Novo Nordisk faces ‘must-win’ battle over U.S. Wegovy, Ozempic in 2026

Novo Nordisk‘s shift from a market darling to a severe 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 12 months on document because it started buying and selling on the Copenhagen inventory change over three a long time in the past. A number of causes lie behind the dramatic drop: a collection of steering 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 permitted within the U.S., making it the primary oral GLP-1 therapy permitted for weight reduction. It despatched shares up almost 10% as traders banked on Novo with the ability to, at the least partly, maintain Eli Lilly and others at bay.

That “early Christmas current,” as one analyst referred to as it, highlights lots of the key themes Novo must face this 12 months.

From injectables to capsules

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 12 months within the GLP-1 area. Analysts largely agreed that the Wegovy tablet’s approval was an enormous deal, regardless that many had already anticipated a constructive choice earlier than the top of the 12 months.

Eli Lilly is predicted to get its personal weight reduction tablet orforglipron permitted by the U.S. Meals and Drug Administration by no later than the second quarter of this 12 months, and traders will carefully 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 instructed CNBC. “It may very well be, probably, an area the place Novo Nordisk is possibly in a position to recapture market shares and possibly enhance progress.”

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, it’s a must to mainly go for both comfort or efficacy whenever you’re discussing capsules versus injections – not on this case,” Novo CEO Mike Doustdar instructed CNBC’s Charlotte Reed in November. “Wegovy in a tablet mainly can have the identical efficacy as its injectable counterpart. That is actually thrilling.”

The broad consensus is that capsules may even be favored by customers. They’ve added benefits similar to not having to be saved chilly just like the injectable model, permitting for easier distribution and ease of getting into new markets.

A shifting narrative?

Eli Lilly’s positioning of its rival drug Zepbound as the very best therapy for reaching weight reduction in the marketplace for once-weekly injections has helped it reach capturing vital 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 reducing weight. “They need to inform a narrative about how weight problems ought to be seen as a illness and the way Wegovy impacts obesity-related ailments,” Sydbank’s Hansen mentioned.

“As we’ll construct and purchase belongings, you’ll usually see that these belongings do a number of issues,” Doustdar mentioned in early November. “They tackle different co-morbidities. Now we have seen that with semaglutide; it helps liver, kidney, coronary heart – that is implausible – we must always truly go and additional develop these,” he mentioned within the context of the long run focus of its pipeline.

Nevertheless, plainly’s not necessary to Individuals or the market, in accordance with 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 need to lose greater than 20% of their physique weight, they at the least need the chance to attain 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 superb place,” Hansen mentioned.

Novo in late November mentioned 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. client

The elevated give attention to the direct-to-consumer market can be one other key space to look at.

The marketplace for weight reduction prescribed drugs is uniquely consumer-driven, contrasting many different blockbuster medication which might be sometimes coated by well being plans within the U.S. or nationwide well being techniques in Europe.

President Donald Trump’s second time period in workplace has introduced a number of complications for pharmaceutical corporations, Novo included. All year long, Trump has teased triple-digit tariffs except pharma corporations make vital investments within the U.S., and has additionally waged a warfare on excessive drug costs for Individuals.

The frustration that U.S. drug costs may be greater than 4 occasions these in Europe is not new. Final 12 months, 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 ready to the bottom degree 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 ready to be launched in January this 12 months.

The brand new direct-to-patient market is rising as a vital driver of future gross sales progress, however compounders — which make cheaper copycat variations of the drug and had been in a position to flourish through the earlier scarcity of semaglutide — stay an actual competitor.

“The TrumpRx deal will assist Novo change into extra aggressive with compounders on worth, though a quicker orforglipron launch might cut back its skill to realize 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 Could, Novo ousted its CEO of eight years, citing “current market challenges” and “the event of the corporate’s share worth.” Six months later, all unbiased members of the board stepped down on account 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 mentioned, including that the event within the U.S. market is a “present me case” for traders. “Proper now, we actually do not see any vital constructive progress right here,” he instructed CNBC on Dec 23.

The Danish drugmaker should subsequently stability 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 client 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 reducing high line,” mentioned Hansen.

Moreover, 2026 will probably carry extra readability on Novo’s next-generation drug CagriSema, which mixes semaglutide, a GLP-1 agonist, with cagrilintide, an amylin analogue.

Long term, competitors is prone to intensify past Lilly and compounders, as a number of drugmakers — together with Pfizer, Amgen, AstraZeneca, Roche — advance late-stage candidates by their pipelines.

The longer term might additionally carry extra diversification in remedies, as many new medication are in improvement that might yield new methods to handle weight reduction long-term, present higher security profiles, and mix medication that focus on a number of totally different appetite-modifying hormones.

“There have been so many strikes this 12 months that present Novo as a conflicted firm – for instance, reaching a take care of Hims after which terminating the deal… negotiating to purchase Metsera, exiting negotiations, after which leaping again in after a signed Pfizer deal,” mentioned 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.”