Novo Nordisk shares plummeted 18% in Europe, with the CEO admitting: "Unprecedented pricing pressure" expected in 2026

Danish pharmaceutical giant Novo Nordisk is facing its most severe performance challenges in nearly a decade. The company expects a significant decline in sales by 2026, amid intensifying market competition.

On February 4, CEO Mike Døstdar stated outright that the company will face “unprecedented pricing pressures” in 2026, with the price reductions of the star weight-loss drug Wegovy in the U.S. having a “painful” financial impact, but this move aims to achieve broader market coverage and long-term growth.

Previously, Novo Nordisk’s 2026 earnings outlook significantly fell short of market expectations, with full-year sales projected to decline by 5% to 13% at fixed exchange rates, far exceeding analysts’ expected decline of about 1.4%. The pessimistic guidance caused notable stock volatility; after the earnings release, Novo Nordisk’s U.S. depositary receipts briefly halted trading on the NYSE. When trading resumed, the stock fell more than 10% near midday, closing down 14.6%. The negative sentiment continued into the European markets after hours, with European stocks dropping 18%.

To stabilize market confidence, Novo Nordisk announced a new share repurchase program, planning to buy back up to 3.8 billion Danish kroner worth of stock from February 4 to May 4, and simultaneously disclosed a new repurchase plan totaling 15 billion Danish kroner, aiming to signal confidence in the company’s long-term value to investors.

Multiple Pressures Erode Revenue Outlook

Novo Nordisk’s 2026 guidance reflects expected sales growth in its international operations and a decline in U.S. sales. While the global GLP-1 market is expected to continue expanding, this will be offset by lower actual selling prices.

One of the main sources of pressure is the “Most Favored Nation” pricing policy promoted by U.S. President Trump. This agreement aims to allow more Americans to access GLP-1 drugs at lower costs but will significantly reduce Novo Nordisk’s actual prices. Additionally, patent expirations for semaglutide in several international markets will also have a substantial impact on revenue.

In the U.S. market, the company’s GLP-1 injection product line is facing dual pressures from changing prescription trends and increased competition. Its flagship products Ozempic and Wegovy are being strongly challenged by competitors like Eli Lilly’s Zepbound. The negative impact of Medicaid cuts to obesity drug coverage further exacerbates the pressure.

Novo Nordisk expects that, when measured in Danish kroner, sales growth adjusted for currency fluctuations will be 3 percentage points lower than at fixed exchange rates, mainly due to the depreciation of the U.S. dollar against the Danish krone. This will be the company’s first annual sales decline in nine years, the last being in 2017, driven by price wars in the U.S. insulin market.

Wegovy Oral Formulation Boosts Confidence

Despite the tough challenges, Novo Nordisk still has some bright spots. The U.S. Food and Drug Administration approved the first oral GLP-1 obesity treatment—once-daily oral semaglutide 25mg, branded as Wegovy tablets—on December 22, 2024.

The product was launched on January 5, 2026, and as of January 23, the total weekly prescriptions were approximately 50,000. Døstdar said that the 170,000 people taking Wegovy tablets are mostly new patients, and the company is very encouraged by the early acceptance of the product in the U.S.

Døstdar emphasized that the company is “very confident” in meeting the demand for Wegovy tablets and remains optimistic about driving sales growth in the coming years. According to Bloomberg Intelligence analyst Michael Shah, citing Symphony Health data, this performance appears to be better than the initial sales of Eli Lilly’s Zepbound.

Novo Nordisk plans to continue launching Wegovy in more markets in 2026 and introduce a 7.2mg dose in several countries. The company continues to focus on expanding access to Wegovy, especially through NovoCare Pharmacy in self-pay channels and collaborations with telemedicine providers.

2025 Performance Slightly Above Expectations

Novo Nordisk’s full-year 2025 results showed a 6% increase in sales to 309.06 billion Danish kroner, with a 10% growth at fixed exchange rates, slightly above the analyst consensus of 307.62 billion Danish kroner. This growth was mainly driven by obesity care, which grew 31% at constant currency, while GLP-1 diabetes product sales increased 6%.

Operating profit was 127.66 billion Danish kroner, down 0.5% year-over-year, but up 6% at constant exchange rates. Net profit was 102.43 billion Danish kroner, up 1.4%. Excluding approximately 8 billion Danish kroner in corporate transformation costs, operating profit would have increased by 6%, and 13% at constant currency.

Q4 results showed sales of 79.14 billion Danish kroner, down 7.6% year-over-year but above the analyst expectation of 76.9 billion Danish kroner. Wegovy sales reached 21.86 billion Danish kroner, surpassing the expected 21.07 billion. Ozempic’s full-year sales were 127.09 billion Danish kroner, exceeding the forecast of 124.87 billion.

U.S. sales grew 8% at constant exchange rates, while international sales increased 14%. The obesity and diabetes care segment generated 289.46 billion Danish kroner, with rare disease sales up 9%. The company provided innovative treatments to 4.6 million patients in 2025.

Shareholder Return Measures

In addition to the share repurchase of up to 3.8 billion Danish kroner from February 4 to May 4, Novo Nordisk’s board also approved a new share repurchase program of up to 15 billion Danish kroner (about $2.4 billion). The board will also propose a final dividend of 7.95 Danish kroner per share at the annual general meeting on March 26, 2026, bringing the total expected dividend for 2025 to 11.70 Danish kroner per share.

Døstdar acknowledged that 2025 was a challenging year for the company but emphasized that despite the pricing pressures and increased competition in 2026, the company remains confident in driving sales growth in the coming years. Novo Nordisk also looks forward to regulatory decisions on next-generation therapies in 2026, including Mim8 in hemophilia and CagriSema in obesity.

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