Novo Nordisk's Dual Strategy: New Drugs and a Massive Buyback Amid Market Pressure

Novo Nordisk's share price hits 12-month low despite a major buyback and launch of Wegovy HD & oral pill, as U.S. pricing pressure and Eli Lilly competition weigh.

Novo Nordisk's share price is languishing near a 12-month low, down approximately 46% over the period and trading around EUR 32.12, well below its 200-day moving average. This persistent decline comes despite a flurry of strategic activity from the Danish pharmaceutical giant, which is deploying a multi-billion dollar share buyback while launching two new products in a single week. The market's muted reaction underscores the deep-seated challenges the company faces from U.S. price regulations and intense competition.

The company is actively supporting its stock through a substantial repurchase program. Since early February, Novo Nordisk has bought back nearly ten million of its own shares, worth about 2.59 billion Danish kroner. This is part of a larger 12-month plan to repurchase shares worth 15 billion kroner in total. The company now holds 0.6% of its own share capital as treasury stock, a move that highlights its financial strength even as it braces for significant operational headwinds.

Those headwinds are crystallizing in the company's own guidance. Management anticipates a currency-adjusted sales decline of 5% to 13% for 2026. This would mark the first annual revenue drop in a quarter of a century. The primary culprits are stricter U.S. government pricing rules under the Most-Favored-Nations agreement and reduced Medicaid reimbursements for obesity medications. Compounding the pressure, rival Eli Lilly now commands over 60% of the U.S. market for obesity therapies, putting Novo Nordisk firmly on the defensive.

In response, the company has launched a one-two punch of new products. On April 7, it began the nationwide U.S. rollout of Wegovy HD, a higher-dose injection containing 7.2 mg of semaglutide—triple the previous maximum dose of 2.4 mg. Clinical trials showed patients on the new dose lost an average of 21% of their body weight, compared to roughly 18% on the standard version. Nearly one in three participants achieved weight loss of 25% or more. Priced at $399 per month for cash payers, with insured patients potentially paying as little as $25 monthly through a savings program, Wegovy HD is a direct competitive challenge to Eli Lilly's Zepbound.

Simultaneously, early data for the oral Wegovy pill reveals it is attracting a new patient demographic rather than converting existing injection users. Many early adopters had previously avoided GLP-1 therapies due to high injection costs or needle anxiety. Analysts at BMO Capital Markets attribute the strong initial demand to the pill's comparatively low entry price of $149 per month and the powerful Wegovy brand. According to a March analysis by GlobalData, total revenue from the Wegovy portfolio is projected to rise from $13.5 billion in 2026 to $18.9 billion in 2031, with the pill expected to contribute $2.76 billion of that growth.

Despite this product offensive, the stock remains under pressure, trading about 29% below its level at the start of the year. The first true stress test for this dual strategy will come with the first-quarter earnings report in May, which will include the initial sales figures for the oral Wegovy pill. This report will provide the first clear look at margin development under the new U.S. pricing regime and is likely to dictate the short-term share price trajectory.

Looking further ahead, investor hopes are pinned on a crucial regulatory decision. The company's CagriSema drug, a combination of two active ingredients, demonstrated an average weight loss of 23% in Phase 3 trials. The U.S. Food and Drug Administration (FDA) is currently reviewing the application, with a decision expected in October 2026. This approval represents the most significant near-term catalyst for the stock, especially ahead of the company's Capital Markets Day in September 2026. Until then, Novo Nordisk must navigate a perfect storm of pricing pressure, market share battles, and investor skepticism.