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#1VICKI MOONEY AND HER DAUGHTER MIA Vicki is living with obesity Spain novo nordisk - a focused healthcare company Investor presentation ADA 2019 novo nordisk#2Investor presentation ADA 2019 Slide 2 Agenda CV aspects of GLP-1s and clinical developments with OzempicⓇ PIONEER highlights Driving innovation in insulin Obesity and NASH pipeline The increasing focus on Real-World Evidence Regulatory update changing diabetes novo nordisk#3Forward-looking statements Investor presentation ADA 2019 Slide 3 Novo Nordisk's reports filed with or furnished to the US Securities and Exchange Commission (SEC), including this presentation as well as the company's statutory Annual Report 2018 and Form 20-F, which were both filed with the SEC in February 2019 in continuation of the publication of the Annual Report 2018, 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. 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 presentation, 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, and failure to maintain a culture of compliance. 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 presentation, reference is made to the overview of risk factors in 'Risk management enables better decision-making' on pp 41-43 in the Annual Report 2018. 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 presentation, whether as a result of new information, future events or otherwise. Important drug information • Victoza® (liraglutide 1.2 mg and 1.8 mg) is approved for the management of type 2 diabetes only SaxendaⓇ (liraglutide 3 mg) is approved in the USA and the EU for the treatment of obesity only novo nordisk#4Investor presentation ADA 2019 OzempicⓇ now launched in 21 countries and continues to gain market shares in the USA Weekly NBRX share 60% 50% 40% 30% 20% 10% 0% Jan 2018 Slide 4 USA GLP-1 NBRx market share NN GLP-1 VictozaⓇ exenatide - - albiglutide USA GLP-1 volume market share OzempicⓇ dulaglutide NN GLP-1 Monthly TRX share 60% VictozaⓇ OzempicⓇ dulaglutide exenatide albiglutide 50.6% 50% 45.9% 39.7% 40% 44.5% 31.2% 30% 31.3% 20% 13.2% 19.4% 10% 9.6% 9.7% 0% May 2019 Feb 2017 May 2019 Source: NBRX-IQVIA LRX Weekly, week ending 19 May 2019 NBRX: New-to-brand prescriptions Source: IQVIA monthly xponent, Apr 2019, weekly xponent for May, week ending 19 May 2019#5Investor presentation ADA 2019 Slide 5 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 5, 8 and 10 results Ziylo acquisition for accelerating glucose responsive insulin PIONEER 2, 3, 4 and 7 results STEP obesity phase 3 initiated OG2023 phase 1 initiated PIONEER 9 and 6 results DUAL VIII completed for XultophyⓇ SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for TresibaⓇ US filing of oral semaglutide and CV label for OzempicⓇ and oral semaglutide AM833 phase 2 initiated LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Mads Krogsgaard Thomsen Chief Science Officer Partnership with Gilead Science announced novo nordisk#6Investor presentation ADA 2019 Slide 6 GLP-1s have positive effects beyond glycaemic control and treatment guidelines have been updated to particularly reflect the CV risk benefits The multifactorial effects of GLP-1s Heart ADA/EASD diabetes treatment guidelines for second- line treatment with established ASCVC or CKD1 First-line therapy is metformin and lifestyle management. If HbA1c above target, proceed as below Established ASCVD or CKD NO Without established ASCVD or Pancreas Beta-cell function² Beta-cell apoptosis² Insulin biosynthesis² Glucose-dependent insulin secretion² Glucose-dependent glucagon secretion² Liver Endogenous glucose production 11 Hepatic insulin sensitivity 11 De novo lipogenesis 11 Lipotoxicity11 Steatosis 12 CV risk³ Fatty acid metabolism4 Cardiac function4 Systolic blood pressure4 Inflammation5 Atherosclerotic plaque progression 5 Brain Body weight6 Food intake ↑ Satiety 8,9 All references and notes on slide 37 YES ASCVD predominates GLP-1 with proven CVD benefit* EITHER/ OR CKD SGLT-2 with proven CVD benefit*, if eGFR adequate HF OR CKD predominant Incretin system Replacement of deficient GLP-1 response 10 If HbA1c above target If further intensification is required or patient is now unable to tolerate GLP-1 and/or SGLT-2, choose agents demonstrating CV safety... SIMPLIFIED ILLUSTRATION#7Investor presentation ADA 2019 Slide 7 Key inclusion criteria defining established CVD differ between GLP-1 CVOTs but trial populations are more comparable with aligned definitions Key inclusion criteria defining established cardiovascular disease across selected CVOTS Established CVD Without established CVD REWIND 21 prior CVD MI Ischaemic stroke Revascularisation.