Novo Nordisk’s Next Hurdle: August Earnings Will Test Whether Pill Uptake Can Counter a 65% Canadian Price Hit

Novo Nordisk shares rebound 10% but remain down 15% YTD. Generic Ozempic competition looms in Canada, while oral pill launch and CagriSema obesity drug offer pipeline upside. Citi maintains neutral.

Novo Nordisk’s shares have clawed back roughly 10% over the past month to trade at €37.96, but the recovery remains fragile. The stock is still down about 15% year-to-date and 36% below the level seen a year ago. All eyes will now turn to August 5, when the Danish drugmaker releases first-half results — the first hard look at how margins are holding up under intensifying competition and a looming generic assault on its core diabetes franchise.

The most immediate threat comes from Canada. Health regulators there have already approved copycat versions of Ozempic from Dr. Reddy’s Laboratories and Apotex, and the arrival of a third generic manufacturer would trigger a local pricing mechanism that slashes Novo Nordisk’s list price by 65%. That kind of discount would carve deep into the revenue stream of a blockbuster that has long been the company’s cash cow.

Management is pushing back on several fronts. Since May 4, Ozempic has been available as a pill in more than 70,000 U.S. pharmacies and selected telemedicine providers — the first oral peptide GLP-1 therapy in the country that both lowers blood sugar and cuts the risk of major cardiovascular events. An application for a higher 25-milligram tablet version is already with the FDA, with a decision expected by the end of 2026. Novo also plans to file for pediatric use of the drug in Type-2 diabetes later this year in the U.S. and Europe.

The bigger pipeline prize, however, is CagriSema, a combination of cagrilintide and semaglutide. Phase 3 data from the REDEFINE 1 trial showed a mean weight loss of 22.7% after 68 weeks — well ahead of semaglutide alone at 16.1% and cagrilintide alone at 11.8%. More than 40% of participants shed at least a quarter of their body weight. The FDA is expected to deliver its verdict on CagriSema in the fourth quarter of 2026, a decision that could reshape the obesity treatment landscape if approved.

But Novo no longer has the oral obesity market to itself. In April, Eli Lilly secured FDA approval for its oral obesity drug Foundayo, ending Novo’s brief monopoly on a non-injected weight-loss pill. One key difference: Foundayo carries no food or fasting restrictions, whereas the oral version of Wegovy must be taken on an empty stomach. That could sway patient choice, though Citi analysts described the launch of oral Wegovy as impressive and noted that injectable Wegovy volumes remain robust.

To steady the ship, Novo Nordisk has been leaning heavily on its share buyback program. The current tranche, running until February 2027, covers up to 11.2 billion Danish kroner as part of a broader envelope of 15 billion kroner. So far the company has repurchased approximately 16 million shares, providing a floor for the stock during a turbulent period.

Citi remains cautious, maintaining a neutral rating with a price target of 290 kroner. The bank projects its 2027 earnings per share to be roughly 7% below the consensus, citing pricing pressure from, among other factors, most-favored-nation pricing mechanisms in the diabetes segment. On the other hand, Citi is significantly more bullish than the Street on Wegovy pill revenue, forecasting $2.7 billion for 2026 and a peak of $8 billion.

After first-quarter numbers, management lifted its full-year guidance. The company now expects adjusted revenue growth of between minus 4% and minus 12% at constant exchange rates, with adjusted operating profit tracking in the same range. The stock currently sits about 10% above its 50-day moving average but well below the 200-day average of €42.35, underscoring how far the shares have to climb to reclaim lost ground.

In the meantime, Novo is pushing ahead with its next-generation pipeline. Two registrational Phase 3 trials for Zenagamtide — a new candidate — have recently begun, testing efficacy against obesity and Type-2 diabetes over 84 weeks. Additional studies are exploring Zenagamtide’s potential in sleep apnea and knee osteoarthritis. Whether any of these bets can offset the generic threat and competitive pressure will likely determine whether the stock’s recent uptick proves sustainable.