Good afternoon. On behalf of the Board, a warm welcome to Novo Nordisk Annual General Meeting in 2023. My name is Helge Lund, and I'm the Chair of the Board of Directors. This year, I'm especially delighted to open the Annual General Meeting, as 2023 marks a major milestone in the evolution of Novo Nordisk. Founded in 1923, this year denotes Novo Nordisk's centenary and underlines the longevity and value of Novo Nordisk's distinct purpose. We will come back to that a little later. For those of you who prefer Danish or English, simultaneous translation is available here in the Bella Center, and online participants can choose the preferred language in the broadcast system. In 2023, Novo Nordisk turns 100 years. For a century, our company has been consistent in the overall mission to drive change, to Defeat Diabetes and other serious chronic diseases.
However, given the health challenges that pose a threat to people's lives and livelihoods, among these, the rise of obesity as one of the world's foremost healthcare challenges, the need for further innovation has never been greater. Turning to the performance of Novo Nordisk, 2022 was a year of substantial progress. This performance is in the light of a difficult macroeconomic and geopolitical environment, including the impact of the war in Ukraine, rising tensions in global trade, and the continuing fallout from COVID-19. In continuation hereof, I would like to take the opportunity to express my deepest sympathy for Ukrainian people living with the hardship of the ongoing war. Our purpose and long-standing aspiration of creating value for society and for our future business is more relevant than ever.
At a time of societal debate about purpose versus profit, Novo Nordisk shows that these two can actually go hand in hand. At Novo Nordisk, we have a special opportunity to execute on the commercial potential that our innovative treatments have to offer while ensuring as many people as possible have access to quality medicines. We continue to serve more patients in need around the world, reaching almost 40 million patients globally in 2020, all with the purpose of driving change in diabetes and other serious chronic diseases. Innovation is our key contribution to patients, societies at large, and is the bedrock of the future of the company. To ensure long-term growth and a robust product pipeline, we continue to broaden our technology platform in early research and enroll a record number of patients in our clinical trials.
The extraordinary demand for Novo Nordisk products in 2022 is largely driven by our new and innovative treatments, which has led to a substantial market growth, especially for GLP-1-based treatments in diabetes and also in obesity. This underpins the importance of ensuring improved treatment for people living with diabetes, obesity, and other serious chronic diseases. On the other hand, this significantly higher than expected demand unfortunately meant that we have struggled to meet the demand, a situation that stresses the vital importance of current and future investments made in our global production capacity in 2022 and also beyond. I would like to add that for us at the board, the supply and demand imbalance has been discussed at every board meeting during 2022, and it is a topic to which we continue to attach a great deal of importance.
In addition to that, we need to develop the medicines for the future and ensure sustainable long-term growth. Thus, a key priority for the next 10 years is to advance scientific understanding and treatment options in our core therapy areas while expanding and diversifying our pipeline into adjacent fields such as cardiovascular, NASH, and also rare blood disorders. This means looking beyond the success of product based on our leading GLP-1 molecule, semaglutide, and adopting new technologies. To achieve this, we need to build further on our deep in-house expertise, coupled with sourcing the best science from outside through partnerships and business development. Overall, 2022 was a year with unusually high sales growth rate for a company of our size, a year that underlines the longevity and value of our distinct purpose.
On behalf of the Board of Directors, I would like to offer my sincere thank yous, first to our CEO, Lars Fruergaard Jørgensen, for his wise leadership of the company. Secondly, to his great leadership team, as well as the Novo Nordisk employees globally for their contribution to the progress made throughout 2022. Lastly, I would like to thank all our shareholders and other stakeholders for continued support. Let me now turn to the introduction of my fellow board colleagues. They are all present at this annual general meeting. During the past year, we have again had excellent collaboration in the board undertaking the task of supervising the company and its management. Also, members of executive management are also present at this annual general meeting. Likewise, the collaboration between the Board of Directors and the executive management team continues to be trusting and transparent.
The relationship grew further during a year in which we were able to meet each other in person more frequently. The management team ensured good operational and strategic progress in this past year. I will come back to this a little bit later. Present in person is also Anders Dons from the company auditors, Deloitte. Finally, I can inform you that the board of directors again this year has appointed attorney Klaus Søgaard to act as chair of the general meeting. Claus is joined on stage by his colleague, Louise Korpela. Louise will be attentive to the shareholders participating virtually. I leave it to you, Claus, to take us through the agenda. Over to you.
Thank you. I'll take the more boring part. I'll take all the formalities. My first obligation is to confirm that the general meeting is duly convened and competent to transact business. I can promise you, I have checked it before I came here. There are certain requirements that has to be fulfilled in the law and also in the articles of association of the company. The meeting has to take place in the Capital Region of Denmark. It has to take place no later than in April, and the meeting has to be called with a notice of 3-5 weeks. Here, the invitation was sent out in the way that it should be sent out on the 22nd of February. My conclusion is that the meeting is legally held.
With regard to quorum, how many who needs to be present in order to make decisions, there are two items on the agenda that involves changes to the articles of association. That is item 9, 8.1, concerning cancellation of shares, and it is 8.3, concerning the authorization to increase the share capital. It follows from Article 9, Section 3 of the articles that at least 2/3 of all possible votes have to be represented today in order to make a final approval today. I confirm that that is the case, as more than 89% of all votes are actually present here, and around 66% of the capital is represented. A little about voting.
The changes to the articles of association, the two I mentioned before in item 8.1 and 8.3, requires approval by 2/3 majority, 2/3 of the votes and 2/3 of the capital represented. Everything else can be approved with simple majority. Attendance is always interesting, and as you can see, we have a full room here, which is very nice after 3 Corona years. A total of 1,015 people have requested an admission card, either to be present here physically or participate virtually. Out of them, 695 are shareholders. A little before we started, 5, 10 minutes before 2, a total of 305 were present, out of which 242 are shareholders. I can see that many have joined us after that time.
Many shareholders have exercised their legal right to vote prior to the meeting today. That is a development we see in all listed companies, that a lot of shares are being voted due to the ability to vote on the voting material being available on the homepage. A total of 7,011 shareholders have forwarded their vote or proxy. That represents 89% of the total votes in the company, which is extremely high, and it is around 99% of the total votes being present today. Even though we are many here, the number of votes that can be exercised here today is rather limited compared to those that has already been given before.
As many have already voted, I can also conclude, not to scare anybody away, that the board's proposals and recommendations will carry support from the needed majority, actually well above 90% on all of the proposals. That should not prevent a good debate today, but hopefully we don't need to carry out actual voting. The numbers will follow directly from the minutes of the meeting, which will be made available for the shareholders on the homepage within two weeks following the meeting today. A little about the different ways where it's possible to participate today. There are actually three different ways. One way is the traditional way to be present here in Bella Center together with me. The second one is to participate virtually via Computershare's meeting services. The third one is to watch the webcast on the homepage, novonordisk.com.
I'll give a few comments with regard to each three possible ways to participate in order to explain how it is possible to get influence and get a debate. First, for those who are participating here in Bella Center, if you want to speak or have a comment, then please move up to this end of the year, the room. We had, at least at the beginning, available seats up here. We'll make sure that those who want to speak can get a seat up here. If a vote is required, I don't think it will be necessary, then we have all received the instruction and the QR code where we can download the relevant material on our telephone via our device camera, as it is called in new Danish. Just follow the link and everything will be self-explanatory.
If we get to a ballot, the ballot will automatically appear on the screen. To vote, simply select your voting preference on the screen. Even though I think we can avoid it's not that difficult to do it. The other possible way of participating is the year virtual participation. It is possible for those who have signed up as shareholders through the virtual participation model to submit comments in writing. Just click on the Q&A function and submit the comments and requests. Simply click on the Q&A icon. Select the relevant agenda item and write the comment. It's possible to write 2,000 characters, believe me, it takes a long time to write 2,000 characters.
