UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

_________________________

FORM 6-K

_________________________


REPORT OF FOREIGN PRIVATE ISSUER

Pursuant to rule 13a-16 or 15d-16
of the Securities Exchange Act of 1934


February 2, 2022

_________________________

NOVO NORDISK A/S
(Exact name of Registrant as specified in its charter)

_________________________

Novo Allé
DK-2880 Bagsværd
Denmark
(Adress of principal executive offices)

Indicate by check mark whether the registrant files or will file annual reports under cover of Form 20-F or Form 40-F

Form 20-F x Form 40-F o


Indicate by check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934.

Yes o No x


If “Yes” is marked, indicate below the file number assigned to the registrant in connection with Rule 12g-32(b):82-________





NEWHEADER.JPG                           NN_LOGOXCMYKXBLUEXSMALL.JPG                         

Financial report for the period 1 January 2021 to 31 December 2021

2 February 2022                                                        

Novo Nordisk's sales increased by 11% in Danish kroner and by 14% at constant exchange rates to DKK 140.8 billion in 2021

•Operating profit increased by 8% in Danish kroner and by 13% at constant exchange rates (CER) to DKK 58.6 billion.
•Sales in International Operations increased by 12% in Danish kroner (14% at CER), and sales in North America Operations increased by 10% in Danish kroner (14% at CER).
•Sales within Diabetes and Obesity care increased by 13% in Danish kroner to DKK 121.6 billion (15% at CER), driven by GLP-1 sales growth of 28% in Danish kroner (32% at CER) reflecting the uptake of Ozempic® and Rybelsus®. Obesity care sales grew by 50% in Danish kroner (55% at CER), and Biopharm sales increased by 1% measured in Danish kroner (4% at CER).
•Within R&D, Novo Nordisk in November 2021 successfully completed the first cohorts from the ongoing phase 1/2 clinical trial with Mim8, and in December 2021 the acquisition of Dicerna Pharmaceuticals was completed.
•In December 2021, a contract manufacturer filling syringes for Wegovy® temporarily stopped deliveries and manufacturing following issues with current Good Manufacturing Practices. Consequently, fewer new weekly patient initiations are expected in the first half of 2022 compared to fourth quarter of 2021. Novo Nordisk still expects to be able to meet demand in the US in the second half of 2022.
•For the 2022 outlook, sales growth is expected to be 6-10% at CER and operating profit growth is expected to be 4-8% at CER. Sales and operating profit growth reported in Danish kroner is expected to be 5 and 7 percentage points higher than at CER, respectively.
•At the Annual General Meeting on 24 March 2022, the Board of Directors will propose a final dividend of DKK 6.90 for 2021 per share of DKK 0.20. The expected total dividend for 2021 is DKK 10.40 per share, of which DKK 3.50 was paid as interim dividend in August 2021. The Board of Directors intends to initiate a new 12-month share repurchase programme of up to DKK 22 billion.

PROFIT AND LOSS 2021 2020 Growth
as reported 		Growth
at CER*
DKK million
Net sales 140,800  126,946  11  % 14  %
Operating profit 58,644  54,126  8  % 13  %
Net profit 47,757  42,138  13  % N/A
Diluted earnings per share (in DKK) 20.74  18.01  15  % N/A
* CER: Constant exchange rates (average 2020).

Lars Fruergaard Jørgensen, president and CEO: "We are very pleased with the double-digit sales growth in 2021 and the progress we have made on our Strategic Aspirations. The results reflect that almost 35 million people with diabetes are now benefiting from our treatments worldwide. In obesity, we are making progress in resolving the Wegovy® supply issue and we expect to be able to meet demand from people living with obesity in the US in the second half of 2022".

On 2 February 2022 at 13.00 CET, corresponding to 07.00 am EST, an earnings call will be held. Investors will be able to listen in via a link on novonordisk.com, which can be found under ‘Investors’.
Novo Nordisk A/S
Investor Relations
Novo Allé
2880 Bagsværd
Denmark 		Telephone:
+45 4444 8888
www.novonordisk.com 		CVR Number:
24 25 67 90
 Company announcement No 7 / 2022


Financial report for the period 1 January 2021 to 31 December 2021
Page 2 of 33
STRATEGIC ASPIRATIONS
STRATEGIC ASPIRATIONS 2025
The strategic aspirations are objectives that Novo Nordisk intends to work towards and are not a projection of Novo Nordisk's financial outlook or expected growth. Novo Nordisk intends to describe how its activities develop in relation to each of the four dimensions on an ongoing basis.

Performance highlights for 2021 (fourth-quarter developments):

Purpose and sustainability Innovation and therapeutic focus
Adding value to society:
•Progress on 'Defeat Diabetes' strategy:
◦Medical treatment provided to 34.6 million people living with diabetes in 2021
◦46 new vulnerability assessments conducted enabling access to insulin to around 82,000 people with diabetes
◦Reaching 18 countries and around 32,000 children in Changing Diabetes® in Children

Progress towards zero environmental impact:
•43% reduction in CO2 emissions compared to 2019

        Evolve culture and ensure distinct core capabilities:
•Launch of an aspirational gender diversity target




Further raise innovation bar for diabetes treatment:
•Approval of Xulthopy® and Ozempic® in China for the treatment of type 2 diabetes
•Resubmission of semaglutide 2.0 mg in the US and approval in the EU in January 2022
•Phase 1 trial completed with a glucose-sensitive insulin

Develop superior treatment solutions for obesity:
•Approval of Wegovy®, semaglutide 2.4 mg, in the US and approval in the EU in January 2022
•Phase 3a development initiated with 50 mg oral semaglutide in obesity
the
Strengthen and progress Biopharm pipeline:
•Sogroya® phase 3 programme in children with growth hormone deficiency successfully completed
•First Mim8 phase 1/2 trial cohorts successfully completed
 
Establish presence in Other serious chronic diseases:
•Phase 3a development initiated with ziltivekimab in cardiovascular disease and semaglutide in NASH and Alzheimer's disease

Acquisition of Dicerna Pharmaceuticals and its RNAi platform to be applied across therapy areas

Commercial execution Financials
       Strengthen diabetes leadership to more than one-third
•Diabetes value market share increased by 0.8 percentage point to 30.1% (MAT)

 Strengthen obesity leadership and double sales:
•Obesity care sales increased by 55% (CER) to DKK 8.4 billion

 Secure a sustained growth outlook for Biopharm:
•Biopharm sales increased by 4% (CER) to DKK 19.2 billion
Deliver solid sales and operating profit growth:
•Sales growth at 14% (CER)
•International Operations sales growth of 14% (CER)
•US sales growth of 13% (CER) with 60% of sales coming from products launched since 2015
•Operating profit growth of 13% (CER)

          Drive operational efficiencies:
•Continued productivity gains in Product Supply

Enable attractive capital allocation to shareholders:
•Free cash flow of DKK 29.3 billion
•Share buyback of DKK 20 billion
•Total dividend of DKK 10.40 per share and payout ratio of 49.6%









Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 3 of 33
PERFORMANCE HIGHLIGHTS
FINANCIAL HIGHLIGHTS FOR 2021
PROFIT AND LOSS 2021 2020 2019 2018 2017  % change
 2021 to
 2020 		 % change
 2021 to
 2020 at CER
(Amounts are in DKK million, except for earnings per share and dividend per share)
Net sales 140,800 126,946 122,021 111,831 111,696 11  % 14  %
Gross profit 117,142 106,014 101,933 94,214 94,064 10  % 14  %
Gross margin 83.2% 83.5% 83.5% 84.2% 84.2%
Sales and distribution costs (37,008) (32,928) (31,823) (29,397) (28,340) 12  % 15  %
Percentage of sales 26.3% 25.9% 26.1% 26.3% 25.4%
Research and development costs (17,772) (15,462) (14,220) (14,805) (14,014) 15  % 16  %
Percentage of sales 12.6% 12.2% 11.7% 13.2% 12.5%
Administrative costs (4,050) (3,958) (4,007) (3,916) (3,784) 2  % 4  %
Percentage of sales 2.9% 3.1% 3.3% 3.5% 3.4%
Other operating income and expenses 332 460 600 1,152 1,041 (28  %) (27  %)
Operating profit 58,644 54,126 52,483 47,248 48,967 8  % 13  %
Operating margin 41.7% 42.6% 43.0% 42.2% 43.8%
Financial items (net) 436 (996) (3,930) 367 (287) (144  %) N/A
Profit before income taxes 59,080 53,130 48,553 47,615 48,680 11  % N/A
Income taxes (11,323) (10,992) (9,602) (8,987) (10,550) 3  % N/A
Effective tax rate 19.2% 20.7% 19.8% 18.9% 21.7%
Net profit 47,757 42,138 38,951 38,628 38,130 13  % N/A
Net profit margin 33.9% 33.2% 31.9% 34.5% 34.1%
OTHER KEY NUMBERS
Depreciation, amortisation and impairment losses 6,025 5,753 5,661 3,925 3,182 5  % N/A
Purchase of intangible assets 1,050 16,256 2,299 2,774 1,022 (94  %)
Capital expenditure 6,335 5,825 8,932 9,636 7,626 9  % N/A
Net cash generated from operating activities 55,000 51,951 46,782 44,616 41,168 6  % N/A
Free cash flow 29,319 28,565 34,451 32,536 32,588 3  % N/A
Total assets 194,508 144,922 125,612 110,769 102,355 34  % N/A
Equity 70,746 63,325 57,593 51,839 49,815 12  % N/A
Equity ratio 36.4% 43.7% 45.8% 46.8% 48.7%
Diluted earnings per share / ADR (in DKK) 20.74 18.01 16.38 15.93 15.39 15  % N/A
Total dividend per share 1)
10.40 9.10 8.35 8.15 7.85 14  %
Payout ratio 2)
49.6% 50.0% 50.5% 50.6% 50.4%
1) Total dividend for the financial year 2021 including proposed final dividend of DKK 6.90 per share and interim dividend paid in August 2021 of DKK 3.50 per share.
2) Total dividend for the year as a percentage of net profit.
The Board of Directors and Executive Management have approved the Annual Report 2021 of Novo Nordisk A/S
including the audited consolidated financial statements. The Board of Directors and Executive Management also
approved this unaudited financial statement containing condensed financial information for 2021. This financial
statement is prepared in accordance with the recognition and measurement requirements of the International
Financial Reporting Standards (IFRS) as issued by IASB and IFRS as endorsed by the EU.

Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 4 of 33
COMMERCIAL EXECUTION
SALES DEVELOPMENT ACROSS THERAPEUTIC AREAS
Sales grew by 11% measured in Danish kroner and by 14% at CER 2021, driven by growth across all therapy areas with Diabetes care sales growth of 13% (CER), Obesity care sales growth of 55% (CER) and Biopharm sales growth of 4% (CER).

