Novo Nordisk’s High-Stakes Week: Oral Ozempic Hits Pharmacies as Earnings Test Investor Patience

Novo Nordisk launches oral Ozempic in the US amid Q1 earnings decline, Eli Lilly competition, and patent pressures. Analysts cut targets as margins shrink.

The Danish drugmaker is juggling a product launch, a quarterly report, and mounting competitive pressure all within the span of 72 hours. On Monday, Novo Nordisk begins selling its newly formulated oral version of Ozempic across the United States, rebranding what was previously known as Rybelsus under the blockbuster name. The pill, available in three new dosages, targets adults with type 2 diabetes, aiming to lower blood sugar and cut the risk of severe cardiovascular events.

The timing is no accident. Just last month, US rival Eli Lilly rolled out its own obesity pill, prompting Novo to respond with aggressive pricing. Through insurer copay programs, eligible patients can now secure a three-month supply for as little as $25. The move leverages the immense brand recognition of Ozempic, a name that has become synonymous with the GLP-1 revolution.

Earnings Day Brings a Grim Outlook

All eyes turn to Wednesday morning, when Novo Nordisk releases its first-quarter results. Analysts expect revenue of roughly $11.3 billion, with earnings per share landing at $0.87 to $0.88 — a decline of about 16 percent year over year. The options market is pricing in a swing of nearly 7 percent in either direction, reflecting deep uncertainty about the company’s near-term trajectory.

The numbers come against a backdrop of shrinking margins. For the full year 2026, management has guided for a revenue contraction of 5 to 13 percent, a forecast that predates recent clinical setbacks. Patent expirations in China and India are opening the door to cheap generics, while in the US, tough price negotiations are squeezing profitability. Novo hopes to offset some of these losses through higher sales volumes, but analysts remain skeptical.

Three Burning Questions for Management

On the afternoon conference call, investors will demand clarity on three fronts. First, can Novo stick to its existing guidance after the REDEFINE-4 disappointment? Second, how is Wegovy performing in pill form — roughly 50,000 weekly prescriptions were flowing in late January, and the oral format is seen as a critical weapon against Eli Lilly’s encroachment. Third, what is the status of production capacity? Novo has announced Wegovy HD for the US market and plans capital expenditures of around 55 billion Danish kroner this year.

Production Investment and Regulatory Headwinds

To meet global demand for oral GLP-1 therapies, Novo is pouring 432 million euros into retooling a manufacturing site in Athlone, Ireland. That facility will serve markets outside the US, but completion is not expected until the late 2020s. Closer to home, Health Canada has just approved a biosimilar to Ozempic from Dr. Reddy’s Laboratories, adding another layer of price pressure on the core product.

Wall Street has taken notice. Citi has downgraded the stock, Bernstein initiated coverage with an “underperform” rating, and Goldman Sachs, TD Cowen, and Deutsche Bank have all slashed their price targets. Bernstein warns that the cycle of earnings revisions is far from over. The shares, which closed Friday at $43.88 after a nearly 4 percent gain, still sit about 20 percent below their level at the start of the year. They have roughly halved from the 52-week high of €70.13, and with a relative strength index of 23, the stock is technically deep in oversold territory — though that alone does not signal a turnaround.

A Glimmer of Hope from AI

Amid the gloom, there is one constructive development. In mid-April, Novo Nordisk struck a partnership with OpenAI to deploy artificial intelligence across drug discovery, manufacturing, and supply chain operations. The integration is slated for completion by the end of 2026. Financial terms were not disclosed. So far, the market has shrugged off the news, focused instead on the immediate questions that Wednesday’s earnings call must answer.

The next major catalyst arrives in mid-May at the European Obesity Congress in Istanbul, where Novo will present fresh clinical data from its closely watched CagriSema pipeline. Until then, the company’s narrative hinges on whether the Ozempic pill launch can regain momentum and whether management can convince investors that the worst is already priced in.