Q1 Financial Results / Interim Report First Quarter 2026

Zealand Pharma May 7, 2026

Agenda

Q&A

Opening remarks R&D pipeline Financials

Adam Steensberg Chief Executive Officer

David Kendall Chief Medical Officer

Henriette Wennicke Chief Financial Officer

3

Opening remarks

Significant advancements delivered since start of 2026

Petrelintide

• Positive ZUPREME-1 topline results, demonstrating double-digit weight loss and placebo-like tolerability profile

• Confirmed advancement into Phase 3

registrational trials in H2 2026

Early pipeline

• Positive Phase 1a SAD topline results with Kv1.3 inhibitor (ZP9830)

• Announced establishment of new research hub in Cambridge and entered agreement with DCAI to access a leading AI supercomputer

Survodutide

• Positive SYNCHRONIZETM-1 results delivering competitive weight loss and potential for sustained improvements in metabolic health

Capital allocation

• Initiated USD 200 million share buy-back

program

Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally

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Petrelintide has potential to redefine the weight management experience

• Potential first choice treatment option setting a new standard for what to

  expect from a weight management journey

• Petrelintide/enicepatide (CT-388) (GLP-1/GIP) for people who need greater weight loss and/or better glycemic control

• 50/50 profit sharing on both monotherapy and combination

  USD 700m in milestone payments expected in 2026a

  • USD 575m of the total USD 1,225m in development milestones

    • USD 125m of the total USD 250m in anniversary payments

aZealand Pharma will pay Roche USD 350 million in four installments throughout 2026-2027 for the contribution of CT-388 in the first combination product arising from the collaboration.

6

x

Equal partnership with co-development and co-commercialization

Opening remarks

Executing on our strategy to establish leadership in obesity and metabolic health

Redefining the near-term future of weight management

Expanding capabilities to enhance our pipeline

METABOLIC

FRONTIER 2030

Two mid- to late-stage candidates

Leading programs backed by strong partners

Leverage internal metabolic health expertise

Partnerships for external innovation

Petrelintidea Survodutideb

Cambridge, MA.

research hub

Danish Centre for

AI Innovation

5

launches

+10

clinical programs

#1

in cycle times

from idea to clinic

aZealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe.

bSurvodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

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Opening remarks

Significant pipeline progress and several Phase 2/3 clinical readouts remaining in 2026

Building the pipeline

of the future

ZP9830 (Kv1.3)

Results from Ph1a SAD and MAD, and clinical advancement

Progress pre-clinical programs

at accelerated speed

• Establish Boston research site

Partnerships to evolve and fuel

platform

Survodutideb

(GCGR/GLP-1R)

Results from Ph3 obesity

program

• SYNCHRONIZETM-1

SYNCHRONIZETM-2 SYNCHRONIZETM-CVOT SYNCHRONIZETM-MASLD

Petrelintidea

(amylin analog)

• Results from Ph2 ZUPREME-1

Results from Ph2 ZUPREME-2

Initiation of Phase 3a program

Initiation of Ph2 with

petrelintide/CT-388

NON-EXHAUSTIVE

Executing on rare disease programs

Dasiglucagon for CHI:

U.S. regulatory submission

Glepaglutide for SBS:

Progression of Ph3 EASE-5 trial

aZealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe.

bSurvodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

CGCR=glucagon receptor; GLP-1R=glucagon-like peptide-1 receptor; CVOT=cardiovascular outcomes trial; MASLD=metabolic dysfunction-associated steatotic liver disease; SAD=single ascending dose; MAD=multiple ascending dose; CHI=congenital hyperinsulinism; SBS=short bowel syndrome. 8

R&D pipeline

Clinical pipeline: Five launches by 2030

aInvestigational compounds whose safety and efficacy have not been evaluated or approved by the U.S. Food and Drug Administration (FDA) or any other regulatory authority. bZealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. cSurvodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