If you have a lot to say, those of you who are participating from outside this room here, please start writing as soon as possible. We'll pick it up when we get to the right item. We don't want to cut anybody away. If we are going to vote, those who are participating virtually will be able to vote directly in the app. You may either click on the bar on the top of the screen or on the Vote icon. The ballot will then appear, and you simply have to select your voting preference on the screen. For those of you who have problems here in the room, it's the easiest way to put up a hand, and I'm sure somebody will come and assist.
If you are participating virtually, there is a dial number for Computershare, which is on the screen that can be seen for those participating virtually. The number is 45460997. Even though there is a telephone on my desk, I'm not gonna answer the phone when it calls. The third possible way to participate is through the webcast. Those who have joined the webcast can view and listen in, but will not be able to ask questions or to vote. Needless to say that we will only deal with matters that relate to the company and to the AGM. If there are several questions with the same background, questions might be bundled and asked and answered together.
Shareholders may request that an item is put up for vote, as I have said, but I have also said that I hope we can avoid it because I don't think it's necessary. All the relevant information will be seen in the minutes that will be available within two weeks. Everything will be recorded in the minutes, and they will, the originals be in English and be translated into Danish and will be available within the two weeks I said. That was a lot about formalities. Now we can get to the real thing. We can get to the report from the board of directors and the management. As usual, the first five items will be presented together by the chairman and the CEO of the company.
After the presentation of these five items, it will be possible to ask questions and come up with suggestions. I'll come back to that. First of all, I'll give the floor to Lars Fruergaard Jørgensen. Please take us through your performance during 2022.
Thank you, Helge and Claus. As mentioned by Helge, we are standing here with the 100th anniversary of Novo Nordisk. 2023 will be an immense milestone for Novo Nordisk as a company in many ways. More about that later. Before turning to 2023, I would like to dive into some of the highlights of the 2022 performance. 2022 proved to be both a challenging year and a year with strong results and progress achieved by Novo Nordisk. First and foremost, I would like to extend my gratitude to all the colleagues at Novo Nordisk globally who each and every one played a key role in this achievement. Turning to our strategic aspirations for 2025, they consist of four dimensions which provide clear midterm direction on how we plan to deliver on our purpose and drive growth.
I'll now take some time to go through some of the key milestones in 2022. Firstly, purpose and sustainability, which at its core is a commitment to add value to society and to our long-term business. This mission is embedded in our business with environmental, social, and financially responsibility having been anchored in our Novo Nordisk articles of association since 2004. In terms of our environmental footprint, it is our responsibility to reduce our carbon emissions as swiftly as possible, meeting our target of reaching net zero emissions by 2045. Initiatives already in place today has meant a 29% reduction in CO2 emissions when compared to 2019. Initiatives include switching our global production network to 100% renewable power, as well as leveraging biogas in two of our production sites.
Another example includes converting our company car fleet towards the aim of 100% electrical or plug-in hybrid cars by 2030. In 2022, almost 40 million people were treated with Novo Nordisk products. More than 36 million of those are people living with diabetes. Our purpose to Defeat Diabetes and other serious chronic diseases relies not only on innovation, but also ensuring that the right treatments reach patients in need. In 2022, we reached around 5.5 million patients through our various affordability programs. In our Changing Diabetes in Children program, we are now treating more than 41,000 children with the aspiration that no child should die from Type 1 diabetes.
In April 2022, we obtained a positive European Medicines Agency scientific opinion supporting the storage of two of our human insulins outside refrigeration for up to four weeks if kept below 30 degrees Celsius. By documenting improved thermostability of these products, we hope to address a barrier faced by many vulnerable patients with diabetes living in challenging settings where refrigeration may not always be available. In terms of our aspiration of being a sustainable employer, we expanded the number of women in senior leadership positions to 39%, compared with 36% in 2021. We see good progress across our initiatives, but recognize that even more can be done going forward, and we're determined to do so. As pertains to innovation and therapeutic focus, 2022 included exciting trial initiations and readouts, leading to a strong pipeline progress across all disease areas.
In diabetes care, we're pleased with the phase II data with CagriSema in type 2 diabetes, as well as the successful completion of the pivotal phase III program for insulin icodec. Pending regulatory submission and review, insulin icodec may be the world's first once-weekly insulin on the market. Within obesity care, we have initiated the phase III program called REDEFINE for CagriSema, and the first two trials have now started. Furthermore, we got the results from STEP TEENS, a trial testing Wegovy in adolescents with obesity or overweight. The results indicated BMI reductions of 16% in adolescents treated with semaglutide 2.4 mg. Within rare disease, we have completed the phase III trial for concizumab in patients with hemophilia and have also initiated phase III dosing with Mim8 in hemophilia A.
Lastly, we have acquired Forma Therapeutics to expand our pipeline in sickle cell disease, as well as filed for regulatory review with Sogroya within rare endocrine disorders. Progress has also been made within the area of other serious chronic diseases. A phase III trial was initiated in cardiomyopathy based on the acquired assets from Prothena in 2021. Likewise, we are pleased to have initiated the first two phase I trials within non-alcoholic steatohepatitis, also called NASH, based on Dicerna's RNA technology platform, which we acquired in 2021. Commercially, during 2022, we exceeded expectations. We grew our business and served more patients. For diabetes care, we progressed our core aspiration of reaching more than a third of the diabetes value market. We now hold 31.9% market share of the diabetes value market.
Obesity care sales in 2022 increased by 84%, while rare disease delivered on the aspiration of sustained growth with 1% sales growth. Turning to financials, we delivered 16% sales growth for the group driven by both operating units. The strong sales growth has unfortunately resulted in periodic supply constraints and related drug shortage notifications across a number of products and geographies. Operating profit growth reflected the sales growth and continued investments in the future growth drivers and grew by 16%. In 2022, free cash flow ended at DKK 57.4 billion. We remain committed to provide attractive capital allocation by returning DKK 49.4 billion to shareholders. The 16% sales growth resulted from the following dynamics within our therapeutic areas.
GLP-1 sales, sorry, GLP-1 diabetes sales grew by 42%, with 57% sales growth in international operations and 36% growth in North America operations. The sales growth was driven by Ozempic as well as Rybelsus, which has now been launched in 43 markets. Insulin sales declined by 11%, driven by both North America operations and international operations. In the U.S., insulin sales were driven by lower realized prices as well as decline in volume, whereas for IO, impact was from the implementation of the volume-based procurement in China starting in May 2022. Obesity care sales delivered 84% sales growth in 2022. I will elaborate on this shortly. Rare disease sales grew by 1%. This was driven by rare blood disorders growing by 7%, driven by NovoSeven RT, as well as the launch products Esperoct and Refixia.
This was partly countered by rare endocrine disorder sales due to lower realized prices in the U.S., as well as supply constraints in the final quarter of 2022. Obesity care sales grew, as I mentioned, by 84% in 2022. We are encouraged by the continued expansion of the global branded obesity market with a volume growth of more than 50% as people living with obesity continues to seek treatment. In the U.S., we were very happy to announce that all dose strengths of Wegovy were made available in December 2022. Since then, Wegovy prescription trend has accelerated and reached all-time high, underlying the significant unmet need for people living with obesity. Furthermore, many patients have been waiting for all doses of Wegovy to be available again, which has created an initial pent-up demand.
In International Operations, we were encouraged by the 2022 performance of Saxenda, driving 82% sales growth. We are excited that Wegovy is now launched in Denmark and Norway, the first two markets outside of the U.S. Early feedback from patients and prescribers has been encouraging. During 2023, we plan to launch in more countries in IO, depending on the supply and demand development. As previously mentioned, we had a strong trial initiation and regulatory year in 2022. Looking towards 2023, this looks again to be an eventful year across our four therapeutic areas in terms of clinical trial initiations and readouts. Within diabetes, we expect to submit the once-weekly insulin icodec for regulatory review in the U.S., E.U., and China. This is expected to happen during the first half of the year.
