After several consecutive quarters on the backfoot, Danish drug juggernaut Novo Nordisk is receiving warmer feedback on its starting performance in 2026, thanks in no small part to its head start over rival Eli Lilly in the burgeoning market for oral obesity therapies.
With adjusted net sales (PDF) of 70.1 billion Danish kroner ($11 billion) for the first three months of the year, Novo’s first-quarter haul was down some 4% year over year. But strong performance from the company’s obesity franchise—and an impressive early showing from its Wegovy pill launch—saw the company’s stock price trading up around 3% Wednesday morning.
Novo’s share price has been volatile since around the middle of 2024, as the evolving commercial GLP-1 market for diabetes and obesity saw Lilly eking out a notable lead, despite Novo’s first-comer advantage with both its diabetes injectable Ozempic and its obesity blockbuster Wegovy.
This volatility led to the replacement of Novo’s former CEO, Lars Fruergaard Jørgensen, with longtime company insider Mike Doustdar last summer.
The Q1 performance put Novo’s adjusted sales 1% ahead of consensus estimates for the period, according to a note from analysts at Jefferies, who caveated that the performance remained in line with expectations when taking Wegovy pill stocking moves into account. Nevertheless, strong showings across the company’s GLP-1 franchise helped offset a “notable miss” on market expectations for its insulin portfolio, according to the analysts.
While Novo may not be out of the woods yet—and with Lilly’s own oral obesity launch of Foundayo in April tipped to begin picking up more steam in Q2—the company is sitting pretty for now thanks to strong early metrics from its Wegovy pill, approved late last year and rolled out in the U.S. on Jan. 5.
“It is no secret that the Wegovy pill is off to a record-breaking start in the U.S.,” CEO Doustdar said on a May 6 analyst call. “Since launching it some 16 weeks ago, we have seen over 1 million people using Wegovy pill as the global momentum behind the peptide-based therapy accelerates.”
With the product’s debut, Novo has been focusing Wegovy pill “use, users and usage,” the company’s EVP of U.S. operations, Jamey Millar, said on the call.
He noted that the momentum behind the pill is “far outpacing” any other prior GLP-1 launch in the U.S., with total prescriptions in the first quarter landing at 1.3 million. By April 17, oral Wegovy has generated some 2 million total prescriptions, which Millar said Novo estimates amounts to more than 1 million people treated since launch.
Breaking the dynamics down further, Millar noted that around 80% of patients who have taken up the Wegovy pill are new to the GLP-1 class, adding that “we also see patients coming to Wegovy pill from competitor products with limited cannibalization from injectable Wegovy.”
Pricing moves and a new competitor
Moving forward, Novo expects to see sales from self-pay and commercial insurance channels level out a bit, thanks to the pill’s inclusion on major PBM formularies by the end of the first quarter, Millar explained, confirming that most sales to date have come from self-paying patients.
Tackling the Foundayo competition issue head on, Millar noted that while it’s still early days for the two companies’ launches, “I think what we see so far is an affirmation of the strength of the Wegovy pill profile.”
Millar added that “the No.1 decision criteria” for obesity treatment choice is efficacy, “and we have unsurpassed efficacy with that 17% weight loss with Wegovy pill.” The executive further cited a recent indirect treatment comparison that Novo performed between the products that suggested greater efficacy for oral Wegovy and a lower chance of discontinuation tied to side effects.
The FDA approved Foundayo on April 1 based on data which demonstrated an average weight loss of 12.4% for patients on the Lilly drug versus placebo.
Doustdar also weighed in on Novo’s pricing calculus for its Wegovy pill, and how the cost of the medicine fits into its greater market expansion goals, describing the current alignment between price and uptake as a “sweet spot.”
Novo debuted the drug with the cost of the pill’s starting 1.5-mg dose set at $149 per month for cash-paying patients, while commercially insured patients using savings plans could initially pay as little as $25 for the same supply. Novo has priced its second Wegovy pill dose at $199 per month, while the highest doses are charged at $299 monthly for patients who aren’t using insurance.
“We are seeing a situation where, at the current prices, we had 2 million scripts after 16 weeks—more than 200,000 scripts per week—despite [a] competitor now having come more than a month into the game,” Doustdar said, alluding to the recent launch of Foundayo.
While Novo believes it has “priced this product perfectly correct” for the present, the CEO admitted that in the long run, “prices have to come down if your ambition is to get to hundreds of millions of patients.”
Still, “for now, this is the right price” for the Wegovy pill, he said.
Taking a look at the numbers, which Novo does not break out individually for all of its drugs, total obesity care sales landed at 20.9 billion kroner ($3.3 billion) in the first quarter, up some 22% at constant exchange rates. Diabetes sales grew 12% to 44.9 billion kroner ($7 billion)
Injectables Wegovy garnered 18.2 billion kroner ($2.9 billion) for the period, up 12% at constant currencies, compared to the initial 2.26 billion kroner (around $355 million) ginned up by the obesity med’s oral counterpart. Ozempic, for its part, charted 8% sales growth to nearly 28 billion kroner ($4.4 billion) over the three-month span.
With higher expectations for its GLP-1 products, Novo has adjusted its forecast for the year slightly upwards. Now, the company expects its adjusted sales performance in 2026 to work out to a 4%-to-12% decline, slightly softer than the negative 5%-to-13% range the company had forecasted as of early February.
The Jefferies team figures that the new estimate works out to a range of around 264 billion kroner (nearly $42 billion) to 288 billion kroner ($45.3 billion) for the full year.