03 the Global Diabetes Care Market CMD2011

8/2/2019 03 the Global Diabetes Care Market CMD2011

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Novo Nordisk Capital Markets Day

The

global d

care


2/49


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Novo Nordisk Capital Markets Day 5 M

Capital markets expect diabetes care to contin

outgrow the general pharmaceutical industryGrowth in global pr

escription sale

s versus di

abetes care sales (CAG

Source: EvaluatePharma, data retrieved January 21, 2011

Diabetes Care salesTotal Prescription sales

2000-2005 2005-2010 2010-2015

Insulin and GLP-1 sales

10.7%12.3%

18.4%

6.4%

12.0%

15.9%

3.6%

7.8%

9


4/49


Diabetes market development

20

40

60

80

100

120

140

160

180

200

Global diabetes care marketby treatment class

Global insulin mby segment

Note: *in DKK. Monthly MAT, volume figuresSource: IMS

0

50

100

150

200

250

300

350

400

Feb

2006

Long acting

Premix

Fast acting

CAGR volume: 7.1%CAGR value*: 14.3%

tMU

34%

35%

31%

Note: Monthly MAT, value figuresSource: IMS

OAD Insulin GLP-1

Feb

2006Feb

2011

DKK

billion

Total market:CAGR 11.4%

CAGR 7.8%

CAGR 14.3%

Injectables:CAGR 15.6%


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Sustained double-digit insulin market growth

Global insulin market growth2006-2011

The fundamental growof the insulin m

Volume

Prevalence of diabetes

Diagnosis rates and treatment

Intensification of insulin regime

Growing BMI

Life-length

Value

Conversion to new generations

Device penetration

Price changes

Source: IMS, Monthly MAT, value figures

0

20

40

60

80

100

MAT Feb 2006 Volume

contribution

Mix/price

contribution

MAT Feb 2011

44.4

bDKK86.7

bDKK

DKK

billion

21.6

bDKK

20.7

bDKK


6/49


Globally, diabetes has become an epidemic -

d

lifestyle changes and demographicsDiagnosis and optima

remains a challenge

the

All peoplewithdiabetes

50% arediagnosed

50% haveaccess to care

50% get

Source: International Diabetes Foundation: Diabetes Atlas, 2000 and 2009Note: Data covers the 20-79 age-group. IO: International Operations, Japan includes Korea

Estimated number of people with diabetes

projections appear conservative

JP, Korea

Europe

N. America0

50

100

150

200

250

300

350

400

450

2000 2010 2030

151

285

439

Millionpeople

InternationalOperations

China

Japan

Europe

North

America

CAGR:6.6%

CAGR:

2.2%

//


7/49


The world is growing unhealthier

Prevalence of overweight and obesity in selected countries

Adapted from: Sassi, F. et al. 2009 The Obesity Epidemic: Analysis of Past and Projected Future Trends in SelectedOECD Countries, OECD Health Working Papers, No. 45, OECD Publishing. Available at:http://www.ecoclimax.com/2010/10/past-and-projected-future-overweight.html

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

1970 1980 1990 2000 2010 2020

Proportionofoverw

eightandobese

ofpopulation(%)


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Life expectancy

has on

average

risen by 4 mon

year

since

1970

Source: www.nationmaster.com, CIA world fact book

Life expectancy at birth (weighted average)

1970 2010

69 years

56 years


9/49


Life expectancy

has on

average

risen by 4 mon

year

since

1970

Source: www.nationmaster.com, CIA world fact book

Life expectancy at birth (weighted average)

69 years

56 years

82 years?

1970 2010 2050


10/49


Implied

development

in insulin consumption

Insulin co

nsumption i

n selected

countries

a

verage

insulin units pe

Sources: Calculation based on IMS volume figures and United Nations Population Division demography data

2000 2010

238

165

264

53

1

349

293

426

99

United

States Germany United

Kingdom ChinaJapan


11/49


Modern insulin is replacing human insulin

as

insulin replaced animal insulin

0%

20%

40%

60%

80%

100%

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Share of totalinsulin volume

Source: IMS, annual volume figures

Modern

Human insulin

Animal

insulin


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Modern insulin constitute more than 80% of th

insulin value marketShare of totalinsulin value

Source: IMS, monthly MAT value figures

Modern

Human insulin

Animal

insulin0%

20%

40%

60%

80%

100%

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 20

Modern

Human insulin

Animal

insulin


13/49


Two-thirds of insulin volume is injected via a m

pen device

Source: IMS, annual volume figures

0%

20%

40%

60%

80%

100%

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Share of totalinsulin volume

