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Results for the year (Tables)
 12 Months Ended
Dec. 31, 2023
Analysis of income and expense [abstract]  
Gross-to-net sales reconciliation
Gross-to-net sales reconciliation
DKK million202320222021
Gross sales608,645455,692340,180
US Managed Care and Medicare(223,191)(161,123)(112,929)
US wholesaler charge-backs(74,435)(56,443)(40,354)
US Medicaid rebates(31,821)(24,667)(19,810)
Other US discounts and sales returns(28,481)(18,300)(14,119)
Non-US rebates, discounts and sales returns(18,456)(18,205)(12,168)
Total gross-to-net sales adjustments(376,384)(278,738)(199,380)
Net sales232,261176,954140,800
Provisions for sales rebates
Provisions for sales rebates
DKK million202320222021
At the beginning of the year69,49950,82234,052
Additional provisions, including increases to existing provisions285,266206,354155,602
Amount paid during the year(250,316)(189,580)(141,370)
Adjustments, including unused amounts reversed during the year(2,364)(1,141)(284)
Effect of exchange rate adjustment(2,207)3,0442,822
At the end of the year99,87869,49950,822
DKK million
Provisions
for sales
rebates1
Provisions
for legal
disputes		Provisions
for product
returns
Other
provisions2
2023 Total2022
Total
At the beginning of the year69,4992,3761,0301,97274,87755,894
Additional provisions, including increases to existing provisions285,2661,9371,010588288,801207,715
Amount used during the year(250,316)(226)(531)(173)(251,246)(190,278)
Adjustments, including unused amounts reversed during the year(2,364)(240)12(431)(3,023)(1,668)
Effect of exchange rate adjustment(2,207)(61)11(25)(2,282)3,214
At the end of the year99,8783,7861,5321,931107,12774,877
Non-current liabilities3
4513,7636131,8226,6494,590
Current liabilities99,42723919109100,47870,287
1. Provisions for sales rebates are related to US Managed Care, Medicare, Medicaid, 340B Drug Pricing Program and other types of US rebates, as well as rebates in a number of European countries and Canada. 2. Other provisions consists of various types of provisions, including obligations in relation to employee benefits such as jubilee benefits. 3. For non-current liabilities, provisions for sales rebates are expected to be settled after one year, provisions for product returns will be utilised in 2024 and 2025. In the case of provisions for legal disputes, the timing of settlement cannot be determined.
Contingent liabilities
Novo Nordisk is currently involved in pending litigations, claims and investigations arising out of the normal conduct of its business. While provisions that Management deems to be reasonable and appropriate have been made for probable losses, there are inherent uncertainties connected with these estimates.

Pending litigation against Novo Nordisk
Since January 2021, Novo Nordisk has made a number of changes to its policy in
the US related to facilitating delivery of its discounted medicines to commercial pharmacies that contract with covered entities participating in the 340B Drug Pricing Program. On 30 January 2023, the US Court of Appeals for the Third Circuit issued a ruling holding that Novo Nordisk’s drug distribution policy was consistent with the 340B statute. However, rulings in similar cases involving other manufacturers are pending before the US Courts of Appeals for the Seventh and DC Circuits, and such cases may be subject to further discretionary appellate review before the US Supreme Court. Depending on the outcome of any subsequent rulings and appeals in these matters, there may be a material impact on Novo Nordisk’s financial position, net sales and cash flow.