During 2023, we also plan to get phase III results for once-daily oral semaglutide 25 and 50 milligram, as well as initiate the phase III program for CagriSema, both in Type 2 diabetes. Within obesity care, another oral phase III readout, namely the 50 milligram once daily oral semaglutide, is also anticipated during the first half of the year, where our expectation is to reach a level of efficacy comparable to Wegovy. We look forward to sharing the results from the ongoing SELECT cardiovascular outcomes trial in the middle of 2023. Turning to the rare disease franchise, we expect regulatory feedback from Sogroya, our once-weekly human growth hormone treatment in children. Here we, depending on the outcome, plan for first launches during the year.
Lastly, within other serious chronic diseases, ziltivekimab, for the treatment of heart failure with preserved ejection fraction, will initiate phase III-B in the first half of 2023. Ziltivekimab was acquired from Corvidia Therapeutics in 2020, and is currently also tested in one further indication in phase III. Moving on to expansion within our production capacity. As mentioned, a strong sales growth was seen in 2022, which unfortunately also resulted in periodic supply constraints and related drug shortage notifications across a number of products and geographies. The outlook for 2023 will also include an expectation of continued periodic supply constraints. The main driver hereof are higher than expected volume growth for GLP-1-based products such as Ozempic and capacity limitations at some manufacturing sites. We have a strong focus on gradually increasing our supply capacity.
In 2023, we expect to increase our capital expenditure to around DKK 25 billion. This is a significant step up compared to 2022 and reflects the innovation-based growth strategy that we are pursuing in Novo Nordisk. The CapEx increase is primarily related to investments in additional capacity for active pharmaceutical ingredient production and fill finished capacity for both current and future injectable and oral products. As an example, we are significantly expanding our manufacturing facilities in Kalundborg, as illustrated on the photo on this slide. The investments will gradually add capacity, flexibility and resilience in our manufacturing setup, while also accommodating for potential upside to forecasts. In the coming years, the capital expenditure to sales ratio is expected to be low double digit.
In closing, I would like to reiterate that during 2022 we exceeded expectations on many fronts, growing our business, serving more patients, and expanding our pipeline for long-term success. As mentioned, we also experienced periodic supply constraints, and we continue to work hard to ensure scaling and gradual expansion of our supply capacity. Lastly, we continue to progress on our efforts for being a sustainable company. I want to take this opportunity to thank all my Novo Nordisk colleagues around the globe for their hard work and commitment during another demanding year, as well as our board of directors and our shareholders for your continued support.
We have now entered 2023, which I remind is a truly significant year in the history of Novo Nordisk as we celebrate our 100-year anniversary. In this period, we have grown from 2 small Danish companies into a global company, developing essential medicines for millions of patients around the world. In 2023, we look forward to continuing our focus on commercial execution, expanding our pipeline, and investing significantly in expansion of our production capacity for current and future products. We have now reached item 2 on the agenda: presentation and adoption of the statutory annual report for 2022. The annual report was published on February 1, 2023, and included financial results and the outlook for 2023. Sales grew by 16% at constant exchange rates, and 26% in DKK, while operating profit grew by 15% and 28% respectively.
Looking over the functional lines, cost of goods sold increased by 20% in DKK, resulting in a gross profit of 84%. Sales and distribution costs increased by 25% in DKK, driven by both operational units and launch activities for Rybelsus and Ozempic, as well as market development activities within obesity. The increase is also reflecting higher distribution costs in 2022. Research and development costs increased by 35%, driven by increased late-stage clinical trial activities in 2022, mainly related to increased activities within other serious chronic diseases and GLP-1. Further R&D increase is driven by operating costs and amortizations related to Dicerna Pharmaceuticals, which was acquired in 2021. Net financial items showed a loss of DKK 5.7 billion, driven by losses on hedged currencies, primarily related to US dollars. Net profit increased by 16%.
Total assets increased by around DKK 47 billion to DKK 241 billion from the end of 2021 to the end of 2022. The increase in total assets is primarily driven by non-current assets due to the acquisition of Forma Therapeutics. Free cash flow increased from DKK 29 billion in 2021 to DKK 57 billion in 2022. The increase was driven by higher net profit and higher provision for rebates in the US, partially driven by changed distribution policy for the so-called 340B program. Hereby, we conclude the presentation of the financial statement and balance sheet. now over to you, Helge, for the proposed capital allocation to our shareholders.
Thank you, Lars. In the annual report, we have stated that sales are expected to grow between 13% and 19%, measured at constant exchange rates. The guidance reflects continued strong momentum in the business across both North America and international operations, mainly driven by volume growth of GLP-1-based treatments for diabetes and obesity care. This is partially countered by declining sales in rare disease due to supply constraints. Furthermore, intensified competition and continued pricing pressure within diabetes, especially in the U.S., is expected to impact sales. The outlook is also dependent on the supply and demand development. The annual report also included an operating profit outlook between 13% and 19%, measured at constant exchange rates. This reflects the sales growth outlook and continued investments in future and current growth drivers within research and development, and also in the commercial area.
This brings me to item 3 on the agenda: resolution to distribute the profit. In 2022, our performance has also resulted in a continued attractive capital allocation to our shareholders. Novo Nordisk returned around DKK 49 billion to shareholders through share buybacks and dividends. In August 2022, Novo Nordisk paid an interim dividend of DKK 4.25 per share. The board proposes that the final dividend for 2022 is DKK 8.15 per share, which is to be paid this month. Consequently, the total dividend will be DKK 12.40 per share. The total dividend increased by 19% compared with 2021, corresponding to a payout ratio of 50.3%, making it actually the 27th consecutive year with increasing dividend.
Again, a short comment on 2023 expectations, where the board has approved a new share repurchase program of up to DKK 28 billion to be executed over the course of 12 months. With that, back to you, Claus.
Thank you. I'll be short. I just want to remind the shareholders, especially those who participate virtually, that following the presentation of item 4 and 5, we will take questions and comments to items 1 to 5. If there are questions pending, please write them so we have them when we get to that. With that in mind.
I want to say that we will now continue with agenda item 4, presentation and advisory vote on the remuneration report. Item 5, which is the board remuneration, including change to the remuneration policy. I hand back to Helge Lund.
Thank you, Claus. Again, this year we have published a report on board and executive remuneration, which is accessible on our website. Let me give a description of the executive remuneration for 2022. The total CEO remuneration in 2022 was DKK 60 million, 3% up compared to 2021. The new incentive programs have been designed to support our strategic aspirations for 2025, as shown on this slide. For the short-term incentive, the performance of the CEO in 2022 resulted in a payout at 77% of the maximum. This is due to very good business performance, particularly on commercial execution and financial parameters, but also on non-financial targets.
Moreover, as a CEO, Lars is an effective and respected CEO leading based on our values with a clear strategic direction and ambitions, and collaborating effectively with the board and his executive team, as well as the broader organization. The supply challenges negatively impacted the individual performance, and thus the short-term incentive in 2022. For the long-term incentive programs granted in 2021 and 2022, the good business performance supporting our strategic aspirations for 2025 resulted in the incentives tracking above target on parameters related to commercial execution and financials. While parameters relating to purpose and sustainability, and innovation and therapeutic focus are tracking around target levels. In 2022, the executive remuneration was in line with the remuneration policy.
In addition, the board finds that remuneration structure and mix of fixed salary, pension, and the incentive programs provide a good balance between fixed and variable remuneration, and a strong link to our strategic aspirations for 2025. In conclusion, the board finds the total remuneration of the executives to be at the right level. This brings me to the approval of the actual board remuneration for 2022, and the remuneration level for 2023. Elaborate information about the board's remuneration is provided in the Remuneration Report, so I will focus only on a few elements. The board remuneration consists of a fixed annual base fee, a multiplier of the fixed base fee for the chair committee and members of the committees, and fees for ad hoc tasks and the travel allowance, as shown on this slide.