Prefill

Durable device

Vial

and syringe

N N di k C it l M k t D 5 M


14/49


Characteristics of the insulin industry

Chronic

disease leading to life-long patient-drug relationship

Significant and

growing patient population

Continuous upgrade

of insulin treatment

Significant usage ofmodern pen devices

Strong brand loyalty and

limited switching

between therapies

Many prescribers requiring significant commercial operations

High volume production with significant capital investment required

Limited abbreviated regulatory pathways

for approval of biosimilar insul



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Novo Nordisk device development for improve

treatment1923 -

1985 1985 -

2010



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Diabetes is chronic disease leading to long pat

relationshipInsulin treatment is ge

nerally char

acterised by strong brand loyaland limited sw

itching betwee

n therapies

54 years Average

life

expectancy

with

type 2diabetes

Diagnosis

of

type 2 diabetes

OAD treatment

Insulintreatment

8 years

12 years 74 years

Sources: Calvert MJ, McManus RJ, Freemantle N (2007) Management of type 2 diabetes with multiple oral hypoglycaemic agents or insulin in retrospective cohort study Br J Gen Pract 57: 455-60. The British Journal of Diabetes & Vascular Disease 2008 8:92. 2005 -2008 National HeaNutrition Examination Survey. http://www.newsobserver.com/2011/03/03/1025677/type-2-diabetes-linked-to-shorter.html#storylink=misearexpectancy in Individuals with type 2 Diabetes, Diabetes (2007); 56: (supp1): A596



17/49


Novo Nordisk has significant operations across

world to remain competitive

China: ~2,100 F

Japan & Korea: ~900 F

International Operations: ~2,700 FTEs

North America: ~4,000 FTEs Europe: ~3,100 FTEs

FTEs represent full-time employee equivalents in Novo Nordisks sales regions (excludes a.o. employees in headquarter and manufacturing)



18/49


Insulin manufacturing process

Fermentation Recovery Purification Formulation Filling Assembly

API: insulin crystals F&F: liquid form Device & p



19/49


Novo Nordisks global manufacturing setup

Montes Claros

ClaytonChartres

Denmark

Tianjin

Device manufacturing

Packaging

Filling plant project

Formulation & filling

Assembly

Packaging


Assembly

Packaging


Assembly

Packaging

API production


Assembly

Packaging

Device & needle manufacturing

Packag

Koriyama



20/49

p y

0%

10%

20%

30%

40%

50%

60%

70%

Novo Nordisk has sustained

a global insulin m

leadership

position

Insulin value market share

worldwideInsulin volume mar

worldwide

Source: IMS Monthly MAT, value figures

0%

10%

20%

30%

40%

50%

60%

70%

Feb

2006Feb

2011Feb

2006

Novo Nordisk Sanofi-Aventis Eli Lilly Others

44%

33%

22%

1%

Novo Nordisk Sanofi-Aventis

Source: IMS Monthly MAT, volume figures



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0%

10%

20%

30%

40%

50%

60%

70%

through

focus

on

improvements

for patients

Modern insulin global volumemarket share

Prefilled device globvolume market


0%

10%

20%

30%

Feb

2006Feb

2011Feb

2006

Novo Nordisk Sanofi-Aventis Eli Lilly Others

46%

34%

19%

1%

FlexPen SoloStar




22/49

with

a strong

portfolio

of

modern

insulins

Strong current portfolioNovo Nordisks modern i

insulin volume mar

0%

10%

20%

Feb

2006

NovoMix NovoRapid




23/49

0%

1%

2%

3%

4%

5%

0

1

2

3

4

5

6

7

Novo Nordisk is now also expanding into earlie

treatment and growing the GLP-1 classVictoza

is driving the expansion ofthe global GLP-1 market

North America constitutesthe GLP-1 value m

Source: IMS Monthly MAT, value figures (DKK)

GLP-1 sales in bDKK

(right axis)

Diabetesmarket

share(value)

Feb

2006Feb

2011

26%

72

*Annual value of diabetes market MAT February 2011Source: IMS, Monthly value data (DKK)

