Novo Nordisk warns Wegovy price cuts may slash 2026 sales and profits by up to 13%
Nearly US$50bn in market value vanished from Novo Nordisk in one day after the company warned of “unprecedented” pricing pressure that will drive a sharp drop in sales and profits in 2026.
Novo Nordisk now expects adjusted sales and adjusted operating profit at constant exchange rates to fall between 5 percent and 13 percent this year, ending years of double-digit growth, Reuters reported.
CEO Mike Doustdar told journalists that “our 2026 guidance reflects a year of unprecedented pricing pressure” and called the impact “painful” but an “investment for our future.”
The main hit comes from lower realised prices in the United States, tougher competition and patent expiries for semaglutide – the active ingredient in Wegovy and Ozempic – in some markets outside the US.
Chief Financial Officer Karsten Munk Knudsen told Reuters that US pressure is driven more by a larger-than-expected shift to self-paying patients and higher rebate demands from insurers than by the Trump administration’s “most favored nation” pricing policy.
He said US sales are expected to fall in the “teens,” signalling a steeper decline than the overall guidance.
Novo Nordisk has cut prices aggressively in the US cash-pay market.
The company is selling lower doses of its daily Wegovy pill for US$149 per month for self-paying patients, rising to US$199 in April, while the Wegovy injection is priced at US$349 per month for cash payers.
The company also struck a landmark deal with US President Donald Trump to lower prices on its blockbuster drugs for Medicare and Medicaid and sell them directly to consumers at a discount on a new website, TrumpRx.gov, CNBC reported.
Demand for the oral Wegovy pill remains strong despite the lower pricing.
Weekly prescriptions reached about 50,000 by January 23, far above the roughly 20,000 per week suggested by market tracking data that exclude cash-pay channels such as NovoCare and telehealth services, according to Reuters.
Knudsen said about 90 percent of Wegovy pill sales in the US are cash-pay and described the contribution from telehealth partnerships as “tremendous.”
Novo Nordisk faces rising competitive and regulatory challenges.
Eli Lilly’s Zepbound injection now leads the US obesity market, and generic copies of Ozempic are likely to appear in international markets later this year, Bloomberg reported.
At the same time, as many as 1.5m Americans use compounded versions of GLP-1 weight-loss medications rather than branded products, Reuters said.
Knudsen told Reuters the company is “still frustrated” that “mass marketing of a product unapproved by the FDA” continues and said it is up to US regulators and politicians to address this.
Union Investment portfolio manager Markus Manns, whose firm holds Novo Nordisk and Eli Lilly shares, said “Novo has provided shocking guidance for 2026” and that “nobody had a double-digit profit decline on the agenda.”
The warning follows an earlier cut to the 2025 outlook that triggered a 23 percent single-day share price drop in July last year, CNBC reported.
The latest setback comes after a boom fuelled by the June 2021 launch of Wegovy, which helped turn Novo Nordisk into Europe’s most valuable listed company at more than US$600bn in 2024 before its value fell to US$259bn by the close on Tuesday, Reuters reported.
When asked by CNBC if Novo Nordisk is in crisis, Doustdar replied “no” and said that while “2025 presented significant challenges affecting our performance and share price, those adversaries have also made us more resilient.”
