Novo Nordisk A/S (NOVOB) Earnings Call Transcript & Summary

Good day, and thank you for standing by. Welcome to the Q2 2026 Novo Nordisk AS 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 speaker today, Michael Novod, Head of Investor Relations. Please go ahead.

Thank you very much, operator. Welcome to this Novo Nordisk Earnings Call for the Second Quarter of 2026. My name is Michael Novod. I'm the Head of Investor Relations at Novo Nordisk. With me today, I have CEO of Novo Nordisk, 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 Munk Knudsen All speakers will be available for the Q&A session. Today's call is being webcasted live, and a recording will be made available on our website. The call is scheduled to last 1 hour. Next slide, please. The presentation is structured as outlined on Slide 2. Please note that all sales and operating profit growth statements will be at CER unless otherwise specified. Next slide, please. As usual, we need to advise you that this call will contain forward-looking statements. These are subject to risks and uncertainties that could cause actual results to differ materially from expectations. For further information on the risk factors, please see the company announcement for the second quarter of 2026 and the slides prepared for this presentation. With that, over to you, Mike, for an update on our strategic milestones for the second quarter of 2026.

Thanks, Michael. Next slide, please. In the second quarter of this year, we have continued to deliver on our priorities to improve commercial competitiveness, progress our pipeline and make focused investments while delivering returns. Today, Novo Nordisk is serving more than 46 million people living with obesity and diabetes. We are treating almost 70% more people living with obesity compared to just a year ago with nearly 5 million people on our obesity treatments. We've taken the successful U.S. launch of the Wegovy pill to global markets. We now have around 1.5 million people on the Wgobi Pill worldwide. This is a testament to our increased efforts in manufacturing and across the entire value chain to bring innovation to people. Within research and development, we continue to advance our pipeline across therapy areas. We have received more than 10 regulatory approvals and started more than 5 clinical trials in the second quarter. We have also received -- we have also announced top line results from ZEUS, the first 3 trials with ziltivekimab in patients with ASCVD, chronic kidney disease and inflammation. While the outcome was not what we had hoped for. This single event does not change our strategy. Novo Nordisk remains committed to helping patients with comorbidities related to obesity and diabetes, including cardiovascular disease. Martin will speak to this later. In the second quarter of 2026, we continue to invest in growth opportunities to drive competitiveness and progress our pipeline. This includes more than DKK 26 billion invested into R&D and commercial activities. And lastly, we're happy to see that we have been able to raise our 2026 guidance once again. Karsten will elaborate on this later on during the call. Next slide, please. In the second quarter of 2026, adjusted sales grew 7%, driven by volume growth, partially offset by lower realized prices. U.S. operations grew 4%, reflecting volume growth, primarily driven by GLP-1 in obesity. International operations grew 10% mainly driven by region [indiscernible] . From a therapy point of view, Obesity care sales increased by 16%, driven by volume growth across the Wegovy product portfolio in both U.S. and IO partially offset by lower realized prices. Our GLP-1 sales in diabetes increased by 2%, driven by U.S. operations. GLP-1 diabetes sales in U.S. benefited from a gross to net rebate adjustments related to prior periods. And with that, over to you, Jamey.

Thank you, Mike. Next slide, please. We continue to see encouraging use of the Wegovy pill 6 months into the U.S. launch. Wegovy is the strongest ever GLP launch by volume and we have now reached over 5 million total prescriptions. It took 12 weeks to reach the first 1 million TRxs, yet the latest 1 million TRxs were added in just 4 weeks. Weekly prescriptions as of July 17 were 267,000. The Wegovy pill uptake is driven by its efficacy, favorable tolerability profile and ease of use. Based on the latest data and in the face of competition launched in early April, the Wegovy pill has captured around 90% of the oral obesity medication market. Furthermore, a recently published study showed that weight loss in the real world exceeded that seen in the OASIS 4 clinical trial at the same point in time reinforcing the efficacy's of the pill and patient usage in practice. The Wegovy pill is expanding the market as we continue to see roughly 80% of patients being GLP-1 treatment naive. We also find people coming to Wegovy pill from competitor products and limited cannibalization an injectable Wegovy, which is encouraging. On usage, we are seeing continued progress in titration dynamics with higher dose prescriptions increasing steadily week over week. This suggests people are progressing through titration and continuing treatment, which is also supported by more than 20,000 people currently utilizing the Wegovy pill subscription model for the 2 higher doses. Overall, trends remain in line with our expectations. From an access perspective, quality of access for obesity GLP-1s remains poor and is a key focus area. While we see uptake for the pill in the reimbursed commercial channel, the majority of total prescriptions are self-pay. We're excited about the expansion of access for obesity medication in the 65-plus age population with the recently available Bridge program in Medicare Care Part D. While it is early days, we are encouraged by the strong participation in the program. Wegovy pill appears to be the oral option of choice, and we will continue to focus on educating and differentiating Wegovy injectable to capture higher market share. The branded obesity medication market continues to expand in Q2 2026, growing volumes at around 70% compared to Q2 2025. The Wegovy franchise is playing a major role in this expansion, where the franchise continues to be the leader measured on NBRx with a market share of around 60% during the month of July. And with that, I will turn it over to Emil.

