Novo Nordisk warns of 2026 sales and profit decline as two top executives leave

Novo Nordisk said it expects sales and operating profit to fall between 5% and 13% in 2026, a warning that sent its shares down more than 15% and came as two senior executives prepared to leave the company ^[1].

The Danish drugmaker released the outlook on Tuesday, Feb. 3. Novo said it expects U.S. sales to decline amid "intensifying competition" and lower prices in parts of its business, and it flagged a hit from the "Most Favored Nation" pricing deal it struck with the Trump administration ^[1].

CEO Maziar Mike Doustdar told journalists Wednesday that the guidance "reflects a year of unprecedented pricing pressure." "We do not take this lightly, and we will do what we can to pursue volume opportunities in obesity and diabetes," he said ^[1].

The numbers behind the warning

In 2025, Novo posted sales growth of 10% and operating profit growth of 6% at constant exchange rates, the company said ^[1]. Total sales came to about 309 billion Danish kroner, or nearly $50 billion, a 6% increase measured in kroner. Ozempic, its type 2 diabetes drug, brought in roughly 127 billion kroner (about $20 billion) for the year, while Wegovy, the same semaglutide molecule approved for obesity, accounted for 79.1 billion kroner (nearly $13 billion) ^[1].

Novo also expects a currency hit in 2026 because the U.S. dollar has lost value against the Danish krone, its local currency ^[1]. Outside the U.S., Novo expects sales to grow as the global GLP-1 market expands, but it anticipates patent expirations for its key semaglutide molecule in some international markets ^[1]. Lower sales, combined with what the company described as "targeted investments in current and future growth opportunities within R&D and commercial," feed into the profit projection. Novo plans to reinvest some of the savings from the thousands of layoffs it is working through ^[1].

One bright spot was the Wegovy pill. Doustdar said more than 170,000 people were on it in about four weeks, more than double the uptake of previous branded anti-obesity drugs launched in the U.S. He added that most prescriptions appear to be for patients new to these medications, "suggesting that the market is indeed expanding" ^[1].

Leadership changes

Dave Moore, executive vice president of U.S. operations, is leaving for personal reasons ^[1]. Novo credited him with creating its global business development function and overseeing the launch of Ozempic. Jamey Millar replaces him, joining this week from his prior role as CEO of UnitedHealth Group's Optum Specialty Holdings ^[1].

Ludovic Helfgott, executive vice president of product and portfolio strategy, is leaving to pursue new opportunities ^[1]. Novo said Helfgott boosted its "presence and competitiveness in rare blood and endocrine disorders" and ended up leading commercial strategy, medical affairs and business development across all therapy areas. Hong Chow, formerly executive vice president and head of China and international at Merck KGaA, takes the role ^[1].

Investors sent Novo's share price down more than 15% after the disclosures, and trading was briefly halted Tuesday because of the volatility, Bloomberg reported ^[1]. Jefferies analysts wrote in a note to clients that the company's fourth-quarter 3% sales beat will likely be "overshadowed" by the need for market watchers to trim their forecasts ^[1].

Why it matters for patients

The pressures Novo describes are the backdrop for what U.S. patients pay for these drugs and how easily they can get them. Novo ties its expected U.S. sales decline to lower prices in some areas of its business and to a government pricing deal — forces that can work in patients' favor on cost, but can also shape which products companies promote and how ^[1].

The Wegovy pill figures matter because they suggest the market is drawing in people who were not already taking an anti-obesity drug, rather than only switching existing patients. Novo says it is still early in the launch, so whether that pattern holds has not been established ^[1].

Turnover in the top U.S. operations job and in product and portfolio strategy means the people making decisions about supply, launches and pricing in the U.S. are changing. Novo has not disclosed how, or whether, these changes will affect specific products or patient programs ^[1].

What happens next

Jamey Millar joins Novo's U.S. operations leadership this week ^[1]. The company has not disclosed a start date for Hong Chow in the product and portfolio strategy role ^[1]. Novo's guidance covers the full year 2026; the company has not said when it will next update those figures, and it has not said whether more leadership changes are coming ^[1].