* Hospitalisation for unstable angina Myocardial ischaemia PCI Age 50 to 54 years, with 21 prior CVD Age 55 to 60 years, the above, or evidence of other vascular or renal disease Age ≥60 years, the above, or 2 CV risk factors LEADER/SUSTAIN 63 21 of the following: • CVD CeVD PVD Chronic HF (NYHA class II or III) Chronic kidney disease of stage 3 or higher LEADER: age ≥50 years with 21 prior CVD SUSTAIN 6: age ≥50 years with clinical evidence of CVD LEADER: age ≥60 years with 21 CV risk factor SUSTAIN 6: age ≥60 years with subclinical evidence of CVD Trial population based on previous MI/stroke vs CV risk factors MI/Stroke CV risk factors 22%¹ 40% 41% 78% 60% 59% REWIND n=9,901 LEADER n=9,340 Mean follow up: 5.4 years Mean follow up: 3.8 years SUSTAIN 6 n=3,297 Mean follow up: 2.1 years *Coronary: carotid or peripheral; CeVD: cerebrovascular disease; CV; cardiovascular; CVD: cardiovascular disease; CVOT: cardiovascular outcomes trial; HF: heart failure; MI: myocardial infarction; NYHA: New York Heart Association; PCI: percutaneous coronary intervention; PVD: peripheral vascular disease 1844; 5. 1. Gerstein HC et al. Diabetes Obes Metab 2017, Based on 1. Gerstein, HC et al. Diabetes Obes Metab 2017; doi:10.1111/dom. 13028; 2. Marso SP et al. N Engl J Med 2016;375 311-322; 3. Marso SP et al. N Engl J Med 2016; Ischaemic stroke (5.3%) and Prior MI (16.2%);#8Investor presentation ADA 2019 Comparison of post-hoc analyses of SUSTAIN 6, LEADER and REWIND for prior and no prior MI/stroke subgroups Slide 8 Outcome Prior MI/stroke No. events* Sema Pbo Hazard ratio (95% CI) Interaction p-value SUSTAIN 6 With 66 88 0.76 (0.55 1.05) 3-point MACE 0.75 Without 42 58 0.70 (0.47 1.04) Outcome Prior MI/stroke No. events* Lira Pbo Hazard ratio (95% CI) LEADER With 322 372 0.84 (0.72 0.97) 3-point MACE 0.56 Without 286 322 0.89 (0.76 1.05) Prior No. events* Outcome MI/stroke Dula Pbo Hazard ratio (95% CI) REWIND With 196 236 0.79 (0.66 0.96) 3-point MACE 0.18 Without 396 423 0.93 (0.81 1.07) With prior MI/stroke Without prior MI/stroke 1.0 2.0 *First events Lira N=1,865; Sema N=673; Dula N=1,028 Pbo N 1,827; Pbo N=694; Pbo N=1,007 Lira N=2803; Sema N=975; Dula N=3,896 0.4 Pbo N=2845; Pbo N=955; Pbo N=3,920 Poulter N et al. Abstract 86477, presented at the European Society of Cardiology Congress, Barcelona, 28 August 2017 Leiter L et al. 2019. Cardiovascular Risk Reduction with only once weekly semaglutide in subjects with type 2 diabetes: a post hoc analysis of gender, age, and baseline CV risk profile in the SUSTAIN 6 trial. Cardiovasc Diabeto 18:73. https://doi.org/10.1186/s12933-019-0871-8; Supplement appendix to: Gerstein HC, Colhoun HM, Dagenais GR, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomized placebo-controlled trial. Lancet 2019; published online June 10. CI: confidence interval; CV: cardiovascular; MI: myocardial infarction; PYO: patient-years of observation; Lira: Liraglutide; Sema: Semaglutide; Dula: dulaglutide Pbo: Placebo novo nordisk#9Investor presentation ADA 2019 Slide 9 The FLOW trial is the first dedicated GLP-1 renal outcomes trial to demonstrate that semaglutide delays renal impairment End-stage renal disease (ESRD) often results in chronic dialysis treatment or kidney transplantation¹ C C C C c Healthy kidney ESRD kidney Randomised: >3,000 patients with type 2 diabetes FLOW trial design Semaglutide 1.0 mg Placebo ~20-25 years Event driven • • • 2 in 5 people living with type 2 diabetes will develop chronic kidney disease² Up to 70% of people with type 2 diabetes and chronic kidney disease experience continued deterioration of the kidney function despite the current standard of care3-5 ~10% of the population worldwide is suffering from chronic kidney diseases6 The global dialysis market is currently estimated to be around USD 80 billion? 1 Afkaria et al, Kidney Disease and Increased Mortality Risk in Type 2 Diabetes, J Am Soc Nephrol, 2013; 2 IDF Diabetes Atlas, Eighth edition 2017; 3 Lewis et al. Renoprotective effect of the ARB Irbesartan in patients with T2D and nephropathy (IDNT trial). NEJM 2001; 4 Brenner et al. Renal trial. Effects of losartan on renal and cardiovascular outcomes. NEJM 2001; 5 Lewis et al. The effect of ACE inhibition on diabetic nephropathy. NEJM, 1993; 6 National Kidney Foundation (US), 2015 data; 7 Global Market Insights Inc.; Dialysis Market Global Share Analysis 2024, published November 2018 T2D: type 2 diabetes. Trial objective The FLOW trial is the first dedicated GLP-1 renal outcomes trial and is carried out to demonstrate that semaglutide delays the progression of renal impairment and lowers the risk of renal and cardiovascular mortality in people with type 2 diabetes and chronic kidney disease Inclusion criteria • Patients with type 2 diabetes HbA1c ≤10% Impaired kidney function measured by estimated Glomerular Filtration Rate (eGFR)* Trial initiation: Q3 2019 eGFR ≤75 to ≥50* and UACR >300 to <5,000 mg/g or eGFR <50 to ≥25* and UACR >100 to <5,000 mg/g (20% cap of patients having eGFR ≥60*) novo nordisk#10Investor presentation ADA 2019 The FOCUS trial will evaluate long-term effects of semaglutide vs placebo regarding diabetic retinopathy Poor glucose control causes damage to blood vessels