Novo Nordisk reports 10% 2025 sales growth and guides to a 2026 sales decline

Novo Nordisk reported 2025 net sales of DKK 309.1 billion, up 6% in Danish kroner and 10% at constant exchange rates, and guided to its first full-year sales decline of the GLP-1 era: adjusted sales are expected to fall 5% to 13% in 2026 at constant exchange rates ^[1].

Operating profit for 2025 was DKK 127.7 billion, down 1% in kroner and up 6% at constant exchange rates ^[1]. Without about DKK 8 billion in costs tied to a company-wide restructuring, operating profit would have risen 6% in kroner and 13% at constant exchange rates, the company said ^[1]. Net profit was DKK 102.4 billion, up 1%, and diluted earnings per share were DKK 23.03 ^[1]. Pharmaceutical Executive reported the same results in dollars: $43.27 billion in net sales, $17.88 billion in operating profit at constant exchange rates and about $1.12 billion in transformation costs ^[2].

Obesity and diabetes care sales reached DKK 289.5 billion, up 7% in kroner and 10% at constant exchange rates. Obesity care grew 31% at constant exchange rates to DKK 82.3 billion, while GLP-1 diabetes sales rose 6% at constant exchange rates. Rare disease sales were DKK 19.6 billion, up 9% at constant exchange rates ^[1]. US operations grew 8% at constant exchange rates and international operations grew 14% ^[1]. The fourth quarter was weaker than the full year: sales fell 2% and operating profit fell 4% at constant exchange rates ^[2].

For 2026, adjusted sales and adjusted operating profit are each expected to decline 5% to 13% at constant exchange rates, with the adjusted figures excluding a reversal of 340B Drug Pricing Program rebate provisions ^[1]. Novo Nordisk attributed the outlook to lower realized prices, including effects of the "Most Favoured Nations" agreement in the US, the patent expiry of the semaglutide molecule in certain international markets, and competition ^[1]. Pharmaceutical Executive also cited reductions in Medicaid coverage for obesity treatments as a US pressure ^[2]. Novo Nordisk said 2026 sales and operating profit will be helped by a reversal of USD 4.2 billion in 340B rebate provisions ^[1].

"In 2026, Novo Nordisk will face pricing headwinds in an increasingly competitive market. However, we are very encouraged by the promising early uptake from the US launch of Wegovy® pill, and we remain confident in our ability to drive volume growth over the coming years," CEO Mike Doustdar said ^[1][2]. The company said it reached nearly 46 million people with its treatments in 2025 ^[1].

That Wegovy launch is recent. The FDA approved once-daily oral semaglutide 25 mg, sold as the Wegovy pill, on Dec. 22, 2025, and it launched Jan. 5, 2026. As of Jan. 23, weekly prescriptions totaled about 50,000, driven mainly by the 1.5 mg starter dose in the self-pay channel ^[1].

Why it matters for patients

The 2026 guidance is about revenue and profit, not about changes to the medicines themselves. Novo Nordisk ties the expected decline to prices, competition, patent expiry in some international markets and lower Medicaid coverage of obesity treatments in the US ^[1][2]. Whether those pressures reach US list prices or out-of-pocket costs for people taking semaglutide has not been disclosed.

Patients on Ozempic, Wegovy or Rybelsus — all semaglutide — have no signal in these reports that supply or availability will change in 2026; the company did not address supply in its 2025 report or outlook ^[1]. Novo Nordisk said the global GLP-1 market is expected to keep expanding, and that new options such as the Wegovy pill and higher doses of Wegovy should let it continue to increase patient reach and expand volumes ^[1].

The early Wegovy pill numbers show most prescriptions so far are for the 1.5 mg starter dose paid for outside insurance ^[1]. How much insurers will cover the pill, and at what copay, has not been reported. Novo Nordisk has also submitted semaglutide 7.2 mg to the FDA ^[1]; a US approval decision and pricing for that dose have not been announced.

What happens next

Novo Nordisk's annual general meeting is set for March 26, 2026, where the board will propose a final dividend of DKK 7.95 per share, bringing the 2025 total to DKK 11.70, and the company has started a share repurchase program of up to DKK 15 billion ^[1]. Pharmaceutical Executive reported the buyback at about $2.1 billion ^[2].

The company said it expects US regulatory decisions this year for CagriSema in obesity and Mim8 (denecimig) in hemophilia, and plans to present new strategic aspirations at a Capital Markets Day on Sept. 21, 2026 ^[1].