Novo Nordisk Raises 2026 Outlook for Third Time as Wegovy Pill Sales Beat Estimates

Novo Nordisk raised its 2026 outlook for the third time this year on Wednesday, Nov. 4, after sales of its Wegovy pill beat Wall Street forecasts.

The company now expects adjusted sales and operating profit growth of between negative 2% and positive 2% at constant exchange rates. That is up from a range of negative 6% to flat.

The quarter in numbers

Third-quarter sales came in at 79.2 billion kroner (about $11.9 billion), up 4% at constant exchange rates. The FactSet consensus was 73.6 billion kroner. Adjusted operating profit was 31.7 billion kroner against an expected 28.6 billion.

The Wegovy pill, launched in the US in January, brought in 5.39 billion kroner (about $810 million). That is up 53% from the second quarter and above the 4.62 billion analysts expected.

Injectable Wegovy (20.4 billion kroner) and Ozempic (29.7 billion kroner) also came in above expectations. Both continue to lose share to Eli Lilly's Zepbound and Mounjaro.

Novo said it added 1.2 million patients in the second quarter and another 1.2 million in the third. CEO Mike Doustdar called that "quite encouraging" and said the company is at "the growth recovery phase."

Pill versus pill

Novo says the pill took roughly 80% of new-to-brand US prescriptions in the quarter, even with Lilly's rival oral drug on the market. Cumulative prescriptions have passed 8 million, up from more than 5 million in the second quarter.

Lilly's pill, Foundayo, launched in April. It brought in $184 million in the third quarter, $44 million short of analyst estimates.

"We've been able to hold the baton," Doustdar said. He added that Lilly "is trying really hard to reverse this thing, and we need to watch them."

Novo said strong manufacturing output and faster regulatory approvals let it speed up the international rollout. It now plans to launch the pill in more than 20 countries by mid-2027. The target Novo gave at its September capital markets day was the end of 2027.

Outside the US, Novo said the pill holds about 90% of the UK oral obesity market and 80% in the UAE, and it sold about 100,000 packs in Germany in six weeks. Reuters reported the pill is now sold in eight markets. UK weekly sales of roughly 60,000 packs came in below the 65,000 discussed in September.

A government program doing the heavy lifting

Novo's US head said a Medicare pilot, which began in July, was largely behind the roughly 20% quarter-on-quarter rise in Wegovy pill volumes. The GLP-1 Bridge program lets eligible seniors get obesity drugs for $50 a month. CMS runs it outside the standard Part D payment flow, and it is scheduled to end Dec. 31, 2027.

Without it, the US obesity drug category was roughly flat from May to October, Novo's US head said, citing seasonality.

Prices are moving the other way. Novo said Wegovy net price erosion was 30.35% in the quarter. US list prices for Wegovy and Ozempic fall to $675 on Jan. 1, 2027. The company's outlook assumes growth internationally and a decline in the US.

Skeptics and the competitive picture

Markus Manns, a portfolio manager at Union Investment, a Novo shareholder, said the results show Doustdar has stabilized the company. He also warned that "the competitive environment in the obesity market is likely to become increasingly challenging."

Citi analysts kept a neutral rating on the stock. They cited continued uncertainty over near-, mid- and long-term weight-loss drug pricing and the lack of a clear Wegovy successor in the pipeline.

Lilly says it now controls 63% of the US market for GLP-1 and related incretin drugs. Lilly also announced in recent days that its experimental drug retatrutide beat Ozempic in a head-to-head trial.

Novo's pipeline has had setbacks of its own. Its next-generation shot CagriSema failed to beat Zepbound in a head-to-head trial. The company also suffered a setback in a heart disease study and lost a court fight to block Lilly ads claiming obesity drug superiority. Patents on the main ingredient in Ozempic and Wegovy expire several years before Lilly's Mounjaro and Zepbound patents do.

Shares and a CFO exit

Novo shares rose as much as 6.6% in early European trade. The US-listed shares climbed above $42 in the morning session. The stock traded above $140 in June 2024 and has since lost about two-thirds of its value. Reuters reported it was heading for its biggest daily gain since June 19.

Novo also said CFO Karsten Munk Knudsen will leave at the end of 2026 after 27 years with the company, nine of them as CFO. The company said the two sides "mutually agreed" he would leave to pursue other opportunities. Luigi La Corte, currently CFO of Galderma, will succeed him.

The next test arrives on Jan. 1, 2027, when the $675 list price takes effect. Novo has to grow volume faster than prices fall. Part of the pill's recent volume gain came from a Medicare pilot with a set end date of Dec. 31, 2027, and how much of that volume stays afterward is unresolved.