Sales split per therapy  Sales 2021
DKK million 		 Sales 2020
DKK million 		Growth
as reported 		Growth
at CER 		Share of growth
at CER
Diabetes and Obesity care segment
Rybelsus®
4,838  1,873  158  % 168  % 18  %
Ozempic®
33,705  21,211  59  % 64  % 77  %
Victoza®
15,054  18,747  (20  %) (18  %) (19  %)
Total GLP-1 53,597  41,831  28  % 32  % 76  %
Long-acting insulin 18,064  18,439  (2  %) 0  % 0  %
 -   Tresiba®
9,729  8,968  8  % 11  % 6  %
 -   Xultophy®
2,657  2,444  9  % 11  % 1  %
 -   Levemir®
5,678  7,027  (19  %) (17  %) (7  %)
Premix insulin 11,203  10,925  3  % 4  % 2  %
 -   Ryzodeg®
1,711  1,291  33  % 37  % 3  %
 -   NovoMix®
9,492  9,634  (1  %) (1  %) (1  %)
Fast-acting insulin 17,687  18,313  (3  %) (1  %) (1  %)
 -   Fiasp®
1,748  1,385  26  % 29  % 2  %
 -   NovoRapid®
15,939  16,928  (6  %) (3  %) (3  %)
Human insulin 9,052  8,873  2  % 4  % 2  %
Total insulin 56,006  56,550  (1  %) 1  % 3  %
Other Diabetes care1
3,594  4,031  (11  %) (10  %) (2  %)
Total Diabetes care 113,197  102,412  11  % 13  % 77  %
Obesity care (Saxenda® and Wegovy®)
8,400  5,608  50  % 55  % 18  %
Diabetes and Obesity care total 121,597  108,020  13  % 15  % 95  %
Biopharm segment
Rare blood disorders2
10,217  9,662  6  % 9  % 5  %
 - Haemophilia A 2,112  1,713  23  % 25  % 2  %
 - Haemophilia B 637  518  23  % 25  % 1  %
 -  NovoSeven®
7,221  7,203  0  % 4  % 1  %
Rare endocrine disorders3
7,303  7,707  (5  %) (2  %) (1  %)
Other Biopharm4
1,683  1,557  8  % 8  % 1  %
Biopharm total 19,203  18,926  1  % 4  % 5  %
Total sales 140,800  126,946  11  % 14  % 100  %
1) Primarily NovoNorm®, needles and GlucaGen® HypoKit®.
2) Comprises NovoSeven®, NovoEight®, Esperoct®, Refixia® and NovoThirteen®.
3) Primarily Norditropin®.
4) Primarily Vagifem® and Activelle®.



Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 5 of 33
DIABETES AND OBESITY CARE
Diabetes care, sales and market share development
Sales in Diabetes care increased by 11% measured in Danish kroner and by 13% at CER to DKK 113,197 million driven by GLP-1 growth. Novo Nordisk has improved the global diabetes value market share over the last 12 months from 29.3% to 30.1% in line with the aspiration of strengthening the Diabetes care leadership, aiming at reaching a global value market share of more than one third in 2025. The market share increase was driven by market share gains in both International Operations and North America Operations.

In the following sections, unless otherwise noted, market data are based on moving annual total (MAT) from November 2021 and November 2020 provided by the independent data provider IQVIA. EMEA covers Europe, the Middle East and Africa; Region China covers mainland China, Hong Kong and Taiwan, and Rest of World covers all other countries except for North America.
Diabetes care, development per geographical area Novo Nordisk’s share of the total diabetes market (value, MAT) Diabetes care, sales development
November November  Sales 2021
DKK million 		Growth
at CER
2021 2020
Global 30.1  % 29.3  % 113,197  13  %
International Operations 24.9  % 23.2  % 58,692  14  %
 - EMEA * 28.7  % 27.7  % 29,136  12  %
 - Region China ** 33.0  % 30.0  % 15,563  11  %
 - Rest of World *** 15.5  % 13.5  % 13,993  24  %
North America Operations 31.9  % 31.5  % 54,505  12  %
 - The US 31.9  % 31.6  % 51,197  11  %
Source: IQVIA, November 2021 data. *Data for EMEA available for European markets and seven markets outside Europe representing approximately 90% of Novo Nordisk Diabetes care sales in the area. **Data for mainland China, excluding Hong Kong and Taiwan. *** Data for Rest of World available for seven markets representing approximately 70% of total Novo Nordisk’s Diabetes care sales in the area.

GLP-1 therapy for type 2 diabetes
Sales of GLP-1 products for type 2 diabetes (Rybelsus®, Ozempic® and Victoza®) increased by 28% measured in Danish kroner and by 32% at CER to DKK 53,597 million. The GLP-1 segment’s value share of the total diabetes market has increased to 26.5% compared with 21.9% 12 months ago. Novo Nordisk continues to be the global market leader in the GLP-1 segment with a 52.7% value market share, an increase of 2.3 percentage points compared to 12 months ago.
GLP-1, development per geographical area Novo Nordisk's share of the diabetes GLP-1 market (value, MAT) GLP-1, sales development
November November  Sales 2021
DKK million 		Growth
at CER
2021 2020
Global 52.7  % 50.4  % 53,597  32  %
International Operations 58.9  % 53.7  % 16,106  52  %
 - EMEA * 58.3  % 55.1  % 10,209  38  %
 - Region China ** 74.0  % 90.2  % 1,847  73  %
 - Rest of World *** 56.9  % 43.6  % 4,050  85  %
North America Operations 51.8  % 50.0  % 37,491  25  %
 - The US 51.0  % 49.3  % 35,442  24  %
Source: IQVIA, November 2021 data. *Data for EMEA available for European markets and seven markets outside Europe representing approximately 90% of Novo Nordisk GLP-1 sales in the area. **Data for mainland China, excluding Hong Kong and Taiwan. ***Data for Rest of World available for seven markets representing approximately 70% of total Novo Nordisk Diabetes care sales in the area.

Rybelsus® sales increased by 158% measured in Danish kroner and by 168% at CER to DKK 4,838 million. Sales growth was driven by North America Operations as well as EMEA and Rest of World. Rybelsus® has now been launched in 29 countries.

Ozempic® sales increased by 59% measured in Danish kroner and by 64% at CER to DKK 33,705 million. Sales growth was driven by both North America Operations and International Operations. Ozempic® has now been launched in 72 countries.

Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 6 of 33
Victoza® sales decreased by 20% measured in Danish kroner and by 18% at CER to DKK 15,054 million as the GLP-1 market is moving towards once-weekly and tablet-based treatments. The sales decline was driven by North America Operations, EMEA and Rest of World, partially offset by higher sales in Region China.

International Operations
Sales of GLP-1 diabetes products in International Operations increased by 50% measured in Danish kroner and by 52% at CER. Sales growth is driven by all geographical areas. The value share of the GLP-1 class of the total diabetes market has increased to 13.6% from 10.7% 12 months ago. Novo Nordisk is the market leader with a value market share of 58.9%.

EMEA
Sales in EMEA increased by 38% in both Danish kroner and at CER. The sales growth reflects the uptake of Ozempic® and Rybelsus®, partially offset by lower sales of Victoza®. Rybelsus® has now been launched in 24 countries in EMEA. Novo Nordisk remains the market leader in EMEA with a value market share of 58.3%.

Region China
Sales in Region China increased by 77% measured in Danish kroner and by 73% at CER. The sales growth reflects the uptake of Victoza® in China and of Ozempic® in Taiwan as well as launch of Ozempic® in China following the approval in April 2021. As of 1 January 2022, Ozempic® has been included on the National Reimbursement List in China. The GLP-1 class' share of the overall diabetes market value in Region China increased to 5.6% from 2.9% 12 months ago.

Rest of World
Sales in Rest of World increased by 74% measured in Danish kroner and by 85% at CER. The sales growth reflects increased sales of Ozempic® and Rybelsus®, following the launch in Japan, partially offset by Victoza®. Novo Nordisk remains the market leader with a value market share of 56.9%.

North America Operations
Sales of GLP-1 diabetes products in North America Operations increased by 21% measured in Danish kroner and by 25% at CER. Novo Nordisk is the market leader with a 51.8% value market share compared to 50.0% 12 months ago. The value market share of the GLP-1 class of the total North American diabetes market has increased to 31.1% compared to 26.0% 12 months ago.

Sales growth in the US is driven by a prescription volume growth of the GLP-1 class of around 30% in the fourth quarter of 2021 compared to the fourth quarter of 2020. The weekly new-to-brand market share for Ozempic® is 44.9% and 12.7% for Rybelsus®. The combined Novo Nordisk GLP-1 new-to-brand prescription market share is now 63.9%. Novo Nordisk is the market leader with 53.4% measured on total monthly prescriptions for the combined GLP-1 portfolio.

Sales of GLP-1 in the US increased by 24% at CER. The sales increase was driven by continued uptake of Ozempic® and Rybelsus®, partially offset by declining Victoza® sales. GLP-1 sales growth was negatively impacted by rebate enhancements as well as unfavourable channel and payer mix.

Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 7 of 33
Insulin
Sales of insulin decreased by 1% measured in Danish kroner and increased by 1% at CER to DKK 56,006 million. Sales growth at CER was driven by increased sales in International Operations, partially offset by declining sales in the US.

Insulin, development per geographical area Novo Nordisk’s share of the total insulin market (volume, MAT) Insulin, sales development
November November  Sales 2021
DKK million 		Growth
at CER
2021 2020
Global 47.1  % 47.3  % 56,006  1  %
International Operations 50.3  % 50.1  % 39,942  6  %
 - EMEA * 47.6  % 47.6  % 18,214  2  %
 - Region China ** 50.9  % 50.6  % 12,284  8  %
 - Rest of World *** 57.2  % 57.1  % 9,444  11  %
North America Operations 38.6  % 39.6  % 16,064  (9  %)
 - The US 38.1  % 39.4  % 14,949  (9  %)
Source: IQVIA, November 2021 data. *Data for EMEA available for European markets and seven markets outside Europe representing approximately 90% of Novo Nordisk insulin sales in the area. **Data for mainland China, excluding Hong Kong and Taiwan. ***Data for Rest of World available for seven markets representing approximately 70% of total Novo Nordisk Diabetes care sales in the area.

International Operations
Sales of insulin in International Operations increased by 4% measured in Danish kroner and by 6% at CER. Sales growth at CER was driven by all insulin products except for Levemir® and NovoMix®.

EMEA
Sales of insulin in EMEA decreased by 1% measured in Danish kroner and increased by 2% at CER. The sales growth at CER was mainly driven by Tresiba® and Fiasp®, partially countered by Levemir®, NovoRapid® and human insulin. Novo Nordisk has a volume market share of 47.6% of the total insulin market.

Region China
Sales of insulin in Region China increased by 11% measured in Danish kroner and by 8% at CER. The sales growth was driven by Tresiba®, Ryzodeg® and NovoRapid®, partially countered by Levemir® and human insulin. Novo Nordisk has a volume market share of 50.9% of the total insulin market.

Rest of World
Sales of insulin in Rest of World increased by 6% measured in Danish kroner and by 11% at CER. The sales growth at CER was driven by all insulin products except for Levemir® and NovoMix®. Novo Nordisk has a volume market share of 57.2% of the total insulin market.

North America Operations
Sales of insulin in North America Operations decreased by 12% measured in Danish kroner and by 9% at CER. The sales decrease in the US was driven by lower realised prices due to channel and payer mix and rebate enhancements as well as a decline in volume. Changes to the 340B Drug Programme positively impacted sales. Novo Nordisk has a volume market share of 38.6% of the total insulin market.




Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 8 of 33
Obesity care, sales development
Sales of Obesity care products, Saxenda® and Wegovy®, increased by 50% measured in Danish kroner and by 55% at CER to DKK 8,400 million. Sales growth was driven by North America Operations and International Operations. Saxenda® has been launched in 65 countries, and Wegovy® was launched in the US in June 2021. Novo Nordisk currently has a value market share of 77.8% of the global branded obesity prescription drug market. The strategic aspiration for Obesity care is to more than double reported sales from the base in 2019 of DKK 5,679 million by 2025.
Obesity care, development per geographical area Obesity care, sales development
 Sales 2021
DKK million 		Growth
at CER
Global 8,400  55  %
International Operations 3,117  52  %
 - EMEA 1,809  66  %
 - Region China 61  —
 - Rest of World 1,247  32  %
North America Operations 5,283  57  %
 - The US 4,912  58  %
International Operations
Sales of Saxenda® in International Operations increased by 47% measured in Danish kroner and by 52% at CER driven by increased sales in EMEA and Rest of World. Novo Nordisk currently has a value market share of 52.4% in the branded obesity prescription drug market.

