Novo Nordisk's Oral Weight-Loss Gambit: Can a Pill Advantage Finally Move the Needle?

Novo Nordisk shares drop 28% from highs despite FDA approval of higher-dose Wegovy and legal action against Eli Lilly in the oral weight-loss race.

The narrative around Novo Nordisk has become a study in contradiction. On one side sits a pipeline of genuinely encouraging developments — a newly approved higher-dose Wegovy, a legal offensive against its biggest rival, and a growing lead in the emerging oral weight-loss market. On the other sits a share price that keeps sliding, leaving investors to wonder whether any of it matters for the stock's near-term trajectory.

The Danish pharma giant's shares closed Friday at €39.40, down 2.6% on the day and roughly 10% lower over the past month. Since the start of the year, the stock has shed 11%, and it now trades nearly 28% below its 52-week high of €54.86, reached in January. The technical picture offers little comfort: the relative strength index sits at 39, and the share price is 3.3% below its 200-day moving average of €40.27 — a signal that the medium-term downtrend remains firmly in place.

The Pill Race Takes Center Stage

Much of the recent attention has focused on the battle for the oral weight-loss market, where Novo Nordisk believes it holds a decisive edge. Danske Bank has weighed in on the side of the home champion, arguing that Novo can win the US market for weight-loss pills against Eli Lilly, even as most analysts currently favor the American rival.

The timing is notable. Lilly launched its oral candidate Foundayo on Monday, and Citi analyst Geoff Meacham has argued that the product's simpler administration more than compensates for its 2.2 percentage-point disadvantage in weight loss compared with Novo's offering. But Danske Bank counters that Novo's roughly three-month head start in the market, combined with several additional percentage points of weight-loss efficacy, gives the Danish company a meaningful advantage. The Wegovy pill has already racked up more than five million prescriptions.

The efficacy gap is at the heart of a legal dispute between the two companies. Novo Nordisk sued Eli Lilly in late July over what it calls misleading comparisons between high-dose Lilly products and lower-dose Novo versions. The numbers tell the story: Lilly's Zepbound achieves 20.2% weight loss after 72 weeks, while the older Wegovy dosage delivers 13.7%. The newer 7.2-mg version of Wegovy, however, comes in at 19% — and the FDA-approved data shows even better results.

Regulatory Wins and Prescription Realities

The US Food and Drug Administration has now cleared that higher Wegovy dose of 7.2 milligrams, a decision accelerated by a priority voucher program. Trial data shows an average weight loss of 20.7% after 72 weeks, compared with 15% at the standard dose; for patients with type 2 diabetes, the figure was 14.1%. The approval is seen as a crucial tool in countering Lilly's Zepbound, which has been steadily gaining market share.

The regulatory environment is also shifting in Novo's favor. The FDA has tightened its stance against illegal copycat products, and Hims & Hers has already pulled its Wegovy imitation from the market. Søren Løntoft, an analyst at AL Sydbank, called the development positive for Novo's competitive position.

Yet the prescription data tells a more sobering story. Barclays recorded approximately 110,600 Wegovy prescriptions in the US for the week ending July 24, slightly below the prior week's 110,900. Citi, using a different methodology, counted 171,788 prescriptions — also flat. Neither bank sees any acceleration in demand, dampening hopes of a quick recovery.

Beyond the US: European and Gulf Momentum

The oral formulation is gaining traction elsewhere. The European Commission approved the Wegovy pill in July, and interest is building in the United Arab Emirates, where prices range from 779 to 1,610 dirhams depending on dosage. Many first-time users there are deliberately choosing the oral version over injections, and pharmacies are reportedly advising early orders amid concerns about potential supply shortages.

Novo's CEO Mike Doustdar sees the market as still in its infancy. He points out that more than 100 million Americans suffer from obesity, yet only a small fraction currently have access to GLP-1 medications. Broader adoption, he argues, could reduce healthcare costs and boost economic productivity.

A Crowded Field Beyond Lilly

The competitive landscape extends well beyond the two dominant players. Amgen has halted its AMG 513 program in phase 1, redirecting focus to MariTide, which is already in phase 3. Pfizer is targeting a 2028 launch for its monthly injectable verobenatide, while Structure Therapeutics reported weight loss of up to 16.3% in a 44-week study of its oral candidate aleniglipron. The phase 3 data from these challengers, expected in 2027 and 2028, could reshape the market.

Capital Returns and Governance Overhaul

Amid the competitive noise, Novo Nordisk continues its share buyback program, launched in early February and sized at up to 15 billion Danish kroner. To date, the company has repurchased roughly 28.9 million B-shares at an average price of 279.80 kroner, totaling around 8.08 billion kroner. Novo now holds 42.9 million of its own B-shares, approximately 1% of its capital.

On the governance front, the Novo Nordisk Foundation initiated a comprehensive board overhaul in October 2025, confirmed at an extraordinary general meeting in mid-November. The restructuring, now roughly nine months old, continues to shape strategic direction under Doustdar, who took over as CEO last August.

Shareholders also have a dividend to look forward to: Novo Nordisk pays $0.58 per share on August 25, with the stock already trading ex-dividend. The trailing twelve-month yield stands at just under 4% — a rare bright spot for investors watching the gap between the company's operational progress and its languishing share price.

The central question remains whether Novo's time-to-market advantage and superior efficacy data in the oral segment can eventually translate into a sustained stock recovery. For now, the market seems to be taking a wait-and-see approach, even as the company presses its case in court, in regulators' offices, and in pharmacies around the world.