Nonetheless lifetime of the large three injectable prescription weight reduction medicines. Ozempic, Victoza and Wegovy. (Photograph by: Michael Siluk/UCG/Common Pictures Group by way of Getty Pictures)
Ucg | Common Pictures Group | Getty Pictures
Novo Nordisk’s shift from a market darling to a critical underperformer has set the stage for a transitional 2026 because the Danish drugmaker fights to regain investor confidence in its weight reduction enterprise.
Novo’s inventory simply skilled the worst yr on document because it started buying and selling on the Copenhagen inventory trade over three a long time in the past. A number of causes lie behind the dramatic drop: a collection of steerage cuts, strides by chief rival Eli Lilly, a management upheaval, and low-cost copycat medication flooding the essential U.S. market.
With nearly every week to go till 2026, Novo introduced that its new weight reduction tablet below the model identify Wegovy had been accredited within the U.S., making it the primary oral GLP-1 remedy accredited for weight reduction. It despatched shares up almost 10% as buyers banked on Novo with the ability to, no less than partly, maintain Eli Lilly and others at bay.
That “early Christmas current,” as one analyst referred to as it, highlights most of the key themes Novo should face this yr.
From injectables to drugs
Novo’s place as the primary firm to launch an oral choice might assist it make up among the floor it is misplaced over the previous yr within the GLP-1 area. Analysts largely agreed that the Wegovy tablet’s approval was a giant deal, despite the fact that many had already anticipated a optimistic determination earlier than the tip of the yr.
Eli Lilly is predicted to get its personal weight reduction tablet orforglipron accredited by the U.S. Meals and Drug Administration by no later than the second quarter of this yr, and buyers will intently watch how that competitors performs out.
“This approval provides a layer to the entire weight problems area sooner or later,” Sydbank analyst Søren Løntoft Hansen informed CNBC. “It might be, doubtlessly, an area the place Novo Nordisk is possibly capable of recapture market shares and possibly improve development.”
Wegovy-in-a-pill, as Novo calls the oral model of the blockbuster injectable, has proven that sufferers lose on common 16.6% of their physique weight over 64 weeks. In the meantime, orforglipron, averages 12.4% over 72 weeks.
“Often, you must mainly go for both comfort or efficacy if you’re discussing drugs versus injections – not on this case,” Novo CEO Mike Doustdar informed CNBC’s Charlotte Reed in November. “Wegovy in a tablet mainly could have the identical efficacy as its injectable counterpart. That is actually thrilling.”
The broad consensus is that drugs can even be favored by customers. They’ve added benefits comparable to not having to be saved chilly just like the injectable model, permitting for less complicated distribution and ease of getting into new markets.
A shifting narrative?
Eli Lilly’s positioning of its rival drug Zepbound as one of the best remedy for attaining weight reduction in the marketplace for once-weekly injections has helped it reach capturing important market share to surpass Novo’s Wegovy.
In the meantime, Novo Nordisk’s positioning has been totally different as they’ve usually emphazised that treating weight problems goes past dropping pounds. “They wish to inform a narrative about how weight problems must be seen as a illness and the way Wegovy impacts obesity-related ailments,” Sydbank’s Hansen stated.
“As we’ll construct and purchase property, you’ll usually see that these property do a number of issues,” Doustdar stated in early November. “They deal with different co-morbidities. We now have seen that with semaglutide; it helps liver, kidney, coronary heart – that is unbelievable – we must always truly go and additional develop these,” he stated within the context of the longer term focus of its pipeline.
Nevertheless, it appears that evidently’s not necessary to People or the market, in response to Hansen. “The fraction that prescribes Wegovy or weight problems medication in relation to obesity-related ailments may be very small,” he famous, including that even when many sufferers do not essentially wish to lose greater than 20% of their physique weight, they no less than need the chance to realize that highest price of weight reduction.
“It looks like that drives the market, and if Novo Nordisk is ready to faucet into that story with the Wegovy tablet, I feel they’re in a very good place,” Hansen stated.
Novo in late November stated it filed for FDA approval of a better dose of Wegovy injection of seven.2 mg, which might additionally play right into a altering narrative. Trials have proven that the upper dose of Wegovy resulted in a 20.7% weight discount on common — about the identical as Lilly’s Zepbound jab.
