Zealand Pharma A/s · OMXCOP:ZEAL
Zealand Pharma A/s — Investor Presentation (March 2026)
72 slides from Zealand Pharma A/s's investor presentation, March 2026
Slide 1: Zealand Pharma Corporate Presentation
Zealand Pharma Transforming the future of metabolic health Corporate Presentation March 2026
Slide 2: Forward-looking statements
Forward-looking statements This presentation contains “forward-looking statements”, as that term is defined in the Private Securities Litigation Reform Act of 1995 in the United States, as amended, even though no longer listed in the United States this is used as a definition to provide Zealand Phar
Slide 3: Table of contents
Table of contents About Zealand Pharma About Zealand Pharma 4 4 Obesity Obesity 9 9 Petrelintide (amylin analog) Petrelintide (amylin analog) 24 Survodutide (glucagon/GLP-1 receptor dual agonist) 24 Survodutide (glucagon/GLP-1 receptor dual agonist) 37 37 Rare diseases Rare diseases 49 Dasiglucagon
Slide 4: Zealand Pharma is transforming the future of metabolic health
About ZP Zealand Pharma is transforming the future of metabolic health Redefining the near-term future Building the world’s most valuable of weight management metabolic health pipeline +10 clinical Differentiated programs by 2030 Leading programs obesity pipeline Our unfair and Solid cash backed by
Slide 5: Defined by firsts in complex peptide engineering
About ZP Defined by firsts in complex peptide engineering 25+ years of expertise in peptide R&D Strong track record in stabilizing and developing the most challenging peptides Petrelintide Lixisenatide Survodutide First long-acting human ZP9830 First SIP-tail modified First glucagon/GLP-1 amylin-der
Slide 6: Clinical pipeline: Five launches in the next five years
About ZP Clinical pipeline: Five launches in the next five years Obesity and related comorbidities Rare disease Product candidatea Product candidatea Petrelintide Dasiglucagon Obesity Phase 2 Congenital hyperinsulinism Registration (amylin analog)b SC continuous infusion Petrelintide/CT-388 Phase 2-
Slide 7: Building the world's most valuable metabolic health pipeline
About ZP Building the world’s most valuable metabolic health pipeline METABOLIC FRONTIER 2030 ACCELERATE 5 launches in 5 years Progress pre-clinical programs at speed PARTNER +10 clinical programs Evolve and fuel our platform Industry-leading cycle EXPAND times from idea to clinic Establish Boston s
Slide 8: 2026: Most defining and catalyst-rich year yet
About ZP 2026: Most defining and catalyst-rich year yet NON-EXHAUSTIVE Petrelintidea Survodutideb Building the pipeline (amylin analog) (GCGR/GLP-1R) of the future ✓ Results from Ph2 ZUPREME-1 Results from Ph3 obesity ZP9830 (Kv1.3) program Results from Ph1a SAD and MAD, and clinical advancement Res
Slide 9: Obesity
Obesity Corporate Presentation 9
Slide 10: Obesity: greatest healthcare challenge of our time
Obesity: greatest healthcare challenge of our time The obesity epidemic has surged over the past decades, with 50% of adults globally expected to live with overweight or obesity by 20301 >200 complications and comorbidities associated with obesity2 Today, ~35% of U.S. children and adolescents aged 2
Slide 11: Obesity: unique disease area
Obesity Unique disease area 1 The consumer as key decision drivera 2 Unprecedented size and scale Obesity 3 Two key healthcare providers: Primary care and specialty care 4 Heterogeneity and fragmentation 5 Linked to many comorbidities aMedicinal products remain prescription only. Ultimate decision m
Slide 12: Public health challenge: improve treatment penetration and maintenance
Obesity Public health challenge: We must improve treatment penetration and maintenance BMI distribution and GLP-1 usage todaya,1-3 Overweight Obesity High Share of population (%) Treated with GLP-1: ~3-5% of eligible people in the U.S.2 Have been exposed to GLP-1: ~12% of Americans4 Low 15 20 25 30
Slide 13: Beyond weight loss Olympics: key unmet needs