EMEA
Sales of Saxenda® in EMEA increased by 61% measured in Danish kroner and by 66% at CER. Novo Nordisk currently has a value market share of 73.1% in the branded obesity prescription drug market.

Rest of World
Sales of Saxenda® in Rest of World increased by 27% measured in Danish kroner and by 32% at CER. Saxenda® has been launched in 19 countries in Rest of World. Novo Nordisk currently has a value market share of 41.7% in the branded obesity prescription drug market.
North America Operations
Sales of Obesity care products in North America Operations increased by 51% measured in Danish kroner and by 57% at CER. Novo Nordisk now has a value market share of 89.0% in the branded anti-obesity prescription drug market in North America. Wegovy® was made available to patients in June 2021 and market access has progressed and commercial formulary access is now more than 70%. The initial feedback from prescribers has been encouraging and demand from patients exceeded supply.

In December 2021, Novo Nordisk announced that a contract manufacturer filling syringes for Wegovy® pens for the US market has temporarily stopped deliveries and manufacturing following issues with current Good Manufacturing Practices. As a consequence, Novo Nordisk does not expect to be able to meet the demand of Wegovy® in the US in the first half of 2022 and fewer new weekly patient initiations are expected compared to the fourth quarter of 2021. Novo Nordisk still expects to be able to meet demand in the US in the second half of 2022.



Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 9 of 33
BIOPHARM
Biopharm, sales development
Sales of Biopharm products increased by 1% measured in Danish kroner and by 4% at CER to DKK 19,203 million in line with the strategic aspiration of sustained growth in Biopharm. The sales growth at CER was driven by both North America Operations and International Operations. Sales growth was driven by Rare blood disorders.
Biopharm, development per geographical area Biopharm, sales development
 Sales 2021
DKK million 		Growth
at CER
Global 19,203  4  %
International Operations 11,728  3  %
 - EMEA 6,761  3  %
 - Region China 395  (11  %)
 - Rest of World 4,572  5  %
North America Operations 7,475  6  %
 - The US 6,900  7  %
Rare blood disorders
Sales of Rare blood disorder products increased by 6% measured in Danish kroner and by 9% at CER to DKK 10,217 million. The increasing sales were driven by the launch products Esperoct® and Refixia® as well as NovoSeven® and NovoEight®.

Sales of haemophilia A products increased by 23% measured in Danish kroner and by 25% at CER to DKK 2,112 million. The sales increase was driven by both International Operations and North America Operations. Esperoct® has now been launched in 25 countries.

Sales of haemophilia B products increased by 23% measured in Danish kroner and by 25% at CER to DKK 637 million. The sales increase was driven by both International Operations and North America Operations. Refixia® has now been launched in 25 countries.
Sales of NovoSeven® remained unchanged in Danish kroner and increased by 4% at CER to DKK 7,221 million. The sales development was driven by increasing sales in North America Operations, partially offset by declining sales in International Operations. The sales decline in Region China reflects increased distributor stock levels in 2020.

Rare endocrine disorders
Sales of Rare endocrine disorder products decreased by 5% measured in Danish kroner and by 2% at CER to DKK 7,303 million. The sales development was driven by North America Operations' sales decreasing by 12% at CER, partially offset by International Operations sales increasing by 5% at CER. Novo Nordisk is the leading company in the global human growth disorder market with a value market share of 36.3% compared to 35.6% a year ago.


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 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 10 of 33
FINANCIALS
GEOGRAPHIC SALES DEVELOPMENT
Sales increased by 11% measured in Danish kroner and by 14% at CER to DKK 140,800 million in 2021. Sales in International Operations increased by 12% measured in Danish kroner and by 14% at CER. The strategic aspiration for International Operations is sales growth between 6-10%. Sales in North America Operations increased by 10% measured in Danish kroner and by 14% at CER. The strategic aspiration of transforming 70% of sales in the US has progressed, and 60.3% of sales are now derived from products launched since 2015.

Sales split per geographical area  Sales 2021
DKK million 		Growth
as reported 		Growth
at CER 		Share of growth
at CER
International Operations 73,537  12  % 14  % 51  %
 - EMEA 37,706  10  % 12  % 23  %
 - Region China 16,019  14  % 11  % 9  %
 - Rest of World 19,812  14  % 19  % 19  %
North America Operations 67,263  10  % 14  % 49  %
 - The US 63,009  9  % 13  % 44  %
Total sales 140,800  11  % 14  % 100  %

International Operations
Sales in International Operations increased by 12% measured in Danish kroner and by 14% at CER. Sales growth was driven by all therapy areas with GLP-1 sales growing by 52% at CER, insulin sales growing by 6% at CER, Obesity care sales growing by 52% at CER and Biopharm sales growing by 3% at CER.

EMEA
Sales in EMEA increased by 10% measured in Danish kroner and by 12% at CER. Sales growth was driven by Diabetes care growing by 12% at CER driven by increased GLP-1 sales. Obesity care sales increased by 66% at CER and Biopharm sales increased by 3% at CER.

Region China
Sales in Region China increased by 14% measured in Danish kroner and by 11% at CER. Sales growth was driven by Diabetes care growth of 11% at CER reflecting increased insulin and GLP-1 sales, partially offset by Biopharm sales declining by 11% at CER reflecting increased distributor stock levels in 2020.

Rest of World
Sales in Rest of World increased by 14% measured in Danish kroner and by 19% at CER. Sales growth was driven by Diabetes care growing by 24% at CER, reflecting increased GLP-1 and insulin sales, Obesity care sales growing by 32% at CER and Biopharm growing by 5% at CER.

North America Operations
Sales in North America Operations increased by 10% measured in Danish kroner and by 14% at CER. Changes to the 340B Drug Pricing Programme positively impacted sales growth.

The sales increase reflects GLP-1 diabetes sales growing by 25% at CER, Obesity care sales growing by 57% at CER and Biopharm sales growing by 6% at CER. This was partially offset by insulin sales decreasing by 9% at CER driven by lower realised prices due to channel and payer mix and rebate enhancements as well as a decline in volume.
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Financial report for the period 1 January 2021 to 31 December 2021
Page 11 of 33
DEVELOPMENT IN COSTS AND OPERATING PROFIT
The cost of goods sold increased by 13% measured in Danish kroner and by 15% at CER to DKK 23,658 million, resulting in a gross margin of 83.2% measured in Danish kroner compared with 83.5% in 2020. The decline in gross margin reflects lower realised prices in the US, a negative currency impact of 0.2 percentage point and amortisation of intangible assets related to the acquisition of Emisphere Technologies Inc. in 2020. This is countered by a positive product mix driven by increased GLP-1 sales and productivity improvements in line with the strategic aspiration of driving operational efficiencies.

Sales and distribution costs increased by 12% measured in Danish kroner and by 15% at CER to DKK 37,008 million. The increase in costs is driven by International Operations and North America Operations. In International Operations, promotional spend is related to launch activities for Rybelsus® and Ozempic® as well as Obesity care market development activities. In North America Operations, the cost increase is driven by promotional activities for Rybelsus® and Ozempic® as well as market development activities for Obesity care and launch costs for Wegovy®, partially offset by lower promotional spend related to insulin.

Research and development costs increased by 15% measured in Danish kroner and by 16% at CER to DKK 17,772 million. Increased activities within Other serious chronic diseases are driving the cost increase reflecting the progression of the pipeline within cardiovascular disease and NASH. The growth is impacted by amortisation of the priority review voucher for Wegovy® in the US in 2020.

Administration costs increased by 2% measured in Danish kroner and by 4% at CER to DKK 4,050 million, reflecting low spend in 2020 due to COVID-19 impact on activities.

Other operating income and expenses (net) was DKK 332 million compared with DKK 460 million in 2020.

Operating profit increased by 8% measured in Danish kroner and by 13% at CER to DKK 58,644 million.

Financial items (net) showed a net gain of DKK 436 million compared with a net loss of DKK 996 million in 2020.

In line with Novo Nordisk’s treasury policy, the most significant foreign exchange risks for Novo Nordisk have been hedged, primarily through foreign exchange forward contracts. The foreign exchange result was a net gain of DKK 344 million compared with a net loss of DKK 747 million in 2020. This reflects gains on hedged currencies, primarily the US dollar.

As per the end of December 2021, a negative market value of financial contracts of approximately DKK 1.7 billion has been deferred for recognition in 2022.

The effective tax rate is 19.2% in 2021 compared with an effective tax rate of 20.7% in 2020, mainly reflecting non-recurring impact from acquisitions in 2020 and 2021.

Net profit increased by 13% to DKK 47,757 million and diluted earnings per share increased by 15% to DKK 20.74


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Financial report for the period 1 January 2021 to 31 December 2021
Page 12 of 33
KEY DEVELOPMENTS IN THE FOURTH QUARTER OF 2021
Sales in the fourth quarter of 2021 increased by 19% measured in Danish kroner and by 16% at CER compared to the same period in 2020. Operating profit increased by 22% measured in Danish kroner and by 16% at CER.
Please refer to appendix 1 for an overview of the quarterly numbers in DKK and to appendix 6 for additional details on sales in the fourth quarter of 2021.

Sales split per geographical area  Sales Q4 2021
DKK million 		Growth
as reported 		Growth
at CER 		Share of growth
at CER
International Operations 18,216  18  % 15  % 45  %
 - EMEA 9,427  16  % 15  % 22  %
 - Region China 3,710  14  % 5  % 3  %
 - Rest of World 5,079  26  % 26  % 20  %
North America Operations 20,117  20  % 17  % 55  %
 - The US 18,902  19  % 16  % 49  %
Total sales 38,333  19  % 16  % 100  %

The increased global sales of 16% at CER were driven by Diabetes and Obesity care sales as GLP-1 sales increased by 36% at CER, Obesity care sales increased by 73% partially offset by decreased insulin sales by 1%. Biopharm sales increased by 6% at CER.

International Operations
Sales in International Operations increased by 18% measured in Danish kroner and by 15% at CER. Sales growth was driven by all geographical areas.

Sales growth was driven by Diabetes and Obesity care growing by 18% at CER driven by increased GLP-1 sales growing by 65% at CER, insulin sales growing by 4% at CER and Obesity care increasing by 57% at CER. Biopharm sales increased by 5% at CER.

North America Operations
Sales in North America Operations increased by 20% measured in Danish kroner and by 17% at CER. Sales growth was driven by GLP-1 growing by 28% at CER reflecting the prescription volume growth, the uptake of Ozempic® and the launch of Rybelsus®. Insulin sales decreased by 10% at CER driven by lower realised prices. The insulin sales decline was positively impacted by changes to the 340B Drug Pricing Programme. Obesity care sales increased by 83% at CER, reflecting the launch of Wegovy® in June 2021, and Biopharm sales increased by 7% at CER driven by increased NovoSeven® sales, partially offset by lower Norditropin® sales.

