Novo Nordisk’s Pipeline Verdict Looms as Wegovy’s Formulary Edge Crumbles and Buybacks Fall Short

As commercial pressures mount from Lilly rivals and patent expiries, Novo Nordisk's upcoming data readouts for CagriSema and Zenagamtide could shape its weight-loss drug prospects and stock recovery.

The upcoming week marks a pivotal moment for Novo Nordisk. As the American Diabetes Association’s Scientific Sessions kick off in New Orleans on June 5, the Danish drugmaker will present no fewer than 40 abstracts, with the centrepiece being a dedicated R&D investor day on June 7. The data readouts for CagriSema and the next-generation candidate Zenagamtide will be scrutinised against a backdrop of intensifying commercial headwinds that have already shaved roughly 15.4% off the share price since January.

That commercial pressure is coming from multiple directions. From June 1, Lilly’s oral product Foundayo began sharing the same preferred formulary tier as Wegovy at one of the largest US pharmacy benefit managers, with Zepbound joining the fray in October. The loss of exclusivity erodes a key competitive advantage that had buoyed Wegovy through 2025. Meanwhile, Ozempic sales in the first quarter fell 8% year-on-year, and the patent expiry in China looms in 2026, opening the door to generic rivals. Novo Nordisk’s own 2026 guidance, even after a May upgrade, still points to a 4–12% decline in adjusted revenue and profit.

The company has been trying to cushion the blow with a substantial share buyback programme. Since February 4, it has acquired 17,889,179 B-shares at an average price of 263.47 Danish kroner, for a total outlay of roughly 4.71 billion kroner. The programme, which allows for up to 15 billion kroner in repurchases over twelve months, continued in late May with another 840,000 shares bought at prices between 286.16 and 293.42 kroner. Novo now holds 35,074,480 B-shares, representing 0.8% of total share capital. Yet the buyback has barely arrested the slide: at 37.78 euros, the stock is down 15.44% year?to?date and has lost 40.59% over the past twelve months from its 52?week high of 70.13 euros.

All eyes now turn to New Orleans. The REIMAGINE phase 3 trials (studies 1 through 3) will provide the first full efficacy and safety readout for CagriSema in type 2 diabetes patients on various background therapies. That comes after earlier data showed the amylin?GLP?1 combination failed to demonstrate non?inferiority against a rival drug in obesity. The FDA’s decision on weight?loss approval is expected in the second half of the year, and the June 7 data will shape the tone of that review. In addition, phase 2b results for Zenagamtide (formerly Amycretin) will be presented — an injectable molecule that targets both GLP?1 and amylin receptors and is designed to surpass conventional GLP?1 therapies. Beyond metabolic disease, Novo is also exploring cardiovascular inflammation via the POSEIDON study, which enrolled nearly 19,000 patients across 18 countries and found that two out of five high?risk individuals with atherosclerotic cardiovascular disease and chronic kidney disease or heart failure had elevated hsCRP levels despite standard treatment — a clear unmet need the company hopes to address with a first?in?class therapy.

Pricing dynamics in the US are adding another layer of complexity. New state?level agreements based on a most?favoured?nation principle have pushed monthly out?of?pocket costs for obesity treatments below $350, improving patient access but squeezing manufacturer pricing power. Novo Nordisk is responding by expanding its digital direct?to?patient sales channels, aiming to reach consumers outside the traditional insurance?based model. The shift reflects a broader reality: the GLP?1 market is still growing, but the revenue streams are becoming more politicised and transparent.

Technically, the stock is in a tug?of?war. It has climbed back above its 50?day moving average, yet remains well below the long?term 200?day line. The relative strength index stands at 71.6, suggesting the recent recovery may be overstretched in the short run. The buyback provides a mechanical floor, but it cannot substitute for a convincing pipeline story. The data due on June 7 will determine whether Novo Nordisk can credibly refresh that narrative — or whether the commercial erosion will continue to define its trajectory.