Novo Nordisk saw its shares climb as much as 9.2% in Copenhagen on Wednesday after the Danish pharmaceutical giant lifted its 2026 forecast, fueled by unexpectedly strong early sales of its new Wegovy weight-loss pill. The company revealed that U.S. prescriptions for the oral medication had surpassed 2 million since its January 5 launch, far exceeding market expectations.
The upbeat news marks a significant turnaround for Novo Nordisk, which has been working to restore investor confidence after losing ground to Eli Lilly in the lucrative U.S. obesity market. Lilly has gained share with its injectable treatments and recently introduced its own pill, Foundayo, which received U.S. regulatory approval in April. The GLP-1 drug class, which mimics a gut hormone that regulates appetite and blood sugar, has become one of the hottest segments in pharmaceuticals.
Pills are now emerging as the next battleground, potentially attracting patients who are hesitant about injections. However, they also intensify competition in a market that is highly sensitive to pricing, access, and weekly prescription data—factors that can shift billions in market value. Novo's Wegovy pill logged over 200,000 prescriptions in the week ending April 17 alone, with first-quarter sales reaching 2.26 billion Danish crowns, partly driven by pre-launch stocking by wholesalers and telehealth channels.
Novo Nordisk now expects adjusted sales and adjusted operating profit to decline between 4% and 12% this year at constant exchange rates, a narrower range than its prior forecast of a 5% to 13% drop. In the first quarter, adjusted sales fell 10% to 70.06 billion Danish crowns, and adjusted operating profit declined 15% to 32.86 billion crowns. However, reported net sales jumped 24% to 96.82 billion crowns, boosted by the reversal of a provision related to the U.S. 340B Drug Pricing Program, which provides discounts to certain healthcare providers. Reported operating profit surged 54% to 59.62 billion crowns.
Chief Executive Mike Doustdar attributed the upgraded guidance to stronger-than-expected demand for Wegovy outside the U.S., noting that over 1 million patients have taken the Wegovy pill since its launch. The company has also expanded its offerings with recent approvals for a higher-dose injectable version of Wegovy. Despite the positive news, some analysts noted that the guidance upgrade did not fully meet market expectations. Oskar Bernhardtsen, investment strategist at Saxo Bank, called the Wegovy pill "the clear bright spot of the day" but added that the upgrade fell short of what investors had hoped for.
Eli Lilly remains a formidable competitor, having posted a 56% revenue jump in the first quarter to $19.8 billion, driven by its diabetes drug Mounjaro and obesity treatment Zepbound. Lilly's full-year revenue guidance now stands at $82 billion to $85 billion. Mounjaro sales more than doubled to $8.66 billion, while Zepbound brought in $4.16 billion, up 80%. However, early prescription data for Lilly's Foundayo pill has been modest, with just 5,612 scripts in its third week, compared to Wegovy's 18,000 in its first full week and over 134,000 by week sixteen. RBC Capital Markets analyst Trung Huynh cautioned that early snapshots can be misleading, with a clearer trend likely emerging after eight to twelve weeks.
Novo Nordisk faces challenges despite the rapid launch. U.S. adjusted sales dropped 11% in the first quarter, as volume growth was offset by lower realized prices. More than half of U.S. Wegovy sales now go through cheaper self-pay channels, which could keep margins tight as the company pursues higher volumes. The company is targeting the second half of 2026 for its first international launches of the Wegovy pill, pending regulatory approvals. All eyes are now on whether the oral version of Wegovy will prove to be a short-lived U.S. success or a catalyst for a broader shakeup in the obesity drug market, as Novo Nordisk competes not only with Eli Lilly but also with its own established injectable products like Ozempic and Wegovy.
