Novo Nordisk’s offices in Bagsvaerd, Denmark, in December, 2025.Tom Little/Reuters
Wegovy maker Novo Nordisk NVO-N warned on Tuesday that profits and sales could drop as much as 13 per cent this year, the first declines in years, as heavy price pressure from U.S. President Donald Trump adds to fierce competition in the weight-loss market.
The shock warning ends a years-long run of double-digit percentage gains in profits and sales since the launch of Wegovy in June 2021, which ignited a boom in demand for obesity drugs and meteoric growth for the Danish company. In 2024, it was Europe’s most valuable listed company, worth US$600-billion.
Novo said its outlook was hit by lower realized prices, especially in the U.S., fierce competition, and the expiry of patents on semaglutide – the active ingredient in its Wegovy and Ozempic drugs – in some markets outside the U.S.
The group expects adjusted operating profit and adjusted sales at constant exchange rates to both fall by between 5 per cent and 13 per cent this year. Sales rose 10 per cent last year, and analysts had, on average, forecast a 2 per cent decline this year.
“In 2026, Novo Nordisk will face pricing headwinds in an increasingly competitive market,” CEO Mike Doustdar said in a statement.
“However, we are very encouraged by the promising early uptake from the U.S. launch of Wegovy pill, and we remain confident in our ability to drive volume growth over the coming years,” he added.
Novo also said two members of its executive management team – head of U.S. operations Dave Moore and head of product and portfolio strategy Ludovic Helfgott – would leave. They will be replaced by former UnitedHealth Group executive Jamey Millar and Hong Chow from Germany’s Merck Healthcare respectively.
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Pricing concessions agreed with Trump will weigh on sales in 2026 as Novo looks for volumes to flow through, BMO Capital Markets analysts said in a note.
“Following Trump MFN (drug pricing) deals and new needed efforts to maintain access in the obesity market, Novo now faces extensive pricing headwinds in the U.S.,” they said in a note.
Investor focus on Wednesday, when management is due to speak to analysts, will be on the implications of continued compounding – or copycat competition – and uptake of the new Wegovy pill, as well as Doustdar’s new strategy.
Novo’s U.S.-listed shares fell 12 per cent after the earlier-than-expected earnings statement. Its market value peaked in June 2024, but it has since shed about two-thirds of its value.
Shares of U.S.-listed obesity drugmakers and developers also slid, as investors worried about intensifying competition in the blockbuster weight-loss market. Eli Lilly shares were down about 4 per cent in afternoon U.S. trading, Structure Therapeutics fell 6.2 per cent and Altimmune fell 4.2 per cent.
Lukas Leu, a portfolio manager at Novo shareholder ATG Healthcare, told Reuters that the 2026 sales and profit guidance was “worse than expected,” as he expected between flat and minus 5 per cent for both.
Novo and Lilly are locked in a tightening fight in the obesity-drug market, with steep U.S. price pressure under Trump, rising copycat drugs and fresh challengers lining up.
Novo is trying to win back its crown after a bruising year in which Lilly’s rival injectable drug Zepbound overtook Wegovy in U.S. prescriptions and wiped 50 per cent off Novo’s share price.
Under Doustdar, Novo is betting on its newly launched Wegovy pill and aggressive advertising to win back ground.
On a non-adjusted basis, the midpoint of Novo’s 2026 sales outlook would be about minus 1 per cent, helped by a reversal of US$4.2-billion in sales rebate provisions tied to the 340B Drug Pricing Program in the U.S.
Operating profit fell 14 per cent to 31.7 billion crowns in the fourth quarter, compared with the 31.2 billion expected by analysts.
Global Wegovy sales fell 12 per cent in the quarter to 21.9 billion crowns from a year earlier, versus analysts’ expectations of 21.1 billion.