Novo Nordisk's 2025 Crisis, Explained

In June 2024 Novo Nordisk was the most valuable listed company in Europe. Its market capitalization was larger than the annual economic output of Denmark, the country where it is based. Its two semaglutide brands, Ozempic and Wegovy, had created a market that barely existed five years earlier.

Eighteen months later the company had replaced its chief executive, cut 9,000 jobs, lost most of its board, and watched its share price fall by roughly half in a single year.

None of that changed what semaglutide does in the body, and none of it made the medicine harder to get. But it is the biggest business story in this industry, and it explains a lot of what you see in the market now: the price cuts, the cash-pay pharmacy, the wave of television ads. Here is what happened and where things stand.

What actually went wrong at Novo Nordisk?

Five things went wrong at roughly the same time.

Competition arrived and won. Eli Lilly’s tirzepatide, sold as Mounjaro for diabetes and Zepbound for obesity, produced larger average weight loss in trials and steadily took US prescription share. In the first week of September 2026, IQVIA data cited by Citi put Zepbound at just under 772,000 weekly US prescriptions against about 513,500 for the whole Wegovy franchise — a split of roughly 60% Lilly to 40% Novo Nordisk in the branded obesity market, which has held broadly steady all year [16].

Compounding filled a gap Novo Nordisk had left open. While semaglutide was officially in shortage, US compounding pharmacies and telehealth platforms sold large volumes of copies, often far cheaper than the branded product. Novo Nordisk named “persistent use of compounded GLP-1s” as a direct cause when it cut its 2025 forecast [2].

Prices came under political pressure. After a bruising Senate hearing in September 2024, US pricing for GLP-1s became a live political issue, culminating in a most-favored-nation agreement in November 2025 that cut what Medicare and Medicaid pay [11].

The market did not expand as fast as the company assumed. Novo Nordisk had built capacity and forecasts around continued explosive growth in the number of people starting treatment. That growth slowed in the United States.

And the pipeline disappointed. Three high-profile readouts went the wrong way in under a year, which will be covered below.

How bad was the share price fall?

Bad, and it happened in stages rather than all at once.

Novo Nordisk’s US-listed shares closed at an all-time high of $135.66 on June 25, 2024. From there the slide began quietly, then accelerated.

The worst single day was July 29, 2025. Novo Nordisk cut its 2025 sales growth guidance to 8-14% at constant exchange rates, down from 13-21% set only in May, and cut operating profit growth guidance to 10-16% from 16-24% [2]. Shares fell as much as 26% before closing down roughly 23%, the company’s worst trading session on record, wiping about $70 billion off its value in hours [1].

Over the full year 2025, Novo Nordisk’s Copenhagen-listed B shares fell from DKK 624 to DKK 325, a decline of 48% [6]. The fall continued into 2026. On February 4, 2026, the day the company published a 2026 outlook calling for its first ever guided sales contraction, the shares fell nearly 20% in a session, with the chief executive citing “unprecedented” US price pressure. By September 11, 2026 the B shares were at DKK 276, down a further 15% for the year to date.

Its controlling shareholder took the hit too. Novo Holdings, which manages the Novo Nordisk Foundation’s wealth, reported that assets under management fell 34% in 2025, from DKK 1,060 billion to DKK 694 billion, almost entirely because of the drop in Novo Nordisk’s market value [5].

Why did the CEO leave?

On May 16, 2025, Novo Nordisk announced that Lars Fruergaard Jorgensen, chief executive since 2017, would step down by mutual agreement with the board.

The company’s own statement was unusually direct about why. It cited “recent market challenges, the share price decline, and the wish from the Novo Nordisk Foundation” [3]. In the same announcement, Foundation chair Lars Rebien Sorensen — himself a former Novo Nordisk chief executive — joined the board as an observer.

That detail is the key to the whole episode. Novo Nordisk is controlled by a charitable foundation that holds about 77% of the votes through a share class it is legally barred from selling. When that owner decides a change is needed, it does not have to negotiate.

The successor was announced on July 29, 2025, the same day as the big guidance cut: Maziar Mike Doustdar, who had run International Operations since 2014 and joined the company in 1992 as an office clerk in Vienna. He became the first non-Danish chief executive in Novo Nordisk’s history and took the job on August 7, 2025 [19].

What happened to the board?

The board went next.

