Novo Nordisk slumps on tougher 2026 financial outlook

Squeezed by "unprecedented" pricing pressures, Novo Nordisk has forecast a decline in revenues this year, particularly for its GLP-1 agonist business, sparking an 18% fall in its already weakened share price.

The forecasts came as Novo Nordisk reported 10% sales growth in 2025, which new chief executive Mike Doustdar conceded had been a "challenging year," while adding that the company will continue to "face pricing headwinds in an increasingly competitive market."

2026 sales could fall by 5% to 13%, much more than expected by analysts, according to the fourth-quarter update.

The group has started a $2.37 billion share repurchase programme, which could help reduce volatility in its stock but has been billed as meeting "obligations arising from share-based incentive programmes."

While it is facing tough competition from Eli Lilly for its GLP-1-based Wegovy and Ozempic therapies (both semaglutide) for obesity and diabetes – as well as compounding pharmacy-made versions of its drugs – Doustdar has suggested that a key reason for the anticipated fall in 2026 revenues is Novo Nordisk's recently-agreed most-favoured nation (MFN) pricing deal with the US administration.

Signed last November, the deal has reduced the prices of Wegovy and Ozempic significantly – from upwards of $1,000 per month to $350 – when purchased through TrumpRx, the promised federal direct-to-consumer sales channel that was scheduled to go live last month. It also includes price reductions across Medicare Part D and Medicaid, in return for a three-year tariff exemption.

Lilly's rival products Zepbound and Mounjaro (both tirzepatide) also saw steep price reductions as part of the deal.

Doustdar said, however, that the "painful" impact of the pricing pressure would be "an investment for our future," adding that he is "very encouraged by the promising early uptake from the US launch of the Wegovy pill, and we remain confident in our ability to drive volume growth over the coming years."

More details on the rollout of oral Wegovy will no doubt be provided when Novo Nordisk presents its annual update to analysts later today, but last week the company said there had been more than 26,000 prescriptions for the drug since its launch on 5th January.

There's no doubt, however, that with a stream of new incretin drugs for obesity and diabetes heading to market, Novo Nordisk will be unable to look for the stellar growth that propelled it to become – briefly – Europe's most valuable listed company in 2024.

Looking ahead to 2026, Doustdar said Novo Nordisk had high expectations for the potential launches of new incretin combination CagriSema (cagrilintide and semaglutide) and haemophilia therapy Mim8, as well as phase 3 readouts for sickle cell disease (SCD) therapy etavopivat and ziltivekimab for chronic kidney disease (CKD).