Mosaic Health Inc. and Central Virginia Health Services, Inc. (both 340B covered entities) filed a putative class action lawsuit in Federal Court in New York against
Novo Nordisk, Eli Lilly and Company, Sanofi and AstraZeneca alleging a conspiracy
among the manufacturers to artificially fix prices of diabetes medications through
changes to their policies relating to the distribution of 340B drugs. The lawsuit was























subsequently dismissed by the Court on 2 September 2022. Plaintiffs have filed an amended complaint. Novo Nordisk does not expect this matter to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

Novo Nordisk is currently defending several lawsuits, including putative class actions, relating to the pricing of diabetes medicines in the US. The first lawsuit was filed in 2017 and in August 2023 a multi-district litigation was created in the United States District court for the District of New Jersey. Nearly all pending matters also name Eli Lilly and Company and Sanofi as defendants, while certain matters also name Pharmacy Benefit Managers (PBMs) and related entities. Plaintiffs generally allege that the manufacturers and PBMs colluded to artificially inflate list prices paid by consumers for diabetes products, while offering reduced prices to PBMs through rebates used to secure formulary access. Novo Nordisk does not expect the lawsuits to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

In 2016, Novo Nordisk received a Civil Investigative Demand (CID) from the US Department of Justice (DOJ) relating to potential off-label marketing of NovoSeven® (including high dose and for prophylactic use) and interactions with physicians and patients. The DOJ investigation was likely prompted by a lawsuit filed in 2015 by a former Novo Nordisk employee, who alleged Novo Nordisk caused the submission of false claims to Medicare, Medicaid, Federal Employees Health Benefits Program and private insurers in California as a result of the same conduct that was the subject of the DOJ CID. In May 2023, at the Plaintiffs’ request, the case was transferred to the United States District Court for the Western District of Washington. Following transfer,
in July 2023, Plaintiffs filed a motion to revive their nationwide Medicare claims and their Delaware Medicaid claims. Novo Nordisk filed a motion to dismiss these claims. Novo Nordisk does not expect the lawsuits to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

Novo Nordisk, along with Eli Lilly, are defendants in numerous product liability lawsuits (including in the US) related to the use of GLP-1-based treatments. Plaintiffs have alleged that the use of these treatments, including Ozempic®, Wegovy® and Rybelsus®, have caused various gastrointestinal and other injuries. Novo Nordisk is taking actions to address the lawsuits. Novo Nordisk does not expect these lawsuits to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

Pending claims against Novo Nordisk and Investigations involving Novo Nordisk
Novo Nordisk has received Civil Investigative Demands (CIDs) or subpoenas from several US authorities including Attorneys General from the states of Minnesota, New Mexico, Washington, Colorado, Vermont, Texas and the US Federal Trade Commission that call for the production of documents and information relating to, among other things, the company’s trade practices relating to its insulin and GLP-1-based products. Novo Nordisk is cooperating with the relevant government authorities in each of these investigative matters and does not expect these matters to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

In December 2021, Novo Nordisk received a CID from the DOJ relating to the company’s financial relationships with healthcare professional and prescriptions for Ozempic® and Rybelsus® during the period of 1 January 2016 to present. Novo Nordisk is cooperating with the DOJ in this investigation and does not expect this matter to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