DKK

billion

Europe

Rest of

world

Victoza

exenatide


24/49


The

diabe

marketinSVP Re



25/49

The diabetes challenge

Treatment of diabetes today

Victoza

performance

Insulin market performance

Focus areas and priorities

Outline



26/49

2010: ~32 million

6-7% 10-11% 12-13%


27/49

Sources: CDC Behavioral Risk Factor Surveillance System; Narayan, Impact of Recent Increase in Incidence on Future Diabetes Burden, Diabe2006;29:2114-2116; CDC, 2010 National Diabetes Fact Sheet; Boyle, Projection of the year 2050 burden of diabetes in the US adult populathttp://www.pophealthmetrics.com/content/8/1/29; Institute for Alternative Futures projections

64 bUSD

537 bUSD27 bUSD

46 bUSD

30 bUSD

36 bUSD

2010: 299 bUSD

Total annual direct medical and indirect societal costs of diabetes (billio

2015: 374 bUSD 2025

1-2.9b 5-9.9b


28/49

Note: Insulin data include treatment with concomitant non-insulin productsSource: IMS LRx Monthly Regime, 12/10 PROJECTED to Mattson Jack, NHANES IV and Ropers 2010

Treatment of diabetes in the US today

Diet & Exercise11%

OAD -

Met/SU/TZD

55%

Incretin10%

Insulin24%

Share of patients by treatment class

Basal-only40%

Basal-Bolus29%

Premix-only14%

Rapid-only14%

GLP-1 -

20%

DPP-4s80%



29/49

In the US, the insulin market is outgrowing the

diabetes care market


US diabetes care market by treatment class US insulin volume marke

Note: * in DKK. Monthly MAT, volume figuresSource: IMS

DKKbillion

tMU

0

20

40

60

80

100

120

OAD Insulin GLP-1

Feb

2006Feb

2011


CAGR 5.6%

CAGR 18.9%

0

20

40

60

80

100

120

Feb

2006

Long acting

Premix

Fast acting

CAGR volume: 5

CAGR value*: 18



30/49

Victoza

continues to drive GLP-1 growth

Expansion of the GLP-1 market

Source: IMS, NPA Monthly data; IMS LRx Weekly Data

Victoza

source of pa

0

1

2

3

4

5

Nave

Metformin

SU

met

Insulin

TZD

metDPP-IV

exenatide

Mar

2010

Note: Nave is defined as all patients who have not filled a prescSource: IMS, NPA Monthly data; IMS LRx 4 week average NaiveScript Counts

Number

of

patients(thousands)

0

50

100

150

200

250

300

0%

1%

2%

3%

4%

5%

6%

Mar

2010Mar

2011

GLP-1 % of of

diabetes market value(right axis)

GLP-1 TRx

scripts(thousands)

Victoza

exenatide



31/49

Volume growth and value upgrade drive insuli

value expansionUS insulin value market growth

0

10

20

30

40

50

60

February 2006 Volume growth Mix/price

growth

February 2011

DKKbillion

9.0

bDKK

18.5bDKK


19.9

bDKK

47.4

bDKK

Value upgrade

Note: Monthly MAT, volume figuresSource: IMS

0%

10%

20%

30%

40%

50%

60%

70%

80%

Penetration oftotal market

Feb

2006

Device penetration

Modern insulin penetratio



32/49

Novo Nordisk has increased overall insulin ma

share in the US

Note: Monthly MAT, value figures (DKK)Source: IMS

US total insulin value ma

0%

10%

20%

30%

40%

50%

60%

70%

Feb

2006

Novo Nordisk Sanofi-Av

US total insulin volume market share


0%

10%

20%

30%

40%

50%

60%

70%

Feb

2006

42%

32%

26%

Novo Nordisk Sanofi-Aventis Eli Lilly

Feb

2011



33/49

Novo Nordisk has increased modern insulin ma

share in the USUS modern insulin volume market share US modern insulin value m

Note: Monthly MAT, value figures (DKK)Source: IMS

0%

10%

20%

30%

40%

50%

60%

70%

Feb

2006

Novo Nordisk Sanofi-Avent

0%

10%

20%

30%

40%

50%

60%

70%

Feb

2006


37%

44%

19%


Feb

2011



34/49

0%

20%

40%

60%

80%

100%

0%

20%

40%

60%

80%

100%

0%

20%

40%

60%

80%

100%

Insulin market shares and dynamics

US total insulin market shares by segment

Source: IMS, Monthly MAT volume figures

Novo Nordisk Sanofi-Aventis Eli Lilly Conversion rate to modern i

Insu

linmarketshare(v

olume)