On October 21, 2025, Novo Nordisk said chair Helge Lund, vice chair Henrik Poulsen and five independent directors — Laurence Debroux, Andreas Fibig, Sylvie Gregoire, Christina Law and Martin Mackay — would not stand for election at an extraordinary general meeting the Foundation had called [5].

Sorensen said publicly that the outgoing board had been “too slow in recognizing” changes in the obesity drug market. That slowness, in his telling, led to lagging Wegovy growth, which led to the layoffs.

At the meeting on November 14, 2025, shareholders approved the Foundation’s slate. Sorensen became chair, Cees de Jong vice chair, with Britt Meelby Jensen, Kasim Kutay and Stephan Engels joining as shareholder-elected members alongside four employee-elected directors [5]. By the half-year 2026 report the shareholder-elected group had grown to include Helena Saxon, Ramona Sequeira and Jan van de Winkel [8].

Replacing more than half a board in a single special meeting drew a rare public rebuke from some institutional shareholders, but the outcome was never really in doubt given the voting structure.

How many people lost their jobs?

On September 10, 2025, one month into Doustdar’s tenure, Novo Nordisk announced it would cut about 9,000 jobs worldwide — roughly 11% of a workforce that stood at 78,400 [4].

About 5,000 of those cuts were in Denmark, reported at the time as the largest single round of job losses in Danish corporate history. The stated goal was DKK 8 billion, about $1.3 billion, of annual savings by the end of 2026, to be redeployed into diabetes and obesity commercial work and research.

The same announcement cut operating profit growth guidance again, to 4-10% [4].

The numbers show up plainly in the annual report. Headcount fell from 77,349 at the end of 2024 to 69,505 at the end of 2025, a 10% drop, after five years in which the company had nearly doubled in size [6]. One-off restructuring costs of roughly DKK 8 billion are the reason 2025 operating profit fell 1% despite sales growing 10% at constant exchange rates [7].

Which trials went wrong?

Three, in ten months, each one hitting a different part of the growth story.

Alzheimer’s disease, November 24, 2025. The evoke and evoke+ phase 3 trials tested oral semaglutide in 3,808 adults with early symptomatic Alzheimer’s disease. Neither showed a statistically significant slowing of disease progression on the primary measure. Biomarkers improved; outcomes did not. The one-year extension was stopped [12]. This was the industry’s most ambitious bet that GLP-1s would work far beyond metabolic disease, and it did not pay off.

CagriSema versus tirzepatide, February 23, 2026. In the REDEFINE 4 head-to-head trial, Novo Nordisk’s next-generation obesity combination produced 23% mean weight loss at 84 weeks against 25.5% for tirzepatide, failing to show non-inferiority. Shares fell more than 15% to their lowest level since 2021 [13]. Chief scientific officer Martin Holst Lange said tirzepatide had “performed unusually well” compared with previous trials of similar design.

Ziltivekimab in cardiovascular disease, July 31, 2026. The 6,300-patient ZEUS trial of Novo Nordisk’s anti-inflammatory antibody missed its primary endpoint. The drug lowered inflammatory markers as expected but did not reduce major adverse cardiovascular events, with a hazard ratio of 0.99 (95% confidence interval 0.88 to 1.11) [14]. Forbes put the market value erased that day at more than $30 billion; other tallies counting only the US listing were closer to $20 billion. On September 4, 2026 Novo Nordisk told investigators it was also halting HERMES (heart failure outcomes) and ATHENA (quality of life in the same population) for futility, on the recommendation of an independent data monitoring committee, first reported September 7 [22][23]. Only ARTEMIS, the post-myocardial-infarction trial, continues, still due to read out in the first half of 2027; three of the four phase 3 cardiovascular studies of ziltivekimab are now negative or discontinued. (updated 2026-09-14)

Did Novo Nordisk really lose a bidding war to Pfizer?

It did, and the reason is revealing.

In late October 2025 Novo Nordisk made an unsolicited counterbid for Metsera, an obesity biotech that had already agreed to be acquired by Pfizer. Novo Nordisk’s offer eventually reached about $10 billion [9].

Pfizer responded with two lawsuits: one in Delaware Chancery Court seeking to block termination of its own agreement, and one in federal court alleging violations of the Clayton and Sherman Acts [10]. Its core argument was that the dominant obesity drugmaker buying a promising challenger would suppress competition.