At the annual general meeting in March 2022, it was decided to increase the annual base fee for the board members to DKK 755,000. The actual remuneration for the members of the board for 2022 amounted to DKK 20 million in total, which corresponds to the remuneration level approved by the annual general meeting last year. On this background, the board proposes to the general meeting to adopt the actual remuneration for 2022. Regarding the remuneration level for 2023, I'll invite Jeppe Christiansen to the stage. Jeppe is, as you know, the Chair of the Board's Remuneration Committee. The Remuneration Committee assists the board of directors with the preparation and oversight of the remuneration policy, as well as the actual remuneration of the members of the board and executive management. Welcome, Jeppe.
Thank you, Helge. Regarding the remuneration level for 2023, the board proposes to adjust the remuneration level in line with the general salary inflation, and thus increase remuneration by 3.8%, resulting in a base fee level of 784,000 DKK. Also, the board proposes that the travel allowance is similarly adjusted by an increase of 3.7% in line with the salary inflation. The proposed remuneration level is as shown on the slide, as seen up here. Finally, the board propose to increase the base fee multiplier applied to the fee to the chair of the board from 3 to 4 times the base fee. The proposal is a result of the general review of the board remuneration levels undertaken by the Remuneration Committee and the board in 2022.
If adopted, this change will position the fee to the chair above the upper quartile of the Nordic peer group, while still placing, at below the lower quartile of the European Pharma peer group, based on 2022 benchmark figures. The board proposes that the general meeting adopt these remuneration levels for 2023, and that the new multiplier for the chair fee of 4 times base fee is reflected in the remuneration policy. The board expects to continue to generally review the board remuneration level during 2023, in light of the general market developments for board remuneration, as well as the development for Novo Nordisk business. Based on the review, the board may submit a proposal for adjusting board remuneration to the general meeting in 2024. Thanks. Claus.
Thank you. That finalizes the presentation of the first five items on the agenda. To sum up the latter, the proposal with regard to the board fees is that the fees for 2022 are finally adopted as pre-approved last year, so no changes there. With regard to the 2023 remuneration, it is to be indexed with 3.7%-3.8%, and the multiple for the chairman to be changed from three to four, and that to be reflected in the remuneration report or remuneration policy. Now it is possible to ask questions, and I have some sign-ups already. We'll first take two speakers, where the first will be Claus Berner Møller from ATP, and you're welcome to come up here.
The next one is going to be Mikael Bak from the Danish Shareholders Association, and then I'll come back.
Thank you for the floor. My name is Claus Berner Møller, and I represent ATP. Last year I mentioned the amazing sales growth measured in constant exchange rate of 14%. It's 14% it was in 2021, but in 2022, the growth was even higher. It was 16%. I will not be surprised if we, in 2023, will see an even faster growth. Very good. This is a very special situation. The biggest hurdle is not to sell the GLP-1 products, but to produce enough. My question is therefore: What are the key bottlenecks for a smooth production for all the GLP-1 products to a level without constraints? Another big challenge, and maybe the biggest, is the patent expiry of semaglutide. Already now, the CEO of Novo Nordisk has for several years tried to prepare the company.
Novo Nordisk has broadened its therapeutics focus, increased its number of collaborations, in-licensing products and technologies, and even bought companies. I would like to have a status on these initiatives. Have they been successful? Going forward, do Novo Nordisk need to do more in-licensing of phase II and phase III products, or acquisitions of companies with new products? This year, Novo Nordisk is introducing reporting of full Scope 3 emissions. I'm pleased that Novo Nordisk has focused on better reporting on emissions and have a net zero emission target in 2045. Finally, I have a few comments to gender diversity. As of 2022, women fill 39% of senior leaderships, and it was an increase of 3 percentage point. It is a satisfying development, and the goal of at least 45% women in senior leadership positions by the end of 2025 looks achievable.
I have followed this figure for the last years, and I'm pleased that Novo Nordisk takes a leadership position in gender diversity. In the end, I just want to wish Novo Nordisk and their employees all the best for 2023. Thank you.
Thank you. Before I hand over to the chairman and the CEO to answer the questions, I'll give the floor to Mikael Bak from the Danish Shareholders Association.
Thank you, tack. Thank you. I'll be speaking in Danish. I hope that's okay. First of all, I'd like to thank you for a good full report from management. Congratulations on the jubilee. I can see there's something to celebrate next year, as 50 years ago you went on the stock exchange and shareholders were invited in. We can thank you for that. We have something to celebrate there also. In order to stay with the praise, thank you for having a physical meeting. You can follow it at screens, it's nice to be able to meet physically. It's very important for shareholders. I do believe it's also important to the company.
2022, despite the times of uncertainty, it was an excellent year for the company. I believe we should take the opportunity to express our respect and thanks to management and all the skillful employees for this strong effort. I also respect the leadership that really is inspiration to others. It's got to do with Danish leadership culture. Many Danish investors can really benefit from that if they're on the journey. I have three questions for you. First question, when has Novo Nordisk, you come into the world elite? You can be a target of media attacks. Some could be unwarranted, some could be more reasonable. We've seen critical stories about animal trials, stories that I mean, the company really gave nuances, gave good replies. Praise you for that. Other companies, we have seen cases, breaches of human rights.
We've heard about China. These are also complex topics, difficult to relate to. It's important that you relate to them. I'd like to hear from board and management, how do you see the geopolitical risks that exist in the world today? How may that influence your business or our business, I should say? You know, I'm thinking about the uncertainty in big markets. Can that influence growth in the coming 3 to 5 years? Do you think that political unrest and more inequality could also threaten your image and your business looking at the high margins you have on new products such as Wegovy? The other topic is something that analysts are very interested in and also private investors. How long can things be going this well? We hope for a long time.
Can board and management say a bit about what new areas of disease that may follow the blockbuster drugs you have developed? I know you've said something, it would be nice to hear more about that. Finally, a question that I also hear sometimes. The Danish leadership culture. Well, we've heard over the years that despite the success at Novo Nordisk, it can be difficult to retain the best talent, the best leadership candidates. I'm thinking management candidates of 35 to 50 years of age. Maybe they find it difficult to find their way in such a big group as Novo. This has not become less difficult because you're growing so much. You are global. You are focusing on diversity, ethnicity, and so on, and Danish leadership values.
My question is, the high growth expectations and can they mean that you have more international candidates than good Danish candidates so that the Danish DNA of the company could be jeopardized? Do you focus on that? How are you working with that? Those are my questions. I wish the company all the best in 2023. Thank you.
Thank you. I can certainly confirm that it is possible to speak in Danish or to speak in English after your own choice. This contains questions to as well the CEO as to the chairman. I hand over the floor to Lars Fruergaard Jørgensen first.
Thank you for the questions. I'll try to answer in the language they were asked. First, from ATP and thank you, Claus, for both the positive comments and the questions. In terms of bottlenecks in manufacturing, it's not that we have one big bottleneck that we are solving. It's simply under a number of parameters we need to expand capacity. If you consider that Ozempic last year sold worth of DKK 60 billion, that's a huge business and is growing double-digit percentage point year-over-year. On an ongoing basis, we are adding both fill finish capacities or adding filling lines around our manufacturing sites around the world. We're also building up more API capacity.
You know that we just finalized an API facility in the U.S. We have communicated that we are building a new one and investing some DKK 17 billion in Kalundborg to build the next. It's an ongoing expansion of our capacity to support the growth we have. In terms of building for future growth and acknowledging that the products that are currently fueling the growth eventually will go out of patent some ±10 years from now. As you look to, we have already taken measures to make sure that we can build a strong pipeline for that day. We have both in-house developed products.
