Supreme Court declines to hear Novo Nordisk's Inflation Reduction Act challenge

The U.S. Supreme Court has denied Novo Nordisk's petition for review of its challenge to the Inflation Reduction Act's drug pricing provisions, ending the case with no appeals left ^[1]. The denial leaves in place a Third Circuit decision that dismissed the company's challenge ^[1].

Novo Nordisk has not disclosed what the end of the litigation means for its US pricing strategy, contracting or rebate programs, and the company has not said whether any of its semaglutide products will be priced differently as a result ^[1]. How the outcome affects what patients or their insurers pay for Ozempic, Wegovy or Rybelsus also has not been reported ^[1].

The company's most recent half-year report, published August 4, 2026, describes the pricing environment it is operating in. Net sales for the second quarter of 2026 were DKK 78,488 million, up 3% at constant exchange rates, while adjusted net sales rose 7% at constant exchange rates ^[1]. Adjusted operating profit was DKK 33,389 million, up 11% at constant exchange rates ^[1]. Reported operating profit fell 16% at constant exchange rates; Novo Nordisk attributed the decline in part to a DKK 2.6 billion rebate provision reversal tied to the US 340B Drug Pricing Program recorded in the second quarter of 2025, and to DKK 6.3 billion in non-cash impairment charges related to pipeline assets in the second quarter of 2026, including DKK 4.0 billion for monlunabant ^[1].

GLP-1 prescriptions continue to grow. For the week ending July 17, total US Wegovy prescriptions were about 575,000, including more than 265,000 for the Wegovy pill, which has passed 5 million prescriptions since launch ^[1]. Adjusted obesity care sales grew 19% at constant exchange rates in the first half of 2026 ^[1]. Novo Nordisk raised its 2026 outlook, saying adjusted sales growth is now expected to be 0% to -6% at constant exchange rates and adjusted operating profit growth 0% to -6%, with the improved outlook driven by increased expectations for GLP-1 product sales ^[1].

Why it matters for patients

The case concerned the Inflation Reduction Act's drug pricing provisions ^[1]. With the Supreme Court declining to hear it, those provisions stand as the lower courts applied them, and Novo Nordisk has no further appeal ^[1].

For people taking semaglutide, the immediate effect is indirect. The Court's action does not change what is prescribed, what a plan covers, or what a pharmacy charges, and Novo Nordisk's report does not describe any price or rebate changes tied to the litigation ^[1]. Cost-sharing, prior authorization and formulary decisions are set by insurers and pharmacy benefit managers, and those terms are not addressed in the company's disclosures ^[1].

What the report does show is that rebates and government pricing programs remain a live part of the company's US business. Novo Nordisk's second-quarter results were affected by a 340B rebate provision reversal taken a year earlier, and its adjusted figures exclude those swings ^[1].

Supply and access matter too. Novo Nordisk says Wegovy is now launched in about 60 countries and that the Wegovy pill launched in the UAE in June and the UK in July, with encouraging early uptake ^[1]. Those launches do not directly affect US patients, but they show where the company is putting its commercial investment.

What happens next

No further appeals remain in the Inflation Reduction Act case ^[1].

On the commercial side, Novo Nordisk says additional Wegovy pill launches in select markets are planned in the coming quarters, and the rollout of the Wegovy 7.2 mg single-dose pen across the EU is planned for the second half of 2026 ^[1]. Wegovy 7.2 mg received European Medicines Agency approval in July based on STEP UP data showing up to 20.7% mean weight loss, and the Wegovy pill received EMA approval in July based on OASIS 4 data showing up to 16.6% mean weight loss ^[1].