The Federal Trade Commission then warned Metsera about antitrust risk in Novo Nordisk’s deal structure. On November 8, 2025, Novo Nordisk said it would not raise its bid again, stating that it believed its structure was compliant but declining to proceed. Metsera’s shareholders approved the Pfizer deal on November 13 at $86.25 a share [9][10]. Both Pfizer suits were dismissed by stipulation in February 2026.

The lesson for Novo Nordisk is uncomfortable: its size in obesity is now an obstacle to buying its way out of a pipeline problem.

What has Novo Nordisk done since?

A lot, and some of it is working.

It launched the first oral GLP-1 for weight loss. The FDA approved the Wegovy pill (oral semaglutide 25 mg) on December 22, 2025, and Novo Nordisk launched it on January 5, 2026, at $149 a month for the starting dose in the cash-pay channel. The company calls it the strongest GLP-1 volume launch in US history: it reported passing 5 million prescriptions by the August 2026 half-year results, and said more than 80% of new prescriptions for the pill were going to people new to the GLP-1 class [8][19]. That last figure is Novo Nordisk’s own claim about new starts, not a share of all prescriptions, and the weekly counts the company quotes come from its partner-reported paid claims rather than IQVIA, which tracks a lower number.

It launched a higher dose. Wegovy HD (semaglutide 7.2 mg) was approved on March 19, 2026 on the STEP UP trial, which showed 20.7% mean weight loss, and launched in April [8].

It cut prices, twice over. The November 2025 most-favored-nation agreement set Medicare and participating Medicaid prices at $245 a month, put a $50 monthly copay in front of eligible Medicare beneficiaries from July 1, 2026, and put cash-pay doses on the TrumpRx platform [11]. Then in February 2026 the company said it would cut US list prices for Wegovy, Ozempic and Rybelsus to $675 a month from January 1, 2027 — roughly 50% and 35% cuts for Wegovy and Ozempic [17].

It spent heavily on marketing. Novo Nordisk spent an estimated $316 million advertising Wegovy and $169 million advertising Ozempic in the United States in the first nine months of 2025, up 54% and 44% year over year and more than double Eli Lilly’s comparable spending [18]. Doustdar’s framing is that obesity “acts a lot more as a consumer business than a traditional medication.”

It went on the legal offensive — and then settled the biggest fight commercially. Novo Nordisk sued Hims & Hers on February 9, 2026 for patent infringement over compounded semaglutide. A month later, on March 9, it voluntarily dismissed every claim without prejudice, with no ruling on the merits, and the two companies announced an arrangement instead: Hims & Hers would sell FDA-approved Ozempic and Wegovy at the same price as other telehealth platforms and stop advertising compounded GLP-1 products [20]. The Eli Lilly suit is still live — Novo Nordisk filed it in New Jersey federal court on July 21, 2026, alleging false advertising in comparative GLP-1 campaigns [8].

Is the company actually recovering?

The financial answer is mixed, and worth reading carefully because the headline numbers are confusing.

Novo Nordisk entered 2026 guiding to an adjusted sales decline of 5% to 13% at constant exchange rates — its first guided contraction of the GLP-1 era [7]. It then raised that guidance twice: to -4% to -12% in May, and to 0% to -6% in August, both times crediting the Wegovy pill and growth outside the United States [15][8].

You may also see headlines saying first-quarter 2026 sales “jumped 32%.” That number is real but misleading: it includes a one-time reversal of a USD 4.2 billion rebate provision tied to a change in how Novo Nordisk handles the 340B discount program. Strip it out and adjusted first-quarter sales fell 4% [8].

Second-quarter 2026 adjusted sales rose 7% at constant exchange rates to DKK 78.5 billion, and adjusted operating profit rose 11% [8]. Obesity care is growing again. Diabetes, squeezed by pricing and by patent expiries in markets such as Canada, India, China and Brazil, is not.

Doustdar’s own summary, nine months into the job: “I am a lot more optimistic today than the day I got the job” [19].

What is changing at the company right now?

Two things, one week apart.

On September 14, 2026, Novo Nordisk announced a corporate rebrand. It will use the single name “Novo” in day-to-day communication, under the line “Lasting Health Starts Now,” while Novo Nordisk A/S remains the legal company name and the Apis bull logo stays, in updated form. It paired this with a new internal cultural framework, “The Novo Way,” built on customer obsession, competitiveness, clarity, and care and integrity [21]. Nothing about the product names changes: Ozempic, Wegovy, Wegovy HD, the Wegovy pill and the Ozempic pill are unaffected, and US labels still say Novo Nordisk.

