Novo Nordisk’s Pill Push Gains Ground as Profit Outlook Fades

Novo Nordisk's Wegovy pill becomes fastest-selling obesity drug with 3M+ prescriptions, but revenue decline looms as competition from Lilly and generics intensifies.

The Wegovy tablet has become the fastest-selling obesity drug in US history, racking up more than three million prescriptions in just over five months. But even as that oral formulation of semaglutide expands the GLP-1 market — over 80% of users are new to this class of therapy — the Danish drugmaker is bracing for a sharp revenue decline next year and planning a rare cut to its US list prices from January 2027.

The pill’s commercial success is undeniable. At its peak, a new Wegovy tablet prescription was written every five seconds in the US, generating around $355 million in first-quarter sales for the 25 mg formulation alone. The product is now also rolling out internationally, with the United Arab Emirates as the first foreign market. Unlike the injectable version, the tablet does not require continuous refrigeration, a major logistical advantage in hot climates. Further country launches are scheduled for the second half of 2026, pending final approval from the European Medicines Agency, which has already cleared the high-dose injection but is still reviewing the pill.

Yet the competitive pressure on Novo Nordisk is intensifying. Eli Lilly’s Mounjaro overtook the Danish company’s injectable GLP-1 sales in the second quarter of 2025, and one major US pharmacy benefit manager now favours a rival obesity treatment on its formulary. Cheaper compounded variants are also eating into market share. Novo Nordisk hit back with its own clinical data: patients on the Wegovy tablet lost an average of 16.6% of body weight, outperforming Lilly’s experimental oral candidate, which achieved 12.4% in a comparable study. The company has also submitted a registration application for CagriSema to the FDA in December 2025, with a decision expected in the fourth quarter of 2026 and a potential market launch at the end of 2027.

Meanwhile, Novo Nordisk is refining its existing oral GLP-1 portfolio. Health Canada has approved a reformulated version of Rybelsus for Type 2 diabetes, with smaller tablet sizes — 1.5 mg, 4 mg and 9 mg replacing the previous 3 mg, 7 mg and 14 mg doses. The new excipient blend improves absorption of semaglutide without altering clinical efficacy, based on a bioequivalence study involving 546 healthy volunteers. Rybelsus remains the only licensed GLP-1 tablet for Type 2 diabetes in Canada, and its approval was recently expanded to cover cardiovascular risk reduction, including heart attack, stroke and cardiovascular death.

On the capital-returns front, management has been active. Since February 4, 2026, Novo Nordisk has repurchased nearly 18.8 million B-shares at an average price of DKK 264.32, for a total transaction value of approximately DKK 4.96 billion. The buyback programme has a total ceiling of DKK 15 billion and runs for twelve months. The company now holds about 35.9 million treasury B-shares, representing 0.8% of its share capital.

The stock has been under severe pressure, trading at around EUR 37.72 — a 1.68% gain on the day but still roughly 46% below its 52-week high. The 50-day moving average of EUR 36.24 has been recaptured, but the 200-day average at EUR 41.47 remains 9% above the current price. Year to date, the shares are down about 16%. Novo Nordisk has already signalled that 2026 revenue and operating profit will decline, and the planned US list-price reductions for its core semaglutide products from January 2027 underscore that pricing pressure is now baked into the company’s own forecasts, not just an external threat.