Novo Nordisk $NVO ( ▼ 6.18% ) shares are under fresh pressure after management made it clear that 2026 will be a tough year on pricing. While the company’s latest quarter slightly beat expectations, investors are focused on a sales outlook that now calls for declines, not growth.
The message from leadership was blunt: prices are going down.
Guidance Overshadows a Decent Quarter
In Q4, Novo posted sales of $12.3 billion and diluted EPS of $0.94, both modestly above Wall Street estimates. On their own, those numbers would normally be reassuring.
But the full-year 2026 outlook stole the spotlight. Novo said it expects both sales and operating profit to fall between 5% and 13%, far worse than analysts had been expecting. CEO Mike Doustdar said the guidance reflects “unprecedented pricing pressure,” particularly in the US, where Wegovy pricing is expected to move lower before stabilizing.
Patents and Policy Are Hitting at Once
Novo’s annual report highlighted several headwinds. These include lower realized prices tied to a “Most Favoured Nations” pricing agreement in the US and the loss of exclusivity for semaglutide in some international markets. The company also noted that certain favorable US pricing adjustments seen in 2025 will not repeat.
At the same time, semaglutide, the active ingredient in Ozempic and Wegovy, is starting to face patent expirations in major markets such as Canada, India, and China. That opens the door for cheaper competitors and squeezes margins further.
Competition Is Only Getting Tougher
Novo Nordisk $NVO ( ▼ 6.18% ) also faces intensifying pressure from Eli Lilly $LLY ( ▲ 10.33% ) , which has already surpassed Novo in GLP-1 sales. Lilly’s latest results and 2026 guidance blew past expectations, showing that the obesity and diabetes drug race is still growing, just not evenly.
Novo recently launched an oral GLP-1 weight-loss pill and early uptake looks strong. But Lilly is expected to introduce its own pill later this year, raising the stakes in an already crowded field.
For Novo, the story has shifted from being the early leader in GLP-1 drugs to defending share and pricing in a market that is getting more competitive by the quarter.