Novo Nordisk’s $400 Billion Wipeout: Can a Pill and a Buyback Turn the Tide?

Novo Nordisk fights $400B value loss with a $2.2B buyback and oral Ozempic launch, but pricing pressure and Eli Lilly competition weigh on forecasts.

The numbers tell a brutal story. Since hitting its all-time high in 2024, Novo Nordisk has incinerated more than $400 billion in market value. The stock now trades at €38.19, down nearly 38% over the past twelve months. But the Danish pharma giant is fighting back on two fronts: a massive share buyback and a high-stakes pivot from injections to tablets.

On Tuesday, Novo Nordisk announced the completion of the first tranche of a sweeping buyback program, spending roughly 3.8 billion Danish kroner to repurchase millions of its own B-shares. That marks the opening salvo of a plan totaling 15 billion kroner, leaving the company holding 0.7% of its own share capital. The move is a clear signal to jittery investors that management believes the stock is undervalued.

Yet the real drama is playing out in the US pharmaceutical market. Novo Nordisk launched its oral Ozempic tablets nationwide at the beginning of May, targeting adults with type 2 diabetes while also aiming to reduce cardiovascular risk. The pill format represents a strategic bet that patients will prefer swallowing a tablet over injecting themselves, especially as competition from US rival Eli Lilly intensifies.

Early demand data is encouraging. The related oral Wegovy variant racked up roughly 721,000 US prescriptions in the first quarter alone. Telemedicine provider LifeMD reported that daily new patient numbers doubled following Wegovy’s January launch. But there is a catch. Patients appear to be sticking with cheaper starter doses longer than expected, or dropping out of treatment altogether. Barclays analyst James Gordon flagged this unexpected dosing dynamic, warning that the slow shift to higher-priced maintenance doses is weighing on revenue forecasts, even as raw prescription counts climb.

The pricing environment is turning hostile. Novo Nordisk has been forced to cut prices aggressively to secure US market access and keep rivals at bay. The company’s monopoly on oral GLP-1s in America ended in early April when Eli Lilly won approval for its competing product, Foundayo. To complicate matters further, Novo Nordisk is rapidly building up domestic production capacity and stockpiling inventory as a hedge against potential new US tariffs on imported medicines.

All eyes are now on Wednesday’s quarterly earnings report. The February guidance already pointed to a 13% decline in both revenue and profit for the full year 2026. Some investors are betting management will raise the lower end of that forecast, especially after Eli Lilly’s strong quarterly numbers last week provided a tailwind for the entire GLP-1 segment. A massive one-off item could also juice the bottom line: the release of a $4.2 billion provision is expected to inflate reported earnings significantly.

The stock has shown signs of life, climbing nearly 9% over the past week to €38.30 and reclaiming its 50-day moving average. That recovery has lifted shares from the March trough, though the 52-week low of €30.48 remains a potential downside target if Wednesday’s outlook disappoints. With a forward price-to-earnings ratio of roughly 13, the stock is historically cheap — but cheap for a reason.

The oral pill strategy is Novo Nordisk’s best shot at defending its franchise against a well-funded assault from Eli Lilly. Wednesday will reveal whether that bet is paying off, or whether the margin pressure from price cuts and dosing shifts will keep the stock pinned near its lows.