Pressure on Novo Nordisk’s Obesity Franchise

Novo Nordisk is warning that 2026 will be a down year, with adjusted sales and adjusted operating profit both expected to fall 5% to 13% at constant exchange rates. (novonordisk.com) The company reported 2025 sales of 309.1 billion Danish kroner, up 10% at constant exchange rates, and obesity-care sales of 82.3 billion Danish kroner, up 31% on the same basis. Novo said it will start using new adjusted, non-International Financial Reporting Standards measures for 2026 guidance. (novonordisk.com) Reuters reported on February 4 that Novo linked the weaker outlook to “unprecedented” pricing pressure in the United States, where lower realized prices, tougher competition and patent expiry in some markets are hitting semaglutide, the active ingredient in Wegovy and Ozempic. Chief Financial Officer Karsten Munk Knudsen told Reuters U.S. sales are expected to fall in the “teens.” (newsbreak.com) The pressure is landing in Novo’s biggest growth engine. In 2025, obesity-care products grew faster than the rest of the business, and Novo said the global branded glucagon-like peptide-1 obesity market expanded 104% by volume while its own branded volume share was 59.6%. (novonordisk.com) Glucagon-like peptide-1 drugs mimic a gut hormone that lowers appetite and helps control blood sugar. Novo is now trying to show those medicines do more than reduce weight, after a Nature Medicine paper in July 2025 found semaglutide improved fibrosis and inflammation markers in preclinical metabolic liver disease models and shifted blood-protein patterns in patients with metabolic dysfunction-associated steatohepatitis. (nature.com) That liver push continued this week. The University of Toronto said on April 15 that a new mouse study led by Daniel Drucker found glucagon-like peptide-1 medicines improved liver health independent of weight loss, after researchers identified receptors on rare liver sinusoidal endothelial cells. (utoronto.ca) Novo is also leaning on rare blood disorders to widen the pipeline beyond obesity and diabetes. Its research pipeline lists etavopivat in Phase 2 for rare blood disorders and a separate Phase 3 etavopivat program in sickle cell disease. (novonordisk.com) A completed Phase 2 study on ClinicalTrials.gov says etavopivat is an oral activator of pyruvate kinase in red blood cells, designed to improve how those cells make energy and carry oxygen in sickle cell disease and thalassemia. The study enrolled 53 patients and finished in September 2025. (clinicaltrials.gov) Novo’s 2026 story is now split between a price fight around Wegovy and Ozempic and a pipeline effort to prove the company can grow outside its obesity franchise. The next readouts will show whether new indications and rare-disease programs can offset a year the company has already told investors will be weaker. (novonordisk.com)