I mentioned the weekly insulin, which will be a major change for people relying on insulin, injecting themselves on a daily basis today who will go to weekly injections. That's one way to redefine, say, insulin-based treatment. We also have a pipeline for other Type 2 diabetes indications. We are trying to make a glucose-sensitive insulin in Type 1 diabetes, we have a number of assets in also the rare disease area where we think we can redefine what, say, leading innovation looks like. You're also right that we have started to also look at innovation coming from outside. We acquired ziltivekimab. I mentioned that. It's now in phase III development. We acquired Dicerna Pharmaceuticals. It's nice to see that we're now already in phase I development.
What we have acquired from outside is indeed turning into active drug development. Of course there are still risks in the future, but we're pleased that we can turn external innovation also into active pipeline. Helge will address gender diversity later on. To Dansk Aktionærforening.
Now in Danish to the Danish Shareholders Association, thank you very much for your questions. Of course, in view of our growth in sales and our global presence, risk management has become an extremely important part of our everyday lives. Over the past 3 years, first we had the pandemic, and now we have war in Europe. Geopolitical challenges have arisen that will affect the way that products move, and we need to make sure that we now have overlapping supply lines and less dependencies in our system. Of course, image is important, not least when it comes to areas such as obesity, where things are slightly different from the areas where we have previously been active.
We help the weakest patients worldwide getting access to our products. Five and a half people worldwide are covered by a support program from us. That is why we feel a commitment to be there for the weakest citizens that also need our products but don't have sort of the resources to speak up. Strong positions in the different technologies. We believe that you need to be leading in the technologies that you work with. We know about the biologies that we address, the diseases. If you have a strong field to operate within where you are among the top, absolute top in the world, then you also operate with a bit lower risks than some of the others. We are confident in our ability to move forward.
With regard to talents and a talent pipeline, we are a people business, if you like. We have plenty of production plants, but it's actually our employees that are our biggest asset. The Novo Nordisk culture, we call it the Nordic Way, is something that was given to us from our founders, and we set great store by it. We increasingly recruit globally. We also have a management team with international representatives today. Whether you've been with us for 30 years or 1 year, you need to live the way that our culture dictates. We believe that is important. We also wish to take on board diversities. We want people to be themselves on the job and to contribute to the best of their abilities. This is why we give the equal access to all types of talents.
Now I'll hand over to Helge.
Thank you, Lars, and thank you for excellent questions. I'm gonna re-reply in English because Norwegian is not yet a global language, unfortunately, so even in Denmark. On the diversity and inclusion question, I just wanted to start by saying that one aspiration I think we have and any good company would have is try to reflect the societies that we're working in to a much extent as possible. We have diversity in many dimensions. The importance is to enrich the debate and the discussion in the company from many different perspectives. It gives better discussions, more innovation, we believe, and ultimately, I think also we create a company that is more fun to work for and so people can thrive better.
There are many reasons for driving diversity and inclusion, but ultimately to create a better and more competitive company. The team has worked really hard on this topic over the last few years. We have put out objectives and targets that we're working towards to inspire and to drive the effort. We are making progress, but it is more to do at every level of the company to really make sure that we have full diversity. I'll just give you one example. At the board level, 2 years back, we reflected that this company is being global, but basically the board were consisting of people from the US, from Europe, and from Scandinavia. We invited Christina Law on the board. She's here.
She is from Asia. She lives in Asia. She has run emerging markets in different industries in China, in more generally in Asia, in Africa, and in Latin America. I think we can already now see, Christina, that you're enriching our debate and actually proving the point. It is important for us as a company that we also have big eyes on the emerging markets in Asia. On the important question around, you know, whether or not the geopolitical environment is impacting the company, the answer to that is I think with any company yesAnd as a truly global company, we are impacted by global trends.
Ideally, we would like to operate in an environment where we have low tension, high international collaboration and a very stable framework, because that reduces the risk and it's easier to deploy capital and human resources across the world. Unfortunately, we are not there right now. We have had COVID, we had the war, we had increasing geopolitical tensions. I think it's important that we think about the purpose of the company. That is really driving and directing our resources, and our purpose is to serve as many patients as possible and help them with their serious chronic diseases. That applies wherever we are in the world. We cannot be naive. We have to develop a company that is robust, resilient, and also flexible.
We are working to think about the supply chain, our commercial strategy in the different markets around the world and also the organizational capability and leadership capability so that we're even better equipped to work in a global community that is less stable than it was only a few years back. On that basis, also the importance of continuing to develop leadership capabilities, experience and capacities in the company in order to be even better able to deal with all these challenges. Thank you.
Thank you. That was the questions and comments from ATP and from the Danish Shareholders Association. We will also give those who participate virtually a chance to ask questions. Louise, have we any questions? We do not. We will continue here from the audience here. The first speaker will be Peder Hvelplund, and the next after Peder Hvelplund will be Bjørn Hansen.
Thank you. For my sake, and for your sake, I'll give my speech in Danish. First of all, thank you for the report, and thank you for reviewing the financial statements. I think it's quite clear to see that Novo is making a bundle of money, really a big, big bundle of money. That's a good thing, isn't it, for the company? It's good for the board. It's also good for you as shareholders. That profit has a price. That price is paid by consumers. It's paid by some of the patients, for instance, in the U.S., that are depending on medication and for whom it is essential to be able to get that medication. They pay the price for that huge profit that you are making. Particularly in the U.S., we have seen that prices have exploded. There's an evergreening going on, right?
Products are being developed that can be repatented. It's a bit of a paradox to see that we talk about the 100 years of Novo Nordisk. It's also about 100 years ago that a Canadian doctor, Banting, invented insulin but did not take out a patent for it, because to him it was essential that insulin was to be available to everybody and no money should be made from it. Medication was then developed by August Krogh in Denmark that would then lead us to being in a company that has this huge profit. These price increases, they're paid by patients. They have also created a certain political pressure. President Biden, for instance, has encouraged you to reduce prices of medication.
It also meant that the former presidential candidate, Bernie Sanders, who chairs the Health Committee of the Senate, he approached Novo and Eli Lilly and Sanofi as the big insulin producers, encouraged them to reduce prices. It has meant that Novo Nordisk, on 4 out of the 20 products that are marketed, they have reduced their price by up to 75%. That pricing is the result of political pressure because to many people it's evident that this is not a tenable situation that we are in with the pricing of medication. That's why I was very pleased when I saw Lars Fruergaard Jørgensen on the 26th of February this year, he wrote in Berlingske Newspaper that values and culture are a big part of Novo's competitive power.
That gave me the thought, you know, why wait for political pressure then if values and culture are important for your competitive strength? Why shouldn't you take the lead and say that the picture that is made of the unfair pricing of medication, we'll do away with that. That would put Novo Nordisk on the map as the company in the pharmaceutical industry that took the lead in developing more reasonable prices. That's why later at the AGM, there is a proposal from critical shareholders, saying that with the purpose of reducing the profit by DKK 25 billion, you would be able to reduce the price of essential medication. That the price to be paid by people who are dependent on essential medication, that price would be more manageable. It would still mean there would still be considerable profit. This year it's DKK 75 billion.
Reduction by DKK 25 billion would bring you down to the level of about DKK 50 billion you would still have as profit. There'd still be quite a big thing to be paid to shareholders. It wouldn't mean anything regarding the development and research of new medication. You'll still be able to spend the same kind of money so as to continue having a leading position. The message we'll be sending here from the AGM today is that isn't now the time for Novo Nordisk to send a surprising message to not just Denmark, but to the whole world, that the pharmaceutical industry is not greedy. We make sure that medication is available to the people who need it, and that is why we organize our earnings to match. Thank you very much for your attention.
Bjørn Hansen is the next speaker, and after Bjørn Hansen, the chairman and the CEO will reply. Please come up here, Bjørn Hansen.
