Novo Nordisk's Pill Sales Beat Buys Time as Pricing Squeeze Intensifies

Oral Wegovy pill drives Q1 beat with sales doubling forecasts, but Maryland price cap, Supreme Court ruling, and Canadian generics add to headwinds amid 2026 guidance decline.

The pressure on Novo Nordisk’s blockbuster diabetes franchise is coming from all directions. On 18 May 2026, Maryland’s Prescription Drug Affordability Board voted to cap the monthly price of Ozempic at $274 for state and local health plans, effective January 2027. It marks only the second time the board has used that authority, following a similar move against Jardiamine. That same day, the U.S. Supreme Court declined to hear challenges to the Inflation Reduction Act’s drug price negotiation rules, clearing the path for further federal Medicare bargaining. The White House also expanded its TrumpRx.gov platform, now offering over 600 generic drugs at discounted rates.

Yet Novo Nordisk’s latest quarterly results show that its oral GLP-1 pill is gaining traction far faster than analysts anticipated. In the first quarter of 2026, the company posted revenue of 96.8 billion Danish kroner, beating consensus estimates. The oral version of Wegovy—launched in its first full quarter—pulled in 2.26 billion kroner, more than double the 1.16 billion kroner the Street had penciled in. That strong start provides a crucial buffer as the pricing assault gathers pace.

Canadian generics add another front to the battle. Health Canada recently approved initial copycat versions of Ozempic from Dr. Reddy’s Laboratories and Apotex. Under a local pricing mechanism, the arrival of a third generic manufacturer would force Novo Nordisk to slash its list price by 65%. Citi, which rates the stock "Neutral" with a 290-kroner target, warned that the looming price erosion and intensifying obesity-market competition overshadow the pill’s strong debut.

Despite the Q1 beat, management’s full-year guidance points to a 4% to 12% decline in both revenue and profit for 2026, citing generic competition and sustained U.S. pricing pressure. The stock currently trades at around €37.49 in Frankfurt, roughly 37% below its level a year ago. It has recovered about 23% from its March trough, but remains well below the 200-day moving average of €42.31. Analysts are split: of 19 covering the stock, 13 recommend "Hold", with median price target of 295 kroner and a wide range of 175 to 440 kroner.

Share buybacks and pipeline bets. Novo Nordisk has been buying its own shares aggressively, spending nearly 370 million kroner in the week of 6-13 May alone to acquire about 1.24 million B-shares. The current buyback program, worth up to 15 billion kroner, runs until early February 2027 and has already seen roughly 16 million shares removed from the market. The company is also advancing its next-generation candidate, Zenagamtide, which recently entered two pivotal Phase 3 trials for obesity and type 2 diabetes over 84 weeks, with additional studies planned for sleep apnea and knee osteoarthritis.

Meanwhile, competition in the obesity space is heating up. Viking Therapeutics reported Phase 2 data for its oral GLP-1 drug VK2735, showing weight loss of up to 12.2% over 13 weeks—a direct benchmark for Wegovy’s pill version.

The next major test arrives on 5 August 2026, when Novo Nordisk reports first-half results. Investors will be looking for hard evidence that the oral Wegovy ramp can offset the mounting pricing headwinds from both U.S. regulation and Canadian generic entry.