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Financial report for the period 1 January 2021 to 31 December 2021
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PROFIT AND LOSS Q4 2021 Q4 2020  % change
 Q4 2021 to
 Q4 2020 		 % change
 Q4 2021 to
 Q4 2020 at CER
Net sales 38,333 32,138 19  % 16  %
Gross profit 32,092 26,519 21  % 17  %
Gross margin 83.7% 82.5%
Sales and distribution costs (11,632) (9,766) 19  % 16  %
Percentage of sales 30.3% 30.4%
Research and development costs (5,632) (4,483) 26  % 24  %
Percentage of sales 14.7% 13.9%
Administrative costs (1,190) (1,198) (1  %) (1  %)
Percentage of sales 3.1% 3.7%
Other operating income and expenses (4) 106 (104  %) (115  %)
Operating profit 13,634 11,178 22  % 16  %
Operating margin 35.6% 34.8%
Financial items (net) (521) 824 (163  %) N/A
Profit before income taxes 13,113 12,002 9  % N/A
Income taxes (2,221) (2,684) (17  %) N/A
Effective tax rate 16.9% 22.4%
Net profit 10,892 9,318 17  % N/A
Net profit margin 28.4% 29.0%

Costs and operating profit
The gross margin was 83.7% in the fourth quarter of 2021 compared with 82.5% in the same period last year. The 1.2 percentage point gross margin increase reflects a positive product mix, a positive currency impact of 0.6% percentage point, partially countered by lower realised prices in the US.

Sales and distribution costs increased by 19% measured in Danish kroner and by 16% at CER compared with the same period in 2020. The increase was driven by International Operations and North America Operations reflecting the launches of Rybelsus®, promotional activities related to Ozempic® as well as promotional and market development activities related to Obesity care.
Research and development costs increased by 26% measured in Danish kroner and by 24% at CER compared with 2020 driven by the cardiovascular outcomes trials SOUL and SELECT as well as the phase 3 trials with icodec and icosema.
Administrative costs decreased by 1% in both Danish kroner and CER compared with the same period in 2020.

Other operating income and expenses showed an expense of DKK 4 million in the fourth quarter of 2021 compared with an income of DKK 106 million in the same period last year reflecting costs related to the acquisition of Dicerna Pharmaceuticals Inc.
Operating profit increased by 22% measured in Danish kroner and by 16% at CER compared with the same period in 2020.

Financial items (net) showed a net loss of DKK 521 million compared with a net gain of DKK 824 million in the fourth quarter of 2020.

The effective tax rate is 16.9% in fourth quarter of 2021 compared with an effective tax rate of 22.4% in fourth quarter of 2020 mainly reflecting impacts from business development activities in the fourth quarter of 2020.

Net profit increased by 17% to DKK 10,892 million and diluted earnings per share increased by 19% to DKK 4.76.

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Financial report for the period 1 January 2021 to 31 December 2021
Page 14 of 33
CASH FLOW AND CAPITAL ALLOCATION

FREE CASH FLOW IN 2021 AND CAPITAL EXPENDITURE
Free cash flow was DKK 29.3 billion compared with DKK 28.6 billion in 2020 supporting the strategic aspiration to deliver attractive capital allocation to shareholders. The increase is driven by higher net profit and higher provisions for rebates in the US partially driven by changed distribution policy for the 340B programme. This increase is partially countered by an unfavourable impact from change in working capital.

Capital expenditure for property, plant and equipment was DKK 6.3 billion compared with DKK 5.8 billion in 2020.

Novo Nordisk’s financial reserves were DKK 16.1 billion by end of December 2021 comprising cash at bank, marketable securities (measured at fair value based on active market data) and undrawn credit facilities less overdrafts and loans repayable within 12 months.

EQUITY AND CAPITAL ALLOCATION
Total equity was DKK 70,746 million at the end of 2021, equivalent to 36.4% of total assets, compared with 43.7% at the end of 2020. Please refer to appendix 5 for further elaboration of changes in equity.

2021 share repurchase programme
On 5 November 2021, Novo Nordisk announced a share repurchase programme of up to DKK 3.7 billion to be executed from 8 November 2021 to 1 February 2022, as part of an overall programme of up to DKK 20 billion to be executed during a 12-month period beginning 3 February 2021. The purpose of the programme was to reduce the company’s share capital and to meet obligations arising from share-based incentive programmes. Under the programme, Novo Nordisk has repurchased 5,336,989 B shares for an amount of DKK 3.7 billion in the period from 11 November 2021 to 1 February 2022. The programme was concluded on 1 February 2022.

As of 1 February 2022, Novo Nordisk A/S has repurchased a total of 34,773,170 B shares equal to a transaction value of DKK 20.0 billion under the overall 2021 share repurchase programme beginning 3 February 2021.

As of 1 February 2022, Novo Nordisk and its wholly-owned affiliates owned 33,526,721 of its own B shares, corresponding to 1.5% of the total share capital.

Proposed final dividend of DKK 6.90 for each Novo Nordisk A and B share of DKK 0.20
At the Annual General Meeting on 24 March 2022, the Board of Directors will propose a final dividend of DKK 6.90
for each Novo Nordisk A and B share of DKK 0.20. The total dividend for 2021 of DKK 10.40 for each Novo Nordisk A
and B share of DKK 0.20 includes both the interim dividend of DKK 3.50 for each Novo Nordisk A and B share of
DKK 0.20, which was paid in August 2021, and the proposed final dividend of DKK 6.90 for each Novo Nordisk A
and B share of DKK 0.20 to be paid in March 2022. Hence, the total dividend is expected to increase by 14.3%
compared with the 2020 dividend of DKK 9.10 for each Novo Nordisk A and B share of DKK 0.20. The total dividend
for 2021 corresponds to a payout ratio of 49.6%, which is similar to the payout ratio for Novo Nordisk’s peer group
of comparable pharmaceutical companies in 2020. No dividend will be paid on the company’s holding of own B
shares.

2022 share repurchase programme
The Board of Directors has approved a new share repurchase programme of up to DKK 22 billion to be executed
during the coming 12 months. The total programme may be reduced in size, in case of significant business development transactions during 2022.

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Financial report for the period 1 January 2021 to 31 December 2021
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As part of the up to DKK 22 billion 2022 share repurchase programme, Novo Nordisk A/S will initiate a new share
repurchase programme for an amount of up to DKK 4.4 billion in accordance with Article 5 of Regulation No
596/2014 of the European Parliament and Council of 16 April 2014 (MAR) and the Commission Delegated
Regulation (EU) 2016/1052 of 8 March 2016 (the 'Safe Harbour Rules'). For that purpose, Novo Nordisk A/S has
appointed Skandinaviska Enskilda Banken, Danmark, filial af Skandinaviska Enskilda Banken AB (SEB), as lead manager to execute the programme independently and without influence from Novo Nordisk A/S. The purpose of the programme is to reduce the company’s share capital and to meet obligations arising from share-based incentive programmes. Under the agreement, SEB will repurchase B shares on behalf of Novo Nordisk A/S during the trading period starting today, 2 February 2022, and ending on 2 May 2022.

A maximum of 180,000,000 B shares in total can be bought during the trading period. The maximum number of B
shares that can be repurchased on a single trading day may not exceed 20% of the average daily trading volume of
Novo Nordisk B shares on the trading venue, on which the purchase takes place, during the preceding 20 trading
days of the purchase (excluding the day of the purchase), cf Article 3(3) of the Commission Delegated Regulation
(EU) 2016/1052. At least once every seven trading days, Novo Nordisk A/S will issue an announcement in respect of
the transactions made under the repurchase programme.

Novo Nordisk’s majority shareholder Novo Holdings A/S, a holding company fully owned by the Novo Nordisk
Foundation, has informed Novo Nordisk that it intends to consider its participation in the Novo Nordisk share
repurchase programme on a year-by-year basis. For 2022, Novo Nordisk has been informed by Novo Holdings A/S
that it plans to participate in the share repurchase programme. Novo Holdings A/S has an ownership of 28.1% of
the Novo Nordisk share capital, and Novo Holdings A/S currently intends to maintain its ownership of the Novo
Nordisk share capital around 28%.

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 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 16 of 33
OUTLOOK
OUTLOOK 2022
The current expectations for 2022 are summarised in the table below:
Expectations are as reported, if not otherwise stated Expectations
2 February 2022
Sales growth
at CER 6% to 10%
as reported Around 5 percentage points higher than at CER
Operating profit growth
at CER 4% to 8%
as reported Around 7 percentage points higher than at CER
Financial items (net) Loss of around DKK 2.8 billion
Effective tax rate 20% to 22%
Capital expenditure (PP&E) Around DKK 12.0 billion
Depreciation, amortisation and impairment losses Around DKK 6.5 billion
Free cash flow (excluding impact from business development) DKK 50-55 billion
For 2022, sales growth is expected to be 6% to 10% at CER. The guidance reflects expectations for sales growth in both International Operations and in North America Operations, mainly driven by Diabetes and Obesity care. Within Obesity care, the guidance reflects an expectation of meeting the demand for Wegovy® in the US in the second half of 2022.

Intensifying competition within both Diabetes care and Biopharm as well as an estimated negative impact on global sales growth of around 3 percentage points from Volume Based Procurement of insulin in China are also reflected in the guidance. Furthermore, continued pricing pressure within Diabetes care, especially in the US, is expected to negatively impact sales development. Given the current exchange rates versus the Danish krone, growth reported in DKK is now expected to be around 5 percentage points higher than at CER.

Operating profit growth is expected to be 4% to 8% at CER. The expectation for operating profit growth primarily reflects the sales growth outlook and continued investments in current and future growth drivers within research and development and commercial. Across the operating units, commercial investments are related to the continued roll-out of Ozempic® and Rybelsus® as well as global investments in building the anti-obesity market and the launch of Wegovy®. Furthermore, resources are allocated to both early and late-stage pipeline activities. The acquisition of Dicerna Pharmaceuticals Inc. is negatively impacting operating profit growth by around 3 percentage points due to higher operating costs and amortisations of intangible assets . Given the current exchange rates versus the Danish krone, growth reported in DKK is expected to be around 7 percentage points higher than at CER.

For 2022, Novo Nordisk expects financial items (net) to amount to a loss of around DKK 2.8 billion, mainly reflecting losses associated with foreign exchange hedging contracts.

The effective tax rate for 2022 is expected to be in the range of 20-22%.

Capital expenditure is expected to be around DKK 12 billion in 2022 primarily relating to investments in additional capacity for active pharmaceutical ingredient (API) production at existing manufacturing sites. The expected increase in capital expenditure reflects progress of R&D projects based on the oral technology platform.

Depreciation, amortisation and impairment losses are expected to be around DKK 6.5 billion.

The free cash flow is expected to be DKK 50-55 billion. The increase in free cash flow compared to 2021 reflects the impact from the acquisition of Dicerna Pharmaceuticals in 2021.

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Financial report for the period 1 January 2021 to 31 December 2021
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All of the above expectations are based on assumptions that the global or regional macroeconomic and political environment will not significantly change business conditions for Novo Nordisk during 2022, including the potential implications from major healthcare reforms and legislative changes as well as outcome of legal cases including litigations related to the 340B Drug Pricing Programme in the US, and that the currency exchange rates, especially the US dollar, will remain at the current level versus the Danish krone. Neither does the guidance include the financial implications of any significant business development transactions during the remainder of 2022.
FX (average rates) Q4 2021 Q4 2020 % change 2021 2020 % change Spot rate
27 January 2022
USD 651  625  4  % 629  654  (4  %) 667 
CNY 102  94  9  % 97  95  2  % 105 
JPY 5.72  5.98  (4  %) 5.73  6.13  (7  %) 5.78 
CAD 516  479  8  % 502  488  3  % 526 
GBP 877  824  6  % 865  839  3  % 893 
Novo Nordisk has hedged expected net cash flows in a number of invoicing currencies and, all other things being equal, movements in key invoicing currencies will impact Novo Nordisk’s operating profit as outlined in the table below.
Key invoicing currencies Impact on Novo Nordisk's operating profit in the next 12 months of a 5% movement in currency
Hedging period (months)1
USD DKK 2,350 million 12 
CNY2
DKK 360 million 0
JPY DKK 230 million 12
CAD DKK 200 million 9
GBP DKK 120 million 11 
1) As of 27 January 2022.
2) Chinese yuan traded offshore (CNH) used as proxy when hedging Novo Nordisk’s CNY currency exposure.