Other contingent liabilities
In addition to the above, Novo Nordisk is engaged in certain litigation proceedings and various ongoing audits and investigations. In the opinion of Management, neither settlement nor continuation of such proceedings, nor such pending audits and investigations, are expected to have a material effect on Novo Nordisk’s financial position, operating profit or cash flow.
Information by business segment
Business segments – Key figures
Diabetes and Obesity careRare diseaseTotal
DKK million202320222021202320222021202320222021
Net sales215,098156,412121,59717,16320,54219,203232,261176,954140,800
Cost of goods sold(30,483)(23,405)(19,363)(5,282)(5,043)(4,295)(35,765)(28,448)(23,658)
Sales and distribution costs(52,477)(42,392)(33,791)(4,266)(3,825)(3,217)(56,743)(46,217)(37,008)
Research and development costs(28,073)(20,157)(15,600)(4,370)(3,890)(2,172)(32,443)(24,047)(17,772)
Administrative costs(4,435)(3,955)(3,504)(420)(512)(546)(4,855)(4,467)(4,050)
Other operating income and expenses(7)8921991261421331191,034332
Segment operating profit 99,62367,39549,5382,9517,4149,106102,57474,80958,644
Operating margin46.3 %43.1 %40.7 %17.2 %36.1 %47.4 %44.2 %42.3 %41.7 %
Depreciation, amortisation and impairment
losses expensed		(8,195)(5,701)(4,895)(1,218)(1,661)(1,130)(9,413)(7,362)(6,025)
Business segments
Net sales – Business segments and geographical areas
Total International OperationsTotal North America OperationsTotal Novo Nordisk
net sales
Total IOEMEAChinaRest of WorldTotal NAOUS
DKK million202320222021202320222021202320222021202320222021202320222021202320222021202320222021
Diabetes and Obesity care segment:
Rybelsus®
7,3893,1555244,2321,71428913163—3,0261,37823511,3618,1444,31411,0608,0114,24318,75011,2994,838
Ozempic®
26,37817,3698,85614,32710,4176,3934,8212,1963037,2304,7562,16069,34042,38124,84963,01038,75023,16895,71859,75033,705
Victoza®
4,8505,6726,7262,1662,7243,5271,2561,4781,5441,4281,4701,6553,8146,6508,3283,6136,4068,0318,66412,32215,054
Total GLP-138,61726,19616,10620,72514,85510,2096,2083,7371,84711,6847,6044,05084,51557,17537,49177,68353,16735,442123,13283,37153,597
Long-acting insulin11,33911,40311,0747,1037,1576,7291,6491,6362,0802,5872,6102,2653,5665,3386,9902,9314,6856,41214,90516,74118,064
•of which Tresiba®
5,8646,0925,4863,4353,4852,9798481,0501,0951,5811,5571,4121,8883,2614,2431,3332,7233,7937,7529,3539,729
•of which Xultophy®
2,8872,4002,1351,8311,7161,6934094536476394393324095223253995123,2192,8092,657
•of which Levemir®
2,5882,9113,4531,8371,9562,0573925419823594144141,3461,6682,2251,2731,5632,1073,9344,5795,678
Premix insulin9,34210,02310,5122,5702,6222,8794,4414,9125,2242,3312,4892,4092325396912165176659,57410,56211,203
•of which Ryzodeg®
3,7302,8891,7115874953921,9651,2182831,1781,1761,036——————3,7302,8891,711
•of which NovoMix®
5,6127,1348,8011,9832,1272,4872,4763,6944,9411,1531,3131,3732325396912165176655,8447,6739,492
Fast-acting insulin10,41510,82610,9036,6956,4566,4541,5451,9422,2882,1752,4282,1615,5346,6376,7845,2656,2476,35715,94917,46317,687
•of which Fiasp®
1,5121,3541,1061,2661,138965———2462161416616496426186066052,1732,0031,748
•of which NovoRapid®
8,9039,4729,7975,4295,3185,4891,5451,9422,2881,9292,2122,0204,8735,9886,1424,6475,6415,75213,77615,46015,939
Human insulin6,1346,5087,4531,9191,9832,1521,2131,8122,6923,0022,7132,6091,4601,6781,5991,4061,6051,5157,5948,1869,052