which can lead to diabetic retinopathy Healthy eye Diabetic eye FOCUS trial design Superior Rectus Muscle Sclera Lens Pupil Cornea Ciliary body Inferior Rectus Muscle Retina Fovea Optic Disc Optic nerve Central Retinal Vein and Artery Abnormal Blood Vessels Aneurysm Hemorrhages "Cotton Wool" Spots Slide 10 Randomised: ~1,500 patients with type 2 diabetes Antidiabetic SOC + semaglutide 0.5-1.0 mg sc QW Antidiabetic SOC+ placebo 5 years 1 in 3 people living with type 2 diabetes have some degree of diabetic retinopathy¹ About 5-10% of people living with diabetes will develop a vision threatening form of the disease² The global market for treating diabetic retinopathy is currently estimated to be around USD 6 billion³ Trial objective To assess the long-term effects of semaglutide compared with placebo, both added to standard of care, with respect to diabetic retinopathy development and progression Inclusion criteria . Diabetes duration >10 years • HbA1c 7-10% • Exclusion: unstable or active eye disease Trial initiation: Q2 2019 1 IDF Atlas, Eighth edition 2017, 2 Tien Y. Wong, Chui Ming Gemmy Cheung, Michael Larsen, Sanjay Sharma and Rafael Simó, Diabetic retinopathy, Nature Reviews, Disease Primers, VOLUME 2, 2016, 3 Grand View Research; Diabetic Retinopathy Market Analysis Report By Type, published February 2018 QW: once-weekly; sc: subcutaneous; SOC: standard of care novo nordisk#11Investor presentation ADA 2019 Slide 11 SUSTAIN FORTE will evaluate high-dose semaglutide in type 2 diabetes and is expected to conclude by end of 2020 Randomised: 964 patients with type 2 diabetes SUSTAIN FORTE trial design Semaglutide 2.0 mg Semaglutide 1.0 mg 40 weeks Trial objective To establish the effect of semaglutide sc 2.0 mg QW vs. semaglutide 1.0 mg QW on glycaemic control in patients with type 2 diabetes on a background of metformin with or without SU treatment Key SUSTAIN FORTE trial inclusion criteria People with type 2 diabetes from 10 countries • HbA1c 8-10% • Stable dose of metformin +/- SU High-dose semaglutide Supports individualised treatment Offers a simple treatment regimen for intensification Trial initiation: Q2 2019 sc: subcutaneous; QW: once-weekly; SU: sulphonylurea novo nordisk#12Investor presentation ADA 2019 Slide 12 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 2, 3, 4 and 7 results STEP obesity phase 3 initiated PIONEER 5, 8 and 10 results Ziylo acquisition for accelerating glucose responsive insulin PIONEER 9 and 6 results DUAL VIII completed for XultophyⓇ US filing of oral semaglutide and CV label for Ozempic® and oral semaglutide AM833 phase 2 initiated OG2023 phase 1 initiated SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for Tresiba® LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Partnership with Gilead Science announced novo nordisk#13Investor presentation ADA 2019 Slide 13 An overview of the PIONEER programme Diet and exercise k OAD PIONEER 1 Insulin users PIONEER 2 vs SGLT-2 (Met) PIONEER 8 vs placebo (Diet and exercise) PIONEER 3 vs DPP-4 (1-2 OADs: Met + SU) PIONEER 4 vs GLP-1/placebo (1-2 OADs: Met ± SGLT-2) PIONEER 7 Flexible dose adjustment vs DPP-4 with extension (1-2 OADs: Met, SU, TZD, SGLT-2) Add-on to insulin (Insulin + Met) Special populations PIONEER 5 Renal impairment (± Met, ± SU, or ± insulin) PIONEER 6 CVOT (Standard of care) PIONEER 9 vs GLP-1/placebo, Japan (Monotherapy) PIONEER 10 vs GLP-1/placebo, Japan (1 OAD: SU, TZD, a-GI, glinide or SGLT-2) Note: Text in parentheses represents allowed background medications. CVOT: cardiovascular outcomes trial; DPP-4: dipeptidyl peptidase-4 inhibitor; GLP-1: glucagon-like peptide-1 receptor agonist; Met: metformin; OAD: oral anti-diabetes drug; PIONEER: peptide innovation for early diabetes treatment; SGLT-2: sodium glucose co-transporter-2 inhibitor; SU: sulphonylurea; TZD: thiazolidinedione; a-GI: alpha-glucosidase inhibitors; glinide: prandial glucose regulators. novo nordisk#14Investor presentation ADA 2019 The PIONEER programme showed consistent statistically significant reductions in HbA1c and body weight Oral semaglutide lowered HbA1c by 1.0-1.8%- points by end of trial¹ Mean change in HbA1c (%-points) Oral semaglutide lowered body weight by ~2-5 kg by end of trial¹ Slide 14 Mean change in weight (kg) PIONEER trials 1 2 3 4 5 6 7 8 9 10 1 2 3 4 PIONEER trials 5 6 7 8 9 10 0.0% 0+ -1 -0.5% -1.0% -2 -3 -1.9* -2.9 * -1.2%* -2.8* -4 -3.5* -1.4%* -3.7* -4.1 -1.5%* -5 -4.2* -4.7* -4.3* -1.8%* -5.0* -6 -1.0%* -1.1%* -1.1%* -1.5% -1.3%* -1.2%* -1.5%* -2.0% 1 Hypothetical estimand, Mixed Model for Repeated Measurement (MMRM) * Statistically significant vs comparator (vs placebo in PIONEER 1; vs empagliflozin 25 mg in PIONEER 2; vs sitagliptin 100 mg in PIONEER 3; vs VictozaⓇ 1.8 mg in PIONEER 4; vs placebo in PIONEER 5; vs placebo in PIONEER 6; vs sitagliptin 100 mg in PIONEER 7; vs placebo in PIONEER 8; vs VictozaⓇ 0.9 mg and placebo in PIONEER 9; vs 0.75 mg dulaglutide in