Danish pharmaceutical giant Novo Nordisk has received warm feedback on its start-to-2026 performance after several consecutive quarters of underperformance. This is due in no small part to the company’s head start over rival Eli Lilly in the fast-growing market for oral obesity drugs.
With adjusted net sales (PDF) of 70.1 billion Danish kroner ($11 billion) in the first three months of this year, Novo’s first-quarter sales were down about 4% year over year. However, the strong performance of the company’s obesity series and early strong results from the launch of Wegovy tablets sent the company’s stock up about 3% on Wednesday morning.
Novo’s stock price has been volatile since around mid-2024 as the commercial GLP-1 market for diabetes and obesity evolved and Lilly built a notable lead, despite Novo having first-mover advantages in both the diabetes injectable Ozempic and the blockbuster obesity drug Wegoby.
The instability led to former Novo CEO Lars Fluergaard Jorgensen being replaced last summer by longtime insider Mike Doesder.
Jefferies analysts said in a note that Novo’s adjusted sales for the first quarter exceeded consensus estimates for the period by 1%, but cautioned that results remained in line with expectations given the movement in Wigobee’s pill inventory. Nevertheless, strong performance across the company’s GLP-1 franchise helped offset the “noticeable deviation” in market expectations for the company’s insulin portfolio, analysts said.
Novo may not be out of the woods yet, but it was expected to start gaining momentum in the second quarter after Lilly launched its oral obesity drug Foundayo in April. The company is on track for now thanks to strong early indicators for its Wegovy tablet, which was approved late last year and launched in the US on January 5th.
“It’s no secret that Wegovy pills are off to a record start in the U.S.,” CEO Doustdar said on a May 6 conference call with analysts. “Since its launch approximately 16 weeks ago, we have seen more than 1 million people use Wegovy pills as global momentum for peptide-based treatments accelerates.”
With the product’s debut, Novo has focused on the “use, users and usage” of the Wegovy pill, Jamie Miller, the company’s vice president of U.S. operations, said on a conference call.
He noted that the pill’s momentum is “far outpacing” previous GLP-1 launches in the U.S., with total prescriptions reaching 1.3 million in the first quarter. As of April 17, oral Wegovy had issued about 2 million prescriptions in total, and Miller said Novo estimates that more than 1 million people have been treated since its launch.
Breaking down the dynamics further, Miller noted that approximately 80% of patients who took Wegovy pills were new patients in the GLP-1 class, adding, “We are also seeing patients coming to Wegovy pills from competing products that have limited cannibalization with Wegovy injectables.”
Price changes and new competitors
Looking forward, Novo expects sales from self-pay and commercial insurance channels to moderate slightly thanks to the pill’s inclusion in its leading PBM formulations by the end of the first quarter, Miller explained, confirming that most of its sales to date have come from self-pay patients.
Addressing Foundayo’s competition issue head-on, Miller said that while the companies’ launches are still in the early stages, “I think what we’re seeing so far is confirmation of the strength of the profile of Wigoby tablets.”
Miller added that efficacy is the “first criterion” in choosing an obesity treatment, adding: “We have unparalleled efficacy with 17% weight loss with the Wegovy pill.” The executive also cited Novo’s recent indirect treatment comparisons between the products, suggesting oral Wigovy is more effective and less likely to be discontinued due to side effects.
The FDA approved Foundayo on April 1 based on data demonstrating an average weight loss of 12.4% in patients who took the Lilly drug and a placebo.
Dusdahl also reviewed the pricing calculations for Novo’s Wigovy tablets and how the drug’s cost fits into the company’s larger market expansion goals, describing the current price and penetration alignment as a “sweet spot.”
Novo launched the drug with a starting dose of 1.5 mg of tablets priced at $149 per month for cash-paying patients, but commercially insured patients with savings plans can initially pay just $25 for the same supply. Novo is pricing a second dose of Wegovy at $199 per month, but patients without insurance will be charged $299 per month for the highest dose.
“We’re looking at 2 million scripts after 16 weeks at current prices and over 200,000 scripts per week, even though it’s been over a month since our competitors came in,” Doustdar said, alluding to Foundayo’s recent launch.
While Novo believes “the pricing of this product is absolutely correct” for now, the CEO acknowledged that in the long term, “if our goal is to reach hundreds of millions of patients, the price has to come down.”
Still, “this is the right price for now” for Wigovy pills, he said.
Total sales of anti-obesity medicines reached SEK 20.9 billion ($3.3 billion) in the first quarter, an increase of about 22% at constant exchange rates, according to figures that Novo does not aggregate separately for all medicines. Diabetes-related sales increased by 12% to SEK 44.9 billion ($7 billion).
The injectable drug Wegovy earned 18.2 billion kroner ($2.9 billion) in the period, an increase of 12% in constant currencies, compared with the oral obesity drug’s initial 2.26 billion kroner (about $355 million). Ozempic, meanwhile, saw sales rise 8% to nearly 28 billion kroner ($4.4 billion) in the three-month period.
As expectations for GLP-1 products grow, Novo has slightly revised its forecasts upward for this year. The company now expects adjusted sales to decline between 4% and 12% in 2026, a bit more moderate than the 5% to 13% range it had predicted as of early February.
The Jefferies team estimates that the new estimates range from about 264 billion kroner (about $42 billion) to 288 billion kroner (about $45.3 billion) for the full year.