The financial impact from foreign exchange hedging is included in Financial items (net).


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Financial report for the period 1 January 2021 to 31 December 2021
Page 18 of 33
INNOVATION AND THERAPEUTIC FOCUS
Diabetes care
Ozempic® 2.0 mg approved in the EU for the treatment of adults with type 2 diabetes
In January 2022, the European Commission (EC) granted a label expansion for Ozempic® 2.0 mg for the treatment of type 2 diabetes in adults. The label expansion applies to all 27 European Union member states. The label expansion follows a positive opinion received by the European Medicines Agency in November 2021 and it is based on the results from the SUSTAIN FORTE trial. In the trial, people treated with semaglutide 2.0 mg achieved a statistically significant and superior reduction in HbA1c at week 40 compared to semaglutide 1.0 mg. In the trial, both doses of semaglutide appeared to have a safe and well-tolerated profile. The most common adverse events were gastrointestinal. Novo Nordisk expects to launch Ozempic® 2.0 mg in the first European countries in the second half of 2022.

Phase 3 trial with icoSema initiated
In November 2021, Novo Nordisk initiated the first phase 3a trial, COMBINE 3, for icosema, a once-weekly combination of semaglutide and once-weekly insulin icodec. COMBINE 3 is a 52-week trial comparing the efficacy and safety of once-weekly icosema with once-daily basal bolus insulin treatment in approximately 680 people with type 2 diabetes.

COMBINE 3 is the first of three trials from the COMBINE programme. The remaining two trials are planned to be initiated during 2022:

COMBINE 1 is a 52-week trial comparing once-weekly icosema with insulin icodec. The objective of the trial is to assess the efficacy and safety of icosema in people with type 2 diabetes. The trial is expected to enrol approximately 1.290 people.

COMBINE 2 is a 52-week trial comparing once-weekly icoSema with semaglutide 1.0 mg. The objective of the trial is to assess the efficacy and safety of icosema in people with type 2 diabetes. The trial is expected to enrol approximately 680 people.

Phase 2 trial initiated with a fixed dose combination of semaglutide and once-weekly GIP analogue
In November 2021, Novo Nordisk initiated a 34-week phase 2 trial comparing the effect on glycaemic control and body weight of a fixed dose combination of subcutaneous semaglutide and a once-weekly GIP analogue compared to placebo and semaglutide 1.0 mg in people with type 2 diabetes.

Development of insulin 147 terminated
During the second half of 2021, Novo Nordisk terminated the development of insulin 147 due to portfolio considerations following the completion of the phase 1 trial.

Obesity care
Wegovy® approved in the EU for the treatment of obesity
In January 2022, the European Commission (EC) granted a marketing authorisation for Wegovy® for chronic weight management in adults with obesity. Wegovy® is a once-weekly semaglutide 2.4 mg injection for chronic weight management in adults living with obesity (initial BMI≥30 kg/m2) or overweight (initial BMI≥27 kg/m2) with at least one weight-related comorbidity such as high blood pressure, heart disease or type 2 diabetes. The approval applies to all 27 European Union member states. The approval follows a positive opinion received by the European Medicines Agency in November 2021 and is based on results from the STEP phase 3a clinical trial programme. For further information about the positive opinion, please see https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=86334 (the contents of the company's website do not form a part of this Form 6-K).

Novo Nordisk expects approval by the EU of the Flextouch® device for Wegovy® in the second half of 2022 and to launch Wegovy® in the first country in EU hereafter.


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Biopharm
Sogroya® phase 3 programme in children with growth hormone deficiency successfully completed
In December 2021, Novo Nordisk successfully completed a 52-week phase 3 trial, REAL 4, comparing the efficacy and safety of once-weekly Sogroya® with daily Norditropin® in 200 children with growth hormone deficiency. The trial met the primary end-point of non-inferiority in height velocity for once-weekly Sogroya® compared with daily Norditropin®. Sogroya® appeared to have a safe and well-tolerated profile. Following the completion of the 52-week main phase of the trial, an extension phase of the trial is continuing to evaluate long-term safety. Novo Nordisk expects to submit Sogroya® for regulatory approval for the treatment of growth hormone deficiency in children in the first half of 2022.

Phase 3 trial with Macrilen™ in children initiated
In December 2021, a phase 3 trial with Macrilen™ in children was initiated. The trial is conducted in collaboration with Aeterna Zentaris Inc. and evaluates Macrilen™ for the diagnosis of childhood-onset growth hormone deficiency compared to two standard growth hormone stimulation tests (arginine and clonidine). The trial is expected to enrol approximately 100 children and adolescents from 2 to less than 18 years of age with suspected growth hormone deficiency.

Interim results from phase 1/2 clinical trial with Mim8
In November 2021, Novo Nordisk successfully completed the first cohorts from the ongoing phase 1/2 clinical proof of concept trial with Mim8. The last two cohorts are expected to read out in the first quarter of 2022. The multi-cohort 12-week trial enrolled approximately 40 people with haemophilia A. In the completed cohorts, Mim8 demonstrated pharmacokinetic and pharmacodynamic properties supporting weekly as well as monthly dosing and Mim8 appeared to have a safe and well-tolerated profile. In December 2021, first patient first visit occurred for the pivotal phase 3 trial with initiation of a run-in period of 26-52 weeks duration prior to the expected initiation of Mim8 treatment in the second half of 2022.

Partnerships
Collaboration with Staten Biotechnology terminated
In February 2022, Novo Nordisk decided not to exercise the option to acquire Staten Biotechnology and the monoclonal antibody, STT-5058, designed to target lipoprotein ApoC3. Consequently, the collaboration has been terminated. The decision follows evaluations of interim data from the phase 1 trial initiated in June 2020 which is investigating safety, tolerability, pharmacokinetics and pharmacodynamics of STT-5058 compared to placebo in healthy volunteers.

Technology platforms
Acquisition of Dicerna Pharmaceuticals Inc.
On 18 November 2021, Novo Nordisk announced that it had entered into a definitive agreement to acquire Dicerna Pharmaceuticals Inc. (Dicerna). The acquistion was completed on 28 December 2021. The acquisition of Dicerna’s ribonucleic acid interference (RNAi) platform is a strategic addition to Novo Nordisk’s existing research technology platforms and supports the strategy of using a broad range of technology platforms applicable across all Novo Nordisk’s therapeutic focus areas. In 2019, Novo Nordisk entered a research collaboration with Dicerna to discover and develop RNAi therapies using Dicerna’s proprietary GalXC™ RNAi platform technology. The collaboration between Novo Nordisk and Dicerna encompassed the exploration of more than 30 liver cell targets with the potential to deliver multiple clinical candidates for disorders including non-alcoholic steatohepatitis (NASH), type 2 diabetes, obesity and rare diseases. Novo Nordisk expects to initiate clinical development with the first target in 2022. The three clinical assets in Dicerna's pipeline, Nedosiran for primary hyperoxaluria, Belcesiran for Alpha-1 antitrypsin deficiency and DCR-AUD for alcohol use disorder have been added to Novo Nordisk's pipeline. For further information, please read the press release https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=87435 (the contents of the company's website do not form a part of this Form 6-K).








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Purpose and sustainability
ENVIRONMENTAL PERFORMANCE 2021 2020 2019 2018 2017 % change
2020 to 2021
Resources
Energy consumption for operations (1,000 GJ) 3,387 3,191 2,993 3,099 — 6  %
Share of renewable power for production
sites 		100% 100% 76% 77% 79%
Water consumption for production sites (1,000 m3)
3,488 3,368 3,149 3,101 3,276 4  %
Emissions and waste
CO2 emissions from operations and transportation (1,000 tonnes)
174 170 306 278 — 2  %
Waste from production sites (1,000 tonnes) 181 141 124 142 157 28  %
SOCIAL PERFORMANCE
Patients
Patients reached with Novo Nordisk's Diabetes care products (estimate in million) 34.6 32.8 30.0 29.2 27.7 5  %
- Hereof reached via the Novo Nordisk Access to Insulin Commitment (estimate in million) 1.7 3.2 2.9 0.3 0.3 (47  %)
- Hereof children reached through the Changing Diabetes in Children programme (cumulative) 31,846 28,296 25,695 22,876 17,638 13  %
People & employees
Employees (FTE) 47,792 44,723 42,703 42,672 42,076 7  %
Employee turnover 11.0% 7.9% 11.4% 11.7% 11.0%
GOVERNANCE PERFORMANCE
Relevant employees trained in business ethics 98% 99% 99% 99% 99%
Product recalls 1 — 4 3 6
Failed inspections — — — — —
Company reputation (scale 0-100)1
82.6 N/A N/A N/A N/A
1. Company reputation replaces company trust in order to capture more dimensions of how we are perceived by our external stakeholders.
    Environment
Resources
Novo Nordisk's ambition is to have zero environmental impact. The environmental strategy is called Circular for Zero; progress is measured on use of resources, emissions and waste.

In 2021, the energy consumption from operations was 3,387,000 GJ, an increase of 6% compared with 2020 primarily due to a new production facility.

In 2021, 100% of the power sourced across global production was from renewable energy. Novo Nordisk has a target to ensure all direct suppliers supply the company based on 100% renewable power by 2030, and currently direct suppliers accounting for 41% of tier 1 supply chain CO2 emissions have committed to using renewable power

Water consumption at production sites was 3,488,000 cubic meters, an increase of 4% compared with 2020 due to the new production facility.

Emissions and waste
In 2021, total CO2 emissions across our operations and transportation were 174,000 tonnes of CO2, representing a 2% increase compared to 2020 but a 43% decrease from 2019. The reduction compared to 2019 is primarily driven by implementation of renewable energy projects and impacts on travel due to COVID-19.

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Financial report for the period 1 January 2021 to 31 December 2021
Page 21 of 33
Production sites had a total of 181,000 tonnes of waste, an increase of 28% compared to 2020. This increase was due to increased production in Kalundborg, Denmark. During 2021, less than 1% (1,000 tonnes) of waste was sent to landfill.

Social
Patients
Novo Nordisk continued to take action under the social responsibility strategy ‘Defeat Diabetes’ with a keen focus on access and affordability and prevention. In 2021, Novo Nordisk provided medical treatment to an estimated total of 34.6 million people living with diabetes. An increase of 5% from 2020.

In 2021, an estimated 1.7 million people were treated with insulin under Novo Nordisk's Access to Insulin Commitment. Under this commitment, Novo Nordisk offers human insulin vials at a ceiling price of USD 3 to 76 countries, as well as to selected humanitarian organisations and UN agencies providing humanitarian relief. Long-term agreements are currently in place with 10 organisations. An additional estimated 2.2 million patients were reached at or below the ceiling price in countries outside the commitment. The decrease of 47% is due to Novo Nordisk lowering the ceiling price from USD 4 to 3 per vial in second half of 2020 which affects the comparability of 2021 and previous years. Using the previous ceiling price of USD 4, estimated 3.4 million people were reached under the commitment in 2021 compared to 3.2 million people in 2020.

Finally, Novo Nordisk has an ambition that no child should die from type 1 diabetes. To achieve this, the Changing Diabetes in Children programme aims to reach 100,000 children by 2030. By 2021, a total of 31,846 children were reached across 15 countries.

Employees
The number of full-time employees at the end of 2021 increased by 7.0% compared to 12 months ago. The total number of full-time employees was 47,792. The increase is driven by Product Supply, International Operations, R&D and Global Business Services in India, partially countered by North America Operations. The turnover was 11.0% in 2021 compared with 7.9% in 2020.

