Novo Nordisk sales decline guidance for 2026 has rattled markets, with the Danish pharmaceutical group warning that revenue could fall this year even after posting record profits in 2025. The company says price pressure and tougher competition in obesity and diabetes treatments are reshaping a market that has powered its growth for years.
What Novo Nordisk said in its 2025 results
In its financial report for 2025, Novo Nordisk reported net sales of DKK 309.1 billion (€41.4 billion) and net profit of DKK 102.4 billion (€13.7 billion). The results were strong in absolute terms, but the company acknowledged that momentum slowed late in the year, especially in its key obesity portfolio.
The company’s leadership also pointed to a more challenging commercial environment ahead, where discounts, rebate dynamics and payor negotiations in the USA are increasingly shaping net prices.
How big the expected sales drop could be
Novo Nordisk expects sales to decline by 5% to 13% in 2026 (at constant exchange rates), a major shift for a company that has delivered steady growth over decades. The company also expects operating profit to move in the same direction, reflecting the combined impact of lower net prices, intensifying competition and higher commercial spending.
Markets reacted quickly: the group’s USA-listed shares dropped sharply immediately after the early release of the annual report.
Why obesity drugs are facing tougher competition
Novo Nordisk’s blockbuster brands Wegovy (obesity) and Ozempic (type 2 diabetes) sit at the centre of a rapidly expanding market, but one that is now becoming more crowded. Rival products — notably Eli Lilly’s Zepbound and Mounjaro — have accelerated competition in both prescribing and pricing.
At the same time, Novo Nordisk is navigating a period in which demand remains high, but the fight is shifting from pure volume growth to market share, reimbursement and net price.
The USA pricing squeeze and the policy backdrop
The company has flagged growing pressure in the USA, its most important commercial market. In the past year, the USA debate on drug prices has increasingly shaped the broader sector, and Novo Nordisk is not immune: the more weight-loss drugs move from early adoption to mainstream reimbursement, the more payors and policymakers scrutinise cost and value.
That policy context matters well beyond Denmark. It also signals a wider EU question: how to balance access to breakthrough medicines, budget constraints in public health systems, and competition rules in a market increasingly defined by a handful of global players.
Wegovy pill: a key bet to protect volume growth
Novo Nordisk says it is encouraged by the early demand for the Wegovy pill in the USA, where it has started rolling out the product as part of its effort to defend growth. Oral formulations are widely seen as one of the next frontiers in obesity care, potentially expanding access for patients who prefer not to take injections.
The launch, however, comes at a time when Novo Nordisk is under pressure to prove it can keep growing volumes while absorbing lower prices.
