Novo Nordisk Scores UK First for Oral Wegovy, but Pipeline and Price Pressures Cap the Rally

UK approves Novo Nordisk's oral semaglutide for obesity, but stock remains near 46% low. Pipeline updates include Zenagamtide and CagriSema data.

Novo Nordisk has secured a landmark regulatory nod for its oral version of Wegovy in Britain, yet the stock remains stuck near a 46% trough from its 52-week peak. The Danish drugmaker's shares closed Friday at €38.03, barely budging even as the UK's Medicines and Healthcare products Regulatory Agency (MHRA) became the first European authority to approve the semaglutide pill for weight loss on June 11. The approval covers adults with a body mass index of 30 or higher, and those with a BMI of at least 27 who also have a weight-related comorbidity — matching the label in the US and the United Arab Emirates.

The UK decision builds on data from the Phase 3 OASIS 4 trial, which showed an average weight reduction of around 14%, rising to 17% with consistent dosing over 64 weeks, versus low single-digit losses for placebo. It also hands Novo Nordisk a critical lead over rival Eli Lilly in the oral obesity race across two major markets. While Lilly's oral candidate Foundayo managed roughly 20,000 prescriptions in its first weeks after a US green light in early April, the Wegovy pill has already surpassed 3 million scripts in America in just over five months — one of the strongest volume launches in US pharma history. More than 80% of those new prescriptions are coming from patients who had never used a GLP-1 therapy, indicating the oral formulation is expanding the market rather than cannibalising Novo Nordisk's injectable portfolio.

Yet the pipeline story is more nuanced. At the American Diabetes Association's annual meeting in New Orleans, Novo Nordisk presented Phase 2 results for Zenagamtide, a next-generation candidate for type 2 diabetes. The highest 40 mg dose delivered a 1.71 percentage-point reduction in HbA1c over 36 weeks, with nearly 89% of patients hitting the clinically meaningful threshold of below 7%. Body weight fell by 14.6%. The company plans to launch Phase 3 in the second half of 2026, though top-line data are not expected until 2028 at the earliest. Meanwhile, the REIMAGINE programme for CagriSema met its primary and secondary endpoints: in REIMAGINE-1, the 2.4 mg/2.4 mg dose yielded a 2.33 percentage-point drop in HbA1c and a 12.0% weight loss versus placebo, results published simultaneously in The Lancet and The Lancet Diabetes & Endocrinology. But a direct head-to-head with Lilly's tirzepatide in the REDEFINE-4 study told a different story: CagriSema achieved 23% weight loss after 84 weeks yet still missed the non-inferiority target, leaving a regulatory overhang. Novo Nordisk expects a decision on the REIMAGINE programme from authorities in the fourth quarter of 2026.

For now, the UK approval for oral Wegovy is the clearest near-term catalyst, but it does not automatically translate into revenue. The National Institute for Health and Care Excellence (NICE) has yet to complete its cost-effectiveness assessment, and the injectable version of Wegovy already faces tight restrictions on the NHS. Whether the pill will secure reimbursement — and at what price — remains an open question. Outside the UK, Novo Nordisk plans its first international launches of the oral formulation in the second half of the year, including in the UAE, while the European Commission may issue a formal approval following an EMA recommendation in May. On the US front, pricing pressure from most-favoured-nation rules and Medicaid data continues to weigh on margins.

Those headwinds are reflected in the financials. First-quarter 2026 adjusted revenue fell 4% year-on-year, prompting management to issue a cautious full-year outlook calling for adjusted sales growth between minus 4% and minus 12% at constant exchange rates. The same range applies to adjusted operating profit. The company's share buyback programme — up to 15 billion Danish kroner over 12 months — has provided little support. Since 4 February, Novo Nordisk has repurchased roughly 18.8 million B-shares at an average price of 264.32 kroner, consuming about 5 billion kroner of the authorised total. The stock's 200-day moving average of €41.43 sits about 8% above the current level and may act as technical resistance.

Investors now face a wait-and-see period. The next tangible milestone is the second-quarter earnings release on 5 August, before the market opens. In the weeks ahead, the market will also monitor any pricing and private-market entry details for the UK, progress on the EU-wide approval, and the evolution of US pricing pressure. The oral Wegovy approval is a clear positive for the equity, but it is the NHS decision — not the regulatory green light — that will transform promise into profit.