Total insulin37,23038,76039,94218,28718,21818,2148,84810,30212,28410,09510,2409,44410,79214,19216,0649,81813,05414,94948,02252,95256,006
Other Diabetes care1,9872,4282,6446617177138921,1811,4324345304993257979502676608062,3123,2253,594
Total Diabetes care77,83467,38458,69239,67333,79029,13615,94815,22015,56322,21318,37413,99395,63272,16454,50587,76866,88151,197173,466139,548113,197
Wegovy®
1,91354—1,91354———————29,4306,1341,38629,4306,1341,38631,3436,1881,386
Saxenda®
6,4025,8323,1173,7803,5611,809146133612,4762,1381,2473,8874,8443,8973,3064,3683,52610,28910,6767,014
Total Obesity care 8,3155,8863,1175,6933,6151,809146133612,4762,1381,24733,31710,9785,28332,73610,5024,91241,63216,8648,400
Diabetes and Obesity care total86,14973,27061,80945,36637,40530,94516,09415,35315,62424,68920,51215,240128,94983,14259,788120,50477,38356,109215,098156,412121,597
Rare disease segment:
Rare blood disorders6,4326,6715,7844,0213,7953,7123726042222,0392,2721,8505,3445,0354,4335,0704,7104,17011,77611,70610,217
•of which Haemophilia A
1,9391,7691,6251,2711,1371,16222381244455514394835694874685434602,4222,3382,112
•of which Haemophilia B
584479400377294268131341941721284772802373361521021,061759637
•of which NovoSeven®
3,7894,3353,6732,2852,3112,2251365101941,3681,5141,2544,1693,9733,5484,0653,8113,4617,9588,3087,221
Rare endocrine disorders2,0454,9044,8806992,2322,2122162461671,1302,4262,5011,7912,2342,4231,7572,2052,4003,8367,1387,303
Other Rare disease1,0061,0021,0647818048375662201922215456966192033583301,5511,6981,683
Rare disease total9,48312,57711,7285,5016,8316,7615938563953,3894,8904,5727,6807,9657,4757,0307,2736,90017,16320,54219,203
Total sales by geographical area95,63285,84773,53750,86744,23637,70616,68716,20916,01928,07825,40219,812136,62991,10767,263127,53484,65663,009232,261176,954140,800
Total sales growth as reported11.4 %16.7 %11.7 %15.0 %17.3 %9.9 %2.9 %1.2 %13.7 %10.5 %28.2 %13.5 %50.0 %35.4 %10.1 %50.6 %34.4 %9.0 %31.3 %25.7 %10.9 %
Research and development costs
DKK million202320222021
Employee costs (note 2.4)
12,4299,9527,328
Amortisation and impairment losses, intangible assets (note 3.1)
1,7571,364744
Depreciation and impairment losses, property, plant and equipment (note 3.2)
1,313922736
Clinical trial cost9,4686,3134,214
Other research and
development costs		7,4765,4964,750
Total research and development costs32,44324,04717,772
As percentage of net sales14.0 %13.6 %12.6 %
Employee costs and remuneration to executive management and board of directors
DKK million202320222021
Wages and salaries42,86734,57528,939
Share-based payment costs (note 5.1)
2,1491,5391,040
Pensions – defined contribution plans3,2672,4722,022
Pensions – defined benefit plans126185139
Other social security contributions3,0392,7132,203
Other employee costs4,0663,1052,189
Total employee costs for the year55,51444,58936,532
Employee costs capitalised as intangible assets and property, plant and equipment(2,337)(1,451)(1,240)
Change in employee costs capitalised
as inventories		(409)(70)(56)
Total employee costs
in the income statement		52,76843,06835,236
Included in the income statement:
Cost of goods sold15,49011,7669,611
Sales and distribution costs20,81017,70015,003
Research and development costs12,4299,9527,328
Administrative costs3,9623,5173,098
Other operating income and expenses77133196
Total employee costs in the
income statement		52,76843,06835,236

