Novo Nordisk Forecasts 5–13% Sales Drop in 2026, Shares Plunge 14%
Novo Nordisk forecasts 2026 adjusted sales down 5–13% at CER, excluding $4.2 billion 340B rebate reversal, and 11% operating profit growth, as U.S. MFN pricing, semaglutide patent expiries and reduced Medicaid obesity coverage pressure its GLP-1 franchise. Shares tumbled 14% on the weak guidance.
1. Weak 2026 Sales Guidance Highlights Pricing Pressure
Novo Nordisk disclosed that adjusted full-year sales for 2026 are now expected to decline by 5% to 13% at constant exchange rates, a dramatic reversal from the 10% growth achieved in 2025. Management attributed the downturn to lower realized prices driven by the U.S. Most Favoured Nations agreement, intensified GLP-1 competition, patent expiries for semaglutide in key international markets and a reduction in Medicaid coverage for obesity treatments. The stock responded with a 14% drop on the day of the announcement, underscoring investor concern over these structural headwinds.
2. Operating Profit Growth Partially Offsets Revenue Decline
Despite the expected sales drop, Novo Nordisk forecasts adjusted operating profit growth of around 11% at constant exchange rates, buoyed by a one-time $4.2 billion reversal of U.S. 340B drug-pricing provisions. Excluding that nonrecurring item, mid-point operating profit growth remains positive at roughly 11% at CER. The company plans to reinvest savings from its 2025 transformation program into R&D and commercial initiatives, focusing on pipeline expansion in obesity and diabetes and infrastructure to support market-access investments.
3. 2025 Financial Results Showcase Resilience
In 2025, Novo Nordisk delivered sales of DKK 309.06 billion, up 10% at CER, and operating profit of DKK 127.66 billion, up 6% at CER—both exceeding the lower end of prior guidance. Net profit rose to DKK 102.43 billion and earnings per share reached DKK 23.03. U.S. gross-to-net adjustments provided a tailwind to American revenue, while global demand for Wegovy and Ozempic fueled volume growth, supporting margins even as pricing pressures mounted.
4. Competitive Landscape and Patent Expiries Loom Large
Looking ahead, Novo Nordisk faces intensified head-to-head competition from at least five new GLP-1 entrants slated to launch in 2026, including oral formulations. The impending loss of exclusivity for semaglutide in several European and Asian markets will further erode pricing power. To counter these threats, the company is accelerating the rollout of higher-dose Wegovy formulations, advancing its next-generation candidate CagriSema through Phase III trials and expanding telehealth partnerships to bolster self-pay channels.