I'm Bjørn Hansen. As Claus Søgaard said, thank you for the review made by the Chair of the Board and the CEO. It was a full report, and it was joyful. We had it in Danish and English. We were able to follow also the mistakes. This is a very good company, and their profit really brings billions back to society. Created by, I think, as it says in your annual report, 55,000 employees. About DKK 1 million in profit for every employee. That's really formidable. I wonder, could we have 10 companies like yours? That would be great. You can't do much better than this. A few years ago, Well, I've been doing that for many years. The last couple of years I've been abroad, I haven't participated at your AGM. Göran Ando , he was Swedish.
He was also very skillful. Now we have a Norwegian. He can give his reply in Norwegian if he likes. His name is Helge Lund. He's also very skillful. He has a background from BP, Aker ASA in Norway. When you go and buy their shares, you buy and sell. They have 5 or 6 listings on the stock exchange. Perhaps Novo Nordisk has that too via Novo Holdings. The only difference is that in Norway, they speak Norwegian. They speak Norwegian. Anyway, some of it is in American English because of their U.S. or the British BP, British Petroleum. Fortunately, they're still owned by the Brits. I would like to suggest that Novo Nordisk should also present something as we saw at DFDS's AGM yesterday, 44 pages in Danish. Even in DFDS, it said how many shares that each one had.
The salaries here, they're okay when you compare with the size of the company. We shouldn't be sad about that because I know people who work for Novo Nordisk, both here in Denmark and abroad. They have a good salary. One that I knew for 10-12 years, she's not here anymore, but every year for her birthday and for Christmas, she got presents from Novo Nordisk. There was a feeling of social responsibility. We should notice that before we start criticizing Novo Nordisk. Some of the money goes to the employees that create the results. That is really good, and is well seen by all pharmacists.
Lars Fruergaard Jørgensen, I thought when he took over, at first I thought, "Well, some people must know him quite well." But he was kind of in the shade before, but now he's really out of the shade. He has delivered more than what you could expect. Well done. Congratulations. That brings me to the question of dividends. Some people have an objection to that, others think that's great. There's gonna be a big question from the Red-Green Alliance company that we just heard from. In A.P. Møller, you pay DKK 4,300 per share. I hope that the DKK 12.40 will survive without giving any major problems. It's a good thing how you have divided things in terms of your shares, but I don't know quite, I don't know if it's Mr.
Lund or you, Lars, who will explain that to me. I still think that most shareholders are in Denmark, then the U.S. I think it's very good that the Americans can also read their language, billions and so on, which is the U.S. expression. Anyway, that's the way that it's expressed in American English. Seriously, very interestingly is the matter of the future. What patents are coming in Novo Nordisk this year? Who holds the patents? Is that Novo Holdings or is it the Novo Nordisk Foundation? The same thing with trademarks owned by the Novo Group with others. What I can see from your companies around the world, I mean, you are self-owned, if you like, and that's very good. I saw in Dubai, I saw your trademark, and that was it. There was nothing displayed.
It was a disaster for the Ministry of Foreign Affairs. It was courageous for you to come there with A.P. Møller. It was terrible. It was miserable at the Danish stand in Dubai, unfortunately. The Norwegians, they were able to do something. You could really learn a lot from them, and they offered cooperation. I don't know if Novo had understood that. I hope you can do better in the future, and that you can show yourselves and your products. You're working with medication that really heals, and then you're working with weight loss. Well seen, that's the right way to go. I have no doubt that what you are doing with a growth rate of 82%, it would've been over 100 if you hadn't had supply problems. Ukraine, we hear a lot about that, or something about that in the report.
To us, that comes before the climate question. The climate question, we leave that to the scientists. That's what I think you should, and not just a lot of talk. The South Pole has a hole in the ozone layer. They've had it for years, but there are no factories there. Why don't you ask the old polar researchers from Norway? Go to Oslo and go to the museum. There are many good Norwegian books there about polar expeditions. They, the Norwegians came there before the Brits. Anyway, finally, I have a question. My question is, you pay taxes in this kingdom. I don't know what are the taxes in Norway, the dividend tax in Sweden is much lower than here. I can see that shareholders, they pay enough, and Novo is certainly also paying quite a lot.
We must bear one thing in mind, where does the money come from? It comes from trade, it comes from production, it comes from shipping, it comes from all the Danes that are working abroad and producing products for importation and exportation. Thank you for your attention.
Thank you very much to the two speakers.
First to Lars Fruergaard or to Helge Lund.
Thank you for the question. Lars will address the pricing issue. I turn to Norsk.
I will speak in Norwegian. Good questions. First of all, I'd like to say that we as a company are currently developing into a global company, and we compete globally. It's important for us that we can steer our company in that direction, but we should never forget where we come from and where we belong, and that is a strong point for Novo Nordisk. We are a Danish business. We have built a value system and a purpose that is very clear. Thanks to the efforts of previous employees, we are in this position we are today, and we now need to manage what they passed on to us. We need to find the right balance all along.
We want to compete effectively internationally. At the same time, we also need to be perceived of as a good social citizen, also in Denmark as a large company. With regard to climate, we have a climate strategy. We have based it on the best possible available science. We try to become net zero in 2025. Sorry, 2045. We look at how we can reduce CO2 levels. It would be good for the world, also good for our competitiveness because we believe that our customers, the patients, don't only consider the medical effects of what we give them but also consider us as a company. There are things that preoccupy us on the board. Taxes is one. We wish to follow all rules, both national and local and global, where we pay our taxes.
We pay the taxes where the values are created. Carsten is seated in the first row. His team builds upon a strategy that has been developed together with the board. We are very open with regard to the tax payments that we make and the way our system has been designed. It's possible to see that we follow rules and procedures in the countries where we operate. Thank you very much. I will continue in Danish to Peder Hvelplund concerning pricing and patents. If we take insulin, we have four generations in the market, and we are not trying to switch patients to products that are patented. We have several products that are not patented. Not all our products are patented. The insulin from Canada was extracted from animals, from a gland in animals, from the pancreas.
It has only been possible to do what we've done over this 100-year period that we've existed because we got money from sales to further develop our products. Things are very complex when you talk pricing. In the U.S., the far majority of citizens have health insurance and there are some that have a very low own payment. Unfortunately, there are some that have a deductible that makes it difficult for them. We have a number of programs in operation. In 2022, 4,000 Americans got free insulin from Novo Nordisk. If you take the national poverty line, and if you are below that by so and so many %, you can get free insulin. There's also a program called My $99 Program.
You can buy insulin up to $99, and you get three vials with insulin. This means that 1 vial costs only $33, which is a very attractive price. In the U.S., about 1.2 million Americans get assistance from us to get their medication. If you look at the accounts on an average over the past couple of years, the price we get in the U.S. for insulin has declined by 20% per year. As you said yourself, we have also reduced list prices by 75%. If you look at the accounts, we also give discounts to the procurement system in the U.S. to an average of 75%. We do what we can to help patients that are affected.
I've no problem in sitting down with you to go over the systems with you if you so prefer. Mr. Hansen. There were a number of questions. I tried to make a note of all of them. The share portfolios appear in the annual report for members of board and management. If we look at the institutional investors, about 45% of the shares are held by U.S. investors. It's true what you say that it is Novo Nordisk, the operational business that has the patents. We have no involvement here from the Foundation or from anyone else in the family.
Thank you. We do not forget the virtual participants. Louise, anything coming in? No. Anybody else here in the audience who want to speak? Any other comments? That is not the case. As I said, before, I will now sum up the decisions with regard to items 1 to 5. It's not my intention to carry out actual votes because the voting result is known due to the proxies that has come in. The first one was number 1, the board of directors' oral report. That is not a voting item. That is something that's being debated, and when nobody else wants to say anything, that is over. Item 2 was the adoption of the annual report, which I consider to be the case.
