Is the Semaglutide myth over? After selling $36.1 billion last year, Novo Nordisk lowers its earnings forecast

In 2025, Novo Nordisk (NVO.US) achieved net sales of 309.04 billion Danish kroner (approximately $48.95 billion), with its star product semaglutide contributing 73.9% of the revenue. On February 4, Novo Nordisk released its full-year 2025 financial report, disclosing the above information.

Specifically, the full-year sales of semaglutide amounted to 228.288 billion Danish kroner (about $36.1 billion), of which the diabetes injection Ozempic (Chinese brand name: Norveti) sales were 127.089 billion Danish kroner (approximately $20.1 billion), a 10% year-over-year increase; oral Rybelsus (Chinese brand name: Norxin) sales were 22.093 billion Danish kroner (about $3.5 billion), down 2% YoY; the weight-loss version Wegovy (Chinese brand name: Norwin) sales reached 79.106 billion Danish kroner (about $12.5 billion), up 41% YoY, with total sales around $36.1 billion.

In the Chinese market, the combined sales of these three semaglutide series products reached 6.815 billion Danish kroner (approximately $1.079 billion).

Undoubtedly, semaglutide has fully surpassed Merck & Co. (MRK.US)’s pembrolizumab (brand name: Keytruda; Chinese brand name: Keliada; colloquially known as K-drug) in 2025. According to the financial report, in 2025, K-drug’s full-year sales were $31.6 billion, nearly $5 billion less than semaglutide. However, which drug will ultimately be crowned “Global Drug King” in 2025 remains to be seen until Lilly (LLY.US) releases its financial results. As semaglutide’s strongest competitor, Lilly’s tirzepatide sales momentum is rapid, with only about a $1.5 billion difference in sales between the two in the first three quarters of 2025.

Even if semaglutide takes the “Global Drug King” title, it doesn’t mean the battle is over. Alongside the full-year 2025 performance, Novo Nordisk also announced a downward revision of its 2026 sales guidance. The company stated that due to pricing pressures affecting the sales of its best-selling diabetes and weight-loss drugs in the U.S., global sales in 2026 are expected to decline by 5% to 13% compared to 2025 (excluding exchange rate effects).

Novo Nordisk pointed out that the sales outlook is impacted by price reductions, including factors related to the U.S. “Most Favoured Nations” agreement, patent expirations for semaglutide molecules in some international markets, and increased market competition.

Affected by this information, on February 3, U.S. Eastern Time, Novo Nordisk’s stock price plummeted, closing at $50.30 per share, down 14.64%.

However, Novo Nordisk also indicated that the global GLP-1 market is expected to continue expanding. With the launch of new products such as Wegovy tablets and higher-dose Wegovy, the company aims to further increase patient coverage and boost sales.

In recent years, the GLP-1 sector has become one of the most watched and hottest areas in the pharmaceutical industry. Several interviewees at the 2026 J.P. Morgan Healthcare Conference told Times Finance that GLP-1 and metabolic fields are hot topics among attendees this year. Multinational pharmaceutical companies like Lilly, Novo Nordisk, and Pfizer (PFE.US) also emphasized their continued focus on weight-loss markets at the conference.

The competition between Novo Nordisk and Lilly for the global market has never stopped. As a result, price wars have already erupted worldwide, with tirzepatide entering a “20% discount era” in China.

Liu Liheng, Managing Director of CIC Consulting, told Times Finance that the price war in GLP-1 products was expected. As a hot area, GLP-1 drugs have attracted significant attention and investment from biopharmaceutical companies both domestically and internationally. Ultimately, it is almost certain that the competition will shift from innovation to cost reduction.

Following the latest financial report, industry insiders also reported leadership changes at Novo Nordisk. Ludovic Helfgott, Vice President of Product and Portfolio Strategy, will leave to seek new opportunities, and Zhou Hong, Global Executive Vice President of Merck Healthcare and Head of China and International Markets, will succeed him.

Additionally, in the Chinese market, on January 30, Times Finance learned that Zhou Xiapin, Senior Vice President and President of Greater China at Novo Nordisk, will leave the company, with his last working day on March 31, 2026. The new Senior Vice President and President of Greater China will be Cai Yan, a veteran employee, effective March 1 this year. According to Novo Nordisk, Cai Yan has been with the company for over 23 years and has held several key positions in R&D headquarters and the International Operations Department (IO).

In fact, over the past year, Novo Nordisk has undergone internal restructuring with frequent leadership changes. The most notable was the “blood change” and restructuring of the board of directors, with former CEO Lars Fruergaard Jørgensen resigning. Maziar Mike Doustdar (referred to as “Dumaike”), the new CEO, has implemented a series of reforms in the global market. These changes have also affected the organizational structure and personnel in China.

Starting from January 1, 2026, Novo Nordisk China’s Emerging Business Division (EBD) was renamed the Insulin Business Division (IBD), separating from the original GLP-1-related business and focusing on innovative insulin product lines; the Obesity and Diabetes Business Division (DOD) fully took over all semaglutide-related business, strengthening the core position of GLP-1 drugs.

As the “patent cliff” approaches, semaglutide will face dual challenges from generic drugs and other GLP-1 products.

According to data from PharmaCube, in 2025, Novo Nordisk held a 45.8% share of the global GLP-1 diabetes drug market, down from over 50% in 2021-2024. However, in the Chinese market, Novo Nordisk’s share of the GLP-1 diabetes drug market reached 83.1%, increasing year by year compared to 2021-2024.

Currently, besides consolidating its existing product market share, Novo Nordisk is also accelerating the launch of new products. Public information shows that the company has submitted a supplemental new drug application to the U.S. Food and Drug Administration (FDA) for a 7.2 mg dose of semaglutide injection for weight loss. Additionally, Novo Nordisk revealed that its oral semaglutide Wegovy (dose: 25mg) has been on sale in the U.S. since January 5, with over 50,000 prescriptions issued.