Novo Nordisk Warns of First Sales Drop Since Start of Ozempic

The once high-flying Danish drugmaker has struggled to fend off rivals in the weight-loss industry, especially Eli Lilly, which gave a much rosier outlook to investors.

Novo Nordisk, the Danish pharma pioneer behind Ozempic, is in for a bruising year.

The company’s shares plunged on Wednesday after the drugmaker said it expected sales to fall this year as it faced stiff competition in weight-loss drugs and lower prices, partly because of a deal with the White House. For Novo, that would be the first decline in annual sales since 2017, the year before it began selling Ozempic.

Last year, revenue was 309 billion Danish kroner, or about $49 billion, an increase of 10 percent from the previous year, when excluding movements in currency values. That was the slowest pace since 2020. This year, the company said, sales could fall up to 13 percent, without the effect of currency movements, a gloomier outlook than analysts had expected.

Also on Wednesday, Eli Lilly, Novo Nordisk’s chief rival, provided a much brighter picture of the prospects for its weight-loss drugs, which include Zepbound. The American pharma giant said it expected its sales to continue to grow in 2026, amid soaring demand for its weight-loss treatments, which have outpaced Novo’s in prescriptions over the past year.

Lilly’s shares were up about 9 percent in early trading in New York, pushing the company’s value back above $1 trillion, a milestone it first reached late last year.

Novo’s sales warning came as the company started selling a pill version of Wegovy, its weight-loss drug, for which it has high hopes. Since the pill became available for sale in early January, 170,000 people have bought it, the company said. In its deal with the White House, Novo’s starter dose costs $149 a month.

Mike Doustdar, the chief executive of Novo Nordisk, said he was encouraged by the signs from the takeup of the daily pill that lower prices would expand access to the company’s drugs, eventually mitigating the financial hit. The Wegovy pill is selling 15 times as fast in its first month as the weekly injectable did when it became available, he said.

“We are superexcited about the volume uptake that will come on the back of the investment related to the price decrease,” Mr. Doustdar said in an interview.

Still, Novo is in the throes of a punishing turnaround effort. Last year, Mr. Doustdar’s predecessor was ousted, and the company issued severe profit warnings to shareholders and announced thousands of job cuts. Its management and board have also been shaken up: On Wednesday, the company said David Moore, the head of the U.S. operations, where Novo Nordisk makes the majority of its sales, was leaving the company.

Novo’s shares fell more than 15 percent in Copenhagen on Wednesday. They have lost about two-thirds of their value from a peak in 2024, when it was the most valuable public company in Europe.

Novo has struggled to fend off competition by Lilly, as well as the prevalence of less expensive copycat alternatives. The Danish company has also been put under pressure from President Trump to lower drug prices.

There are few signs that those pressures will let up soon. The agreement with the White House is set to expand access to weight-loss drugs through Medicare, the government health insurance program for older people, but not until the second half of the year.

Novo’s weight-loss pill won’t be the only one on the market for long. Lilly expects its oral weight-loss drug to become available in the second quarter, subject to regulatory approval. Analysts have noted that some patients may find it easier to take because it doesn’t have water or food restrictions. Novo’s Wegovy pill must be taken first thing in the morning on an empty stomach.

In addition, more drugmakers are entering the obesity space, such as Pfizer, which is progressing with a monthly weight-loss drug. The patent on semaglutide, the active ingredient in Ozempic and Wegovy, expires in several markets this year, including India, China and Canada, opening the door for cheaper generics.

On Wednesday, Mr. Doustdar said he was most eagerly anticipating the expected launch of a higher dose of semaglutide at 7.2 milligrams. The highest available dose of Wegovy is 2.4 milligrams, which in trials showed that users could achieve a loss of about 16 percent of their body weight, less than the result achieved by Lilly’s drug.

With the higher dose of Wegovy, “you get to the same level weight-loss efficacy as our competition,” he said, “hopefully putting it to rest that one product is more superior in weight loss than the other.”

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