Short acting segment Premix segment Long

Feb

2006Feb

2011Feb

2006Feb

2011Feb

2006



35/49

Focus

areas

for the

US

Expand Victoza

prescribing base and access

Continue modern insulin strategy of value creation by balancingprofitability and access

Preparing for a successful launch of Degludec and DegludecPlus



36/49


The diabe

market



37/49

China is evolving as the worlds #3 pharma

m

20

19

18

1716

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

Netherlands

Poland

Greece

TurkeyAustralia

Mexico

Venezuela

South Korea

India

Russia

Canada

United Kingdom

Brazil

Spain

Italy

France

Germany

China

Japan

United States

2011 Rank

20

19

18

1716

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1 United StatesUnited States1

VenezuelaTurkey12

RussiaRussia11

United KingdomCanada10

CanadaBrazil9

BrazilUnited Kingdom8

SpainSpain7

ItalyItaly6

FranceChina5

TurkeySouth Korea15

South KoreaMexico14

IndiaIndia13

GermanyGermany4

ChinaFrance3

AustraliaGreece17MexicoAustralia16

JapanJapan2

BelgiumPoland20

PolandNetherlands19

GreeceVenezuela18

2013 Rank2009 Rank

20

19

18

1716

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1

Netherlands

Poland

Greece

TurkeyAustralia

Mexico

Venezuela

South Korea

India

Russia

Canada

United Kingdom

Brazil

Spain

Italy

France

Germany

China

Japan

United States

2011 Rank

20

19

18

1716

15

14

13

12

11

10

9

8

7

6

5

4

3

2

1 United StatesUnited States1

VenezuelaTurkey12

RussiaRussia11

United KingdomCanada10

CanadaBrazil9

BrazilUnited Kingdom8

SpainSpain7

ItalyItaly6

FranceChina5

TurkeySouth Korea15

South KoreaMexico14

IndiaIndia13

GermanyGermany4

ChinaFrance3

AustraliaGreece17MexicoAustralia16

JapanJapan2

BelgiumPoland20

PolandNetherlands19

GreeceVenezuela18

2013 Rank2009 Rank

Source: IMS Health MIDAS, Market Prognosis October 2009. Market size ranking in constant USD



38/49

This growth has been driven by five major fact

Source: IMS RDPAC presentation March 2011

Chinas pharmaceutical market is estimated to grow 20% per annum 20

Robust economic growth World #2 economy in 2010

8% GDP growth for the next 5 years (government

Ageing population 2006-2010: +46 million >50 years old

2010-2020: +180 million more

Increasing incidence of chronic diseases Latest study estimates 92 million people with diab Obese population tripled from 2002 to 2010

Sweeping healthcare reforms Broaden coverage and benefits

Strengthen primary care and rural healthcare serv

Improve disease prevention and early diagnosis

Increased investment from all players Increasing M&A activity


S bstantial g o th in diabetes p e alence e p


39/49

Substantial growth in diabetes prevalence exp

the BRIC countries

8 10

51

44

13 10

87

64

0

20

40

60

80

100

Brazil Russia India China

2010

2030

Driven by prevalence growthin the BRIC countries

Millionpeople

Source: International Diabetes Foundation: Diabetes Atlas, 2000 and 2009Note: Data covers the 20-79 age-group. IO: International Operations, Japan includes Korea

Diagnosis, treatment interegional difference remains

0

20

40

60

80

100

People with

diabetes

Diagnosed

diabetics

Tre

diab

% of peoplewith diabetes

2430%


Changing Diabetes in China


40/49

Changing Diabetes

in China

-increasing awareness and diagnosis

Insulin Patient Self-management Guideline, CDS-NN

Changing Diabetes

bus: 3 years, 61 cities, 46,000 patients and ~200 media re

12 more cities will be covered in 2011 Diabetes knowledge websites

for both patients and physicians

GDM program: 3-year, World Diabetes Foundation-Ministry of Health-Novo Nordi

Establish 45 centres, train 4,725 physicians and screen 292,500

women

Localised Barometer

Programme

Diabetes Care Campaign:

Covered 90 hospitals + 200 CHC, 45,952 patients screened, 1,690

physicia

Social Network for Endocrinologists

in China & Medical Information Website: la

Leadership

foras

NNDU

NovoCare

serving

more than

600,000 members

since

2011

Provide comprehensive diabetes knowledge for patients and organise a vari

24-hour hotline service -

>9000 calls per month Patients follow-up calls to ensure successful insulin initiation -

