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

Novo Nordisk’s transformation from market darling to severely underperforming firm has set the stage for a transitional yr in 2026, as Danish drugmaker Novo Nordisk struggles to regain investor confidence in its weight-loss enterprise.

Novo’s share value has simply skilled its worst yr because it started buying and selling on the Copenhagen Inventory Alternate greater than 30 years in the past. There are a number of causes behind the dramatic decline: a collection of steering cuts, the rise of our largest rivals, and so on. Eli Lillymanagement turmoil, and low cost counterfeit medication flooding the important U.S. market.

With a couple of week left till 2026, Novo introduced that its new weight reduction drug, branded Wegovy, has been authorised in the US, making it the primary oral GLP-1 therapy authorised for weight reduction. Traders hoped Novo might a minimum of partially stave off the likes of Eli Lilly, sending the refill practically 10%.

This “early Christmas current,” as one analyst known as it, highlights most of the key themes Novo should face this yr.

From injections to tablets

Novo’s place as the primary firm to launch an oral choice might assist it make up for a few of the floor it has misplaced over the previous yr within the GLP-1 house. Many have been already anticipating a optimistic resolution by the tip of the yr, however analysts largely agreed that the approval of Wigovy tablets was a giant deal.

Eli Lilly is predicted to obtain approval from the U.S. Meals and Drug Administration for its weight reduction drug, or Folgliprone, by the second quarter of this yr on the newest, and buyers can be watching carefully to see how the competitors performs out.

“This approval provides one other layer to the general weight problems house sooner or later,” Sydbank analyst Soren Rontoft Hansen advised CNBC. “This might probably be an space the place Novo Nordisk might regain market share and drive progress.”

Wegobee-in-a-pill, which Novo is looking the oral model of its blockbuster injectable, confirmed sufferers misplaced a mean of 16.6% of their physique weight over 64 weeks. Orforglipron, alternatively, averages 12.4% over 72 weeks.

“Usually, if you speak about drugs and injections, you mainly must go for both comfort or effectiveness, however that is not the case right here,” Novo CEO Mike Doesder advised CNBC’s Charlotte Reid in November. “The capsule type of Wegoby has mainly the identical efficacy because the injectable drug. That is actually thrilling.”

The final consensus is that tablets can even be standard with customers. These have extra advantages, comparable to not requiring refrigerated storage like injectable variations, simplifying distribution and making it simpler to enter new markets.

A altering story?

Eli Lilly has been in a position to seize a bigger market share than Novo’s Wigoby by positioning its rival Zepbound as the most effective therapy for weight reduction with once-weekly injections.

Novo Nordisk, alternatively, has a distinct place and has usually emphasised that treating weight problems is about extra than simply losing a few pounds. “They wish to inform the story of how weight problems needs to be seen as a illness and the way Wegovy impacts obesity-related ailments,” mentioned Sidbank’s Hansen.

“As we construct and purchase belongings, you will notice increasingly more that these belongings serve a number of roles,” Dusdahl mentioned in early November. “These are issues that handle different comorbidities. We noticed that with semaglutide. It is nice that it helps the liver, kidneys and coronary heart. We actually must develop these additional,” he mentioned in relation to the long run focus of the pipeline.

However Hansen mentioned that does not appear to matter to People or the market. “We’ve got a really small proportion of prescribing Wegovy and weight problems medication for obesity-related situations,” he mentioned, including that many sufferers do not essentially wish to lose greater than 20% of their physique weight, however a minimum of need the possibility to attain that highest price of weight reduction.

“That appears to be driving the market. If Novo Nordisk can capitalize on that story with the Wegoby capsule, I believe they’re in a very good place,” Hansen mentioned.

Novo introduced in late November that it had utilized to the FDA for approval of a higher-dose 7.2 mg model of its Wigovy injection, which might additionally affect a change within the narrative. Trials confirmed that prime doses of Wegovy resulted in a mean weight lack of 20.7%, which is about the identical as Lilly’s Zepbound jab.