Obesity Beyond Weight loss Olympics: key unmet needs First wave of incretins New mechanisms and next-gen incretins Better understanding of gut–brain axis biology Unlocked the development of incretins Acceptability Focus on key unmet medical needs and weight loss experience Scientific progress in wei
Slide 14: Obesity demands new classes of drugs
Obesity Obesity demands new classes of drugs Hypertension Dyslipidemia Type 2 diabetes Obesity • Diuretics • Statins • Metformin • GLP-1RA-based therapies • Beta-blockers • Cholesterol absorption • Sulfonylureas (GLP-1 and GLP-1/GIP) • ACE inhibitors inhibitors • Meglitinides • ARBs • PCSK9 inhibito
Slide 15: Two distinct segments, two focus areas
Obesity Two distinct segments, two focus areas Prescriber-driven Consumer-driven Specialist-driven prescriptions focusing on benefits of Consumer-driven primary care prescriptions focusing on treating comorbidities and health impact of weight loss desired weight loss and user experience Objectives:
Slide 16: Obesity impacts several organ systems
Obesity Obesity impacts several organ systems NON-EXHAUSTIVE Musculoskeletal and mechanical Cardiovascular Liver and gut Overweight and obesity CNS and mental health Endocrine Renal Source: American Medical Association 2024: https://www.ama-assn.org/topics/obesity. CNS=central nervous system. 16
Slide 17: Primary care leads; specialty still emerging
Obesity Primary care leads; specialty still emerging ~90% of GLP-1 prescriptions for weight management are driven by primary care providers1,a Identified as primary care providers 7% 5% Nurse practitioner/ Physician assistant 11% Primary care physician 40% Osteopathic physician Endocrinologist Other
Slide 18: Healthier version of themselves, not healthiest
Obesity Healthier version of themselves, not healthiest Decisions driven by more than clinical needs Physical 61% of users in the U.S. self-refer1 Unprecedented willingness to pay out of pocket Social Emotional Highly individualized and cyclical journeys Source: 1Ipsos Obesity and Cardiometabolic Th
Slide 19: Desired weight loss contradicts Weight loss Olympics
Obesity Desired weight loss contradicts Weight loss Olympics 20% want to lose 1–9% Weight loss goals of current GLP-1 2% are unsure users 3% want to lose >30% 14% want to lose 21–30% 63% want to lose 10–20% Source: LifeSci Capital Survey May 2024 (N=819). GLP-1=glucagon-like peptide-1. 19
Slide 20: GLP-1 efficacy: real world vs. clinical trials
Obesity GLP-1 efficacy: real world vs. clinical trials Real-world use of Wegovy by dose1 Real-world use of Zepbound by dose1 100 100 90 90 80 80 Real-world weight reduction: Real-world weight reduction: 70 70 7.7% at 1 year4 12.4% at 1 year4 Users (%) Users (%) 60 60 50 50 40 40 30 30 20 20 33% 10 1
Slide 21: Poor treatment persistence and frequent restarts in the real world
Obesity Poor treatment persistence and frequent restarts in the real world 100 Treatment persistencea Share of GLP-1 users (%) Restarts 80 69% 60 50% 40 34% 22% 20 18% 8% 22% 0 Day Month Month Month Month Month Month Month Month Month Month Month Month 0 1 2 3 4 5 6 7 8 9 10 11 12 Enhancing weight l
Slide 22: Gastrointestinal adverse effects primary reason for discontinuation
Obesity Gastrointestinal adverse effects primary reason for discontinuation Reasons given by GLP-1 users for negative Top five adverse effects experience with current treatments for obesity1 prompting discontinuation2 49%: Adverse effects • Nausea • Vomiting • Diarrhea 32%: Cost concerns • Fatigue •
Slide 23: Zealand Pharma poised to lead in highest unmet needs
Obesity Zealand Pharma poised to lead in highest unmet needs Enhanced weight loss experience to improve treatment Petrelintidea persistence New foundational MoA, redefining the standard of care in weight Petrelintidea management Survodutideb, petrelintidea, Targeted effects on obesity-related comorb
Slide 24: Petrelintide is a 36-amino-acid acylated peptide
Obesity Petrelintide Petrelintide is a 36-amino-acid acylated peptide, based on the peptide sequence of human amylin1 Potent balanced agonistic effects on AMY-1R, AMY-3R, and CTR (motivated by extensive screening)1,3 Chemical and physical stability around neutral pH (allowing for co-formulation and
