Novo Nordisk Eyes Wall Street Listing as Oral Pipeline Bet Takes Center Stage

Novo Nordisk is considering a direct NYSE listing to replace its ADRs, as it shifts to oral therapies and faces a 22% year-to-date share decline.

Novo Nordisk is weighing a direct listing on the New York Stock Exchange, a move that would retire its American Depositary Receipts in favor of ordinary shares traded on Wall Street. Chief executive Mike Doustdar floated the idea in an interview with the Financial Times published Wednesday, saying the Danish drugmaker is fundamentally open to such a step. The stock firmed 0.8% to EUR 34.73 in premarket trading on the news.

The rationale is straightforward: the US capital market matters more to Novo Nordisk with every passing year. Over the past two decades its shareholder base has drifted steadily away from Scandinavia, while more than half of group revenue is now generated in the United States — the same market that absorbs the bulk of Wegovy and Ozempic sales. Swapping ADRs for directly traded common stock could smooth access for American institutions in particular. AstraZeneca, Novo's British rival, took a comparable route to the US exchanges earlier this year.

Doustdar was careful not to let expectations run ahead of reality. While he sees clear merits in a direct US listing, he said the company is not actively pursuing the option in day-to-day operations. The NYSE question has been debated internally for years, yet no active dialogue with exchange representatives has taken place since he took the helm last year. Copenhagen remains Novo Nordisk's primary trading venue for the time being.

A strategic pivot toward tablets

The listing discussion lands as Novo Nordisk pushes a broader transition from weekly injections to oral therapies. That shift was underscored on September 17, when the company struck a deal with Orbis Medicines worth up to USD 1.4 billion covering research and licensing of oral cardiometabolic treatments. Management's message is unambiguous: the next era of the market will not be decided by syringes alone.

Investors, though, are hunting for proof of future growth. The shares closed Tuesday at EUR 34.43, down 1.2%, extending a year-to-date decline of 22%. The stock now trades 37% below its 52-week high, and a 52-week low of EUR 30.25 has become the line in the sand for chart watchers — hold above it and the case for a bottom stays alive; lose it and the correction could deepen.

Pricing power under the microscope

The central question is whether Novo Nordisk can reshape its product portfolio fast enough to offset margin pressure. At Monday's capital markets day, executives faced pointed questions on pricing power and future acquisitions. The company aims to bring more than five blockbuster medicines to market by 2030, with pipeline revenue targeted to exceed DKK 150 billion by 2035. Hitting those numbers requires new compounds that do more than replace existing injectables — they must generate profitable incremental business.

Competition is sharpening the challenge. According to LSEG data, sales of Eli Lilly's rival Zepbound are expected to outpace Wegovy by more than USD 7 billion this year. Should competitors advance faster in oral formats or offer steeper discounts, Novo's revenue ambitions come under threat. The roughly 9% slide during Monday's capital markets day laid bare how skeptical the market remains about management's long-range assumptions.

CagriSema as the next test

The near-term catalyst is already circled on calendars: the US Food and Drug Administration's decision on the CagriSema filing for weight control is expected in the fourth quarter. A favorable verdict would let Novo Nordisk open the next chapter of its pipeline as planned. Strong trial data in injectables, paired with a deliberate build-out of tablet partnerships such as the Orbis tie-up, form the foundation for the billion-dollar revenue targets the company has set for the coming decade.

Failure carries its own costs. Developing effective oral medicines demands heavy financial commitments with no guaranteed outcome, and if pipeline projects stumble or commercialization slips, Novo risks ceding share in its high-margin core business. Whether the group can defend its dominant position against mounting competition hinges directly on how well it executes this innovation cycle.