COPENHAGEN, Feb 4, 2026, 10:03 CET
- Novo Nordisk warned that adjusted sales and operating profit in 2026 may drop between 5% and 13% at constant exchange rates
- The warning signals rising U.S. price pressure and intensifies competition with Eli Lilly in the obesity drug market
- CEO Mike Doustdar described the U.S. price cuts for Wegovy as “painful,” but noted they might help broaden access
Novo Nordisk shares dropped sharply on Wednesday after the Danish pharmaceutical giant flagged a potential 13% decline in sales and profit for 2026, marking a notable reversal for the company behind weight-loss drug Wegovy and diabetes treatment Ozempic. Early trading in Copenhagen saw shares plunge 18%, according to the Financial Times.
The outlook is crucial since Novo is at the heart of the obesity-drug surge, but it now signals the easy-growth phase has ended. U.S. politics and payer resistance are creeping into guidance, even as competitors ramp up pricing and fight for market share.
Novo’s warning sent shockwaves through the wider group of obesity drug stocks, as investors took the company’s forecast as a signal for the entire sector, not just Novo.
On Tuesday, Novo forecast adjusted operating profit and adjusted sales—excluding certain items and calculated at constant exchange rates—to drop between 5% and 13% in 2026. This contrasts with analysts’ consensus, which had pointed to about a 2% sales decline, the company noted.
Novo pointed to weaker realised prices—particularly in the U.S.—along with intensified competition and patent expiries for semaglutide in certain markets beyond the U.S. Semaglutide is the key ingredient in Wegovy and Ozempic.
Chief executive Mike Doustdar warned Novo will face “pricing headwinds” as the market grows more crowded, but expressed he was “very encouraged” by early demand for the new Wegovy pill in the United States.
Novo reported that weekly prescriptions for oral Wegovy hit roughly 50,000 by Jan. 23, surpassing figures from market tracking that excludes certain cash-pay methods like direct-to-consumer and telehealth channels.
“Compounding” is another pressure point — these are custom-made medicines crafted by specialised pharmacies that can mimic branded drugs when shortages or other issues arise. Reuters reported that up to 1.5 million Americans may be using compounded versions of GLP-1 weight-loss drugs; GLP-1 targets the hormone pathway to suppress appetite and regulate blood sugar.
Reuters reported that Eli Lilly’s injectable Zepbound has surpassed Wegovy in U.S. prescriptions, intensifying the competition for the company. Following Novo’s update, Eli Lilly shares dropped, as did those of smaller obesity-drug makers.
BMO Capital Markets analysts warned that pricing concessions struck with the Trump administration will pressure 2026 sales as Novo aims to boost volumes. They highlighted “extensive pricing headwinds” linked to Trump’s “MFN” strategy — meaning “most-favoured-nation” pricing, which seeks to align U.S. prices more closely with those in other countries.
Investors are also processing another wave of management shifts. Novo announced that Dave Moore, head of U.S. operations, and Ludovic Helfgott, chief of product and portfolio strategy, are departing. The company has tapped executives from UnitedHealth and Germany’s Merck Healthcare to fill their roles.
Several shareholders described the numbers as outright worse than the market anticipated. Markus Manns, portfolio manager at Union Investment, labeled the outlook “shocking guidance.” Lukas Leu from ATG Healthcare added the forecast was “worse than expected.”
Novo’s quarterly results didn’t help calm nerves. Operating profit dropped 14% to 31.7 billion Danish crowns in Q4, Reuters reported. Global Wegovy sales slipped 12% to 21.9 billion crowns, but still came in just above analyst forecasts. The company also noted that its midpoint guidance benefits from a $4.2 billion reversal of rebate provisions linked to the U.S. 340B Drug Pricing Program, a federal discount initiative for select hospitals and clinics.
The forecast remains uncertain, hinging on several tricky factors: how sharply U.S. prices adjust under the new agreements, if compounding eases off or sticks around, and whether the pill boosts total volumes instead of merely shifting demand away from injections. If these all take a negative turn simultaneously, the decline might not just be a “kitchen sink” year but set a new baseline.
Doustdar told reporters Wednesday that the U.S. price cuts for Wegovy are “painful” for the company’s results but might serve as an “investment in the future” if they help attract more patients to the treatment. https://www.reuters.com/business/healthcar…