PIONEER 10) Note: Results shown are: PIONEER 1 and 5 for 26 weeks with 14 mg oral semaglutide, PIONEER 2, 4, 8, 9 and 10 for 52 weeks with 14 mg oral semaglutide; PIONEER 3 for 78 weeks with 14 mg oral semaglutide; PIONEER 7 for 52 weeks with a mixed dose; PIONEER 6 following occurrence of 137 MACE with a median follow-up time of 16 months. MACE: major adverse cardiovascular events; FDA: The US Food and Drug Administration novo nordisk#15Investor presentation ADA 2019 The PIONEER 6 trial investigated cardiovascular safety of oral semaglutide vs placebo Slide 15 PIONEER 6 trial design Oral semaglutide 14 mg + standard of care Randomised: 3,176 patients with type 2 diabetes Placebo + standard of care Trial objective 137 MACE Confirm the cardiovascular safety of oral semaglutide in patients with type 2 diabetes Inclusion criteria • Age ≥50 years and clinical evidence of CV disease or age ≥50 years and subclinical evidence of CV disease • Antidiabetic drug-naïve or current treatment with one or more oral or injectable antidiabetic agent(s) (excl. DPP-4 and GLP-1) PIONEER 6 headline results 21% non-significant reduction of primary endpoint¹ for oral semaglutide-treated patients compared to placebo-treated subjects (HR: 0.79) - CV death significant (HR: 0.49) Non-fatal MI - non-significant (HR: 1.18) Non-fatal stroke - non-significant (HR: 0.74) All-cause mortality - significant (HR: 0.51) Results were based on 137 MACE with median follow-up of 16 months PIONEER symposium on Tuesday June 11th from 9.45 - 11.45 (pacific time) 1 The primary endpoint of the PIONEER 6 trial was defined as the MACE composite outcome of the first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke. CV: cardiovascular; DPP-4: dipeptidyl peptidase-4 inhibitor; GLP-1: glucagon-like peptide-1; MACE: major cardiovascular event; HR: hazard ratio; MI: myocardial infarction; PIONEER: peptide innovation for early diabetes treatment novo nordisk#16Investor presentation ADA 2019 Slide 16 The SOUL trial will provide robust evidence on the cardiovascular benefits of oral semaglutide in people with type 2 diabetes Randomised: 9,642 patients with type 2 diabetes SOUL trial design Oral semaglutide 14 mg + standard of care Placebo + standard of care Event-driven SOUL trial key inclusion criteria Key endpoints Primary: · Cardiovascular death, non-fatal myocardial infarction or non-fatal stroke (MACE) Secondary confirmatory: 5-component composite CKD endpoints Cardiovascular Death à composite peripheral artery endpoint Standard of care allows all glucose lowering drugs except GLP-1s; CKD: chronic kidney disease People with type 2 diabetes from 34 countries with primarily moderate Chronic Kidney Disease • HbA1c ≤10% Age ≥50 years At least 1 of the following: Coronary heart disease, Cerebrovascular disease, Symptomatic peripheral arterial disease, Chronic kidney disease Trial initiation: Q2 2019 novo nordisk#17Investor presentation ADA 2019 Slide 17 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 5, 8 and 10 results Ziylo acquisition for accelerating glucose responsive insulin PIONEER 2, 3, 4 and 7 results PIONEER 9 and 6 results DUAL VIII completed for XultophyⓇ STEP obesity phase 3 initiated OG2023 phase 1 initiated SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for Tresiba® Martin Lange SVP Global Development US filing of oral semaglutide and CV label for Ozempic® and oral semaglutide AM833 phase 2 initiated LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Partnership with Gilead Science announced novo nordisk#18Investor presentation ADA 2019 Slide 18 In Dual VIII, 66% of people on glargine U100 required treatment intensification compared to 37% on XultophyⓇ Trial design Dual VIII - durability "need for treatment intensification" Duration 104 weeks Time to need for treatment intensification* glargine U100 Probability of need for treatment intensification (%) 70 IDegLira 66.2% patients required treatment intensification Randomised: 1,012 patients K. IDegLira QD + OAD(s) K 60 50 40 Insulin glargine QD + OAD(s) 30 26 weeks Continued trial drug period 0-78 weeks ↑ 20 37.4% patients required treatment intensification End of trial 10 "get to target" "durability" 0 12 26 38 52 64 78 90 104 Weeks Trial objective To compare long-term glycaemic control of IDegLira vs. insulin glargine U100 in insulin naïve subjects with type 2 diabetes inadequately controlled on OAD(s)¹ 1 According to the ADA definition of HbA1c > 7%; *HbA1c ≥7% at 2 consecutive visits. Full analysis set. Treatment policy strategy. Patients discontinuing treatment contribute to analyses as needing treatment intensification from time of discontinuation. IDegLira/Xultophy®: insulin degludec/liraglutide; Glargine U100: insulin glargine U100; n: number of patients; OAD: oral anti- diabetes drug; QD: once-daily novo nordisk#19Investor presentation ADA 2019 Slide 19 In Dual VIII, mean HbA1c was comparable for XultophyⓇ compared with glargine U100 but with a lower actual insulin dose Mean change in HbA1c (%-point) IDegLira glargine U100 Actual daily Actual daily insulin dose (U) IDegLira glargine U100 Mean change in total insulin HbA1c (%) dose (U) 9.0 60 51 U 8.5 50 8.0 40 36 U 7.5 30 7.0 20 6.5% 6.5 10 6.4% 6.0 + 0 + + 04 12 26 38 52 0 12 26 38 52 64 78 90 104 64 78 90 104 Weeks Weeks At week 104, 90 patients (27.36%) had max dose of IDegLira. 