The U.S. shopper
The elevated deal with the direct-to-consumer market can be one other key space to observe.
The marketplace for weight reduction prescribed drugs is uniquely consumer-driven, contrasting many different blockbuster medication which might be usually lined by well being plans within the U.S. or nationwide well being techniques in Europe.
“The marketable improvement for Wegovy and Ozempic is a must-win battle for [CEO] Mike Doustdar and the brand new board.”
Søren Løntoft Hansen
Sydbank analyst
President Donald Trump’s second time period in workplace has introduced a number of complications for pharmaceutical firms, Novo included. All year long, Trump has teased triple-digit tariffs until pharma firms make important investments within the U.S., and has additionally waged a warfare on excessive drug costs for People.
The frustration that U.S. drug costs will be greater than 4 instances these in Europe is not new. Final yr, Novo’s then-CEO Lars Fruergaard Jørgensen testified on the U.S. Senate panel chaired by Sen. Bernie Sanders, who referred to as for the corporate to “cease ripping us off” with excessive drug costs.
However Trump has taken it additional, advocating a so-called “Most Favored Nation” pricing for medicines, whereby the U.S. worth is about to the bottom stage in comparison with different rich nations.
In November, the Trump administration reached a take care of Novo and Lilly to decrease costs of their bestselling GLP-1 medicines on each Medicare and Medicaid, in addition to agreements to supply them on to customers at a reduction on the web site TrumpRx.gov, which is about to be launched in January this yr.
The brand new direct-to-patient market is rising as a crucial driver of future gross sales development, however compounders — which make cheaper copycat variations of the drug and had been capable of flourish in the course of the earlier scarcity of semaglutide — stay an actual competitor.
“The TrumpRx deal will assist Novo turn out to be extra aggressive with compounders on worth, though a sooner orforglipron launch might scale back its skill to achieve momentum within the [direct-to-patient] channel forward of Lilly,” famous Morningstar’s Karen Andersen.
“We have already seen the direct-to-patient market starting to develop properly in 2025, significantly for LillyDirect… oral GLP-1 medication can be even higher suited to this channel,” she added. “That may additional push the market towards money pay.”
Headwinds
Traders are additionally ready to see if Novo’s new management will ship on its try to enhance U.S. operations.
In Might, Novo ousted its CEO of eight years, citing “latest market challenges” and “the event of the corporate’s share worth.” Six months later, all impartial members of the board stepped down as a consequence of a disagreement with Novo’s controlling shareholder over the tempo of change and discontent over the way it had addressed challenges within the U.S. market.
“The marketable improvement for Wegovy and Ozempic is a must-win battle for [CEO] Mike Doustdar and the brand new board,” Hansen stated, including that the event within the U.S. market is a “present me case” for buyers. “Proper now, we actually do not see any important optimistic progress right here,” he informed CNBC on Dec 23.
The Danish drugmaker should due to this fact steadiness progress on its tablet model and higher-dose jabs of Wegovy with these a number of headwinds in 2026.
Decrease pricing for each the Medicare and shopper cash-pay channel on account of MFN, in addition to patent expiries in jurisdictions together with Brazil, Canada and China will “most likely result in a lowering prime line,” stated Hansen.
Moreover, 2026 will possible convey extra readability on Novo’s next-generation drug CagriSema, which mixes semaglutide, a GLP-1 agonist, with cagrilintide, an amylin analogue.
Long run, competitors is more likely to intensify past Lilly and compounders, as a number of drugmakers — together with Pfizer, Amgen, AstraZeneca, Roche — advance late-stage candidates via their pipelines.
The long run might additionally convey extra diversification in remedies, as many new medication are in improvement that would yield new methods to handle weight reduction long-term, present higher security profiles, and mix medication that concentrate on a number of totally different appetite-modifying hormones.
“There have been so many strikes this yr that present Novo as a conflicted firm – for instance, reaching a take care of Hims after which terminating the deal… negotiating to accumulate Metsera, exiting negotiations, after which leaping again in after a signed Pfizer deal,” stated Andersen.
“This [Wegovy pill approval] win is symbolically essential for Novo, after a collection of disappointments with knowledge and monetary efficiency,” she added. “It wanted a win, and now it simply must execute.”