US customers

The elevated concentrate on the direct-to-consumer market can even be an necessary space to concentrate on.

The marketplace for weight reduction medication is uniquely consumer-driven, in distinction to many different blockbuster medication, which are sometimes coated by the U.S. medical insurance system or European nationwide well being care programs.

President Donald Trump’s second time period in workplace has prompted some complications for pharmaceutical corporations, together with Novo. All year long, President Trump has teased triple-digit tariffs on drug corporations until they make investments closely in the US, and he has additionally waged a struggle on excessive drug costs for People.

Complaints that U.S. drug costs could possibly be greater than 4 occasions increased than in Europe aren’t new. Final yr, Novo’s then-CEO Lars Fluergaard Jorgensen testified earlier than a U.S. Senate committee chaired by Sen. Bernie Sanders, calling on the corporate to “cease ripping us off” with excessive drug costs.

However President Trump has gone even additional, advocating so-called “most-favored-nation” pricing, which might set U.S. drug costs on the lowest ranges in comparison with different rich international locations.

In November, the Trump administration reached an settlement with Novo and Lilly to cut back the costs of their best-selling GLP-1 medication in each Medicare and Medicaid, and to supply them on to customers at discounted costs on the TrumpRx.gov web site scheduled to launch in January.

Though the brand new direct-to-patient market is rising as a key driver of future gross sales progress, compounders who produce cheaper counterfeit medication and have been in a position to thrive even with the earlier semaglutide scarcity stay the actual opponents.

“Whereas the cope with TrumpRx will assist Novo develop into extra aggressive with formulators on value, an earlier launch of Orforglipron might scale back the corporate’s skill to realize traction available in the market.” [direct-to-patient] “They’re operating the channel earlier than Lily,” mentioned Morningstar’s Karen Andersen.

“We’re already seeing the direct-to-patient market beginning to develop nicely in 2025, particularly with LillyDirect…oral GLP-1 medication can be much more suited to this channel,” she added. “This can push the market additional towards money funds.”

Headwind

Traders can even be watching to see whether or not Novo’s new administration succeeds in its makes an attempt to enhance its U.S. operations.

In Could, Novo fired its CEO after eight years, citing “latest market points” and “inventory value tendencies.” Six months later, all impartial members of the board resigned, citing disagreements with Novo’s controlling shareholder over the tempo of change and dissatisfaction with how the corporate was addressing the challenges of the U.S. market.

“The marketable growth of Wegovy and Ozempic is a battle that should be received. [CEO] “I do not see any vital optimistic developments right here at this level,” Hansen advised CNBC on Dec. 23, “Mike Douster and the brand new board,” including that developments within the U.S. market are a “show-me case” for buyers.

The Danish drugmaker will subsequently must stability these a number of headwinds in 2026 with the progress made within the growth of a pill model and a better dose of Wigovy.

Hansen mentioned decrease costs in each Medicare and client money cost channels because of the MFN, in addition to patent expirations in jurisdictions comparable to Brazil, Canada and China, “will doubtless lead to decrease gross sales.”

Moreover, in 2026 we are going to study extra about Novo’s next-generation drug Kaglisema, which mixes the GLP-1 agonist semaglutide with the amylin analog kagrylintide.

In the long run, competitors from a number of drug corporations past Lilly and compounders is more likely to enhance. pfizer, amgen, AstraZeneca, Roche — Advance late-stage candidates by the pipeline.

There’s additionally potential for better therapy diversification sooner or later, as many new medication are below growth that will present new methods to handle weight reduction over the long run, provide a greater security profile, and mix medication that concentrate on a number of completely different appetite-modifying hormones.

“There have been so many strikes this yr that point out Novo is an adversary, comparable to reaching an settlement with Hims after which terminating the deal…negotiating the acquisition of Metzer, closing the deal, then getting into the cope with Pfizer after which re-entering,” Andersen mentioned.

“this [Wegovy pill approval] “The win is symbolically crucial for Novo, which has skilled a collection of disappointments in its information and monetary efficiency,” he added. “We would have liked a win, so now we simply must get it executed.”