Third one was resolution to distribute profit, where it was described that the total dividend for the year is DKK 12.40, out of which a part has already been paid. I suppose there are no objections to that, so I consider that to be approved. The next was the presentation and advisory vote on the Remuneration Report. It's a legal requirement that there is an advisory vote, not a binding vote. We don't need to do an actual vote now because we know the results. I would consider that to be granted. Next was 5, the approval of the remuneration of the Board of Directors. 5.1 was final decision on what was pre-approved last year without any changes. I consider that to be granted. 5.2 was the remuneration level for 2023.
What we heard there was an indexing 3.7% to 3.8%, and the multiple for the chairman was increased from 3 to 4. Consider that to be approved. 5.3, that is actually reflecting this in the remuneration policy, so that's the only change to that. I would consider that to be approved too. Thank you for that brings us to agenda item 6 and 7. We will also here do that together, giving a chance to those who participate virtually to ask questions, write the questions while we go through these two items. The first one is election of members to the board of directors. Shareholders will be able to ask questions following the presentation of both of them.
According to Article 10, Section 2, all board members elected by the general meeting are up for election every year. Besides that, the general meeting shall elect the chair and the vice chair directly. I'll give the floor to Helge Lund to present the board's proposal and to describe the annual self-evaluation process. Please, Helge.
Thank you, Claus. Let me start with a few words on the collaboration among the board members and the composition of the board. The collaboration in the board and between the board, Lars, and the executive team continues to be, I would say, excellent and open. The continued progress of the company in line with our strategic aspirations is the overall guide for the board's work and the basis for addressing topics of short as well as long-term nature. Each year, the board conducts a board evaluation. In 2022, the evaluation was facilitated internally. The overall outcome of the 2022 board evaluation was high board effectiveness, alignment on strategic priorities and focus areas, and high level of trust and commitment, and strong collaboration between the board of directors and the executive management team. Furthermore, all board committees demonstrated high effectiveness.
Key focus areas for the board of directors in 2023 are to center the strategy review process around specific identified key strategic topics, and to continue focusing on organizational transformation, talent pipeline, leadership development, and succession planning. When recommending candidates to be nominated, the board takes into consideration the balance between renewal and continuity, the desired competencies and experience, the performance of the individual board members, the ambition for diversity as well as independence. With the proposed candidates, we will fulfill our diversity ambition of being at least two shareholder elected members of Nordic nationality and two of non-Nordic nationality, and supplemented by being at least three shareholder elected board members of each gender. Diversity among board members across gender and other dimensions remains a key priority. Now back to you, Claus Søgaard.
Thank you. I will briefly go through the proposals from the board. When we have been through that with regard to the board of directors and the auditors, of course, there is a chance to ask questions from the audience and also for those participating virtually. The first item is 6.1, election of the chairman of the board. As I mentioned, it follows from the articles of association that the chairman must be elected directly by the shareholders' meeting. The board proposes re-election of Helge Lund as chair of the board for another year. As to now, there are no other proposed candidates for the position. With regard to 6.2, it's election of the vice chair. It is the same. It follows from the articles of association that the vice chair is being elected directly by the shareholders' meeting.
With regard to the proposals, here it is Henrik Poulsen who is suggested. For him and also for Helge Lund, their functions, their CV follows from the material which was sent out together with the notice for the meeting. 6. 3 of the agenda is the election of other members to the board. The general rule in Article 10, Section 2 is that there should be 4- 10 shareholder elected board members, including the chair and the vice chair. I have already described who is suggested for chairman and vice chairman. The board proposes to elect Laurence Debroux, Andreas Fibig, Sylvie Grégoire, Kasim Kutay, Christina Law, and Martin Mackay, and they are all present here. Also here, information is included in the material which was sent out together with the call for the meeting. Also here, there are no other proposed candidates.
Mr. Jeppe Christiansen, who was speaking just before, is not seeking re-election, and the proposal is therefore to elect six ordinary members, plus the chair and the vice chair. In addition to the board members elected by the shareholders, there are four employee representatives on the board in accordance with Danish law. The current employee representatives are Elisabeth Dahl Christensen, Liselotte Hyveled, Mette Bøjer Jensen, and Thomas Rantzau. The employee elected members are of course not up for election here. They were elected last year, and they are elected for a four-year period in accordance with Danish law. The last item I will present right now, that is item seven, appointment of auditor. The board proposes to reappoint Deloitte as the company's auditor. Deloitte was first time elected in 2021, and it's based upon a recommendation from the audit committee.
Now it is possible to ask questions or come with comments to all these proposals. Any comments? Is that a speaker or are you intending to leave the room? I see nobody who wants to speak in here. Do we have any virtual participation? Perhaps participation, but not questions. That brings me to confirm the election and re-election as I indicated before. Congratulations with another year to the board and also to the auditors. That brings us to item 8, where we have four proposals, three from the board of directors and one from a shareholder from Kritiske Aktionærer. I will just describe the four proposals, and then I'll give a chance to comment on them and reason why they are brought forward.
The first one, 8.1, reduction of the company's B-share capital by nominally DKK 5 million by cancellation of B shares. I tend to say that this is business as usual. The last many years, this has been a proposal where those shares which has been reacquired during the year are being canceled, resulting in a reduction of the share capital, the B-share capital. That's one proposal. Item two is authorization to the board of directors to allow the company to repurchase own shares. Here I can repeat, business as usual, not just in this company, but basically in all listed companies in Denmark. The board ask for an authorization to be able to repurchase 10% of the share capital with a cap, cannot hold more than 10%, and with a 10% limit on the deviation from the listed price.
That is the authorization being used to acquire shares, which then are being canceled at the next ordinary general meeting. The third one, 8.3, is authorization to the board of directors to increase the company's share capital. You might expect I would repeat, business as usual. That is a standard authorization that has been in the articles of association, but where the board always just ask for a 1-year renewal. The present one expires in 2024, and the board ask for an extension with 1 year until 2025. At the same time, the board suggest to reduce it, so it will reflect 10% of the year capital of the company following the cancellation of the B-shares I referred to before. That was three standard items. The next item is item 8.4. It's a proposal from Kritiske Aktionærer on product pricing.
I give the floor to Frank Aaen , who would like to reason the proposal. After that, I'll hand over to the chairman to comment on the proposal. Let's go, Frank Aaen .
You see the proposal in the convening notice. It's item 8.4, as mentioned. I thought it had been read out, so that's why I'm just finding it out here. Novo Nordisk must reduce the prices of item medicines, so the profit, the operating profit, is aimed at being reduced by DKK 25 billion. Compared to the profit in 2022 of DKK 74.8 billion, the profit will still be able to reach just under DKK 50 billion, corresponding to the annual profits in each of the years 2015, 2016, and 2017. Peter Værløwn, he gave the reason for it a little while ago. He said why we think this is a good idea. Not only will reduction of prices be good for people who need to buy this medication, but it would also... You shouldn't, as a shareholder, disregard that.
It will really bring Novo into an offensive front compared with the global pharmaceutical industry, because we know they make huge amounts of money in the pharmaceutical industry. It would be wonderful if a big company like Novo would take the lead and say, "We reduce our prices, even if it means we get a smaller profit. We'll do it in favor of those who need our medication." It's obviously a good proposal. I do not think that the board's reasoning that I can read in the convening notice, I can see why they're against it, but it doesn't seem very convincing to me. Prices are agreed with the health authorities and purchase organizations. I see. That's interesting. That's no argument against our proposal.
You know, I mean, they would just be happy to get lower prices, so that's not gonna be a problem, is it? Secondly, prices reflect the innovation and the risks that Novo Nordisk has undertaken developing these drugs. That is correct, that's the way it should be, the way the world works. I recognize that. Other than that, there is a huge dividend to shareholders. Our proposal can be financed by cutting dividends by half. If we cut dividends by half, this is what our proposal means, there would still be the same money available in the group to cover the risks and the costs of developing new medication. Where's the problem? Oh, that's you. You're the problem. I see. Okay. Yeah. I want to say, shareholders in Novo Nordisk, the last five years have received something like DKK 200 billion in dividend.