GCGR=glucagon receptor; GIP=gastric inhibitory polypeptide; GLP-1R=glucagon-like peptide-1 receptor; GLP-2R=glucagon-like peptide-2 receptor; MASH=metabolic dysfunction-associated steatohepatitis; SC=subcutaneous; T2D=type 2 diabetes. 9

R&D pipeline

Phase 3 trials with petrelintide to initiate this year

Phase 2 results showed double-digit weight loss with placebo-like tolerability

Phase 2 ZUPREME-1 results

(Petrelintide DG3)

• Double-digit weight loss at 42 weeks

• 98% of participants escalated to targeted maintenance dose

• No participant discontinued treatment due to GI AEs

• ~70% of participants did not report any GI AE

• Advancing to Phase 3 registrational trials in H2 2026

Pbo-adj. % of participants

80% of events were mild

16.7%

Additional ZUPREME-1

data at ADA

<0.0%

1.0% 2.3%

Nausea Vomiting Diarrhea Constipation

Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Source: Data on file.

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R&D pipeline

In Phase 3 trial, survodutide delivered competitive weight loss and meaningful metabolic improvements

Survodutide holds potential as a differentiated therapy for people living with obesity or overweight, delivering competitive weight loss with the potential to directly support liver function

SYNCHRONIZETM-1: Overweight/obesity without T2D2

Baseline characteristics3:

Female: 59%, Body weight:109 kg, BMI: 38 kg/m2

Survodutide 6.0 mg QW Survodutide 3.6 mg QW

• Up to 16.6% weight loss after 76 weeks of treatment with survodutide (vs. 3.2% in placebo arm)a

• Initial analyses indicate that body weight reduction predominantly driven by loss of fat tissue

• Delivered statistically significant reduction in waist circumference - clinical marker closely linked to visceral fat and cardiometabolic risk

  Week

  Placebo QW

  0 Dose escalation 24

  76 Follow 79

  up

• GI AEs were the most commonly reported side effects with no new safety concerns observed outside of what is expected for GLP-1 class

  Primary endpoints: Body weight change (%) at week 76,

  Body weight reduction ≥5% from baseline to week 76

  Full SYNCHRONIZETM-1 data at ADA in June

  Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

  aUsing the efficacy estimand, the estimated treatment effect assuming patients remained on treatment for the entire study duration.

  Sources:1Zealand Pharma Company Announcement No. 10/2026, April 28, 2026; 2Wharton et. al, Obesity Silver Spring 2024;33(1):67-77 (adapted with permission from Wiley); 3Le Roux et al. Diabetes Obes Metab 2025; doi: 10.1111/dom.70196 11

  R&D pipeline

  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=725)

• SYNCHRONIZETM-22: Overweight/obesity with T2D (N=~750)

• SYNCHRONIZETM-CVOT3: Long-term CV safety in patients with

  ADA - June 7, 2026

  obesity and established CVD/CKD or risk factors for CVD (N=~5,500)

• SYNCHRONIZETM-MASLD4: Overweight/obesity with confirmed or

  We expect Phase 3 data from key trials in the SYNCHRONIZE program to be

  presumed MASH (N=~250)

  ADA - June 7, 2026

  reported and presented in detail at

  scientific meetings throughout 2026

• SYNCHRONIZETM-JP5: In Japanese participants (N=~270)

• SYNCHRONIZETM-CN6: In Chinese participants (N=~300)

Boehringer Ingelheim could be the third company to market in the U.S. and Europe in this new era

of therapies for chronic weight management - with a first-in-class glucagon/GLP-1 receptor dual agonist

Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

Sources: 1ClinicalTrials.gov (NCT06066515); 2ClinicalTrials.gov (NCT06066528); 3ClinicalTrials.gov (NCT06077864); 4ClinicalTrials.gov (NCT06309992); 5ClinicalTrials.gov (NCT06176365); 6ClinicalTrials.gov (NCT06214741). CKD=chronic kidney disease; CV=cardiovascular; CVD=cardiovascular disease; GLP-1=glucagon-like peptide-1; MASLD=metabolic dysfunction-associated liver disease;

