Novo Nordisk closes its worst year on record, down nearly 50%
Novo Nordisk's stock fell nearly 49% in 2025, its worst year ever, and the company now expects lower prices and falling US revenue in 2026 — changes that shape what semaglutide costs and who can get it.
Novo Nordisk, the maker of Ozempic, Wegovy and Rybelsus, ended 2025 with its shares down nearly 49% in Copenhagen trading, the worst annual performance in the company's history [1]. One source describes the drop as nearly 50% [2]. The slide capped a year in which the Danish drugmaker lost ground in the US obesity market and faced mounting pressure on the prices it can charge.
The scale of the problem became clearer when Novo Nordisk pre-released its 2026 outlook in early February 2026. The company said sales and operating profit would each fall 5% to 13% at constant exchange rates, compared with analyst expectations of declines of roughly 1.4% and 3.1% [1]. Shares dropped about 18% in Copenhagen and 5.37% in New York to $47.60 on Feb. 4, 2026 [2]. Bank of America analyst Sachin Jain put the adjusted sales guidance about 8% below consensus at the midpoint [2].
The 2025 numbers behind the drop
On paper, 2025 was not a bad year for revenue. Full-year sales rose 6% to 309.06 billion Danish kroner, or 10% at constant currencies, slightly beating expectations [1]. Obesity care sales grew 31% at constant currencies, while GLP-1 diabetes sales grew 6% [1]. Ozempic brought in DKK 127.09 billion for the year [1]. Fourth-quarter sales fell 7.6% year over year to DKK 79.14 billion but still beat forecasts, with Wegovy at DKK 21.86 billion in the quarter [1]. Operating profit was DKK 127.66 billion, down 0.5% as reported [1]. The company said it provided innovative treatments to 46 million patients in 2025 [1].
What spooked investors was the outlook, not the past. Novo Nordisk pointed to three main forces: lower realized prices under the "most-favored-nation" agreement with the US government, expiry of the semaglutide molecule patent in some international markets, and tougher competition [1][2]. The company also cited reduced Medicaid coverage for obesity medications in the US and a one-time $4.2 billion rebate provision reversal tied to the 340B program that will not repeat [1]. Eli Lilly's Zepbound was named as a direct competitive pressure on Ozempic and Wegovy [1].
CEO Mike Doustdar told CNBC that "people should expect that it goes down before it comes back up" [2]. Asked whether the company was in crisis, he said "no" [2]. Barclays analysts said some investors might read the guidance as a "kitchen sink" forecast that could be beaten, but warned that similar thinking failed after Novo cut guidance in July 2025 and the stock fell 23% in a single day [2].
Why it matters for patients
Much of Novo Nordisk's projected revenue decline comes from charging less, not selling less. The company said the global GLP-1 market should keep expanding and that it expects to increase volumes and patient coverage, offset by lower realized prices [1]. In practical terms, the financial pain investors dislike reflects price cuts aimed at broadening access.
The clearest example is the oral Wegovy pill, a once-daily 25 mg oral semaglutide. Source [1] lists the FDA approval date as Dec. 22, 2024, which is hard to reconcile with the US launch date of Jan. 5, 2026, given in the same source; the approval year appears to be a reporting error, and the correct date is not established by these sources [1]. The starting dose is marketed at $149, described as a fraction of earlier injectable pricing [2]. Early uptake figures differ: source [1] cites about 50,000 total weekly prescriptions by Jan. 23, driven by the 1.5 mg starting dose in the cash-pay channel, while source [2] reports 170,000 patients after four weeks [1][2]. Doustdar said "the price hit on the existing business trumps, basically, the great pill launch that we've had" [2].
What happens next
Novo Nordisk plans to launch Wegovy in more markets in 2026 and roll out the 7.2 mg dose in several countries [1]. Regulatory decisions are expected in 2026 for CagriSema in obesity and Mim8 in hemophilia [1]. The board proposed a final dividend of DKK 7.95 per share at the annual general meeting on March 26, 2026, and approved a buyback of up to DKK 15 billion [1]. Dave Moore, head of US operations, is leaving and will be succeeded by Jamey Millar, formerly of UnitedHealth Group [2].
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Sources
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