Slide 25: Amylin and GLP-1 exert distinct physiological effects
Obesity Petrelintide Amylin and GLP-1 exert distinct physiological and potentially distinct pharmacological effects Amylin GLP-1 Increases satiety1,2 Reduces appetite7 Effect on food intake Smaller meals, prolonged fullness6 Fewer meals, less food-seeking7 Leptin sensitivity Restores leptin responsi
Slide 26: Consistent results from the Phase 1 program with petrelintide
Obesity Petrelintide We remain encouraged by the consistency of the results from the Phase 1 program with petrelintide MAD trial Part 1 MAD trial Part 2 SAD trial1 (6-week study)2 (16-week study)3 % change in body weight % change in body weight % change in body weight from baseline at Day 7 from bas
Slide 27: Positive topline results from Phase 2 ZUPREME-1 trial
Obesity Petrelintide In Q1 2026, we reported positive topline results from the Phase 2 ZUPREME-1 trial A randomized, double-blind, placebo-controlled, Phase 2 dose-finding trial with petrelintide Dose Safety escalation follow-up Primary endpoint: • Percentage change in body weight Petrelintide dose
Slide 28: Baseline characteristics were balanced across dose cohorts
Obesity Petrelintide Baseline characteristics were balanced across dose cohorts BMI Gender Weight Body Mass Index Age 53% of participants Mean 107 kg Mean 37 kg/m2 Mean 47 years were female Source: Data on file. 28
Slide 29: Sustained double-digit weight loss
Obesity Petrelintide Sustained double-digit weight loss with multiple levers to optimize trial conditions for greater efficacy Change in body weight (%) from baseline • Body weight reduction continued through week 42, suggesting at week 42, efficacy estimand the potential for continued weight loss w
Slide 30: Best-in-class gastrointestinal tolerability profile
Obesity Petrelintide Petrelintide demonstrated a potential best-in-class gastrointestinal tolerability profile GI AEs largely comparable to placebo Pbo-adj. % of Pbo-adj. % of Pbo-adj. % of Pbo-adj. % of participants with participants with participants with participants with 20% nausea vomiting diar
Slide 31: Placebo-like discontinuation rates
Obesity Petrelintide Treatment persistence supported by placebo-like discontinuation rates Treatment discontinuation rate due to AEs Treatment discontinuation rate due to GI AEs 20% 20% 15% 15% 10% 10% 4.9% 4.5% 4.8% 5% 5% 1.5% 0.0% 0.0% 0% 0% Placebo Petrelintide Petrelintide Placebo Petrelintide P
Slide 32: Double-digit weight loss with tolerability comparable to placebo
Obesity Petrelintide Sustained, double-digit weight loss with a tolerability profile comparable to placebo Efficacy • Up to 10.7% mean weight loss at week 42 versus 1.7% for placebo; further weight loss expected over time • Nearly 100% of participants on petrelintide achieved weight reduction • Effi
Slide 33: Petrelintide progressing towards Phase 3 initiation in H2 2026
Obesity Petrelintide The petrelintide monotherapy program is progressing towards Phase 3 initiation in H2 2026 Robust Phase 2 program ZUPREME-1 (obesity w/o T2D)1 42-week topline data reported in Q1 2026 ZUPREME-2 (obesity w. T2D)2 28-week topline data expected in H2 2026 Comprehensive Phase 3 progr
Slide 34: Phase 2 trial with petrelintide/CT-388 planned for H1 2026
Obesity Petrelintide Phase 2 trial with petrelintide/CT-388 planned for initiation in H1 2026 Zealand Pharma and Roche aim to maximize the dose of petrelintidea and optimize the dose of CT-388 Petrelintide as the foundationa Strategic objectives of the Phase 2 trial Identify the doses that maximize
Slide 35: Petrelintide potential to establish a new treatment paradigm
Obesity Petrelintide Petrelintide has the potential to establish a new treatment paradigm for chronic weight management ILLUSTRATIVE Clinically meaningful weight reduction Placebo-like tolerability Sustained, double-digit weight loss with Excellent tolerability profile, comparable multiple levers to
Slide 36: Collaboration and license agreement with Roche
