Summary of Novo Nordisk's Acquisition of Akero Therapeutics Conference Call Company and Industry - **Company**: Novo Nordisk (NYSE: NVO) - **Acquisition Target**: Akero Therapeutics, Inc. - **Industry**: Pharmaceutical, specifically focusing on diabetes, obesity, and metabolic diseases such as MASH (Metabolic Associated Steatotic Liver Disease) Core Points and Arguments 1. **Acquisition Announcement**: Novo Nordisk announced the acquisition of Akero Therapeutics, marking the largest R&D-related acquisition in its history, aimed at enhancing its portfolio in diabetes and obesity treatments [4][2][5] 2. **Strategic Fit**: The acquisition is strategically aligned with Novo Nordisk's focus on diabetes, obesity, and related comorbidities, particularly through Akero's late-stage asset, efruxifermin (EFX), which targets MASH [4][5][10] 3. **Market Need**: Over 250 million people globally are affected by MASH, indicating a significant unmet medical need and commercial opportunity for innovative treatments [5][6] 4. **Efruxifermin's Potential**: Efruxifermin is positioned as a leading treatment option for MASH, with promising Phase II data showing efficacy in fibrosis regression, particularly in late-stage F4 patients [8][10][11] 5. **Clinical Trial Results**: In the HARMONY Phase II trial, 49% of F2-F3 patients achieved fibrosis improvement, while 29% of F4 patients showed similar results in the SYMMETRY Phase IIb trial [11][12] 6. **Future Development Plans**: The ongoing SYNCHRONY Phase III program will further evaluate efruxifermin across all MASH stages, with initial results expected next year [12][11] 7. **Integration with Existing Portfolio**: Efruxifermin complements Novo Nordisk's existing GLP-1 portfolio, with potential for combination therapies to enhance treatment efficacy [26][27] 8. **Financial Impact**: The acquisition is expected to have a low single-digit dilutive impact on earnings, with a projected 3% impact on operating profit for the following year due to increased R&D costs [56][58] Additional Important Points 1. **Regulatory Considerations**: The FDA's requirements for accelerated approval in MASH will be critical for the success of efruxifermin, particularly in the F2 and F3 stages [50][48] 2. **Competitive Landscape**: The acquisition positions Novo Nordisk favorably against competitors in the FGF21 space, with expectations of superior efficacy and safety profiles for efruxifermin compared to other assets [20][41] 3. **CEO's Vision**: The acquisition aligns with the new CEO's strategy to enhance Novo Nordisk's leadership in diabetes and obesity treatments, emphasizing innovation and patient impact [14][62] This summary encapsulates the key points discussed during the conference call regarding Novo Nordisk's acquisition of Akero Therapeutics, highlighting the strategic importance, market potential, and future plans associated with this significant move in the pharmaceutical industry.

Rezdiffra Launch and Market Penetration - Rezdiffra achieved net sales of $212.8 million in 2Q25, annualizing at over $800 million[12, 14] - Quarter-over-quarter growth from 1Q25 to 2Q25 was 55%[13] - Over 23,000 patients are on Rezdiffra as of 2Q25, representing approximately 7% of the current Rezdiffra F2/F3 target market of 315,000 patients[17] - Approximately 80% of the top target prescribers (~6,000) have prescribed Rezdiffra as of 2Q25[19] Strategic Developments - A new U S Rezdiffra patent extends strategic runway and adds significant additional revenue to 2045[10] - Madrigal entered into a global license agreement for an oral GLP-1 (SYH2086), with an upfront payment of $120 million and up to $2 billion in milestones and royalties[27, 28] Financial Position - Madrigal has $802 million in cash, cash equivalents, restricted cash, and marketable securities as of June 30, 2025[44] - The company secured up to $500 million in non-dilutive senior secured credit to advance the MASH pipeline as of July 17, 2025[7, 44] European Expansion - A positive CHMP opinion was received in June 2025, supporting European approval, with a German launch expected in 2H25[29, 30] - There are approximately 370,000 F2/F3 MASH patients diagnosed and under the care of liver specialists across Europe[31] Potential in F4c Cirrhosis - There is a significant unmet need in F4c cirrhosis, with approximately 245,000 diagnosed F4c patients under the care of liver specialists in the U S[33, 35] - Data supports the potential benefit of Rezdiffra in F4c for liver stiffness reduction, with a mean change from baseline of -6.7 kPa at Year 2[36]