75.3% were at target <7%; IDegLira/XultophyⓇ: insulin degludec/liraglutide; glargine U100: insulin glargine U100 novo nordisk#20Investor presentation ADA 2019 Slide 20 In Dual VIII, mean body weight gain was 1.7 kg lower for XultophyⓇ and with lower risk of hypoglycaemia compared with glargine U100 Body weight - change from baseline Mean change body weight (Kg) 4.0 IDegLira Severe or blood glucose confirmed symptomatic hypoglycaemic episodes over 104 weeks Number of episodes glargine U100 per patient 3.4 kg 2.0 IDegLira glargine U100 3.0 2.0 1.0 0.0 1.5 1.0 1.7 kg* 0.5 0.0 -1.0 04 12 26 52 Weeks 78 104 0 8 Means from the MMRM model * statistically significant vs. insulin glargine U100 after 104 weeks; Kg: kilograms; CI: confidence interval; ETD: estimated treatment difference; IDegLira/XultophyⓇ: insulin degludec/liraglutide; glargine U100: insulin glargine U100; LS: least squares; MMRM: mixed model repeated measurement 56% rate reduction* 16 24 32 40 48 56 64 72 80 88 96 104 Weeks Severe or blood glucose confirmed symptomatic hypoglycaemia: An episode that is severe according to the American Diabetes Association classification or BG confirmed by a plasma glucose value < 3.1 mmol/L (56 mg/L) with symptoms consistent with hypoglycaemia. CI: confidence interval; conf., confirmed; ERR: estimated rate ratio; Symp: symptomatic novo nordisk#21Investor presentation ADA 2019 Slide 21 Innovation and convenience for patients on basal insulin with once-weekly insulin LAI287 Rationale for a once-weekly insulin Provide an efficacious, safe and convenient once-weekly alternative to once-daily basal insulin for patients with type 2 diabetes LAI287 phase 2 programme 2019 H1 | 2019 H2 2020 H1 180 Fewer injections Lower treatment burden could lead to higher compliance T2D, insulin naïve + OAD vs glargine ~250 patients, 26 weeks T2D, insulin naïve Different titrations vs glargine ~200 patients, 16 weeks T2D, + OAD With and without loading dose vs glargine ~150 patients, 16 weeks Expected phase 2 programme completion: H1 2020 T2D: type 2 diabetes; OAD: oral antidiabetes drugs novo nordisk#22Investor presentation ADA 2019 Slide 22 Connected insulin pen resulting in improved adherence and 'time in range' in Swedish study Novo PenⓇ 6 with Glooko/DiasendⓇ system More accurate data leading to better doctor- patient conversations and treatment results 1. NovoPenⓇ 6 2. Data capture 3. Data storage glooko HCP In-clinic data box 6.2 Patient 4. HCP review of data glooko 43% fewer missed meal-time insulin injections 28% increase in dose of meal- time insulin FGM/CGM blood glucose data Storage of data on cloud Visualisation of patient data (insulin dosing and glucose data) on same interface using HCP platform Anonymised data transfer to Novo Nordisk for research and product development purposes For more details, see ADA 2019 Late-breaking poster presentation 126-LB and Poster presentation 1076-P; HCP: healthcare professional; FGM: flash glucose monitor; CGM: continuous glucose monitor 2 more hours in good glucose control per person per day novo nordisk#23Investor presentation ADA 2019 Slide 23 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 5, 8 and 10 results PIONEER 2, 3, 4 and 7 results Ziylo acquisition for accelerating PIONEER 9 and 6 glucose responsive insulin results DUAL VIII completed for XultophyⓇ STEP obesity phase 3 OG2023 phase 1 initiated initiated Martin Lange SVP Global Development SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for TresibaⓇ US filing of oral semaglutide and CV label for Ozempic® and oral semaglutide AM833 phase 2 initiated LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Partnership with Gilead Science announced novo nordisk#24Investor presentation Clinical projects in obesity and NASH Phase 1 PYY 1562 analogue GG-co-agonist Tri-agonist 1706 Phase 2 Obesity PYY 1875 analogue Amylin AM833 NASH Semaglutide NASH Semaglutide NASH + Gilead Science I PYY: peptide YY; GG: GLP-1 and glucagon; NASH: nonalcoholic steatohepatitis; GLP-1: glucagon-like peptide-1 ADA 2019 Slide 24 Phase 3 Marketed Semaglutide obesity Saxenda I liraglutide injection Develop new biologics combined with GLP-1 to achieve >20% weight loss Enter NASH by leveraging GLP-1 and other internal assets as well as in-licensing external opportunities novo nordisk#25Investor presentation ADA 2019 Slide 25 The phase 3a programme STEP and the CV outcomes study SELECT were initiated in 2018 for semaglutide in obesity Semaglutide in obesity phase 3a programme, STEP, expected to include ~4,500 patients¹ Cardiovascular outcomes study, SELECT, initiated for semaglutide in obesity 2018 2019 STEP 1: Weight loss 1,950 patients, 68 weeks STEP 2: T2D non-insulin patients 1,200 patients, 68 weeks STEP 3: Maximising weight loss 600 patients, 68 weeks STEP 4: Maintained weight loss 900 patients, 68 weeks 2020 Expected phase 3a programme completion: 2020 Semaglutide 2.4 mg sc QW ~17,500 people with obesity¹1 Placebo Event-driven Completion: Pre-defined number of events 1 Inclusion criteria: Male or female, age ≥18 years, BMI: ≥30 kg/m² or ≥27 kg/m² and ≥1 comorbidity Note: All treatment arms are adjunct to diet and exercise CV: cardiovascular; T2D: type 2 diabetes; BMI: body mass index 1 Inclusion criteria: Male or female > 45 years, BMI >27 kg/m², myocardial infarction or stroke >60 days, HbA1c <6.5% QW: once-weekly; sc: subcutaneous; BMI: body mass index novo nordisk#26Investor presentation ADA 2019 Slide 26 Amylin AM833 could become the next step in getting closer to the ambition of >20% weight loss Phase 1b amylin and semaglutide combination multiple dose trial Randomised: 80 people with obesity Cohort 5 - QW sema + QW AM833 Dose E 4* 4-week escalation steps (fixed ratio) Cohort 4 - QW sema + QW AM833 Dose D 4* 4-week escalation steps (fixed ratio) - Cohort 3 QW sema + QW AM833 Dose C 4* 4-week escalation steps (fixed ratio) Cohort 2 - QW sema + QW AM833 Dose B 4* 4-week escalation steps (fixed ratio) Cohort 1 QW sema + QW AM833 Dose A 4*4-week escalation steps (fixed ratio) 20 weeks treatment Phase 2 dose finding trial Randomised: 700 people with obesity AM833, 4.5 mg QW AM833, 2.4 mg QW AM833, 1.2 mg QW AM833, 0.6 mg QW AM833, 0.3 mg QW Liraglutide, 3.0 mg QD Trial objective ~19 months To assess the safety, tolerability, and PK properties, and to explore PD effects of multiple subcutaneous doses of amylin AM833 initiated simultaneously with semaglutide in people with overweight or obesity (BMI 27-39.9 kg/m2) Trial rationale Placebo Diet and physical activity counselling 26 weeks + 6 weeks follow-up To find optimal dose of sc. administered amylin AM833 QW for weight loss in people being overweight or with obesity (BMI 27-39.9 kg/m2) Primary endpoint Change from baseline to week 26 in body weight (%) Trial initiation: Q1 2019 novo nordisk QW: once-weekly; sema: semaglutide; sc: subcutaneous#27Investor presentation ADA 2019 Novo Nordisk is investigating opportunities within NASH Semaglutide NASH phase 2 programme 2016 2017 2018 2019 2020 Semaglutide 0.1, 0.2 and 0.4 mg QD vs placebo in patients with NASH ~320 patients, 72 weeks Semaglutide 0.4 mg QD vs placebo in patients with NASH ~70 patients, 72 weeks Slide 27 Proof of concept phase 2 combination trial design 100 NAFLD/NASH MRI-PDFF with > 10% steatosis FibroScan with liver stiffness ≥ 7 kPa or historical liver biopsy Sema 2.4 mg once weekly sc Sema 2.4 mg + FIR 20 mg once daily oral Sema 2.4 mg + CIL 30 mg once daily oral Sema 2.4 mg + CIL 100 mg once daily oral Sema 2.4 mg + FIR 20 mg + CIL 30 mg 24 weeks + 7 weeks follow-up Semaglutide 2.4 mg QW vs placebo in patients with NASH ~70 patients, 48 weeks Expected phase 2 programme completion: H2 2020 Trial information • Safety and tolerability trial Initiation Q3 2019 • MRI-PDFF, MRE & biomarkers at least at: 0, 12, 24 weeks QD: Once-daily; QW: once-weekly; sc: subcutaneous; MRI-PDFF: magnetic resonance imaging-estimated proton density fat fraction; MRE: magnetic resonance elastography; NASH: nonalcoholic steatohepatitis; NAFLD: Nonalcoholic fatty liver disease; kPa: kilopascals; FIR: firsocostat (ACC inhibitor); CIL: cilofexor (FXR agonist); ACC: acetyl-CoA carboxylase; FXR: Farnesoid X receptor novo nordisk#28Investor presentation ADA 2019 Slide 28 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 5, 8 and 10 results PIONEER 2, 3, 4 and 7 results Ziylo acquisition for accelerating glucose responsive insulin PIONEER 9 and 6 results DUAL VIII completed for XultophyⓇ STEP obesity phase 3 initiated OG2023 phase 1 initiated SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for TresibaⓇ US filing of oral semaglutide and CV label for Ozempic® and oral semaglutide AM833 phase 2 initiated LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Stephen Gough Global Chief Medical Officer Partnership with Gilead Science announced novo nordisk#29Investor presentation ADA 2019 Slide 29 Novo Nordisk continues to invest in post-approval trials across the portfolio to support clinical findings in real-world settings OZEMPİC semaglutide injection Xultophy insulin degludec/liraglutide [rDNA origin] injection TRESIBA insulin degludec [rDNA origin] injection 6 M • • Semaglutide in patients with type 2 diabetes: real-world analysis in the Canadian LMC Diabetes Registry: the SPARE study (poster presentation 995-P) Real-world effectiveness of semaglutide in early users from a US commercially insured and Medicare Advantage population (poster presentation 1006-P) The outcomes associated with