Thank you, Jamey. Please turn to the next slide. In the second quarter of 2026, GLP-1 sales in international operations grew by 13%, driven by volume growth and market expansion with a highlight being obesity franchise growth of 37%. Novo Nordisk continues to be volume market leader outside the U.S. with around 58% GLP-1 volume market share. While our market share has been declining over recent quarters, we see encouraging trends as our share of growth continues to stabilize. This indicates that we are gradually seeing the benefits of our efforts, including the step-up approval and launches of the Wegovy 7.2 milligram and Ozempic 2.0 milligram. In the U.K., we go with 7.2 milligrams in a single dose pen is now broadly available. Since the introduction of the step up data earlier this year, we have seen a market share increase in the GLP-1 market. In the EU, Wegovy 7.2 milligram in the single dose pen was recently approved, and we look forward to launching the pen in the first EU markets during Q3. Ozempic continues to see solid sales momentum with sales growth of 10% in the second quarter. This is partially driven by Ozempic 2.0 milligram, which is now launched in around 10 countries with good uptake coupled with strong overall Ozempic performance across key European markets. Recently, we saw the first generic entries in the early LOE markets. While modest so far, the LOE impact is expected to be back-end loaded in the second half of 2026. Although it is early days, we generally see the market expanding in the earlier week countries mainly driven by more products being available at lower prices and significant promotional investments by new entrants. While the generic players have started to capture market share, we have so far been able to grow our absolute volumes. In Canada, our leading tactic is a savings card program, and we've seen good volume retention for both Ozempic and Wegovy in the cash and private insurance channels. Next slide, please. Recently, we launched Wegovy pill in the first IO countries, the U.K. and UAE. This marks an important milestone as we are now able to offer people a weight loss efficacy on par with that of injectable Wegovy in a once-daily easily administrated pill in these countries. In the U.K., the Wegovy pill was made broadly available in early July, becoming the first once-daily oral GLP-1 treatment for weight management. It is estimated that around 20 million adults live with obesity in the U.K. Prior to the launch, around 1.6 million people were treated with obesity medication in this market. Just 3 weeks into the launch, we estimate around 300,000 patients have started on the Wegovy pill. While it's early days, it appears that the majority of the new patients are GLP-1 treatment naive, suggesting a market expansion. The launch uptake means that our overall GLP 1 obesity market share has increased markedly. When looking at IQV selling data to private providers and pharmacies in July, we've seen an increase in the overall Novo Nordisk obesity market share from around 30% prior to the launch to now 45%. In the UA, we also observed encouraging trends. The Wegovy became available in early June, roughly 1 month after an oral competitor entered. Despite not being the first mover, the Wegovy pill has already captured around 50% market share in the oral segment. We are pleased to see these encouraging uptakes and expect to launch the Wegovy pill in selected countries in the coming quarters, starting with Germany in September. With that, over to you, Martin.

