Novo Nordisk veteran Maziar Mike Doustdar—who is set to assume the role of CEO on Thursday—will have his work cut out turning things around at the Danish drugmaker, which is facing a commercial reckoning on two fronts.
Despite being first to market with its landmark GLP-1 drugs for diabetes and obesity, Ozempic and Wegovy, Novo has swiftly lost ground to its chief metabolic medicine rival Eli Lilly and the Indianapolis pharma's counterpart medicines Mounjaro and Zepbound. Separately, as both Novo and Lilly struggled to meet demand during the initial launches of their products, a booming GLP-1 compounding industry has sprung up in the U.S.
While the FDA formally put the kibosh on mass compounding of Novo’s GLP-1 medicines on May 22, the practice has more or less continued unabated. The market for compounded semaglutide in the U.S. is now roughly “equal” in size to Novo’s own GLP-1 business, the company’s outgoing CEO, Lars Fruergaard Jørgensen, said on a media call Wednesday.
The company’s struggles have seen its share price drop precipitously in recent months. Novo’s shares were worth around $130 this time last year but have since fallen to a little more than $45. Midday Wednesday, the company’s stock was trading down nearly 4% after Novo reported its half-year financial results.
Novo on Wednesday reported year-over-year sales growth of 16% to 154.9 billion Danish kroner (roughly $24.9 billion) through the first six months of 2025. The company’s diabetes and obesity care sales—which naturally include Ozempic and Wegovy—grew 18% at constant currencies during the period, delivering a six-month haul of 145.5 billion kroner ($22.7 billion).
Looking at just the second quarter, Ozempic sales increased around 10% to 31.79 billion kroner (nearly $5 billion), while combined Wegovy and Saxenda sales in obesity leapt 46.5% to 20.37 billion kroner ($3.17 billion).
Even though Novo’s core drugs continue to grow, the performance in the first half of the year marks a “sharp slowdown” for the company, analysts at ODDO BHF wrote in a note to clients Wednesday.
Novo has already telegraphed expectations for slower Wegovy and Ozempic sales growth in the back half of the year, revising its sales and profit forecast downward last week. Regarding revenue, Novo now expects to deliver sales growth between 8% and 14% for all of 2025, compared with a prior forecast of 13% to 21%.
As for Doustdar’s vision for the company, “we’re going to focus more on diabetes and obesity, as this is our main core and has always been,” the soon-to-be CEO said on Novo’s earnings call Wednesday.
“I think I’ve been put into this position because I execute good and I outcompete my competition,” he added. “At least in [international operations] I have done that, and I plan now to do more of that for the rest of the company.”
Doustdar has been with Novo for more than three decades and served in the role of EVP of international operations leading up to his CEO appointment.
While Novo had previously predicted that GLP-1 compounding would decrease following the FDA restrictions in May, the company’s guidance no longer accounts for an assumed reduction in U.S. compounding activities this year, Novo’s chief financial officer, Karsten Munk Knudsen, said on the Wednesday media call with Jørgensen.
In the U.S., weekly Ozempic prescriptions are now averaging around 690,000, while Wegovy is racking up around 280,000 scripts per week, Novo’s EVP of U.S. operations and global business development, David Moore, said on Novo’s analyst call Wednesday.
For comparison, Novo’s research suggests there are roughly 1 million patients now using compounded GLP-1s in the U.S., he said.
As Novo looks to expand the reach of its semaglutide duo, the company aims to start marketing Ozempic to cash-paying patients later this year, Moore said.
The company will also continue to pour investments into direct-to-consumer sales options through its NovoCare Pharmacy and seek further team-ups with telehealth companies, the U.S. EVP added.
Novo’s prioritization of DTC sales will have the added benefit of helping the company align with the Most Favored Nation drug pricing demands laid out by President Donald Trump last week, outgoing CEO Jørgensen noted on Novo’s call with journalists.
Meanwhile, “there is nothing categorically off the table,” Moore said of the actions Novo could take to snuff out illicit compounding. His response came after an analyst speculated that the Supreme Court might need to intervene due to the ambiguity of current U.S. compounding guidelines, which have enabled outsourcers to continue mass marketing of compounded GLP-1s by arguing that they are creating personally tailored doses for patients.
Novo has already launched a bevy of lawsuits against med spas, pharmacies and weight loss clinics peddling compounded semaglutide, and on Tuesday, the company filed 14 more. Some of the companies targeted in the new round of legal action include Prism Aesthetics, Mochi Health and Fella Health, Reuters reported Tuesday.
Several of the companies in Novo’s crosshairs have also been targeted by Eli Lilly in its own slate of lawsuits around compounded tirzepatide, the molecule underpinning Mounjaro and Zepbound.
As Doustdar prepares to take the reins at the company, outgoing CEO Jørgensen warned that cost-cutting measures could be on Novo’s horizon.
“We probably won’t be able to avoid layoffs,” he admitted in an interview with Danish news outlet DR, as quoted by Reuters. "When you have to adjust a company, there are some areas where you have to have fewer people, some [areas] where you have to be smaller."
Jørgensen noted that those decisions will fall on Doustdar, but the incoming CEO appears to have cost realignment on the brain as well.
“[W]hen I think about the future and the huge opportunities that we have, we need to be able to finance that and not fall behind the competition,” Doustdar said on Novo’s earnings call. “[W]e need to reallocate and relook at our cost base and really put the money where the growth is.”