Obesity Petrelintide A transformative collaboration and license agreement to unlock the full potential of petrelintide True partnership agreement ✓ Shared vision for petrelintide as a future foundational therapy for weight management ✓ Co-development and co-commercialization (up to 50% in U.S. and E
Slide 37: Oxyntomodulin is the scientific foundation for survodutide
Obesity Survodutide Oxyntomodulin is the scientific foundation for the investigation of survodutide • Hormone with dual agonism at GCG and GLP-1 receptors that reduces body weight by Oxyntomodulin increasing energy expenditure and regulating appetite1 • Clinical application is limited due to a short
Slide 38: Glucagon/GLP-1 dual agonism regulates energy expenditure and intake
Obesity Survodutide Glucagon/GLP-1 dual agonism offers coordinated regulation of energy expenditure and energy intake GCG/GCGR GLP-1/GLP-1R4 Energy expenditure (metabolic rate) Insulin secretion Food intake Liver Adipose tissue Liver Pancreas GI tract Brain (direct) (indirect) (indirect) Fatty acid
Slide 39: 16-week Phase 2 trial in T2D
Obesity Survodutide In a 16-week Phase 2 trial in T2D, survodutide effectively reduced HbA1c and body weight Change in HbA1c Change in body weight 0 0.0 0 -0.25% -1.20% -0.5 -0.5 -2 Mean (SE) absolute Mean (SE) relative change (%) change (%) -1.0 -1.0 -4 -1.47% -5.40% -1.5 -1.5 -6 -2.0 -2.0 -1.88% -
Slide 40: 46-week Phase 2 obesity trial: up to 18.7% weight reduction
Obesity Survodutide In a 46-week Phase 2 trial in obesity, survodutide dose-dependently reduced body weight by up to 18.7% Randomized, double-blind, placebo-controlled Phase 2 trial of survodutide in people with overweight or obesity Mean relative change at Week 46 (%) 0 -2 Placebo -2.0% (n=76) -4 c
Slide 41: Survodutide reduced blood pressure
Obesity Survodutide Survodutide substantially reduced blood pressure, with heart rate effects consistent with GLP-1RAs Absolute change in blood pressure at Week 461 Absolute change in heart rate (bpm)2 Systolic blood pressure 20 Mean change in heart rate from baseline 15 Adjusted mean (95% CI) absol
Slide 42: No unexpected safety findings in Phase 2 obesity trial
Obesity Survodutide Treatment with survodutide in the Phase 2 obesity trial showed no unexpected safety findings Survodutide Survodutide Placebo TEAE, n (%)a 3.6 mg (n=77) 4.8 mg (n=77) (n=77) GI TEAE Nauseab 48 (62.3) 49 (63.6) 15 (19.5) As expected, GI AEs were the most frequent TEAEs Vomitingb 26
Slide 43: Topline results expected from Phase 3 SYNCHRONIZE-1
Obesity Survodutide We expect topline results from the Phase 3 SYNCHRONIZETM-1 trial with survodutide in H1 2026 Randomized, double-blind, placebo-controlled Phase 3 trial in people with overweight or obesity without T2D1 Dose escalation Safety Primary endpoint: (every 4 weeks) follow-up • Percentag
Slide 44: SYNCHRONIZE Phase 3 program may pave way for submissions in 2026
Obesity Survodutide Results from the Phase 3 SYNCHRONIZETM program may pave the way for regulatory submissions in 2026 Large, global Phase 3 program in obesity • SYNCHRONIZETM-11: Overweight/obesity w/o T2D (N=~720) • SYNCHRONIZETM-22: Overweight/obesity with T2D (N=~750) • SYNCHRONIZETM-CVOT3: Long
Slide 45: Urgent need for better treatment options in MASH
Obesity Survodutide Urgent need for better treatment options in MASH Survodutidea holds potential to revolutionize treatment of MASH and establish a strong foothold in the prescriber-driven segment People who are overweight or have “See Obesity, Think Liver” obesity ~15–30%2,3 T2D MASLD ~75%1 ~10–15
Slide 46: Best-in-disease potential in Phase 2 MASH trial
Obesity Survodutide Survodutide demonstrated best-in-disease potential in the 48-week Phase 2 trial in people with MASHa MASH resolution with no worsening in fibrosis Improvement in liver fibrosis with no worsening of MASH Paired biopsy results (F2/F3) Paired biopsy results (F2/F3) 100 p<0.001 100 p
Slide 47: Largest ever Phase 3 program in MASH initiated