Thank you, Jamey. Please turn to the next slide. Last week, we announced the headline results from So, the first cardiovascular outcome trial investigating [indiscernible] SUS was a large-scale cardiovascular outcome tran with more than 6,300 people enrolled and randomized in a 1:1 ratio to receive once-monthly sinibecumab 15-milligram or placebo on top of standard of care. The eligibility criteria were designed to include patients with established cardiovascular disease, established chronic kidney disease and inflammation as measured by high-sensitivity [indiscernible] protein equal to or above 2-milligram per liter. The primary objective was to demonstrate superiority of once monthly citivecumab versus placebo on top of standard of care to reduce the risk of major adverse cardiovascular events. Form -- the trial demonstrated robust execution with treatment adherence discontinuation rates consistent with the expectations. Though unexpected findings were observed with respect to dosing treatment exposure or imbalances in standard of care management across treatment groups. While ziltivekimab showed target engagement and inhibition of the ISX pathway as reflected by expected reduction in free IL-6 and HSCRP, respectively, this does not translate into Mace reductions with a hazard ratio of 0.99. From a safety standpoint, the overall rates of adverse events and serious adverse events were similar between those treated with ziltivekimab and those on placebo. Consistent with targeting IL-6 inhibition a higher proportion of people treated with [indiscernible] had serious infections compared to placebo. Importantly, no difference in all-cause mortality was observed with a hazard ratio of 0.99. While the ZEUS trial did not validate the IL-6 hypothesis in this specific high-risk population, this does not change our strategic commitment to cardiovascular disease. The trial will inform our ongoing cardiovascular research and the development of treatments for the millions of people living with cardiovascular disease. Cardiovascular outcomes trial Artemis and Hermes, which evaluates ziltivekimab in people with acute myocardial infection and heart failure will preserve ejection fraction, respectively. Our plan to continue with results expected during the first half of 2027. Please go to the next slide. Beyond the ZEUS readout, we have had a busy second quarter across all our therapy areas. Starting with obesity, we successfully completed the REDEFINE-9 trial which was a 68-week efficacy and safety trial testing [indiscernible] maintenance doses of 1.0 and 1.7 milligram of each component in people with overweight obesity. For both lower doses of CagriSema, there was an achievement of superior weight loss compared to placebo. In the trial, CagriSema appeared safe and well tolerated, consistent with the previous CagriSema trials. We expect to share detailed data later this year. We also initiated the CagriSema Phase IIIb trial looking at the higher fixed dose combination of CagriSema with 2.4 milligram of cagintide and 7.2 milligram of semaglutide. The redefined high-dose trial comprises of 2 individual sub studies, one in people with obesity with heart diabetes and other in people with obesity and type 2 diabetes. Each sub study evaluates the body weight reduction with CagriSema high dose compared to calm 2.4 milligram of each component and semaglutide 7.2 milligram alone. We still expect a U.S. decision for CagriSema and obesity at the end of 2026 with the potential launch in 2027. We also initiated the Phase II trial for our triple agonist targeting GLP-1, GIP and Amlin receptors evaluating different dose escalation regimen for up to 39 weeks. The Phase II trial is expected to read out in the second half '27. Within diabetes, we initiated a Phase II trial for UPT 251 in people living with type 2 diabetes. The trial will investigate the safety, tolerability and efficacy of once-weekly UPT 251 for up to 40 weeks. The trial is expected to read out by the end of 2027. We also completed the open-label head-to-head reimagined for trial investigating CagriSema 2.4 milligram versus teseplatide 15 milligram. When evaluating effects people treated with CagriSema achieved a weight loss of 15.2% and an A1c of 1.9 percentage points, respectively, at 68 weeks. For the dual primary endpoint, CagriSema demonstrated noninferiority versus tesepatide for weight reduction but not for A1C reduction. Looking ahead to the remainder of 26, we are set to deliver a number of important milestones and regulatory achievements. In obesity, we plan to initiate several large stage programs, including oral tenagantide and obesity and [indiscernible] high-dose marking important steps in advancing our next-generation of bet portfolio. Within obesity-related comorbidities we anticipate Phase III safety results from the [indiscernible] trial of ephroxyfermin in people living with mesh and fibrosis stages F1 to F4. The trial's primary endpoint is safety and tolerability. In that [indiscernible] , we expect to initiate reimagine switch, evaluating the safety and tolerability of switching from [indiscernible] 1.0 milligram and 2.0 milligram of CagriSema. Results are anticipated in the second half of 2017. In addition, we plan to initiate ambition the Phase III development program for Seagate. On regulatory milestones, we continue to anticipate a U.S. regulatory decision for oral semaglutide 25-milligram in type 2 diabetes as well as U.S. and EU regulatory decisions for dense in hemophilia A. We also remain on track to submit etabopivad in both EU and U.S. in the fourth quarter following the positive Hibiscus results announced earlier this year. Taking together these milestones underscore the breadth and the strength of our pipeline as we continue to advance innovative therapies across obesity, diabetes, rare diseases and associated comorbidities. With that, over to you, Karsten.