use of iDeg Lira in a large real-world cohort of patients with type 2 diabetes in Sweden (poster presentation 1110-P) The first real-world study describing change in glycated hemoglobin (HbA1c) among US patients initiating iDegLira (publication only) A multicenter, prospective, observational study that evaluates the safety and effectiveness of switching from other basal insulins to degludec, as part of routine clinical care, in patients with type 1 or type 2 diabetes: the ReFLECT study (poster presentation 374-P) A prospective, non-interventional pilot study running including twelve diabetes clinics from different parts of Sweden. Patients with type 1 diabetes using CGM were included if their treating physicians decided to offer them a NovoPen® 6 (Late-breaking poster presentation 126-LB) CGM: continuous glucose monitor novo nordisk#30Investor presentation ADA 2019 REFLECT is a RWE trial investigating the safety and efficacy profile of TresibaⓇ for degludec naïve patients with T1D/T2D N=1,267 T1D and T2D patients planned to ReFLECT trial design Degludec QD + standard of care Hypo recor ding Hypo recor Hypo recor ding ding 3 9 Months Months Months initiate degludec Hypo recor ding Hypo recor ding -4 Weeks 12 Key ReFLECT trial inclusion criteria Trial objective To confirm the safety and effectiveness of degludec in patients with T1D or T2D in routine clinical practice Primary endpoint Change in rate of any hypoglycaemia of patients before and after treatment change to degludec People with type 1 and 2 diabetes from 7 countries 0 • T1D and/or T2D adults Male or female > 18 years • Insulin using, planned initiation with degludec No previous use of degludec RWE: real-world evidence; QD: once daily; T1D: type 1 diabetes; T2D: type 2 diabetes Slide 30 novo nordisk#31Investor presentation ADA 2019 Slide 31 REFLECT demonstrated lower hypoglycaemia risk-profile of TresibaⓇ as well as increased quality of life vs other basal insulins Significant reduction of all types of hypoglycaemic events Patients' treatment satisfaction and quality of life Observed treatment difference at 12 months follow-up from baseline with TresibaⓇ Baseline 12 months follow-up % 50 T1D any hypoglycaemic episodes 0.80 [0.75;0.87]* T2D any hypoglycaemic episodes 0.49 [0.41;0.60]* 40 T1D non-severe hyp. episodes T2D non-severe hyp. episodes T1D nocturnal hyp. episodes T2D nocturnal hyp. episodes T1D ADA-defined severe hyp. episodes T2D ADA-defined severe hyp. episodes 0.81 [0.75;0.87]* 0.49 [0.41;0.59]* 0.58 [0.49;0.70]* 0.36 [0.21;0.61]* 0.41 [0.23;0.73]+ NA DTSQ-s total score 10 29.9 30.0 30 26.0 25.7 20 0.125 0.25 0.5 Favours degludec *p<0.001, p=0.003 1 2 Rate ratio (follow-up/baseline) Negative binomial regression model with log link and log of exposure as offset T 4 Favours previous basal insulin ADA: American Diabetes Association; NA: not available; T1D: type 1 diabetes; T2D: type 2 diabetes; hyp. hypoglycaemic 8 T1D T2D Percentages are based on the number of patients who responded that they used the specific flexibility option one or more times and calculated based on number of patients with evaluable data DTSQ: Diabetes Treatment Satisfaction Questionnaire; QoL: quality of life; SF: Short Form; T1D: type 1 diabetes; T2D: type 2 diabetes#32Investor presentation ADA 2019 Slide 32 Progress on several projects since ADA last year June 2018 A A June 2019 Bridging strategy for semaglutide CV labels PIONEER 5, 8 and 10 results PIONEER 2, 3, 4 and 7 results STEP obesity phase 3 initiated Ziylo acquisition for accelerating glucose responsive insulin PIONEER 9 and 6 results DUAL VIII completed for XultophyⓇ OG2023 phase 1 initiated SELECT obesity CVOT phase 3 initiated REFLECT RWE trial completed for Tresiba® US filing of oral semaglutide and CV label for OzempicⓇ and oral semaglutide AM833 phase 2 initiated LAI287 phase 2 initiated EU and CA filings of oral semaglutide GLP-1 Insulin Obesity & NASH Real-World Evidence Regulatory Robin Evers SVP Medical Affairs, Regulatory Affairs & Safety Partnership with Gilead Science announced novo nordisk#33Investor presentation ADA 2019 Slide 33 Oral semaglutide filed in the USA, the EU and Canada, and OzempicⓇ CV risk reduction indication filed in the USA Expected timelines for the FDA review Q1 2019 | Q2 2019 | Q3 2019 | Q4 2019 | Q1 2020 Oral semaglutide Expected review time: 6 months Oral semaglutide (CV indication) Expected review time: 10 months Ozempic® (CV indication) Expected review time: 10 months Oral semaglutide filed in key markets Three FDA filings: . NDA for oral semaglutide for glycaemic control . NDA for oral semaglutide CV indication . SNDA for Ozempic® CV indication Regulatory filing in the EU for oral semaglutide for type 2 diabetes treatment Regulatory filing in Canada for oral semaglutide for type 2 diabetes treatment CV: Cardiovascular; FDA: the US Food and Drug Administration; Q: Quarter; NDA: New Drug Application; SNDA: Supplementary New Drug