Novo Nordisk's slide continues after CEO warns of “unprecedented pricing pressure” as outlook overshadows Q4 results
Novo Nordisk’s shares are tumbling further in premarket trading on Wednesday after CEO Mike Doustdar warned that the Danish pharma giant will face “unprecedented” price pressures in 2026, addressing the company’s annual sales forecast which showed a decline in revenue.
“Our 2026 guidance reflects a year of unprecedented pricing pressure,” said Doustdar on a call with journalists, adding in an interview with CNBC that people should expect that US pricing “goes down before it comes back up,” as headwinds from lower US Wegovy pricing emain.
On Tuesday, NVO shares fell double-digits after it forecast that sales and operating profit for 2026 will both decline by between 5% and 13% — analysts were expecting very modest growth in each.
In its 2025 annual report, released on Wednesday morning, the company detailed the disappointing guidance, citing “lower realised prices, including the MFN (“Most Favoured Nations”) agreement in the US and the loss of exclusivity for the semaglutide molecule in certain markets in International Operations.” Novo also added that “positive impacts related to US gross-to-net sales adjustments during 2025 are not anticipated to reoccur.”
Across its actual Q4 results, things were a little rosier: sales and diluted EPS figures for Q4 2025 came in at $12.3 billion and $0.94, respectively, slightly beating analyst consensus estimates in both cases by 0.9% and 1.4% (forecasts compiled by Bloomberg).
Meanwhile, Eli Lilly reported quarterly earnings results and posted 2026 guidance on Wednesday that crushed Wall Street estimates. Indeed, although Novo was first to the GLP-1 market, Lilly is proving fierce competition, having surpassed the Danish giant’s sales by Q2 of last year. The Mounjaro maker’s earnings on Wednesday showed that the gap is only getting wider.
Just as Novo launched a new oral GLP-1 for weight loss in January — and early signs show uptake is strong — Lilly also has a weight loss pill expected to come to market later this year. Novo is also facing patent expiry for semaglutide, the active ingredient in Ozempic and Wegovy, starting this year in major markets like Canada, India and China.