Thank you, Martin. Please turn to the next slide. In the second quarter of 2026, our adjusted sales increased by 7% at constant exchange rates, reaching DKK 78.5 billion. This was driven by TL volume growth across geographies and a favorable rebate adjustment related to prior periods. The adjusted gross margin was realized at 78.2% compared to 82.7% in Q2 '25, reflecting lower realized prices onetime cost of around DKK 3 billion related to rightsizing of manufacturing capacity agreements, as well as a negative currency impact. This was partially countered by productivity gains and a positive product mix from increased Tier 21 sales. Adjusted operating profit increased by 11% at constant exchange rates, driven by higher sales and lower cost for the quarter. Through our disciplined cost base approach, we are now ahead of plan to deliver the DKK 8 billion of savings from the company-wide transformation announced back in the third quarter of 2025. which are being reinvested into growth opportunities. At the end of the second quarter, the number of full-time employees was around 6,700, which is a decrease of almost 12,000 employees compared to -- corresponding to roughly a 15% decline compared to 12 months ago. Please go to the next slide. For the first 6 months of 2026, Novo Nordisk has delivered a better-than-expected start to the year. As a result, we have raised our guidance again. The adjusted sales growth is now expected to be 0% to minus 6% at constant exchange rates. The improvement in the outlook is mainly driven by increased expectations for GLP-1 product sales. The outlook reflects expectations for sales growth within international operations and expectations for sales decline within U.S. operations. In [indiscernible] operations, the outlook is based on current growth trends, including continued volume penetration for GLP-1 treatments and market expansion, mainly within obesity. In addition, the outlook is based on negative impacts from the compound patent expiry of the semaglutide molecule in certain markets. Novo Nordisk continues to roll out the Wegovy product portfolio in more markets during 2026, including the Wegovy pill. In U.S. operations, the outlook is based on current prescription trends for the injectable T1 portfolio intensifying competition as well as negative impact from reduced obesity mitigation coverage in Medicaid. Further lower realized prices linked to investments in market access amplified by the most favorite nations agreement with the U.S. administration is assumed. Novo Nordisk further focuses on expanding access, particularly in the self-pay channel through [indiscernible] Pharmacy and collaborations with Chile health organizations as well as the bridge program in Medicare Part D. uptake related to the launch of the Global in January 2026 is reflected in the outlook based on a range of assumptions as outlined in the company announcements. Adjusted operating profit is now expected to be 0% to minus 6% at constant exchange rates. The expectation for adjusted operating profit growth primarily reflects the improved sales outlook combined with targeted investments in current and future growth opportunities within R&D and commercial, partly funded by reinvestment of savings from the company-wide transformation in 2025 as well as further optimization initiatives and disciplined resource allocation. Other key modeling considerations for 2026 are shown on the slide. That was the outlook for 2026. Now over to you, Mike.

Thank you, Karsten. Please go to the next slide. While 2026 continues to be a challenging year for Novo Nordisk, it has also been an exciting and an important one. We are encouraged by the first half results and by the progress we have made across several areas compared with the expectations we had at the beginning of the year. At the same time, the year is far from over, and we maintain mindful for the headwinds we are facing in the second half. Our priorities for 2026 remain clear, and there's still significant work ahead of us. As Jamey and Emil explained, we continue to strengthen our competitiveness by expanding our product offerings globally and bringing innovation to many more people. Our pipeline continues to advance at speed with additional first-in-human dosing and initiation of late-stage clinical trials across multiple therapy areas. And finally, we're progressing ahead of our transformation plan announced last September. Creating greater capacity to invest in future growth opportunities. On behalf of the entire management team, we look forward to discussing these areas in greater depth at our Capital Market Day in September. And with that, let me hand it back to you, Michael.

Thank you, Mike. Next slide, please. With that, we're now ready for the Q&A. We kindly ask all participants to limit her or himself to one or maximum 2 questions, including subquestions. Operator, we're now ready to take the first question.

[Operator Instructions] And our first question comes from the line of James Quigley from Goldman Sachs.