MASH=metabolic dysfunction-associated steatohepatitis; T2D=type 2 diabetes. 12

Financials

Q1 2026 Profit & Loss

Q1 2026 OPEX compositiona

DKK million

P&L reflecting strategic investments

in differentiated R&D assets and organization

82

(14%)

22

(4%)

469

(82%)

Research and Development

Sales and Marketing General and Administrative

aOther operating items of DKK 22 million in Q1 2025 consist of transaction-related costs associated with the

Roche partnership agreement. 13

Financials

Financial muscle to deliver

on Metabolic Frontier 2030 strategy

16000

14000

15,109

-672 31 14,468

Total milestones of USD 700 million from Roche in 2026c

Cash position (DKK million)a

12000

10000

8000

6000

4000

2000

1,633

9,022

Executing on key strategic priorities and more:

• Maximize the value of petrelintide

• Invest significantly in early-stage research pipeline

• Inorganic investments to enhance R&D capabilities

• USD 200 million share buy-back program

0

2023 2024b 2025b CF from

operations

Other cash adjustments

March 31,

2026

aCash position includes cash, cash equivalents and marketable securities; bEIB loan Tranches B and C (EUR 20 million each) are excluded from this chart. The two tranches are subject to pre-specified milestones being met; cMilestone

payments expected in 2026 include USD 575 million linked to the initiation of Phase 3 trials with petrelintide monotherapy, and an anniversary payment of USD 125 million. Zealand Pharma will pay Roche USD 350 million in four installments throughout 2026-2027 for the contribution of CT-388 in the first combination product arising from the collaboration. 14

Financials

2026 financial outlook

aNet operating expenses consist of R&D, S&M, and G&A; bIncludes a development milestone payment of USD 575 million from Roche that is linked to Phase 3 initiation with petrelintide monotherapy and an anniversary payment of USD 125 million.

Financial guidance based on foreign exchange rates as of May 6, 2026.

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Concluding remarks

2026 transformational milestones shaping long-term value creation

H1 2026 H2 2026

NON-EXHAUSTIVE

Petrelintide/enicepatide (CT-388)

Initiation of Phase 2

Petrelintide

Topline results from Phase 2 ZUPREME-2

Petrelintide

ZUPREME-1 data at ADA

Petrelintide

Initiation of Phase 3 program

Survodutide

Topline results from SYNCHRONIZETM-2 and SYNCHRONIZETM-CVOT

Survodutide

Full data from SYNCHRONIZETM-1 and -MASLD at ADA

ZP9830 (Kv1.3 ion channel blocker)

Topline results from Phase 1a trial (MAD)

ZP9830 (Kv1.3 ion channel blocker)

Initiation of Phase 1b/2a trial

Dasiglucagon for CHI

U.S. regulatory submission

Zealand Pharma has a collaboration and license agreement with Roche for petrelintide, including co-development and co-commercialization in the U.S. and Europe. Survodutide is licensed to Boehringer Ingelheim from Zealand Pharma, with Boehringer solely responsible for development and commercialization globally.

ADA=American Diabetes Association; CVOT=cardiovascular outcomes trial; MASLD=metabolic dysfunction-associated steatotic liver disease; MAD=multiple ascending dose; SAD=single ascending dose; CHI=congenital hyperinsulinism. 16

Zealand Pharma upcoming investor conferences

• Berenberg Healthcare Conference, New York, May 19

• Jefferies Global Healthcare Conference, New York, June 3

• Goldman Sachs 47th Annual Global Healthcare Conference, June 9

• SEB Summer Seminar, Copenhagen, June 17

• J.P. Morgan European Healthcare Forum, London, June 18

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