Novo Nordisk Faces First Generic Challenge in Canada as Wegovy Oral Pill Dominates US Market

Novo Nordisk's US Wegovy surges with 65% of new scripts, raising guidance, but Canadian Ozempic generic approval threatens 65% price cut, signaling international revenue erosion.

The Danish pharmaceutical giant is navigating a tale of two markets. While its oral Wegovy pill is shattering records in the United States, the first-ever generic version of Ozempic has been approved in a G7 country, sending a warning shot across Novo Nordisk's flagship GLP-1 franchise.

Health Canada granted the initial approval for an Ozempic generic from India's Dr. Reddy's Laboratories in late April, followed swiftly by a green light for Canadian manufacturer Apotex. Seven more generic applications are pending. The opening was created years ago when Novo Nordisk missed a fee payment, causing its primary semaglutide patent to expire in Canada back in 2020. An eight-year data protection period ended in early 2026, and a secondary patent lapsed in March 2026, clearing the legal pathway.

Canadian pricing regulations add a further sting: once three generics are on the market, a mandated price cut of 65% off Novo's list price kicks in. The company's head of international operations characterized the likely impact as a low-single-digit percentage hit to revenue during the quarterly earnings call, though not all equity analysts share that relatively sanguine view.

Across the border, the picture could hardly be more different. The launch of the oral Wegovy pill in the US has been explosive, with more than two million prescriptions written since January. Even the April market entry of Eli Lilly's competing drug Foundayo failed to dent momentum — Wegovy has captured 65% of new US prescriptions. The strong performance prompted management to raise its full-year guidance for both revenue and operating profit.

Behind those prescription numbers lies an increasingly robust clinical profile. Data presented at the European Obesity Congress in Istanbul showed premenopausal women with obesity achieving an average weight loss of nearly 23% on Wegovy. Real-world evidence also pointed to sharp reductions in migraine and depression. A post-hoc analysis of the SELECT study demonstrated that perimenopausal patients saw a 42% lower risk of heart attacks and strokes, compared with a 13% reduction in postmenopausal women.

Novo Nordisk is also pushing beyond obesity. Phase 3 results for its hemophilia A candidate Denecimig showed a 43% reduction in bleeding events with monthly dosing versus standard preventive treatments, marking a potential advance in rare disease therapy.

The share price, however, tells a more cautious story. The stock traded at €38.16 in early June, down roughly 15% since the start of 2026 and about 35% lower than a year ago, far from its 52-week high of €70.13. Citi analysts lifted their price target to 290 Danish kroner from 275 kroner after the first-quarter results but kept a Neutral rating, citing ongoing price erosion in the diabetes portfolio. BMO Capital Markets, also at Hold, views the Canadian generics as the beginning of a structural decline in international semaglutide revenue and a bellwether for how biosimilars might challenge established GLP-1 brands. Bernstein remains a seller.

On the capital allocation front, Novo Nordisk completed a tranche of its ongoing buyback program between February and May, purchasing nearly 14.8 million B-shares at an average price of 257.47 kroner. The overall program authorizes up to 15 billion kroner over twelve months.

Investors will get a closer look at the pipeline and commercial strategy on June 7, when the company hosts an R&D investor event at the American Diabetes Association's annual meeting. The focus is expected to be on pipeline updates and the first detailed assessment of generic competition in Canada — a market that, for now, is a special case. The main US semaglutide patent runs until 2032, with similar protection in Europe. But analysts increasingly view the Canadian experience as a potential preview of the competitive dynamics that could follow the patent cliff.