Novo Nordisk at a Tipping Point: Oral Wegovy Nears EU Market as US Formulary Edge Disappears

EMA recommends oral Wegovy approval as CVS Caremark removes Novo Nordisk's exclusivity, adding Lilly's drugs; stock plunges 44% from peak but pipeline shows promise.

The coming weeks will test Novo Nordisk on multiple fronts at once. While the European Medicines Agency has just issued a positive recommendation for the oral version of Wegovy, opening the door to a major new market, the company is simultaneously losing the preferential treatment its blockbuster weight-loss injection once enjoyed from the largest US pharmacy-benefit manager. The convergence of regulatory progress and commercial headwinds has left the stock trading near 39.23 euros — more than 44% below the 52-week high of 70.13 euros set in June 2025.

CVS Caremark, the dominant US drug-benefit intermediary, is rewriting its formulary for the weight-management category. Starting June 1, it added Eli Lilly’s new daily pill Foundayo (orforglipron) to its preferred list, and from October 1 it will reinstate Zepbound as a preferred injectable option. That reverses the exclusive advantage Wegovy had enjoyed since May 2025, when CVS had excluded Zepbound from its formulary. Novo Nordisk says Wegovy will remain listed, but its solitary position is gone. Tom Scales, the company’s market-access chief, argued that both Wegovy variants retain “strong formulary access” in the United States — though analysts wonder how long that can hold under mounting price pressure. CVS itself projects the intensified competition will shave 10% to 15% off costs across the entire weight-management category.

The hit to Novo Nordisk’s stock has been severe. Year-to-date losses stand at roughly 12.5%, and the valuation has compressed sharply. With a price-to-earnings ratio of about 10.5 — far below the historical average of 26 — and a dividend yield near 4%, the shares look cheap on paper. The relative strength index of 47.6 suggests neither overbought nor oversold territory. The stock’s 50-day moving average of 35.27 euros sits just below the current level, hinting at a modest bounce, but nothing approaching a trend reversal.

Yet Novo Nordisk is building a powerful counter-narrative in its pipeline. The EMA’s Committee for Medicinal Products for Human Use (CHMP) has recommended approval of both a 25-milligram oral Wegovy pill and a high-dose 7.2-milligram injectable formulation for weight management and cardiovascular-risk reduction. The recommendation is based on the pivotal OASIS 4 phase 3 trial, which showed an average weight loss of 16.6% after treatment. More than a third of participants shed at least 20% of their body weight. If the European Commission follows the CHMP advice, Novo Nordisk expects to launch in select non-US markets during the second half of 2026. In the United States, the oral pill has been on the market since January and has already generated over two million prescriptions.

The pipeline showcase continues at the American Diabetes Association’s annual meeting in New Orleans from June 5 to 8. Novo Nordisk will present 40 abstracts, headlined by phase 3 data for CagriSema, a fixed-dose combination of an amylin receptor agonist and a GLP-1 receptor agonist designed to improve both blood-sugar control and weight loss in type 2 diabetes. The company filed CagriSema with the US Food and Drug Administration in December 2025, with a decision expected in the fourth quarter of 2026. Also on the docket are phase 2 results for Zenagamtide, a novel injectable dual GLP-1/amylin candidate. Novo Nordisk will host a research-and-investor event on June 7.

Management is signaling confidence in its pipeline through a share buyback program of up to 15 billion Danish kroner, launched in February 2026. As of May 22, the company had repurchased roughly 17 million B-shares at an average price of 262.22 kroner, for a total outlay of 4.47 billion kroner. The purchases amount to a tangible vote of faith in the company’s long-term prospects — even as short-term market dynamics turn more hostile.

For investors, the near-term trajectory hinges on two events. The ADA conference will either validate CagriSema’s potential and lift the stock from its troughs, or fail to offset the growing competitive pressure from Eli Lilly and the loss of CVS’s exclusivity. Meanwhile, the EU decision on the oral Wegovy pill promises to unlock a new revenue stream outside the United States, but the rollout will not begin until the second half of 2026 — and by then, the formulary landscape in Novo Nordisk’s most important market may look very different.