On September 21, 2026, the company holds its first Capital Markets Day under Doustdar, in London, where it has said it will lay out the updated strategy, long-term financial targets and previously undisclosed early-stage pipeline assets [21]. That event had not happened when this article was last verified, so nothing from it appears here yet.

What does this mean if you take one of these medicines?

Practically, less than the headlines suggest.

The supply shortage that defined 2023 and 2024 ended. Novo Nordisk’s manufacturing capacity is larger now than it has ever been, and the CEO has described the company’s ability to ramp production as “second to none” [19].

Prices in the cash-pay channel have come down substantially, and list prices are scheduled to fall further in 2027. Medicare coverage for obesity medicines exists for the first time through a temporary bridge program.

What has not changed is that the decision about whether a GLP-1 medicine is appropriate, which one, and at what dose belongs with a healthcare provider. Corporate turbulence is a business story, not a clinical one. If your prescription, coverage or cost changes, your prescriber and your plan are the right places to sort it out.

Sources

1. Wegovy maker Novo’s profit warning triggers $70 billion share rout — Reuters, July 29, 2025
2. Novo Nordisk shares plunge 23% after Wegovy maker names new CEO, cuts full-year guidance — CNBC, July 29, 2025
3. Lars Fruergaard Jorgensen to step down as CEO of Novo Nordisk — Novo Nordisk A/S, May 16, 2025
4. Novo Nordisk to lay off 9,000 workers in major restructuring — BioPharma Dive, September 10, 2025
5. Novo Nordisk chair and directors quit after boardroom rift — CNBC, October 21, 2025
6. Five-year overview, Novo Nordisk Annual Report 2025 — Novo Nordisk A/S
7. Novo Nordisk financial report for 1 January to 31 December 2025 (Form 6-K) — Novo Nordisk A/S via SEC EDGAR, February 3, 2026
8. Novo Nordisk financial report for 1 January to 30 June 2026 (Form 6-K) — Novo Nordisk A/S via SEC EDGAR, August 4, 2026
9. Pfizer wins bidding war for Metsera with $10B offer — BioPharma Dive, November 8, 2025
10. Superior until it was not: regulatory closing risk in Novo Nordisk’s bid for Metsera — White & Case LLP via JD Supra, 2026
11. Trump, Eli Lilly, Novo Nordisk unveil deals to cut obesity drug prices — CNBC, November 6, 2025
12. Evoke phase 3 trials did not demonstrate a statistically significant reduction in Alzheimer’s disease progression — Novo Nordisk via GlobeNewswire, November 24, 2025
13. Novo Nordisk sinks 16% after weight loss drug fails to match Eli Lilly’s in trial — CNBC, February 23, 2026
14. Novo Nordisk provides update on the ZEUS phase 3 trial — Novo Nordisk via GlobeNewswire, July 31, 2026
15. Novo Nordisk (NVO) Q1 2026 earnings: Wegovy sales jump — CNBC, May 6, 2026
16. The oral GLP-1 tracker: Novo’s Wegovy pill vs Lilly’s Foundayo — Fierce Pharma, September 11, 2026
17. Novo Nordisk announces significant reduction in US list price for Wegovy, Ozempic and Rybelsus — Novo Nordisk via PR Newswire, February 24, 2026
18. Exclusive: Novo’s Wegovy and Ozempic US advertising spend doubles rival Eli Lilly — Reuters, January 28, 2026
19. ‘I’m a lot more optimistic today’: Mike Doustdar on his first year as Novo Nordisk CEO — Fierce Pharma, June 11, 2026
20. Hims & Hers shares surge after Novo Nordisk drops patent infringement case over compounded weight loss drugs — CNBC, March 9, 2026
21. Novo Nordisk enters next chapter to bring better health to more people, supported by ‘Novo’ rebrand and updated corporate culture — Novo Nordisk via GlobeNewswire, September 14, 2026
22. Novo Nordisk stops two cardiovascular trials of drug aimed at lowering inflammation — STAT News, September 7, 2026
23. Novo Nordisk cans two more trials of IL-6 heart drug for futility — Endpoints News, September 7, 2026