Q1 2026: Wegovy pill posts DKK 2.26 billion in its first quarter; guidance raised

Novo Nordisk reported on May 6 that its oral semaglutide obesity drug, the Wegovy pill, generated DKK 2,256 million in sales during the first three months of 2026 — roughly $355 million ^[2][3]. That was about double the DKK 1.16 billion that analysts polled by Reuters had expected ^[1]. The company raised its full-year outlook and its shares climbed ^[1].

The pill launched in the US on Jan. 5, 2026 ^[3]. Novo said it was dispensed about 1.3 million times during the first quarter and more than 2 million times in total by April 17, which the company called the strongest GLP-1 volume launch ever in the US ^[2]. For the week ending April 17, weekly prescriptions for the pill topped 200,000, out of roughly 475,000 total weekly Wegovy prescriptions across all forms ^[2]. Novo said the quarter's sales figure was inflated somewhat by "pre-launch pipeline fill" — stocking inventory with wholesalers and telehealth partners ^[2].

Who is taking it, and at what price

Jamey Millar, Novo's head of US operations, said about 80% of people starting the Wegovy pill were new to GLP-1 drugs entirely, and that the company sees "limited cannibalization from injectable Wegovy" ^[3]. CEO Mike Doustdar told CNBC that people are using "both" pill and pen, describing a "synergetic effect" rather than one product eating the other ^[1]. Novo estimates more than 1 million people have been treated since launch ^[3].

Most sales so far have come from people paying cash ^[3]. Novo priced the starting 1.5-mg dose at $149 a month for cash-paying patients, with commercially insured patients using savings plans initially paying as little as $25 for the same supply; the second dose level is $199 a month and the highest doses $299 a month without insurance ^[3]. Millar said the company expects the mix of self-pay and commercial insurance sales to even out now that the pill was added to major pharmacy benefit manager formularies by the end of the first quarter ^[3]. Doustdar called the current price a "sweet spot" but acknowledged that in the long run, "prices have to come down if your ambition is to get to hundreds of millions of patients" ^[3].

The rest of the numbers

Reported first-quarter sales rose 32% at constant exchange rates to DKK 96,823 million ($15.2 billion), boosted by a one-time $4.2 billion provision reversal tied to the US 340B Drug Pricing Program ^[1][2]. Excluding that item, adjusted sales fell 4% and adjusted operating profit fell 6% ^[2]. Injectable Wegovy sales rose 12% to DKK 18,235 million ^[2]. Ozempic came in at DKK 27,825 million; Novo's own filing lists that as an 8% decline at constant rates, while Fierce Pharma described it as 8% growth — the company's filing shows a decline ^[2][3]. Rybelsus fell 15% ^[2].

Novo raised 2026 guidance for both adjusted sales and adjusted operating profit to a decline of 4% to 12%, up from a projected drop of 5% to 13% ^[1][2][3]. Shares rose 6.7% in morning trading in Copenhagen and closed about 2.3% higher, per CNBC; Fierce Pharma reported the stock trading up around 3% Wednesday morning ^[1][3]. Analysts at Jefferies said the modest change to the bottom end of the range could be read as a negative ^[1].

Why it matters for patients

The practical story here is access. Novo says the pill is drawing people who had never used a GLP-1 before, and formulary additions at large PBMs mean some people who paid cash in January may see insurance pick up part of the cost later in the year ^[3]. Pricing is tiered by dose, so monthly cash cost rises as the dose goes up ^[3].

On effectiveness, Novo cites 17% weight loss for the Wegovy pill ^[3], while the FDA approved Eli Lilly's orforglipron pill, Foundayo, on April 1 based on average weight loss of 12.4% versus placebo ^[3]. No head-to-head trial comparing the two pills has been run ^[1]. Novo also launched Wegovy HD, injectable semaglutide 7.2 mg, in the US on April 7, after the STEP UP trial showed 20.7% mean weight loss ^[2].

What happens next

Novo expects the first Wegovy pill launches outside the US in the second half of 2026, pending regulatory decisions ^[1][2]. Lilly CEO David Ricks said Foundayo's ramp-up will take "quarters, not days" ^[1].