Novo Nordisk beat analyst expectations for the fourth quarter, but the result was overshadowed by softened expectations for this year.
Novo Nordisk’s sales are expected to decline by 5% in 2026—a “short term headwind” caused by lower drug prices in the U.S., CEO Maziar Mike Doustdar said in a brief video announcing the results.
Novo will officially report earnings on Wednesday morning, but the pharma offered an unexpected preview of fourth quarter and full year results on Tuesday afternoon. The company beat analyst expectations in Q4, but this result was overshadowed by the softened expectations for 2026, BMO Capital Markets wrote in a note shortly after the release.
Novo’s shares declined 14% to $50.54 on Tuesday afternoon, compared to $58.93 at close on Monday.
But the Danish pharma is in the middle of what the CEO called the most successful pharma launch ever, with over 100,000 Americans already taking its Wegovy pill. Doustdar is confident that the company can weather the bumpy road ahead.
“It is clear we face a challenging year, but here’s the opportunity. There will soon be 2 billion people globally living with obesity, overweight or diabetes, and our ambition is to serve as many of these people as possible,” Doustdar said in the video.
GLP-1 brands Ozempic and Wegovy beat expectations by 9% and 3%, respectively, which contributed to the overall 3% beat, BMO noted. Diabetes therapy Ozempic booked 32.2 billion DKK ($5 billion) for the fourth quarter, bringing total sales for the year to 127.1 billion DKK ($20.1 billion). Weight loss therapy Wegovy, meanwhile, collected 21.9 billion DKK ($3.5 billion) for the last quarter of the year and 79.1 billion DKK ($12.5 billion) for full-year 2025.
The sales for the semaglutide franchise still put Novo in the upper echelon of pharma’s earners. Ozempic was the second-best-selling drug of 2024 with $16.9 billion total—which the drug has exceeded for 2025.
Doustdar attributed the challenges to declining drug prices in the U.S. The company, along with rival Eli Lilly, appeared at the White House in November 2025 to announced lowered prices for their GLP-1 products.
“Following Trump MFN deals and new needed efforts to maintain access in the obesity market, Novo now faces extensive pricing headwinds in the U.S.,” BMO wrote.
The firm agreed that the Wegovy pill is off to a good start but said the challenges in the injectables market are offsetting those gains.
Novo did, however, get a boost thanks to the reversal of rebating provisions through the 340B Drug Pricing Program, which is expected to positively impact sales and operating profit by $4.2 billion. Without that benefit, BMO put the revenue decline at 8% to 16% on a reported basis while operating profit is expected to decline this year by 10% to 18%.
The pharma will officially report earnings tomorrow morning. BMO expects Novo’s shares to remain under pressure today after the results preview. The firm expects investors to want to know more about the guidance change and assumptions for the GLP-1 franchise—particularly the oral Wegovy launch.