Governance
In 2021, 98% of employees completed and documented their Business Ethics training, with the remaining 2% missing mainly due to employees being on leave.

Novo Nordisk had one product recall from the market and no failed inspections in 2021. The company reputation was 82.6 on a 0-100 scale.

For further information about Novo Nordisk's performance and strategies with Purpose and Sustainability, please see the Annual Report 2021.

CORPORATE GOVERNANCE

Board of Directors and Executive management remuneration
Long-term incentive programme 2022
The Board of Directors has established a long-term incentive programme for 2022 covering Executive Management and - in line with previous years - a number of mid to senior managers (in total approximately 1,550 employees) with a three-year performance period (2022-2024). The measures are linked to the Strategic Aspirations 2025. Within Purpose & Sustainability, measures are mainly linked to environmental, social and governance activities and within Innovation & Therapeutic Focus, the measures include key R&D activities. For Commercial Execution, the measure is sales growth and for Financials, the measure is operating profit growth.

Around 1,000,000 Novo Nordisk shares may be allocated at target (at maximum target achievement the number of shares is around 2,600,000), and the value at launch of the programme will be based on the average share price for Novo Nordisk B shares on Nasdaq Copenhagen in the 15 days trading window (2 February to 16 February 2022) following the release of the annual report for 2021. It is currently estimated that the value at target is approximately DKK 650 million.


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Financial report for the period 1 January 2021 to 31 December 2021
Page 22 of 33



Remuneration Report 2021
Novo Nordisk has prepared a separate Remuneration Report describing the remuneration awarded or due during 2021 to the Board members and Executives as registered with the Danish Business Authority. The Remuneration Report will be submitted to the Annual General Meeting for an advisory vote. The Remuneration Report is available at novonordisk.com.


LEGAL MATTERS
Abbreviated New Drug Applications has been filed for semaglutide with the U.S. FDA
In January 2022, Rio Biopharmaceuticals Inc. (Rio), Aurobindo Pharma USA Inc. (Aurobindo), Sun Pharmaceutical Industries Limited (Sun) and Zydus Worldwide DMCC (Zydus), notified Novo Nordisk, that they have filed Abbreviated New Drug Applications (ANDAs) for semaglutide, the active pharmaceutical molecule in Ozempic® with the U.S. Food and Drug Administration. Accordingly, these ANDAs contain Paragraph IV certifications to obtain approval to engage in the commercial manufacture, use, or sale of Ozempic® before the expiration of five of the patents currently listed for Ozempic® in the Orange Book with expiration dates ranging from August 2027 until December 2033, including the drug substance patent expiring June 2032 (all expiration dates assume paediatric exclusivity). Novo Nordisk is fully prepared to enforce its patents including through litigation. Novo Nordisk does not expect these matters to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.

Settlement of securities lawsuit in Denmark
On 14 January 2022, Novo Nordisk announced that the company had settled a securities lawsuit in Denmark filed in August 2019. The settlement contains no admission of liability, wrongdoing or responsibility by Novo Nordisk and no payment will be made by Novo Nordisk to the plaintiffs.

The lawsuit was filed by a number of shareholders and alleged that Novo Nordisk had made misleading statements and did not make appropriate disclosures regarding its sales of insulin products in the US. The original claim was for a total amount of DKK 11.8 billion.

Novo Nordisk has received a Civil Investigative Demand from the U.S. Department of Justice
In December 2021, Novo Nordisk received a Civil Investigative Demand from the U.S. Department of Justice (DOJ) in connection with a False Claims Act investigation it is conducting related to Novo Nordisk's financial relationships with healthcare professionals and prescriptions for Ozempic® and Rybelsus® during the period 1 January, 2016 to the present. Novo Nordisk is cooperating with DOJ in this investigation. Novo Nordisk does not expect the investigation to have a material impact on Novo Nordisk’s financial position, operating profit or cash flow.
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Financial report for the period 1 January 2021 to 31 December 2021
Page 23 of 33
MANAGEMENT STATEMENT
The Board of Directors and Executive Management have approved the Annual Report 2021 of Novo Nordisk A/S,
including the audited consolidated financial statements. The Board of Directors and Executive Management have
also approved this financial statement containing condensed financial information for 2021.

The consolidated financial statements in the Annual Report 2021 have been prepared in accordance with
International Financial Reporting Standards (IFRS) as issued by the International Accounting Standards Board (IASB)
and with the IFRS as endorsed by the EU. Furthermore, the Annual Report 2021, including the consolidated financial
statements and management review, is prepared in accordance with additional Danish disclosure requirements for
listed companies and in accordance with the International Integrated Reporting Framework.

This financial statement has been prepared in accordance with the recognition and measurement requirements in
the IFRS, the accounting policies as applied in the audited consolidated financial statements of 2021 and additional
Danish disclosure requirements for listed companies.

In our opinion, the accounting policies used are appropriate, and the overall presentation of this financial statement
is adequate. Furthermore, in our opinion, this company announcement of the financial statement for 2021 includes
a true and fair account of the development in the operations and financial circumstances of the results for the year
and of the financial position of the Group as well as a reference to the most significant risks and elements of
uncertainty facing the Group in accordance with Danish disclosure requirements for listed companies.

Bagsværd, 2 February 2022
Executive Management:
Lars Fruergaard Jørgensen
President and CEO
Karsten Munk Knudsen
CFO
Monique Carter
Martin Holst Lange Marcus Schindler Camilla Sylvest
Henrik Wulff
Board of Directors:
Helge Lund
Chair
Jeppe Christiansen
Vice chair
Laurence Debroux
Andreas Fibig Sylvie Grégoire Mette Bøjer Jensen
Kasim Kutay Anne Marie Kverneland Martin Mackay
Henrik Poulsen Thomas Rantzau Stig Strøbæk

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Financial report for the period 1 January 2021 to 31 December 2021
Page 24 of 33
About Novo Nordisk
Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat diabetes and other serious chronic diseases such as obesity and rare blood and endocrine disorders. We do so by pioneering scientific breakthroughs, expanding access to our medicines and working to prevent and ultimately cure disease. Novo Nordisk employs about 47,800 people in 80 countries and markets its products in around 170 countries. Novo Nordisk's B shares are listed on Nasdaq Copenhagen (Novo-B). Its ADRs are listed on the New York Stock Exchange (NVO). For more information, visit novonordisk.com, Facebook, Twitter, LinkedIn, YouTube.

Financial calendar
3 March 2022 Capital Markets Day in Copenhagen, Denmark
24 March 2022 Annual General Meeting
4 May 2022 Financial statement for the first three months of 2022
4 August 2022 Financial statement for the first six months of 2022
2 November 2022 Financial statement for the first nine months of 2022

Contacts for further information
Media:
Mette Kruse Danielsen +45 3079 3883 mkd@novonordisk.com
Michael Bachner (US) +1 609 664 7308 mzyb@novonordisk.com
Investors:
Daniel Muusmann Bohsen +45 3075 2175 dabo@novonordisk.com
Ann Søndermølle Rendbæk +45 3075 2253 arnd@novonordisk.com
David Heiberg Landsted +45 3077 6915 dhel@novonordisk.com
Jacob Martin Wiborg Rode +45 3075 5956 jrde@novonordisk.com
Mark Joseph Root (US) +1 848 213 3219 mjhr@novonordisk.com
Further information about Novo Nordisk is available on novonordisk.com.

Forward-looking statements
Novo Nordisk’s reports filed with or furnished to the US Securities and Exchange Commission (SEC), including this document as well as the company’s statutory Annual Report 2021 and Form 20-F both filed with the SEC in February 2022 in continuation of the publication of the Annual Report 2021, 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.

In this document, examples of forward-looking statements can be found under the headings ‘Outlook’, ‘Research and Development update’ and 'Equity’.

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 document, 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, such as 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, including as a result of interruptions or delays affecting supply chains on which Novo Nordisk relies, 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 including the risk of cybersecurity breaches, 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, failure to maintain a culture of compliance, epidemics, pandemics or other public health crises, and factors related to the foregoing matters and other factors not specifically identified herein.

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 document, reference is made to the overview of risk factors in ‘Risk Management’ of the Annual Report 2021.

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 document, whether as a result of new information, future events or otherwise.
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Financial report for the period 1 January 2021 to 31 December 2021
Page 25 of 33
APPENDIX 1: QUARTERLY NUMBERS IN DKK
(Amounts in DKK million, except number of full-time equivalent employees, earnings per share and number of shares outstanding).
% change
2021 2020 Q4 2021 vs.
Q4 Q3 Q2 Q1 Q4 Q3 Q2 Q1 Q4 2020
Net sales 38,333 35,622 33,041 33,804 32,138 30,927 30,006 33,875 19  %
Gross profit 32,092 29,563 27,494 27,993 26,519 25,772 25,234 28,489 21  %
Gross margin 83.7% 83.0% 83.2% 82.8% 82.5% 83.3% 84.1% 84.1%
Sales and distribution costs (11,632) (9,119) (8,001) (8,256) (9,766) (8,174) (7,398) (7,590) 19  %
Percentage of sales 30.3% 25.6% 24.2% 24.4% 30.4% 26.4% 24.7% 22.4%
Research and development costs (5,632) (4,252) (3,944) (3,944) (4,483) (3,911) (3,291) (3,777) 26  %
Percentage of sales 14.7% 11.9% 11.9% 11.7% 13.9% 12.6% 11.0% 11.1%
Administrative costs (1,190) (1,024) (904) (932) (1,198) (1,006) (827) (927) (1  %)
Percentage of sales 3.1% 2.9% 2.7% 2.8% 3.7% 3.3% 2.8% 2.7%
Other operating income and expenses (4) 81 134 121 106 127 120 107 (104  %)
Operating profit 13,634 15,249 14,779 14,982 11,178 12,808 13,838 16,302 22  %
Operating margin 35.6% 42.8% 44.7% 44.3% 34.8% 41.4% 46.1% 48.1%
Financial income 254 790 90 1,753 1,352 162 97 17 (81  %)
Financial expenses (775) (927) 48 (797) (528) (279) (519) (1,298) 47  %
Financial items (net) (521) (137) 138 956 824 (117) (422) (1,281) (163  %)
Profit before income taxes 13,113 15,112 14,917 15,938 12,002 12,691 13,416 15,021 9  %
Income taxes (2,221) (2,993) (2,794) (3,315) (2,684) (2,393) (2,791) (3,124) (17  %)
Net profit 10,892 12,119 12,123 12,623 9,318 10,298 10,625 11,897 17  %
Depreciation, amortisation and
impairment losses 		2,082 1,349 1,217 1,377 1,379 2,130 1,158 1,086 51  %
Capital expenditure 2,049 1,175 1,709 1,402 1,518 1,401 1,239 1,667 35  %
Net cash generated from operating activities (3,017) 21,507 25,255 11,255 172 17,506 24,261 10,012 N/A
Free cash flow (22,993) 19,616 23,164 9,532 (12,994) 11,224 22,666 7,669 77  %
Total assets 194,508 174,084 158,095 141,387 144,922 139,947 136,121 126,256 34  %
Total equity 70,746 66,112 65,559 58,496 63,325 59,573 60,054 54,399 12  %
Equity ratio 36.4% 38.0% 41.5% 41.4% 43.7% 42.6% 44.1% 43.1%
Full-time equivalent employees end of period 47,792 46,982 45,971 45,157 44,723 44,326 43,526 43,158 7  %
Basic earnings per share/ADR (in DKK) 4.77 5.29 5.26 5.47 4.02 4.42 4.54 5.07 19  %
Diluted earnings per share/ADR (in DKK) 4.76 5.27 5.26 5.45 4.01 4.42 4.53 5.05 19  %
Average number of shares outstanding (million) 2,284.0 2,291.9 2,300.8 2,309.6 2,318.9 2,329.0 2,338.8 2,348.8 (2  %)
Average number of diluted shares outstanding (million) 2,290.6 2,297.3 2,306.3 2,315.6 2,325.1 2,335.1 2,344.9 2,354.8 (1  %)
Sales by business segment:
   Total GLP-1 16,372 13,848 12,077 11,300 11,780 10,651 9,425 9,975 39  %
   Long-acting insulin 4,677 4,416 4,149 4,822 5,013 4,048 4,220 5,158 (7  %)
   Premix insulin 2,691 2,844 2,715 2,953 2,705 2,572 2,693 2,955 (1  %)
   Fast-acting insulin 4,520 4,359 4,252 4,556 4,231 4,589 4,379 5,114 7  %
   Human insulin 2,085 2,391 2,041 2,535 1,678 2,194 2,314 2,687 24  %
   Total insulin 13,973 14,010 13,157 14,866 13,627 13,403 13,606 15,914 3  %
   Other Diabetes care 816 859 809 1,110 975 954 977 1,125 (16  %)
   Total Diabetes care 31,161 28,717 26,043 27,276 26,382 25,008 24,008 27,014 18  %
   Obesity care (Saxenda® and Wegovy®)
2,459 2,398 1,992 1,551 1,385 1,338 1,308 1,577 78  %
   Diabetes and Obesity care total 33,620 31,115 28,035 28,827 27,767 26,346 25,316 28,591 21  %
   Rare blood disorders1)
2,490 2,326 2,723 2,678 2,140 2,311 2,401 2,810 16  %
   Rare endocrine disorders1)
1,719 1,805 1,859 1,920 1,833 1,891 1,952 2,031 (6  %)
   Other Biopharm 504 376 424 379 398 379 337 443 27  %
   Biopharm total 4,713 4,507 5,006 4,977 4,371 4,581 4,690 5,284 8  %
Sales by geographic segment:
   International Operations 18,216 18,337 18,237 18,747 15,430 15,988 16,115 18,296 18  %
   - EMEA 9,427 9,170 9,579 9,530 8,138 8,318 8,167 9,674 16  %
   - Region China 3,710 4,257 3,722 4,330 3,248 3,549 3,474 3,813 14  %
   - Rest of World 5,079 4,910 4,936 4,887 4,044 4,121 4,474 4,809 26  %
   North America Operations 20,117 17,285 14,804 15,057 16,708 14,939 13,891 15,579 20  %
   - The US 18,902 16,181 13,754 14,172 15,877 14,144 13,028 14,775 19  %
Segment operating profit:
   Diabetes and Obesity care 11,861 13,052 12,155 12,470 9,106 9,748 11,434 13,456 30  %
   Biopharm 1,773 2,197 2,624 2,512 2,072 3,060 2,404 2,846 (14  %)
1) Comparative numbers have been restated as Macrilen™ (previously disclosed under Other biopharm) is now disclosed as part of Rare endocrine disorders.
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Financial report for the period 1 January 2021 to 31 December 2021
Page 26 of 33
APPENDIX 2: INCOME STATEMENT AND STATEMENT OF COMPREHENSIVE INCOME
DKK million 2021 2020
Income statement
Net sales 140,800 126,946
Cost of goods sold (23,658) (20,932)
Gross profit 117,142 106,014
 
