or GLP-1, we have a strong belief in diabetes across IO.
Emil Larsen
Jamey Millar
In the U.S., we'll continue to focus on the efficacy in terms of A1c reduction in type 2 diabetes and also the holistic cardiovascular benefits that semaglutide uniquely owns in that space. The Ozempic pill was just introduced this week, and we think that will bring new life into Ozempic, leveraging the iconic naming and awareness of Ozempic generally.
Jamey Millar
Martin Lange
It's important to call out that the 2 tri-agonists are different biologies — one combining GLP-1, GIP and glucagon, the other GLP-1, GIP and amylin. Based on what we see so far, they both have substantial potential to induce weight loss with a good safety and tolerability profile, but they may also contain individual traits that could clearly differentiate them — effects on liver, bone, or differentiated weight loss in different subpopulations.
We intend to progress both to understand the full efficacy framework and safety and tolerability. We already have Phase II data for UBT251 showing stellar weight loss potential in both obesity and diabetes, and with Phase II data coming from our internal tri-agonist next year, we'll have better visibility on how to potentially differentiate.
Martin Lange
Operator
Your last question comes from the line of Carsten Lonborg Madsen from Danske Bank.
Operator
Carsten Madsen
I was interested in hearing your commentary on the ex-U.S. oral Wegovy launch — you were quite clear the U.S.
would be a full broad-based aggressive launch. What's your commentary on ex-U.S., including observations on pricing levels outside the U.S.
for the Wegovy tablet?
Carsten Madsen
Unknown Executive
We are excited to have the opportunity to launch in selected key markets that lend themselves particularly well to the Wegovy pill in IO, and we see a lot of halo effects from the U.S. already on our injectable franchise.
We are going to go all in when we get the chance to launch — there will not be any half measures in IO where we launch. But of course, the general play in IO this year is the high-dose 7.2 milligram launches where we see good traction with the messaging already — and when we bring the device, we have a strong belief that will be part of turning around brand sentiment.
That's why we have 20 launches planned. But it's a nice additional decision to also get to launch the Wegovy pill.
Unknown Executive
Michael Novod
Thanks. This concludes the Q&A session.
Thank you for participating, and please feel free to contact Investor Relations regarding any follow-up questions. Before we close, over to Mike for the final remarks.
Michael Novod
Maziar Doustdar
I'm very satisfied with our announcement today. 2026 is off to an exciting start, but we have much work left to do.
This year, we are looking forward to, first, continuing to drive uptake with new products while providing access to many more patients worldwide. Second, progressing our pipeline across therapy areas and development stages, building innovation from within and through business development.
Third, continuing to make this the best organization for our employees and patients through fast decisions and intentional resource allocation. And fourth, strengthening the foundation of Novo Nordisk by sustaining our purposeful direction and building partnerships such as the collaboration with OpenAI, ensuring strong positioning not only for this year but for many more years to come.
Thank you very much. Stay tuned.
Maziar Doustdar
Operator
Thank you. This concludes today's conference call.
Thank you for participating. You may now disconnect.