Novo Nordisk's Wegovy pill posts $355 million in first quarter as guidance rises

Novo Nordisk said its Wegovy pill, the oral form of semaglutide, brought in DKK 2.26 billion, or about $355 million, in the first three months of 2026, its first full quarter on the U.S. market ^[1][2][3]. The Danish drugmaker also raised its 2026 forecast on May 6, citing higher expectations for GLP-1 product sales ^[1][2].

The pill launched in the U.S. on Jan. 5 ^[2][3]. Novo reported about 1.3 million prescriptions in the quarter and more than 2 million since launch ^[1][2]. For the week ending April 17, weekly prescriptions for the pill exceeded 200,000 ^[2]. Novo called it "the strongest-ever GLP-1 volume launch in the US" ^[2]. Quarterly pill sales beat analyst estimates of 1.16 billion kroner compiled by Reuters ^[1], though Novo said the figure included pre-launch stocking with wholesalers and telehealth partners ^[2].

Across the company, reported net sales rose 32% at constant exchange rates to DKK 96.8 billion ($15.2 billion), and reported operating profit rose 65% ^[1][2]. Excluding a $4.2 billion one-time reversal of a provision tied to the U.S. 340B Drug Pricing Program, adjusted sales fell 4% and adjusted operating profit fell 6% ^[1][2]. Adjusted obesity care sales rose 22% to DKK 20.9 billion ^[2][3]. Injectable Wegovy sales rose 12% at constant rates to DKK 18.2 billion, slightly short of LSEG estimates ^[1][2]. Ozempic adjusted sales fell 8% to DKK 27.8 billion ^[1][2]. One trade publication described the diabetes and Ozempic figures as growth rather than declines ^[3]; Novo's filing reports them as decreases at constant exchange rates ^[2].

Full-year guidance now calls for adjusted sales and adjusted operating profit to fall 4% to 12% in 2026, an improvement on the previously projected 5% to 13% decline ^[1][2][3]. Novo shares rose 6.7% in morning trading in Copenhagen before closing about 2.3% higher ^[1]; the trade report described the stock as up about 3% during the morning ^[3]. Jefferies analysts wrote that the guidance change was unlikely to lift consensus forecasts and that not raising the bottom of the range more may be seen as a negative ^[1].

Competition and pricing

Eli Lilly launched its own obesity pill, Foundayo (orforglipron), in the U.S. in April after FDA approval on April 1 ^[1][3]. CEO Mike Doustdar said the Wegovy brand now holds 65% of all new U.S. prescriptions and called the situation a "turnaround situation" ^[1]. He said pill sales are growing by double digits despite the new competitor ^[1].

Jamey Millar, Novo's U.S. operations head, said about 80% of people who have taken the Wegovy pill are new to the GLP-1 class ^[3]. No head-to-head trial of the two pills has been run ^[1]; Novo cited an indirect comparison suggesting greater efficacy and a lower chance of discontinuation for its pill ^[3]. Lilly's approval was based on average weight loss of 12.4% versus placebo ^[3], while Novo cites 17% weight loss for the Wegovy pill ^[3].

Novo set the starting 1.5 mg dose at $149 per month for cash-paying patients, with commercially insured patients using savings plans initially paying as little as $25; the second dose is $199 and the highest doses $299 per month without insurance ^[3]. Millar said most sales so far have come from self-paying patients and that he expects self-pay and insurance channels to level out after the pill's addition to major pharmacy benefit manager formularies ^[3]. Doustdar said prices will have to come down over the long run to reach far more patients, but that "for now, this is the right price" ^[3].

Why it matters for patients

There are now two oral GLP-1 pills marketed for weight loss in the U.S., plus the older injectable options ^[1][3]. For people who prefer a daily tablet to an injection, the Wegovy pill adds a choice with published cash prices ^[3]. Novo also launched a higher-dose injectable, Wegovy HD (semaglutide 7.2 mg), in the U.S. on April 7 after FDA approval in March; in the STEP UP trial it produced 20.7% mean weight loss ^[2].

Coverage is still in flux. Novo has said insurance formulary placement expanded at the end of the first quarter, which could shift how much patients pay out of pocket ^[3]. How quickly prices fall, and whether employers and insurers keep covering the pills, has not been disclosed ^[3].

What happens next

Pending regulatory decisions, Novo expects the first Wegovy pill launches outside the U.S. during the second half of 2026 ^[1][2]. Lilly has said the Foundayo rollout will take "quarters, not days" ^[1]. Novo has not reported a head-to-head study of the two pills, and none has been announced ^[1].