It's a lot of money, isn't it? I think shareholders could make do with less. I recognize the third point, that Novo delivers on the strategy for social responsibility. That's all very fine. Whatever you do, as we have heard up here from [uncertain], is very, very good. Continue that. Do even more of it. That is not the problem. I really recognize that. Our proposal would be a huge contribution towards being socially responsible. I think there's no denying that. Let me say finally, now that I have all you shareholders in front of me, shareholders have done nothing to develop or produce the products that people need. Zip. Nothing have you done. Let me be a bit sort of direct here. This company doesn't need shareholders.
I mean, the foundation has so much money that if you need more capital for production, for Novo Nordisk, the foundation has more than enough money. You don't have to go to the stock market. I know that if you reduce dividends, the share price will go down, people will perhaps be selling their shares. I'm saying, "So what? What's the problem with that?" The company won't suffer from that. Let me just finish by saying that I hope that some people have supported our proposal. I know how it's going, I still hope this can raise discussions about whether this company should take the lead even more than before when it comes to reducing prices of vital medication. Thank you.
Helge Lund. After Helge Lund, it will be possible to ask other questions.
Thank you, Claus. I would like to thank Kritiske Aktionærer and Frank Aaen for the proposal. The board of directors does not support the proposal, and allow me to also tie a few comments to that. In Novo Nordisk, we have decided on and implemented a social responsibility strategy called Defeat Diabetes, in which securing the access to and affordability of our vital medicines, as well as prevention of diseases are key objectives. In 2022, the number of people with diabetes treated with Novo Nordisk products was 36.3 million. Of these, close to 5.5 million were reached via our access and affordability initiatives. I think it was mentioned earlier by Lars. We continue to set ambitious targets for our initiatives moving forward.
The Changing Diabetes in Children program aims to reach 100,000 children by 2030. By the end of 2022, the program provided free care to more than 41,000 children and adolescents living with Type 1 diabetes in 18 low and middle-income countries. Moreover, the prices charged for our products reflect the innovation and risk undertaken by Novo Nordisk over many years in developing the pharmaceutical products, and the prices are set and agreed with healthcare authorities and buyers around the world. With that, back to you, Claus.
It is now possible to ask questions with regard to these four proposals. Anybody here who wants to say anything with regard to item 8.1, 8.2, 8.3, or 8.4? Anything from the virtual participants? That's not the case. I will conclude on the four proposals. The reduction of the share capital with 5 million B shares has been approved. 8. 2, the authorization to repurchase shares, own shares, has been approved. 8. 3, the authorization to increase share capital has been approved. With regard to 8. 4, the proposal from Kritiske Aktionærer has not been approved. I have agreed with you that we don't need to take a formal vote, but all the votes that has come in will be disclosed in the minutes that will be available within the next two weeks.
I can say that more than 99% was against the proposal, just for your information. There were also some votes in favor. That brings us to the last item on the agenda. That is item 9, any other business. This is where nothing can be decided, but also almost everything that's relevant for the company can be discussed. Does anybody want the to come up? I will ask a little later. First of all, the Chairman, Helge Lund, had asked for the floor.
Thank you, Claus. Before rounding off, I would like to extend a thank you. Firstly, I would like to thank Jeppe Christiansen. Jeppe steps down from the board of directors as he has decided to not stand for reelection this year. Jeppe has served on the board of Novo Nordisk since 2013, so 10 years. During Jeppe's decade on the board, he has served in multiple board committees as a member and Chair alike. Most recently as a Chair of the Remuneration Committee. Also, Jeppe held the seat of Vice Chair of the Board from his first election to the board in 2013 and until last year.
Speaking on behalf of all my colleagues in the board and myself, I thank Jeppe for his tenure, initiatives, perspectives, sparring, support, and each big and small thing, and there are many, which he has done for Novo Nordisk, our patients, shareholders, employees, and stakeholders at large. Jeppe has been a tremendous asset to the board and will also be missed for his energy and wide range of competencies. For me personally, Jeppe has been a valued sparring partners of over nine years. Your dedication to Novo Nordisk and to our mission has been unwavering and immensely valuable. Thank you, Jeppe.
Before I hand over to the chairman to close the meeting, it's still possible to get the floor and to be able to ask questions or comments. Bjørn Hansen, you're welcome. Anybody else who wants to speak afterwards? I don't see it.
Yes, I have a proposal concerning your travel expenses. I don't know if it's plus or minus DKK 36 million, but what about buying a small plane in the US? One that can go from coast to coast. I think that's important. It gives a bit of prestige also. When I lived there, everybody who had 40 men working for them had a small plane of their own. Anyway, you can start up with a couple of those that can fly from coast to coast and maybe also in Europe or Asia. That was it for me. Thank you.
We have one more speaker.
Thank you. What I want to ask is, would it be possible to have the general meeting at a place where it doesn't cost DKK 240 to park in order to participate in the meeting? I think that's a money machine. It's not all right. Thank you.
That was a very specific question. I don't know whether it's gonna be Lars or the chairman who will respond to that and to the other comments.
Two questions concerning traffic, you could say.
About the possibility of acquiring private planes, it's never gonna happen. Not as long as I'm here, no. On the contrary, we have decided to reduce our use of planes for business by 50%. We'll be traveling less by plane in order to emit less CO2. About parking, we picked this location because of its capacity to be able to fit everyone. I don't know if you can negotiate the price of parking. Let's look at that for next year. Thank you.
Any other questions or comments? It's the last chance now. Any input from the virtual participants? No? Nobody here. Anybody? Yes, please come up here. I'm sorry, we can't hear you from here. Kindly come up here, also for those who participate virtually.
I'm Danish. I will present this in English. What kind of investors do we have in Novo Nordisk? I'm an investor. I'm a private investor. Is it not time for a stock split? A stock split could be the reason to attract us to other investors. I don't know the composition of investors. I just think it's a very interesting question to be highlighted here at such an occasion.
Precise question, Lars Fruergaard Jørgensen.
I cannot give you all the details on the split investors. Maybe we can get back somehow on that. I cannot give you any details about stock split either because that will be announced when it happens. You can of course look in the past that when the stock has, you know, passed DKK 1,000, we have sometimes elected to split the share and make it more affordable for all. So there are no decisions made on that. Thank you.
Now it is last chance. Anybody else? Nobody here in the audience. Nobody virtual. That was the last chance, and it has really been a pleasure to stand here in front of this crowd, and I'll hand over to the chairman now to finalize the general meeting.
Thank you, Claus. This has been Claus Søgaard's last meeting as a chair of our annual general meeting. Not because we would not like to continue, but because Claus is scaling back a bit. Claus has actually chaired our general meetings since 2007, and has been a safe hand, a valued partner and advisor for the company and our shareholders throughout that period. I want to thank Claus for once again having guided us to so professionally through this meeting too. It has always been such a pleasure working with you, Claus. Thank you. I would like to thank all the shareholders for attending this year's annual general meeting.
In Novo Nordisk, we always value interactions with shareholders, either in person or virtually, and we are looking forward to meeting you all again in the spring of 2024, with or without parking fees. Until then, please stay safe. For shareholders participating in person here in Bella Center, please leave the room using the doors at the back of the hall where you entered. We will be serving a cup of coffee on first floor if you wish so. There you will also be able to meet Novo Nordisk's management. For those of you who have borrowed a headset or voting device, please hand it back on your way out. Lastly, I will mention that the informal shareholders meeting will follow this meeting. It will begin at 5:00 P.M. here in this room.
With that, I hereby declare the general meeting closed. Thank you for coming.