Application novo nordisk#34Investor presentation ADA 2019 Slide 34 R&D milestones in 2019 Project TresibaⓇ RyzodegⓇ OzempicⓇ Anti-IL-21 Q1 2019 US submission (CV label update) Q2 2019 Phase 3b results (vs glargine U300) CN regulatory decision ✓ FOCUS trial initiation (OT²) FORTE initiation (dose trial) Phase 2 results Clinical milestones¹ Regulatory milestones¹ Q3 2019 Q4 2019 FLOW trial initiation (Outcomes trial³) LAI287 LAIsema Oral semaglutide Amylin - AM833 Tri-agonist 1706 PYY 1562 Semaglutide combination Phase 1 initiation US submission US submission (CV) ✓ Phase 2 initiation EsperoctⓇ/N8-GP Concizumab Somapacitan Diabetes Phase 2 results Phase 1 results SOUL trial initiation (CVOT) EU submission US regulatory decision Japan submission PoC phase 2 initiation US regulatory decision CHMP recommendation✓ Obesity NASH Phase 3 initiation (GHD) Haemophilia Growth disorders Phase 1 results Phase 1 results Japan regulatory decision Phase 3 initiation US and EU submission (AGHD) Japan submission (AGHD) 1 Expected to be published in the given quarter or in the subsequent quarterly company announcement; 2 Diabetic retinopathy outcome trial; 3 Diabetes kidney disease outcome trial; GG-co-agonist in obesity phase 1 decisive results are now expected in 2020; OT: Outcomes trial; GHD: Growth hormone deficiency; AGHD: Adult growth hormone deficiency; CVOT: Cardiovascular outcomes trial; CV: Cardiovascular; PoC: proof of concept; NASH: nonalcoholic steatohepatitis#35Investor contact information Investor presentation ADA 2019 Slide 35 Share information Novo Nordisk's B shares are listed on the stock exchange in Copenhagen under the symbol 'NOVO B'. Its ADRs are listed on the New York Stock Exchange under the symbol 'NVO'. For further company information, visit Novo Nordisk on: www.novonordisk.com 09 Aug 2019 01 Nov 2019 05 Feb 2020 Upcoming events Financial statement for the first six months of 2019 Financial statement for the first nine months of 2019 Financial statement for the full year of 2019 Investor Relations contacts Novo Nordisk A/S Investor Relations Novo Allé DK-2880 Bagsværd Peter Hugreffe Ankersen Valdemar Borum Svarrer +45 3075 9085 [email protected] +45 3079 0301 [email protected] [email protected] Ann Søndermølle Rendbæk +45 3075 2253 Kristoffer Due Berg (USA) +1 609 235 2989 [email protected] changing diabetes novo nordisk#36References and notes for slide 6 The multifactorial effects of GLP-1s Pancreas Beta-cell function2 Beta-cell apoptosis? Insulin biosynthesis? Glucose-dependent insulin secretion² Glucose-dependent glucagon secretion² Liver Endogenous glucose production¹¹ Hepatic insulin sensitivity11 De novo lipogenesis" Lipotoxicity Heart CV risk³ Fatty acid metabolism* Cardiac function Systolic blood pressure Inflammation" Atherosclerotic plaque progression³ Brain Body weight Food intake? Satiety. Steatosis12 Investor presentation ADA 2019 Slide 36 ADA/EASD diabetes treatment guidelines for second- line treatment with established ASCVC or CKD1 First-line therapy is metformin and lifestyle management. If HbA above target, proceed as below Established ASCVD or CKD Without NO established ASCVD or YES ASCVD predominates GLP-1 with proven CVD benefit* EITHER/ OR CKD SGLT2 with proven CVD benefit*, if eGFR adequate HF OR CKD predominant Incretin system Replacement of deficient GLP-1 response¹0 1 Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD); 2 Campbell JE, DJ Drucker. Cell Metab. 2013;17:819-837; 3 Marso SP et al. N Engl J Med. 2016;375:311-322; 4 Ryan D, Acosta A. Obesity. 2015;23:1119-1129; 5 Hogan AE et al. Diabetologia. 2014;57:781-784; 6 Baggio LL, Drucker DJ. J Clin Invest. 2014;124:4223-4226; 6 Bagger JI et al. Clin Endocrinol Metab. 2015;100:4541-4552; 8 Flint A et al. J Clin Invest. 1998;101:515- 520; 9 Blundell J et al. Presented at the 76th Scientific Sessions of the American Diabetes Association June 10-14, 2016, New Orleans, Louisiana, USA: Oral Presentation 23-OR; 10 Tong J, D'Alessio D. Diabetes. 2014;63:407-409; 11 Armstrong MJ, et al. J Hepatol. 2016;64:399-408; 12 Armstrong MJ, et al. Lancet. 2016;387:679-90. If HbA1c above target If further intensification is required or patient is now unable to tolerate GLP-1 and/or SGLT2, choose agents demonstrating CV safety... SIMPLIFIED ILLUSTRATION *Proven CVD benefit means it has label indication of reducing CVD events. For GLP-1 strongest evidence for liraglutide>semaglutide> exenatide extended release. For SGLT-2 evidence modestly stronger for empagliflozin>canagliflozin. ASCVD: atherosclerotic cardiovascular disease; CKD: chronic kidney disease; CV: cardiovascular; CVD: cardiovascular disease; CVOT: cardiovascular outcome trial; DPP-4: dipeptidyl peptidase-4 inhibitor; eGFR: estimated glomerular filtration rate; GLP-1: glucagon-like peptide- 1 receptor agonist; HF: heart failure; SGLT-2: sodium glucose co- transporter-2 inhibitor novo nordisk

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