Sales and distribution costs (37,008) (32,928)
Research and development costs (17,772) (15,462)
Administrative costs (4,050) (3,958)
Other operating income and expenses 332 460
Operating profit 58,644 58644000000 54,126
Financial income 2,887 1,628
Financial expenses (2,451) (2,624)
Profit before income taxes 59,080 53,130
Income taxes (11,323) (10,992)
NET PROFIT 47,757 42,138
Basic earnings per share (DKK) 20.79 18.05
Diluted earnings per share (DKK) 20.74 18.01
Segment Information
Segment sales:
   Diabetes and Obesity care 121,597 108,020
   Biopharm 19,203 18,926
Segment operating profit:
   Diabetes and Obesity care 49,538 43,744
    Operating margin 40.7% 40.5%
   Biopharm 9,106 10,382
    Operating margin 47.4% 54.9%
Total segment operating profit 58,644 54,126
Statement of comprehensive income
Net profit for the period 47,757 42,138
    Other comprehensive income
    Items that will not subsequently be reclassified to the Income
    statement
    Remeasurements on defined benefit plans 146 (67)
    Items that will be reclassified subsequently to the Income
    statement
    Exchange rate adjustments of investments in subsidiaries 1,624 (1,689)
    Cash flow hedges, realisation of previously deferred (gains)/losses (1,802) 329
    Cash flow hedges, deferred gains/(losses) incurred during the period (1,755) 1,384
    Other items 112 10
    Tax on other comprehensive income, income/(expense) 1,005 (577)
  Other comprehensive income for the period, net of tax (670) (610)
TOTAL COMPREHENSIVE INCOME FOR THE PERIOD 47,087 41,528

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Financial report for the period 1 January 2021 to 31 December 2021
Page 27 of 33
APPENDIX 3: CASH FLOW STATEMENT
DKK million 2021 2020
Net profit 47,757  42,138 
Adjustment for non-cash items:
    Income taxes in the Income Statement 11,323  10,992 
    Depreciation, amortisation and impairment losses 6,025  5,753 
    Other non-cash items 13,009  7,849 
Change in working capital (8,656) (4,353)
Interest received 241  100 
Interest paid (261) (422)
Income taxes paid (14,438) (10,106)
Net cash generated from operating activities 55,000  51,951 
 
Purchase of intangible assets (1,050) (16,256)
Proceeds from sale of property, plant and equipment —  7 
Purchase of property, plant and equipment (6,335) (5,825)
Acquisition of businesses (18,283) — 
Proceeds from other financial assets —  12 
Purchase of other financial assets (4) — 
Purchase of marketable securities (7,109) — 
Sale of marketable securities 1,172  — 
Investment in associated company —  (392)
Dividend received from associated company 4  18 
Net cash used in investing activities (31,605) (22,436)
Purchase of treasury shares (19,447) (16,855)
Dividends paid (21,517) (20,121)
Proceeds from borrowings 22,160  5,682 
Repayment of borrowings (6,689) (950)
Net cash used in financing activities (25,493) (32,244)
NET CASH GENERATED FROM ACTIVITIES (2,098) (2,729)
Cash and cash equivalents at the beginning of the year 12,226  15,411 
Exchange gain/(loss) on cash and cash equivalents 591  (456)
Cash and cash equivalents at the end of the period 10,719  12,226 

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Financial report for the period 1 January 2021 to 31 December 2021
Page 28 of 33
APPENDIX 4: BALANCE SHEET
DKK million 31 Dec 2021 31 Dec 2020
ASSETS
Intangible assets 43,171  20,657 
Property, plant and equipment 55,362  50,269 
Investments in associated companies 525  582 
Deferred income tax assets 8,672  5,865 
Other receivables and prepayments 267  674 
Other financial assets 916  1,066 
TOTAL NON-CURRENT ASSETS 108,913  79,113 
Inventories 19,621  18,536 
Trade receivables 40,643  27,734 
Tax receivables 1,119  289 
Other receivables and prepayments 5,037  4,161 
Marketable securities 6,765  — 
Derivative financial instruments 1,690  2,332 
Cash at bank 10,720  12,757 
TOTAL CURRENT ASSETS 85,595  65,809 
TOTAL ASSETS 194,508  144,922 
EQUITY AND LIABILITIES
Share capital 462  470 
Treasury shares (6) (8)
Retained earnings 72,004  63,774 
Other reserves (1,714) (911)
TOTAL EQUITY 70,746  63,325 
Borrowings 12,961  2,897 
Deferred income tax liabilities 5,271  2,502 
Retirement benefit obligations 1,280  1,399 
Other liabilities 360  — 
Provisions 4,374  4,526 
Total non-current liabilities 24,246  11,324 
Borrowings 13,684  7,459 
Trade payables 8,870  5,717 
Tax payables 3,658  3,913 
Other liabilities 19,600  17,005 
Derivative financial instruments 2,184  1,365 
Provisions 51,520  34,814 
Total current liabilities 99,516  70,273 
TOTAL LIABILITIES 123,762  81,597 
TOTAL EQUITY AND LIABILITIES 194,508  144,922 

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Financial report for the period 1 January 2021 to 31 December 2021
Page 29 of 33
APPENDIX 5: EQUITY STATEMENT
DKK million Share
capital 		Treasury
shares 		Retained
earnings 		Other reserves Total
2021
Balance at the beginning of the year 470  (8) 63,774  (911) 63,325 
Net profit for the year 47,757  47,757 
Other comprehensive income for the year 146  (816) (670)
Total comprehensive income for the year 47,903  (816) 47,087 
Transfer of cash flow hedge reserve to intangible assets 13  13 
Transactions with owners:
Dividends (21,517) (21,517)
Share-based payments 1,040  1,040 
Tax related to restricted stock units 245  245 
Purchase of treasury shares (6) (19,441) (19,447)
Reduction of the B share capital (8) 8  — 
Balance at the end of the year 462  (6) 72,004  (1,714) 70,746 
At the end of the year proposed final dividends (not yet declared) of DKK 15,690 million (DKK 6.90 per share of DKK 0.20) are included in
Retained earnings. No dividend is declared on treasury shares.
DKK million Share
capital 		Treasury
shares 		Retained
earnings 		Other reserves Total
2020
Balance at the beginning of the year 480  (10) 57,817  (694) 57,593 
Net profit for the year 42,138  42,138 
Other comprehensive income for the year (67) (543) (610)
Total comprehensive income for the year 42,071  (543) 41,528 
Transfer of cash flow hedge reserve to intangible assets 326  326
Transactions with owners:
Dividends (20,121) (20,121)
Share-based payments 823  823 
Tax related to restricted stock units 31  31 
Purchase of treasury shares (8) (16,847) (16,855)
Reduction of the B share capital (10) 10  — 
Balance at the end of the year 470  (8) 63,774  (911) 63,325 
At the end of the year proposed final dividends of DKK 13,496 million (DKK 5.85 per share of DKK 0.20) are included in Retained earnings. No dividend is declared on treasury shares.

Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 30 of 33

APPENDIX 6: SALES SPLIT PER AREA
Q4 2021 sales split per area
DKK million Total International
 Operations 		EMEA Region
China 		Rest of
World 		North America
Operations 		The US
Diabetes and Obesity care segment
Rybelsus®
1,823 234 110 — 124 1,589 1,565
% change at CER 117% — — — — 93% 91%
Ozempic®
10,716 2,749 1,800 165 784 7,967 7,460
% change at CER 70% 139% 86% — 336% 54% 52%
Victoza®
3,833 1,496 777 356 363 2,337 2,266
% change at CER (22%) (4%) (13%) 37% (9%) (30%) (30%)
Total GLP-1 16,372 4,479 2,687 521 1,271 11,893 11,291
% change at CER 36% 65% 43% 100% 122% 28% 26%
Long-acting insulin 4,677 2,743 1,656 505 582 1,934 1,768
% change at CER (9%) 13% 6% 33% 21% (30%) (32%)
Tresiba®
2,731 1,426 762 303 361 1,305 1,174
% change at CER 19% 32% 22% 139% 11% 7% 5%
Xultophy®
673 535 414 1 120 138 135
% change at CER 10% 15% 3% — 84% (4%) (3%)
Levemir®
1,273 782 480 201 101 491 459
% change at CER (44%) (11%) (10%) (21%) 9% (65%) (66%)
Premix insulin 2,691 2,436 675 1,172 589 255 247
% change at CER (4%) (4%) (1%) (10%) 2% (2%) (2%)
Ryzodeg®
424 424 86 76 262 — —
% change at CER 31% 31% 32% — 9% — —
NovoMix®
2,267 2,012 589 1,096 327 255 247
% change at CER (9%) (10%) (4%) (15%) (2%) (2%) (2%)
Fast-acting insulin 4,520 2,720 1,637 519 564 1,800 1,685
% change at CER 4% 1% 1% (7%) 11% 9% 8%
Fiasp®
495 307 268 — 39 188 178
% change at CER 34% 27% 22% — 67% 49% 51%
NovoRapid®
4,025 2,413 1,369 519 525 1,612 1,507
% change at CER 1% (1%) (3%) (7%) 8% 5% 5%
Human insulin 2,085 1,670 518 583 569 415 394
% change at CER 18% 8% (7%) 12% 24% 89% 105%
Total insulin 13,973 9,569 4,486 2,779 2,304 4,404 4,094
% change at CER (1%) 4% 1% 1% 14% (10%) (11%)
Other Diabetes care1
816 588 178 283 127 228 189
% change at CER (20%) (19%) 2% (25%) (26%) (22%) (26%)
Total Diabetes care 31,161 14,636 7,351 3,583 3,702 16,525 15,574
% change at CER 15% 16% 13% 6% 34% 14% 13%
Obesity care (Saxenda® and Wegovy®)
2,459 814 526 23 265 1,645 1,542
% change at CER 73% 57% 78% — 19% 83% 86%
Diabetes and Obesity care total 33,620 15,450 7,877 3,606 3,967 18,170 17,116
% change at CER 18% 18% 16% 6% 33% 18% 17%
Biopharm segment
Rare blood disorders2
2,490 1,362 871 46 445 1,128 1,061
% change at CER 13% 13% 21% (59%) 18% 14% 16%
Haemophilia A 581 435 297 4 134 146 138
% change at CER 33% 29% 29% (33%) 35% 46% 50%
Haemophilia B 162 107 71 1 35 55 19
% change at CER 20% 50% 56% — 37% (16%) (31%)
NovoSeven®
1,690 802 492 41 269 888 867
% change at CER 8% 3% 13% (61%) 9% 14% 14%
Rare endocrine disorders3
1,719 1,147 481 56 610 572 565
% change at CER (8%) (1%) (8%) 121% 1% (20%) (20%)
Other Biopharm4
504 257 198 2 57 247 160
% change at CER 25% (8%) (5%) — (20%) 101% 202%
Biopharm total 4,713 2,766 1,550 104 1,112 1,947 1,786
% change at CER 6% 5% 7% (23%) 5% 7% 7%
Total sales 38,333 18,216 9,427 3,710 5,079 20,117 18,902
% change at CER 16% 15% 15% 5% 26% 17% 16%
% change as reported 19% 18% 16% 14% 26% 20% 19%
Share of growth 100% 45% 22% 3% 20% 55% 49%
1) Primarily NovoNorm®, needles and GlucaGen® HypoKit®.
2) Comprises NovoSeven®, NovoEight®, Refixia®, NovoThirteen® and Esperoct®.
3) Primarily Norditropin®.
4) Primarily Vagifem® and Activelle®.
Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 31 of 33

2021 sales split per area
DKK million Total International
Operations 		EMEA Region
China 		Rest of
World 		North America
Operations 		The US
Diabetes and Obesity care segment
Rybelsus®
4,838 524 289 — 235 4,314 4,243
% change at CER 168% — — — — 144% 142%
Ozempic®
33,705 8,856 6,393 303 2,160 24,849 23,168
% change at CER 64% 147% 106% — 347% 46% 45%
Victoza®
15,054 6,726 3,527 1,544 1,655 8,328 8,031
% change at CER (18%) (4%) (17%) 45% (3%) (26%) (26%)
Total GLP-1 53,597 16,106 10,209 1,847 4,050 37,491 35,442
% change at CER 32% 52% 38% 73% 85% 25% 24%
Long-acting insulin 18,064 11,074 6,729 2,080 2,265 6,990 6,412
% change at CER 0% 13% 6% 38% 17% (15%) (16%)
Tresiba®
9,729 5,486 2,979 1,095 1,412 4,243 3,793
% change at CER 11% 26% 17% 155% 5% (4%) (6%)
Xultophy®
2,657 2,135 1,693 3 439 522 512
% change at CER 11% 21% 6% 200% 156% (17%) (17%)
Levemir®
5,678 3,453 2,057 982 414 2,225 2,107
% change at CER (17%) (7%) (6%) (9%) (3%) (29%) (30%)
Premix insulin 11,203 10,512 2,879 5,224 2,409 691 665
% change at CER 4% 4% 3% 5% 3% 6% 6%
Ryzodeg®
1,711 1,711 392 283 1,036 — —
% change at CER 37% 37% 33% — 15% — —
NovoMix®
9,492 8,801 2,487 4,941 1,373 691 665
% change at CER (1%) (1%) (1%) 0% (3%) 6% 6%
Fast-acting insulin 17,687 10,903 6,454 2,288 2,161 6,784 6,357
% change at CER (1%) 3% 0% 7% 6% (6%) (7%)
Fiasp®
1,748 1,106 965 — 141 642 605
% change at CER 29% 34% 27% — 116% 20% 22%
NovoRapid®
15,939 9,797 5,489 2,288 2,020 6,142 5,752
% change at CER (3%) 0% (3%) 7% 2% (8%) (9%)
Human insulin 9,052 7,453 2,152 2,692 2,609 1,599 1,515
% change at CER 4% 3% (8%) (1%) 19% 8% 10%
Total insulin 56,006 39,942 18,214 12,284 9,444 16,064 14,949
% change at CER 1% 6% 2% 8% 11% (9%) (9%)
Other Diabetes care1
3,594 2,644 713 1,432 499 950 806
% change at CER (10%) (10%) 1% (10%) (23%) (10%) (11%)
Total Diabetes care 113,197 58,692 29,136 15,563 13,993 54,505 51,197
% change at CER 13% 14% 12% 11% 24% 12% 11%
Obesity care (Saxenda® and Wegovy®)
8,400 3,117 1,809 61 1,247 5,283 4,912
% change at CER 55% 52% 66% — 32% 57% 58%
Diabetes and Obesity care total 121,597 61,809 30,945 15,624 15,240 59,788 56,109
% change at CER 15% 16% 14% 11% 24% 15% 14%
Biopharm segment
Rare blood disorders2
10,217 5,784 3,712 222 1,850 4,433 4,170
% change at CER 9% 4% 6% (40%) 8% 16% 18%
Haemophilia A 2,112 1,625 1,162 24 439 487 460
% change at CER 25% 24% 19% 50% 35% 32% 34%
Haemophilia B 637 400 268 4 128 237 102
% change at CER 25% 33% 34% — 28% 12% 23%
NovoSeven®
7,221 3,673 2,225 194 1,254 3,548 3,461
% change at CER 4% (6%) (3%) (45%) 0% 15% 17%
Rare endocrine disorders3
7,303 4,880 2,212 167 2,501 2,423 2,400
% change at CER (2%) 5% 1% 147% 4% (12%) (13%)
Other Biopharm4
1,683 1,064 837 6 221 619 330
% change at CER 8% (5%) (7%) 20% 3% 39% 67%
Biopharm total 19,203 11,728 6,761 395 4,572 7,475 6,900
% change at CER 4% 3% 3% (11%) 5% 6% 7%
Total sales 140,800 73,537 37,706 16,019 19,812 67,263 63,009
% change at CER 14% 14% 12% 11% 19% 14% 13%
% change as reported 11% 12% 10% 14% 14% 10% 9%
Share of growth 100% 51% 23% 9% 19% 49% 44%
1) Primarily NovoNorm®, needles and GlucaGen® HypoKit®.
2) Comprises NovoSeven®, NovoEight®, Refixia®, NovoThirteen® and Esperoct®.
3) Primarily Norditropin®.
4) Primarily Vagifem® and Activelle®.
Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 32 of 33
APPENDIX 7: NON-IFRS FINANCIAL MEASURES (ADDITIONAL INFORMATION)
In this Company Announcement, Novo Nordisk discloses certain financial measures of the Group’s financial performance, financial position and cash flows that reflect adjustments to the directly comparable measures calculated and presented in accordance with IFRS. These non-IFRS financial measures may not be defined and calculated by other companies in the same manner and may thus not be comparable with such measures. The non-IFRS financial measures presented in the Company Announcement are Sales and operating profit at CER, Free cash flow and Financial reserves.

Sales and operating profit growth at CER
'Growth at CER’ means that the effect of changes in exchange rates is excluded. It is defined as Net sales/Operating profit for the period measured at the average exchange rates for the same period prior year compared with Net sales/Operating profit for the same period prior year. Price adjustments within hyperinflation countries as defined in IAS 29 ‘Financial reporting in hyperinflation economies’ are excluded from the calculation to avoid growth at CER being artificially inflated.

Growth at CER is considered to be relevant information for investors in order to understand the underlying development in sales and operating profit by adjusting for the impact of currency fluctuations.

Sales at CER
DKK million 2021 2020  % change
2021 to
2020
Net sales 140,800  126,946  11  %
Effect of exchange rates 3,643  — 
Sales at CER 144,443  126,946  14  %
Operating profit at CER
DKK million 2021 2020  % change
2021 to
2020
Operating profit 58,644  54,126  8  %
Effect of exchange rates 2,332  — 
Operating profit at CER 60,976  54,126  13  %

Free cash flow
Novo Nordisk defines free cash flow as ’net cash generated from operating activities’, less ‘net cash used in investing activities’, less repayment on lease liabilities and excluding net change of marketable securities. Free cash flow is a measure of the amount of cash generated in the period which is available for the Board of Directors to allocate between Novo Nordisk's capital providers, through eg dividends, share repurchases and repayment of debt (excluding lease liability repayments) or for retaining in the business to fund future growth.

The following table shows a reconciliation of Free cash flow with Net cash generated from operating activities, the most directly comparable IFRS financial measure:

Free cash flow
DKK million 2021 2020
Net cash generated from operating activities 55,000  51,951 
Net cash used in investing activities (31,605) (22,436)
Net purchase of marketable securities 5,937  — 
Addition on marketable securities through acquisition of business 861  — 
Repayment on lease liabilities (874) (950)
Free cash flow 29,319  28,565 


Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

Financial report for the period 1 January 2021 to 31 December 2021
Page 33 of 33
Financial reserves
'Financial reserves' is defined as the sum of cash and cash equivalents at the end of the period, marketable securities with original term to maturity exceeding three months and undrawn committed credit and loan facilities, with a maturity of more than 12 months, less loans and bank overdrafts classified as liabilities arising from financing activities with obliged repayment within 12 months of the balance sheet date. The following table reconciles total financial reserves with cash and cash equivalents, the most directly comparable IFRS financial measure:

Financial reserves
DKK million 2021 2020
Cash and cash equivalents 10,719  12,226 
Marketable securities 6,765  — 
Undrawn committed credit facility 11,526  11,531 
Undrawn bridge facility —  5,577 
Borrowings (12,861) (576)
Financial reserves 16,149  28,758 


Strategic aspirations Performance highlights Commercial execution Financials Cash flow and capital allocation Outlook Innovation and therapeutic focus Purpose and sustainability Legal Financial Information
 Company announcement No 7 / 2022

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this report to be signed on its behalf of the undersigned, thereunto duly authorized.

Date: February 2, 2022
Novo Nordisk A/S

Lars Fruergaard Jørgensen
Chief Executive Officer