Number of employees
Number202320222021
Average number of full-time employees59,55251,04646,171
Year-end number of full-time employees63,37054,39347,792
Year-end employees (total)64,31955,18548,478
Remuneration to Executive Management and Board of Directors
DKK million202320222021
Salary and short-term incentive173141126
Pension171312
Benefits19910
Long-term incentive1
12197100
Severance payments——29
Executive Management in total2
330260277
Fees to Board of Directors3
222017
Total352280294
1. Refer to note 5.1 for further information on share-based payment schemes. 2. Total remuneration for persons registered as members of Executive Management with the Danish Business Authority amounts to DKK 195 million (DKK 175 million in 2022 and DKK 202 million in 2021). 3. All members of the Board of Directors are registered with the Danish Business Authority.
Income taxes expensed and paid
Income taxes expensed
DKK million202320222021
Current tax on profit for the year25,91817,82913,871
Deferred tax on profit for the year(4,464)(3,806)(1,528)
Tax on profit for the year21,45414,02312,343
Current tax adjustments recognised
for prior years		(916)339(603)
Deferred tax adjustments recognised
for prior years		453(825)(417)
Income taxes in the income statement20,99113,53711,323
Tax on other comprehensive income
for the year, (income)/expense		359889(1,005)
Computation of effective tax rate
DKK million202320222021
Statutory corporate income tax rate in Denmark22.0 %22.0 %22.0 %
Deviation in foreign subsidiaries' tax rates compared to the Danish tax rate (net)(0.9 %)(1.1 %)(1.5 %)
Non-taxable income less non-tax-deductible expenses (net)(0.7 %)(0.5 %)(0.3 %)
Other adjustments (net)(0.3 %)(0.8 %)(1.0 %)
Effective tax rate20.1 %19.6 %19.2 %
Income taxes paid
DKK million202320222021
Income taxes paid in Denmark for
current year		16,2429,1819,703
Income taxes paid outside Denmark
for current year		8,9065,6473,439
Income taxes paid/(repayments) relating
to prior years		749(313)1,296
Income taxes paid25,89714,51514,438
Computation of effective tax rate
Computation of effective tax rate
DKK million202320222021
Statutory corporate income tax rate in Denmark22.0 %22.0 %22.0 %
Deviation in foreign subsidiaries' tax rates compared to the Danish tax rate (net)(0.9 %)(1.1 %)(1.5 %)
Non-taxable income less non-tax-deductible expenses (net)(0.7 %)(0.5 %)(0.3 %)
Other adjustments (net)(0.3 %)(0.8 %)(1.0 %)
Effective tax rate20.1 %19.6 %19.2 %
Development in deferred income tax assets and liabilities
Development in deferred income tax assets and liabilities
DKK millionProperty,
plant and
equipment		 Intangible
assets		Inventories
Liabilities		OtherOffset
within
countries		Total
2023
Net deferred tax asset/(liability) at the beginning of the year(2,402)(8,279)2,59511,0073,922—6,843
Income/(charge) to the income statement(213)(2,106)(645)3,9733,002—4,011
Income/(charge) to other comprehensive income——(224)(6)(129)—(359)
Income/(charge) to equity————(120)—(120)
Additions from acquisitions————62—62
Effect of exchange rate adjustment54144(9)(547)139—(219)
Net deferred tax asset/(liability) at the end of the year(2,561)(10,241)1,71714,4276,876—10,218
Classified as follows:
Deferred tax asset at the end of the year4332451,82014,7926,986(3,896)20,380
Deferred tax liability at the end of the year(2,994)(10,486)(103)(365)(110)3,896(10,162)
2022
Net deferred tax asset/(liability) at the beginning of the year(1,980)(7,375)3,1956,9322,629—3,401
Income/(charge) to the income statement(413)674(465)3,999836—4,631
Income/(charge) to other comprehensive income——(130)(141)(608)—(879)
Income/(charge) to equity————234—234
Additions from acquisition of businesses (note 5.3)1
—(1,475)——766—(709)
Effect of exchange rate adjustment1
(9)(103)(5)21765—165
Net deferred tax asset/(liability) at the end of the year1
(2,402)(8,279)2,59511,0073,922—6,843
Classified as follows:
Deferred tax asset at the end of the year1
5791952,62711,0274,646(5,170)13,904
Deferred tax liability at the end of the year(2,981)(8,474)(32)(20)(724)5,170(7,061)
1. Comparatives were restated to reflect change in the provisional valuation of net identifiable assets from a business combination completed in 2022. Reference is made to note 5.3.