Obesity Survodutide Largest ever Phase 3 program in MASH with an incretin-based therapy was initiated in October 2024 Inclusion criteria Study design Primary endpoint LIVERAGE1 Efficacy and safety in • Diagnosis of MASHa and • N=1,800 Part 1: 52 weeks participants with MASH biopsy-proven fibrosis •
Slide 48: Survodutide potential in overweight/obesity and MASH
Obesity Survodutide Survodutide holds potential as a leading therapy for people with overweight/obesity and MASH MoA – Dual agonism leveraging GCGR and GLP-1R to achieve Registrational effective body weight reduction and direct liver effects trials Obesity – potential for competitive weight loss and
Slide 49: Rare diseases
Rare diseases Corporate Presentation 49
Slide 50: CHI is a severe, ultra-rare genetic disorder
Rare diseases CHI CHI is a severe, ultra-rare genetic disorder with significant impact on patients’ QoL There is a significant unmet need for an effective treatment CHI is an ultra-rare disease in newborns and children • 1 in 28-50,000 newborns per year are diagnosed with genetically determined CHI
Slide 51: Dasiglucagon potential to address shortcomings of current CHI management
Rare diseases CHI Dasiglucagon has potential to address shortcomings of current management of CHI Current treatments for CHI are associated with Dasiglucagon for subcutaneous infusion* significant limitations and clinical barriers Cited by healthcare providers as greatest limitations5 Wearable s.c.
Slide 52: Three Phase 3 trials form basis of NDA submission
Rare diseases CHI Three Phase 3 trials form the basis of our NDA submission to the U.S. FDA Trial 17103: Dasiglucagon significantly reduced Trial 17109: Dasiglucagon reduced time in the requirement for IV glucose in a hospital hypoglycemia by ~50% and hypoglycemic setting events by 37-40% in a homec
Slide 53: Opportunity to treat up to 800 patients at ultra-rare price levels
Rare diseases CHI Opportunity to treat up to 800 patients at ultra- rare disease price levels in the U.S. Patients eligible for dasiglucagon Ultra-rare disease therapy analogues with clear treatment in the US clinical value command premium prices in US5 Annual treatment cost (k$) Diffuse CHI patient
Slide 54: Short Bowel Syndrome is a rare, chronic and debilitating condition
Rare diseases SBS Short Bowel Syndrome (SBS) is a rare, chronic and debilitating condition High unmet need • SBS is a rare, chronic and debilitating condition resulting in impaired intestinal absorptive capacity1, 2 • SBS is associated with significant medical complications including liver and renal
Slide 55: Glepaglutide best-in-class potential as next-generation GLP-2 therapy
Rare diseases SBS Glepaglutide has best-in-class potential as a next-generation GLP-2 therapy for SBS patients Gattex® (teduglutide): Glepaglutide: only currently available GLP-2 treatment a long-acting stable GLP-2 analoga Effective half-life of 1.3 hours at steady state Effective half-life of ~88
Slide 56: Glepaglutide reduced weekly PS volume in EASE-1
Rare diseases SBS Glepaglutide significantly reduced weekly PS volume at Week 24 in the EASE SBS-1 trial1 Phase 3 trial of glepaglutide in people with SBS (EASE-1) Clinical response was significantly higher with twice Glepa 10 mg TW (N=35) weekly glepaglutide compared to placebo (p=0.0243) Glepa 10
Slide 57: Global teduglutide sales approaching USD 1 billion
Rare diseases SBS Global teduglutide sales approaching USD 1 billion with significant room for market expansion Global teduglutide Sales1,2 (USD Million) Estimated US SBS-IF Patients3 Japan & RoW sales 981 EU/Can sales CAGR +24% ~7,500 +14% 130 US sales 788 133 SBS-IF Pediatric patients ~2,500 699 8
Slide 58: Chronic Inflammation
Chronic Inflammation Corporate Presentation 58
Slide 59: ZP9830 is a Kv1.3 inhibitor for cell-mediated immune disorders
Inflammation ZP9830 ZP9830 is a Kv1.3 inhibitor designed to treat cell- mediated immune disorders ZP9830 inhibits Kv1.3, the main K+ channel of leukocytes from the innate and adaptive immune system1 ZP9830 inhibits Kv1.3, the main K channel of leukocytes from the innate and + adaptive immune system1
Slide 60: Expected topline results from MAD part of Phase 1a in H2 2026
