Novo Nordisk’s Ozempic Pill Hits Shelves as Q1 Earnings Loom and Valuation Debate Deepens

Novo Nordisk faces a pivotal week with Ozempic oral launch, expected Q1 earnings decline, and a 36% stock drop, splitting Wall Street between buyers and skeptics.

Novo Nordisk enters a pivotal week with the launch of its Ozempic-branded oral semaglutide in the US, a first-quarter earnings report that analysts expect to show a sharp decline, and a stock that has shed more than a third of its value since January. The confluence of events has split Wall Street into two camps: those who see a buying opportunity and those who warn the pain is not over.

A Rebranding Gambit Hits the Pharmacy Counter

Starting May 4, Novo Nordisk began selling semaglutide tablets under the Ozempic name in more than 70,000 US pharmacies. The three dosages—1.5 mg, 4 mg, and 9 mg—are approved for adults with type 2 diabetes. This is not a new drug; the tablets were previously marketed as Rybelsus. The company is betting that the Ozempic brand, one of the most recognizable names in pharma, will drive adoption.

Pricing is designed to capture a wide audience. Insured patients will pay as little as $25 for a three-month supply. Cash-pay patients using select telemedicine providers will pay $149 per month for the starter dose. Weight Watchers and GoodRx are signed on as distribution partners.

Novo Nordisk has also filed for an FDA label expansion for a 25 mg tablet, with a decision expected by the end of 2026.

Q1 Earnings: The Numbers Look Ugly

On May 6, before the market opens, Novo Nordisk will report first-quarter 2026 results. Analysts expect revenue to fall roughly 8% year-over-year, with earnings per share dropping about 16%.

The company’s own guidance is bleak. Revenue and operating profit, at constant exchange rates, are forecast to decline between 5% and 13%. The headwinds are well documented: US pricing pressure, reduced Medicaid reimbursements for obesity drugs, and the Most Favored Nations agreement are all squeezing margins.

The stock has already priced in much of the bad news. The ADR closed at $42.22 on May 1, down roughly 36% year-to-date and a long way from the 52-week high of $81.44. The February Phase 3 disappointment for CagriSema triggered the initial sell-off.

A Fractured Analyst Consensus

The valuation debate has become unusually polarized. Morningstar assigns a fair value of just $18 per share, implying the current price of around $40 to $41 is 85% above its intrinsic worth. That sounds paradoxical for a stock that has lost more than half its value from its all-time high, but it underscores how extreme the GLP-1 euphoria of 2024 inflated the valuation.

The broader Wall Street consensus disagrees. Six analysts maintain buy ratings, with an average price target of roughly $58. Their thesis: the long-term growth potential of the GLP-1 market outweighs near-term pricing and competitive pressures. But the bulls are losing converts. Goldman Sachs, TD Cowen, and Deutsche Bank have all cut their price targets. Bernstein initiated coverage with an underperform rating, warning that the earnings revision cycle is not finished. Citi has also downgraded the stock. The consensus now sits at “hold.”

Pipeline Progress Offers a Counterweight

Away from the GLP-1 turmoil, Novo Nordisk reported a notable pipeline win. Etavopivat, a treatment for sickle cell disease, met both primary endpoints in the Phase 3 HIBISCUS trial. The drug reduced the frequency of painful vaso-occlusive crises by 27%. Nearly half of treated patients showed a meaningful improvement in hemoglobin levels, compared with just over 7% in the placebo group.

Novo Nordisk plans to file for regulatory approval in the second half of 2026. The drug already holds Fast Track and Orphan Drug designations from the FDA.

The Week Ahead: A Tailwind from the FDA

The trading week brought sharp swings in both directions. A positive catalyst came from the FDA, which proposed removing semaglutide, tirzepatide, and liraglutide from the 503B bulk substance list—a move that signals a crackdown on compounding competition. The stock gained nearly 5% on the news.

That followed a negative development: Health Canada approved a generic injectable semaglutide, which market observers view as a potential precedent for other markets. On a year-to-date basis, the stock is still down roughly 19% in euro terms, though a 30-day gain of about 14% hints at tentative stabilization.

Indirect support came from archrival Eli Lilly, whose Mounjaro sales grew 125% in the first quarter. Lilly raised its full-year guidance, lifting sentiment across the GLP-1 space. But Lilly’s strength also underscores the competitive pressure on Novo Nordisk.

Structural Pressures and the Outlook

Morningstar expects US semaglutide prices to fall by more than 20% in 2026, earlier than previously assumed. Medicare Part D negotiations and most-favored-nation clauses are compressing margins. The company’s own guidance for a 5% to 13% decline in revenue and operating profit reflects that reality.

Potential offsets include the Wegovy pill—113,000 weekly prescriptions since launch—and an ongoing share buyback program worth 15 billion Danish kroner. The dividend yield stands at roughly 4%, and the price-to-earnings ratio is around 12, historically cheap for Novo Nordisk.

Whether that is enough to rebuild confidence after the May 6 earnings release depends largely on whether management can stabilize the outlook. The next decisive data point is not just the Q1 numbers, but the tone of the guidance that accompanies them.