Novo Nordisk’s Oral Wegovy Breaks Cover as 2 Million Prescriptions Rewrite the Script

Novo Nordisk shares jump 8% as oral Wegovy hits 2M prescriptions since US launch, but adjusted earnings reveal US revenue decline and one-off gains.

Novo Nordisk has thrown off the gloom that has dogged its stock for months, delivering a first-quarter performance that has caught even the most optimistic analysts off guard. The Danish drugmaker’s new oral version of Wegovy has racked up more than two million prescriptions since its US launch in January, a figure that CEO Mike Doustdar described as the strongest debut of any GLP-1 therapy in American history. The news sent shares surging as much as 8 percent in Copenhagen, with the stock last changing hands at €40.81 — still down nearly 9 percent year-to-date, but clawing back a chunk of its recent losses.

The headline numbers from the quarter were eye-catching. On a reported basis, operating profit jumped 65 percent, while adjusted earnings per share came in at $1.04, comfortably ahead of the consensus estimate of $0.87. But beneath the surface lurks a distortion: a one-off release of provisions tied to the US 340B drug pricing program inflated earnings by $4.2 billion. Strip that out, and the picture turns more sobering. Currency-adjusted revenue in the US fell 11 percent, as higher sales volumes failed to offset a sharp decline in net prices. International revenues, by contrast, ticked higher.

What has truly captured the market’s imagination is the uptake of the oral Wegovy pill. Since hitting pharmacy shelves at the start of January, the drug has generated over two million prescriptions, with Doustdar noting that the Wegovy franchise now commands 65 percent of all new US prescriptions in its category. The CEO dismissed fears that the pill would cannibalise sales of the injectable version, arguing that the two formulations complement each other rather than compete.

The strong demand has prompted management to nudge its full-year guidance higher. Novo Nordisk now expects adjusted revenue and operating profit to decline by between 4 percent and 12 percent in 2026 on a currency-adjusted basis, compared with a previous lower bound of minus 13 percent. Jefferies analysts were unimpressed, questioning whether the revision would meaningfully lift consensus estimates given that the upper end of the range remained unchanged.

The competitive landscape remains intense. US rival Eli Lilly launched its own oral obesity drug, Foundayo, last month, though early prescription data suggests Wegovy has maintained a clear lead. A head-to-head clinical comparison has yet to be published, but available data points to a modest advantage for Wegovy on weight loss.

Novo Nordisk has also been busy advancing its broader pipeline. The US Food and Drug Administration approved the high-dose injectable Wegovy HD in March, and the once-weekly basal insulin Awiqli received the green light. The next catalyst is just days away: from May 12 to 15, the company will present fresh clinical data at the European Congress on Obesity in Istanbul, where it is expected to unveil further evidence supporting its oral GLP-1 therapy.

For now, the narrative has shifted decisively. After months of selling pressure, Novo Nordisk has reminded investors that its pipeline — and particularly its oral franchise — still packs a punch. Whether that is enough to sustain the rally will depend on how the pricing headwinds in the US evolve, and whether the company can keep Eli Lilly at bay.