I've got one on the guidance and one on [indiscernible] trajectory, the guidance, the second half implies around 5% or so negative growth. But can you talk to the dynamics and the headwinds that you have there, which of those headwinds could potentially also move forward into impact growth there. And then secondly, on the ex U.S. rigor trajectory. U.K., you said 300,000 patients in the first 3 weeks or so since launch that compares to $48,000 for the U.S. So how comparable are the launch trajectories for the U.S. versus ex U.S. markets? What have you seen in terms of waiting lists and things like that for the U.K.? And are there any similar metrics or expectations you have for the Germany launch that you've seen with the U.K. launch as well?

Thank you very much, James. First question for Karsten and the second question for Emil.

Yes. James, thanks for the question. In terms of outlook and the balance of logic you're after, the simple version is that we take our current run rate where we delivered 2% growth in the first half. and continue with that run rate and then you factor in 2 factors: 1 being loss of [indiscernible] in a few markets, Canada and Brazil mainly which we see happening here predominantly starting in the second half. And then you take into account the favorable gross-to-net effects we had in Q3 and Q4 last year of combined billion. And if you take that carry forward, then, of course, the comparative effect, we don't carry forward into next year whilst the loss of exclusivity impact will annualize into next year.

On your second question, we, of course, are very encouraged by the U.K. mind you, almost 3 out of 10 obesity patients on a once-weekly GLP-1 and I live in the U.K. but it's still only 1.6 million patients being treated out of 20. So the room for market expansion is tremendous in the U.K. And as you rightly point out, there was a pent-up demand. A lot of patients have been on the sidelines, even more than we could have hoped for, and it just goes to show that injections -- the injection barrier is very real and this uptake is, of course, tremendous. We also believe the fact that we don't have drug-drug interactions allow patients on oral contraceptives on statins, et cetera to start easily on a one-day very efficacious option here. So we are super encouraged. We are, of course, optimistic on the continued uptake based on what we hear from the [indiscernible] providers and also the media sentiment. In terms of the reader cross to Germany, it is quite a different market, but Germany is also a market that versus a year ago is now driven by Telehealth, more than half of the growth and 1/3 of the market is already sold through Telehealth channels and there is an increasing awareness in the population and an even larger unmet need because treatment rates lower. So the base -- we start from a different base, but we'll use a lot of the same tactics in Germany, and we are bullish on the uptake there as well.

Thank you very much, Al. Thanks, Kash, James.

And our next question comes from the line of Richard Vosser from JPMorgan.

Two questions, please. First question, just on the redefined reimagined for implications, apologies for the launch of Calgary same in diabetes, just thinking about the positioning of the product, given the HbA1c was inferior compared to Mounjaro and of course, the focus in diabetes on blood glucose control. And then the second question, just is on supply. Could you remind us where you are in the ramp-up of the new API manufacturing facilities? What sort of utilization are you at the new plants how quickly can you anticipate being at full capacity? Where are we heading on there in terms of supply?

First question on reimagine for Martin and then the supply question for Karsten.

Yes. Thank you very much, Richard. I'll just remind you that across the [indiscernible] 2 diabetes trials, we have seen A1C lowering between minus 1.8% and 2.3%. So very, very strong placema control in the reimagined was 1.9%. And at the same time, we've seen an almost unprecedented 15% weight loss. Also reminding you that CagriSema obviously the combination of semaglutide that has a very well-established in bit. It's basically the only and in diabetes, it appears to be the strongest CMA risk reduction assets in the field. That carries into CagriSema and the benefits that we've seen on blood pressure on glycemic control on lipid improvements. And what we've also seen in the preclinical space on potential bone preservation, potentially other benefits of the mild biology that calls for a really, really strong proposition, not only in diabetes, obviously, but also in obesity where we've seen a 23% weight loss. So across the board, we really meet a lot of excitement from investigators but also treating physicians -- looking forward to having yet another new biology with very strong glycemic control weight loss but also other benefits from a combination therapy.

Richard, on your question in terms of API supply from our new facilities, I believe you visited the -- one of the plants in connection with the latest Capital Markets Day in Denmark a couple of years ago. What I'd say is that we have validated the first product in the first finger in the first facility. That's as specific as I can be. So it's progressing very nicely and we are happy with progress. So far, in terms of commercial supply into the marketplace, low utilization, very low utilization from these facilities, which makes us also bullish in terms of being able to supply significant volumes in the years to come, especially the Wegovy pill for ex U.S. rollout.

And our next question comes from the line of Michael Leuchten from Jefferies.