>66,000 calls


Novo Nordisk is the company with the largest


41/49

Novo Nordisk is the company with the largest

diabetes care in China

Branch Office

Frontiers

Li

Tia

Beijing

Hebei

Shanxi

Shando

Jiang

Zh

Fujian

JiangxiHunan

Guangxi

Anhui

HenanShanxi

Hubei

Xinjiang Gansu

Sichuan

Tibet

Qinghai

Inner Mongolia

Yunnan

Guizhou

Chongqing

Ningxia

Hainan

Guangdong

Guangzh

Wuhan

Hong

A total of 3,375 employees across

Commercial operations in China

Manufacturing

R&D

Hong Kong

Taiwan


The Chinese insulin market is expanding signif


42/49

The Chinese insulin market is expanding signif

predominately driven by the premix segment

1

2

3

4

5

6

Chinese diabetes care marketby treatment class by value Chinese insulin market

0

4

8

12

16

20

24

Feb

2006

Lon

P

Fas

CAGR volume: 26.8%CAGR value*: 38.8%

tMU

14%

53%

33%

OAD Insulin GLP-1

Feb

2006Feb

2011

DKK

billion


CAGR 27.8%

CAGR 38.8%

Note: *in DKK. Monthly MAT, volume figures. IMS projects thmarket based on hospital data from 14% of Chinese hospitalSource: IMS

Note: Monthly MAT, value figures. IMS projects the Chinesemarket based on hospital data from 14% of Chinese hospitalsSource: IMS


Novo Nordisk is leading the total diabetes mar


43/49

0%

10%

20%

30%

40%

50%

60%

70%

Novo Nordisk is leading the total diabetes marChina

Total diabetes care valuemarket shares Total insulin volume m

0%

10%

20%

30%

40%

Feb

2006

37%

9%

6%


Feb

2011

15%

4%

Bayer-Schering Bristol Myers-Squibb

Source: IMS Monthly MAT, value figures. IMS projects the Chinesemarket based on hospital data from 14% of Chinese hospitals

Novo Nordisk Sanofi-Ave

Shanghai Fosun Tonghua

D

Feb

2006

Source: IMS Monthly MAT, volume figures. IMS projects tmarket based on hospital data from 14% of Chinese hosp


and maintaining clear leadership in the signi


44/49

and maintaining clear leadership in the signihuman insulin market

Human insulin value market share Human insulin volume m

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Feb

2006

76%

17%

Novo Nordisk Eli Lilly

Feb

2011

6%

Source: IMS Monthly MAT, value figures.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Feb

2006


Tonghua

Dongbao Novo Nordisk Tonghua

Dong


and maintaining a very solid leadership posit


45/49

and maintaining a very solid leadership positmodern insulin market

Modern insulin value market share Modern insulin volume m

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Feb

2006

53%

32%

8%

Novo Nordisk Sanofi-Aventis

Feb

2011

6%

BJ Ganli

Pharm


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Feb

2006


Eli Lilly

Novo Nordisk Sa

BJEli Lilly



46/49

Outlook for Novo Nordisk in China

Continue to collaborate with public authorities on diabetes awareness

Continue to be the main source of information on diabetes to doctors

Continue to be the leading patient support company in the diabetes fi

Expand operations further into smaller cities and rural areas

Launch of Victoza

in second half of 2011



47/49

Closing


I ti i th k t t i d th


48/49

Innovation is the key to sustained growth

DiabetesModern insulins

Victoza

Degludec*

DegludecPlus*

IDegLira*

FIAsp*

*Note: Degludec is the internal designation for insulin degludec. DegludecPlus is the internal designation for insulin degludec/insulin aspart. IDegLira

is the internal designation forinsulin degludec/liraglutide. FIAsp

is the internal designation for fast acting insulin aspart.


Capital markets expect diabetes care to contin


49/49

Capital markets expect diabetes care to continoutgrow the general pharmaceutical industry

Growth in global pr

escription sale

s versus di

abetes care sales (CAG

Source: EvaluatePharma, data retrieved January 21, 2011

Diabetes Care salesTotal Prescription sales

2000-2005 2005-2010 2010-2015

Insulin and GLP-1 sales

10.7%

12.3%

18.4%

6.4%

12.0%

15.9%

3.6%

7.8%

9

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03 the Global Diabetes Care Market CMD2011

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