Novo Nordisk warns 2026 sales and profit could drop as much as 13%

Novo Nordisk said on Feb. 3 that its 2026 sales and adjusted operating profit could each fall by as much as 13% at constant exchange rates, a forecast that knocked close to $50 billion off the Danish drugmaker's market value the next day ^[1][2].

The company guided to a decline of 5% to 13% for both measures ^[2]. That would be Novo's first sales drop in years ^[1]. Revenue had climbed 10% in 2025, reaching 309 billion Danish kroner ^[1]. A company-compiled poll of analysts had pointed to an average decline of about 2% for 2026, so the outlook landed far below expectations ^[2]. Citi analysts calculated that the midpoint of the guidance sat 8% below consensus for sales and 10% below for operating profit ^[1]. The guidance was published after the European market closed on Feb. 3 ^[1].

Novo's Copenhagen-listed stock opened Feb. 4 at 302.00 kroner, down from 367.80 kroner at the previous close, an 18% slide, according to Pharmaceutical Technology ^[1]. Reuters, writing around midday, described a 16% drop ^[2]. The two figures differ. Reuters said the selloff removed almost $50 billion in value ^[2]. Novo had been Europe's most valuable listed company in 2024, valued above $600 billion; the close on Feb. 3 left it at $259 billion ^[2].

"Our 2026 guidance reflects a year of unprecedented pricing pressure," CEO Doustdar told journalists on a call, describing the hit as "painful" and saying he hoped it would prove "an investment for our future" ^[2]. CFO Karsten Munk Knudsen told Reuters the US squeeze comes more from an unexpectedly large shift toward patients paying cash and from insurers demanding bigger rebates than from the Trump administration's most favored nation policy ^[2]. He said US sales would fall "in the teens" ^[2].

Novo pointed to weaker realized prices, especially in the US, tougher competition and semaglutide patent losses in markets outside the United States ^[2]. Pharmaceutical Technology reported that the company also cited the November 2025 White House pricing deal that cut prices for its Wegovy and Ozempic brands, semaglutide's inclusion under the Inflation Reduction Act — which Novo is contesting in court — and patent expiries in Brazil, Canada and China ^[1]. Eli Lilly's tirzepatide brands, Zepbound and Mounjaro, have overtaken Wegovy and Ozempic as the fastest-selling GLP-1 treatments for obesity and type 2 diabetes respectively, that report said ^[1].

Weekly prescriptions of the oral Wegovy reached roughly 50,000 as of Jan. 23, more than double the 20,000 a week shown in market tracking data that misses cash purchases through NovoCare and telehealth ^[1][2]. About 90% of US sales of the pill have been cash-pay ^[2]. The FDA cleared the oral form in December 2025 ^[1]. Citi analysts wrote that the financial headwinds "are partially offset by an early strong Wegovy pill launch, though it is yet too early to extrapolate" ^[1].

Why it matters for patients

People who pay out of pocket have already seen prices move. Novo sells lower doses of the daily Wegovy pill in the US at $149 a month for self-paying patients, rising to $199 in April, and has offered the Wegovy injection at $349 a month to cash payers since November ^[2]. Lilly plans to cap higher doses of its own obesity pill, if approved, at $399 a month for repeat cash buyers ^[2].

Novo also competes with compounded versions of GLP-1 drugs. As many as 1.5 million Americans use compounded GLP-1 weight-loss medications instead of branded products, Reuters reported ^[2]. Knudsen said Novo remains "still frustrated" that "mass marketing of a product unapproved by the FDA" continues, and that addressing it is up to US regulators and politicians ^[2].

Whether Novo plans further price cuts, or whether insurance coverage or supply for Wegovy, Ozempic and Rybelsus will change, has not been disclosed.

What happens next

The guidance covers the full year 2026, with no quarterly breakdown given ^[2]. The self-pay price of lower-dose oral Wegovy rises from $149 to $199 a month in April ^[2]. Lilly's obesity pill is not yet approved, so its proposed $399 cash price applies only if it wins clearance ^[2]. Novo is counting on CagriSema, its next-generation obesity candidate, which produced positive Phase III trial results earlier that week ^[1]. Its court fight over the Inflation Reduction Act price change is ongoing ^[1].