TLDR
- Novo Nordisk stock crashed 18% in Copenhagen after issuing 2026 guidance showing sales and operating profit declining 5% to 13%
- CEO Mike Doustdar warns investors “it goes down before it comes back up” due to lower U.S. pricing on Wegovy
- 2026 outlook was 8% below analyst expectations at the midpoint, driven by Most Favoured Nations agreement and competition
- Despite strong Wegovy pill launch with 170,000 users in four weeks, pricing pressures on existing products offset gains
- Rival Eli Lilly shares also fell 3.9% on the news as concerns spread across the GLP-1 market
Novo Nordisk delivered a harsh reality check to investors Tuesday night. The Danish drugmaker pre-released its 2026 guidance, showing both sales and operating profit will drop between 5% and 13%.
$NVO cut its 2026 outlook, guiding to adjusted sales and operating profit down 5%–13%, well below Street expectations after 10% growth in 2025.
The company cited U.S. price pressure from a “most favored nations” agreement and partial semaglutide LOE, offset by international… pic.twitter.com/MRfWc9D0Gz
— Polymarket Money (@PolymarketMoney) February 3, 2026
The stock plummeted 18% in Copenhagen trading Wednesday. American depositary shares had already fallen 14.6% in New York the day before.
CEO Mike Doustdar didn’t sugarcoat the situation. “People should expect that it goes down before it comes back up,” he told CNBC on Wednesday morning.
The guidance stunned Wall Street. BofA analyst Sachin Jain noted the 2026 sales forecast came in about 8% below consensus at the midpoint.
This marks the second major guidance cut in less than a year. Last July, Novo slashed its 2025 outlook, sending shares down 23% in a single day.
The company pointed to several culprits for the weak outlook. The Most Favoured Nations agreement in the U.S. is forcing lower prices. The semaglutide molecule patent is expiring in certain international markets. Competition from both compounding pharmacies and Eli Lilly continues to intensify.
Wegovy Pill Can’t Overcome Pricing Pressure
Novo had reason for optimism heading into 2026. The Wegovy pill launch exceeded expectations with 170,000 patients after just four weeks on the market.
Doustdar expressed pride in the rollout. “We knew it’s going to be the best in terms of efficacy of 16.6%, we had expected it to do well, but we did not think that after four weeks of introduction, we will have 170,000 people on the pill.”
But the strong pill performance couldn’t offset pricing hits on existing products. “No matter how well it does in the initial period, the price hit on the existing business trumps, basically, the great pill launch that we’ve had,” Doustdar explained.
The CEO framed the pricing concessions as a long-term strategy. “We are creating affordability for the patients, millions of patients that are right now in need of GLP-1 products, but simply could not afford it,” he said.
Compounding pharmacies selling cheaper knockoff versions of semaglutide continue to eat into market share. Eli Lilly’s competing products add more pressure.
Morgan Stanley analyst Thibault Boutherin said the guidance “confirmed our concerns on U.S. prices and mix.” He sees downside risks if volume growth doesn’t materialize.
The Numbers Tell the Story
For full-year 2025, Novo reported sales increased 6% in Danish kroner and 10% at constant exchange rates to DKK 309.1 billion. Operating profit decreased 1% in Danish kroner and increased 6% at constant exchange rates to DKK 127.7 billion.
Excluding transformation costs, operating profit would have increased 6% in Danish kroner and 13% at constant exchange rates.
U.S. operations saw sales increase 3% in Danish kroner and 8% at constant exchange rates during 2025. International operations performed better with a 10% increase in Danish kroner and 14% at constant exchange rates.
Barclays analysts suggested some might view the guidance as a “kitchen sink” that will be beaten. But they noted the same was said last year, and that didn’t happen.
HSBC analyst Rajesh Kumar raised a key question: “The question becomes if the recovery from here, [will be] a Nike swoosh or U-shaped recovery.”
BMO Capital analyst Evan David Seigerman said pricing concessions weigh on the topline as Novo looks for volumes to flow through. “Following Trump MFN deals and new needed efforts to maintain access in the obesity market, Novo now faces extensive pricing headwinds in the US.”
The ripple effects hit competitors too. Eli Lilly shares closed down 3.9% as concerns spread across the GLP-1 market.
The company also announced Dave Moore, Head of US Operations, will leave for personal reasons and will be succeeded by Jamey Millar.
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