Novo Nordisk cuts 2025 outlook and picks insider Maziar Mike Doustdar as CEO

Two announcements arrived together from Novo Nordisk on July 29: a sharply reduced forecast for the rest of 2025 and a new chief executive. By the afternoon, about $70 billion had been erased from the Danish drugmaker's market value ^[1].

Novo now expects sales to grow 8% to 14% this year at constant exchange rates, where it had previously guided investors to 13% to 21% ^[1][2]. Operating profit growth is projected at 10% to 16%, down from a range of 16% to 24% ^[2]. The company tied the revision to weaker second-half expectations in the United States for Wegovy, its weight-loss drug, and Ozempic, its diabetes treatment ^[2].

Novo listed three causes: continued use of compounded GLP-1s, a market expanding more slowly than anticipated, and competition ^[2]. Compounded products are custom-made medicines using the same active ingredients as brand-name drugs. U.S. law bars pharmacies from replicating approved medicines, but compounding has been allowed for patients who need a dose or formulation that differs from the approved label ^[1].

It is the second time this year Novo has stepped back from its own forecast. A May downgrade came alongside first-quarter sales that fell short of expectations ^[2].

Investors sold heavily. Reuters reported the stock fell as much as 29.8% before paring losses to trade down more than 20% by mid-afternoon, leaving it 44% lower for the year ^[1]. CNBC reported a decline of as much as 26% and a close down 23%, with year-to-date losses above 42% ^[2]. The two accounts differ on the intraday low and on the annual decline. Reuters noted that Novo was worth as much as $615 billion at its peak in June 2024 ^[1].

Much of the concern involves compounding. When the Food and Drug Administration ended permission for compounded copies of Wegovy on May 22, Novo said it expected many of the roughly one million U.S. patients using compounded GLP-1s to move to branded treatments. Chief Financial Officer Karsten Munk Knudsen told analysts that did not happen. "Unfortunately, our latest market research indicates that has not happened," he said, adding that a million or more U.S. patients are still on compounded versions ^[1]. David Moore, who leads Novo's U.S. operations, said the company has increased its contact with the FDA about limiting unlawful compounding. "Compounding continues to be an issue that we have to address," Moore said ^[1].

Markus Manns, a portfolio manager at Union Investment, a Novo shareholder, called the size of the cut "a shocker" and said the company's problems run deeper than compounded copycats ^[1]. Angelo Meda of Banor SIM in Milan said, "The stock has gone from being a market darling to one of its biggest letdowns," and described the leading worry as "the illegal channel siphoning away market share - something that's hard to quantify" ^[1].

Maziar Mike Doustdar, who joined Novo in 1992 and most recently ran its international operations, starts Aug. 7 ^[1][2]. He replaces Lars Fruergaard Jorgensen, whose removal was announced in May ^[1][2]. "We need to increase the sense of urgency and execute differently," Doustdar told analysts on a call ^[1]. Chairman Helge Lund called him "the best person to lead Novo Nordisk through its next growth phase" ^[2]. Some analysts and investors had pushed for an American or a leader with deep U.S. experience, a market Novo has lost ground in to Eli Lilly, whose Zepbound has outpaced Wegovy by more than 100,000 prescriptions a week this year ^[1].

Why it matters for patients

Nothing in the announcement changes what Wegovy or Ozempic are approved to treat, and no safety finding, recall or label change has been reported. The practical signal is about access: by Novo's own estimate, a million or more Americans are still getting GLP-1 drugs through compounding pharmacies rather than through the company's FDA-approved products ^[1]. That is relevant to anyone whose prescription comes from a compounder, because the FDA's May action appears to have moved fewer patients than the manufacturer predicted ^[1].

Novo has not said whether list prices, discount programs or supply arrangements will change because of the guidance cut. The reports also do not break down how much U.S. business shifted to compounded products versus Zepbound or other rivals, and where patients now using compounded GLP-1s will end up has not been disclosed.

What happens next

Novo reports second-quarter sales on Aug. 6 ^[2], and Doustdar takes over the following day ^[1][2]. The company has not said when it will update guidance again. Two things to watch: whether U.S. sales of Wegovy and Ozempic recover in the second half of the year, and whether the number of patients using compounded versions falls. Novo has not given a target or a deadline for either.