Inflammation ZP9830 In H2 2026, we expect to topline results from MAD part of Phase 1a trial and Phase 1b/2a initiation Development program Positive results from Phase 1a SAD trial progressing at full speed ✓ Well tolerated, with no serious or severe AEs or ➢ Topline data from MAD part of Phase 1a t
Slide 61: Research strategy
Research strategy Company Presentation 61
Slide 62: Zealand Pharma is built to lead in metabolic health
Research Zealand Pharma is built to lead in metabolic Idea health Insights modulating multi- hormonal circuits Utpal Singh David Kendall Discovery Chief Scientific Officer Chief Medical Officer >25 years of data to build ML models Medical Steven Johnson Steven Smith Led by experts and pioneers in Ch
Slide 63: Delivering outcomes that will increase human health span
Research Delivering outcomes that will increase human health span Weight loss with higher acceptability to shatter Convenience and Improved bone and adherence ceiling durability muscle health Quality & Durability Era Leptin sensitivity to Improved beta-cell restore brain’s function for T2D and regul
Slide 64: Expanding platform reach through partnerships
Research Expanding platform reach through partnerships to reimagine medicine creation Expand toolbox Build multi-asset amylin franchise and expand toolbox to enable tissue- selective targeting Strengthen platform Access technologies (AI/ML) to develop predictive models leveraging our legacy data and
Slide 65: Building a multi-asset amylin franchise
Research Building a multi-asset amylin franchise to expand treatment options Oral small-molecule amylin True once-monthly injectable amylin ✓ Broader accessibility ✓ Specifically designed for less frequent dosing ✓ Maintain favorable tolerability profile ✓ Greater flexibility in treatment options Fo
Slide 66: Investing in advanced computational methods for medicine creation
Research Investing in Structural dynamics and legacy data will enable precise molecule advanced design and pivot from empirical sequence screening computational Static model Dynamic model methods for Static views constrain design: Molecular dynamics can reveal novel design: medicine creation 3D stru
Slide 67: Integrating two biotech powerhouses in metabolic health
Research Integrating two biotech powerhouses in metabolic health Expand the reach of our platform Copenhagen: Boston: Accelerate Build on our heritage medicine creation • Peptide engineering • AI-ML driven peptide discovery with legacy data • Structural biology • Automation to accelerate • Deep prec
Slide 68: Additional company information
Additional company information Corporate Presentation 68
Slide 69: In 2025, net positive result of DKK 6.5 billion
In 2025, we delivered a net positive result of DKK 6.5 billion DKK million FY 2025 FY 2024 P&L reflecting strategic investments in differentiated R&D assets and organization Revenue 9,215 63 Gross profit 9,214 55 FY 2025 OPEX compositiona DKK million Research and development expenses -1,605 -920 Sal
Slide 70: Strong financial terms and commitments from partners
Strong financial terms and commitments from partners Petrelintide and petrelintide/CT-388 Survodutide 50% profit share in U.S. and Europe Solely responsible for development Tiered double-digit % royalties on net sales in RoW and commercialization globally ranging up to high-teens Up to USD 1.2bna in
Slide 71: Strong financial muscle to bridge the path to profitability
Strong financial muscle to bridge the path to profitability ILLUSTRATIVE Robust capital position more than sufficient to deliver on key strategic priorities Short- to mid-term topline drivers 13x 15,109 2026 • USD 125 million - anniversary payment (Roche) Cash position (DKK million)a increase vs. 20
Slide 72: Zealand Management Team
Zealand Management Team Adam Henriette Utpal Steven David Eric Ivan M. Christina S. Steensberg Wennicke Singh Johnson Kendall Cox Møller Bredal Chief Chief Chief Chief Chief Chief Chief Chief Executive Financial Scientific Development Medical Commercial Operating People Officer Officer Officer Offic