Shares in Novo Nordisk have plummeted after the drugmaker forecast a dip in sales and profit growth below analyst expectations for 2026 amid pricing and patent expiry headwinds.
For the coming year, Novo expects sales could drop by as much 13% at constant exchange rates (CER). This would mark the first sales decline in years for the company, which has risen to dominate the obesity treatment space. Adjusted operating profit growth could also drop by 13% at CER, according to Novo.
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The guidance, which was published after the European market closed on 3 February, was punished by investors at market open. When the Copenhagen stock exchange began trading on 4 February, shares in Novo were down 18% – dropping to DKr 302.00 ($47.76) from DKr 367.80 at the previous market close. The company has a market cap of DKr 1.38tn.
According to Citi analysts, 2026 guidance for sales and operating profit is 8% and 10% below consensus, respectively, at the midpoints.
The outlook for 2026 marks a quick downturn from 2025, in which Novo reported CER sales growth of 10% to reach DKr 309bn.
The guidance states that the weak 2026 outlook reflects pricing headwinds in the US, with the company directly referencing impacts from President Trump’s Most Favored Nation (MFN) policy. In November 2025, Novo struck a pricing deal with the White House that saw prices for its semaglutide brands Wegovy and Ozempic slashed. It also set a price for its then pending oral Wegovy in obesity. The drug was approved shortly after by the US Food and Drug Administration (FDA) in December 2025.
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By GlobalDataThe agreement came amid threats of tariffs by Trump on imported drugs, which would have severely impacted Novo, given the US represents its most lucrative market. Separate price erosion has come via semaglutide’s inclusion under the Inflation Reduction Act (IRA) – a price change that Novo is currently fighting in court.
Patent expiries of semaglutide in certain markets – including Brazil, Canada, and China – also blunted the sales outlook for 2026. Competition from Eli Lilly and compounders further constricted market share.
Novo is fighting to regain a foothold in a weight loss sector it once dominated. Lilly’s tirzepatide brands, Zepbound and Mounjaro, have usurped Wegovy and Ozempic as the fastest selling obesity and type 2 diabetes GLP-1RAs, respectively.
Novo was once the most valuable company in Europe but has since slipped down the rankings due to declining share price. Lilly, meanwhile, became the first trillion-dollar market cap company in healthcare, reflecting the differing fortunes of the two rivals.
An avenue for growth for Novo will likely be in the oral obesity treatment space. The Danish company became the first to win FDA approval for a GLP-1RA pill in obesity, beating Lilly’s orforglipron to market. As of 23 January, total weekly prescriptions amounted to around 50,000 for the pill, according to Novo.
Citi analysts added: “[Financial] headwinds are partially offset by an early strong Wegovy pill launch, though it is yet too early to extrapolate.”
Novo will also be pinning hopes on next-generation obesity drug CagriSema to fill revenue gaps. The therapy produced positive results in a Phase III trial earlier this week.
The obesity market across the seven major markets (7MM: the US, France, Germany, Italy, Spain, the UK, and Japan) is forecast to reach $173.5bn by 2031, as per GlobalData analysis.
GlobalData is the parent company of Pharmaceutical Technology.