Two questions, please. One for Mike. Just a clarification, Mike, on your BD strategy. I think there was an FT article that suggested you'd be willing to look at larger transactions. And then I think this morning on the media call, you said you more focused on bolt-on acquisitions, just sort of clarifying like what size of potential additions to the portfolio you're looking at? And why you're making that choice? And then going back to Martin, the reimagined for failure. Can you help me think through what that may or may not mean for nicotine because we keep seeing data points that suggest that adding a novel GLP-1 with an AML doesn't us to 1 plus 1 to equal 2. It's more like 1.5. And I just wonder what that means for a molecular asset that is combining those 2 where you just have less ability to titrate the 2 components up or down? Like how do I think about the ability to get that molecular structure into the right landing zone from an efficacy and tolerability perspective?

Great. First question for Mike on BD and then on Karsten also agent for Martina.

Thanks, Michael. So I don't measure our ambition by the number or the size of the acquisition we make I measured by the quality of innovation we bring to the patients. I've repeatedly have said, Michael, that I'm very proud of our internal R&D and pipeline but no company has a monopoly on good ideas. So what I look right now is what Martin is doing within the areas we are operating and some of the comorbidities of obesity and diabetes. And while getting incredibly proud, I've also said we are in every data room, try and see who else has a better idea? Who else can give us assets that we can bolt on and complement what basically Martin & Co are doing, and that's what we are active on. The comment to financial times, just for clarity has been, is there 1 day that you can foresee transformation and transformative M&A. And I have said that I'm a person who never starts with a no. So one day maybe, but you have to be in a very different situation that Novo Nordisk has today. for that one day for us to think about it. Today, we are trying to bolt on to what Martin is doing in various areas.

Okay, Mike. And Martin, on...

Yes. Thank you very much, Michael, for that question. So obviously, as we've discussed before, we do not believe that we have seen the final data on [indiscernible] in and of itself as we've previously discussed, there is a need for individualized treatment. We are testing that in what we believe is the right setting in redefine and therefore, both from a weight loss potential and potentially also from a glycemic to potential just with CagriSema, we do believe that we could potentially see even further weight loss and potentially even further placemacontrol. As you remember from Phase II percentage in obesity, we've seen 24% weight loss in a matter of 6 months treatment. This seems to be a very powerful proposition. I cannot, at this point, speculate whether it's going to be fundamentally different from CagriSema but right now, the indications are both in diabetes and obesity when it comes to [indiscernible] and weight loss, that tenant will be a substantial addition to what we can do in obesity and certainly also in diabetes. Again, I'm looking forward to also show the redefined 9 data, the individualized treatment getting patients to their desired weight loss or their desired target as different doses will also come clearly through redefine 9 and we'll share those data later this year to give you further insights.

And our next question comes from the line of Carsten Lonborg Madsen from Danske Bank.

I think I'll just take one question here, disguised in 2 questions, I guess. The Wegovy U.S. performance, minus 22% in constant exchange rates Jamey, could you try to give us some info on the dynamics you are seeing here in Q2 for [indiscernible] the U.S. market? And also maybe help us understand a little bit the very large discrepancy versus Q1 and also the prescription data that we can see with points to growth, of course, but then there's a pricing component. Should we worry that there's an increasing pricing pressure seen or maybe like-for-like pricing pressure on new channels at lower prices coming on stream?

Thank you very much, Carsten. That's one for you, Jamey.

Yes. I think as we highlighted at the beginning of the year, we were expecting volume growth but continued price pressure. And that's what we've seen. I think you answered the question almost in your question, we did see volume growth with Wegovy injectable, but that was offset by lower realized prices that we anticipated. So no new price dynamic impacting it. It's the price dynamic that we started the year with. [indiscernible] Asian add on?

Yes, and just building on Jamie's comment, what you should also be conscious of carton is that the business mix has changed for Wegovy injectible in the U.S. and actually what Jamie and the team has very successfully pulled off in terms of the brand to get self-pay going. So right now, for the Wegovy injectable in the U.S. self-pays to the tune of 35% of total Wegovy Injectable compared to a year ago where we were around the 10% to 15% range. It's at a different price point, but it's a good way to unlock volume. And then I'd secondly say that we don't see a lot of direct cannibalization from switching to the Wegovyi pill. But of course, indirectly, we don't know how many on Wegovy pill would otherwise have started on the injectable. So it's just important to take that into account when you look at the script trends.

Our next question comes from the line of Michael Nedelcovych from TD Cohen.