Novo has “gone shopping” to fill pipeline gaps, with a focus on obesity and diabetes, plus an expansion in blood and endocrine disorders, liver diseases and cardiovascular conditions.
Novo CEO Maziar Mike Doustdar sought to bring investors on side at the company’s Capital Markets Day on Monday, promising diversification via dealmaking and new disease areas to reach $23 billion in sales in 2035.
“We are incredibly convicted that there is a bright future for Novo, but we also realize that it’s not enough for us to be convicted. We have to convince you,” Doustdar said, acknowledging the investor pressure the company has faced recently.
But his words appeared to leave investors less convicted than Doustdar and his team. Novo’s shares slid 7% to $40.20 on Monday morning. BMO Capital Markets anticipated this slide as the playbook laid out by Doustar seemed to mirror what investors had expected.
With an eye toward the expiration of bestseller semaglutide’s patent, Novo plans to launch five multi-blockbusters by 2030, including cagrilintide and CagriSema. These launches will build to the $23 billion sales goal. Novo recorded 127.7 billion DKK ($19.6 billion) in profit for the full year 2025.
“While these ambitions reflect Novo’s confidence in continued growth, investors had already priced in similar growth expectations, potentially pressuring shares on U.S. open,” the firm wrote at the halfway mark of the Capital Markets Day, which was hosted in London.
Investors had been expecting compound annual growth rate (CAGR) of about 3.65% whereas Novo estimated 3.53%.
BMO, therefore, continues to give Eli Lilly the edge in the cardiometabolic market as the American rival’s tirzepatide franchise continues to take market share from Novo’s Ozempic and Wegovy. Lilly’s oral option Foundayo, which has not enjoyed as strong a launch as the Wegovy pill, is also continuing to build momentum.
Finding good ideas
Doustdar’s address to investors closely follows the Danish pharma’s rebrand. Last week, Novo officially dropped the Nordisk from its name and turned its iconic Apis bull to face the right, signaling a future-focused company mission.
On Monday, Doustdar gave investors an inside look at Novo’s business plans to go along with its rebrand, including where executives may focus their dealmaking efforts.
“We will be more active within business development,” Doustdar promised. “We’ve done quite well on trying to look at the gaps we have, scientific gaps or strategic gaps in the company . . . and [have] gone shopping.”
Key areas for expansion will of course be in Novo’s core obesity and diabetes portfolio, but the CEO said his team is also looking to expand in blood and endocrine disorders, liver diseases and cardiovascular disease. The goal is to have 10 Phase 3 launches in less than a decade—five in obesity and diabetes and five in the newer indications.
That expansion could come via assets already in the pipeline, but Doustdar said Novo is looking at potential deals as well.
“Increasingly, we tell ourselves we don’t have a patent or a monopoly on all the good ideas. So we have to go out and look what else people are doing,” Doustdar said. “We will be selective, we will be disciplined, but we will continue bolting on with business development.”
Novo’s cardiovascular ambitions took a major hit in July with the unexpected failure of the Phase 3 Zeus trial of ziltivekimab. Then earlier this month, the company shuttered two more late-stage studies for the IL-6 inhibitor, with analysts questioning whether the target was valid in chronic cardiovascular disease.
Doustdar acknowledged these setbacks but said the company has not been deterred from cardiovascular as a result.
Head-to-head battle
Novo has been in a fierce battle with Lilly over control of the obesity market. Key to Novo’s strategy now is the Wegovy pill, which launched earlier this year and has since reached 7 million prescriptions, according to Doustdar. This makes for the best U.S. product launch by volume of all time, the CEO added.
Lilly, meanwhile, has not seen such quick uptake as its oral offering Foundayo, a new molecule that consumers are less familiar with.
To continue this drive, Novo plans to up its manufacturing capacity for the pill to be able to serve 10 times the patients being reached today, Doustdar said.
But like Lilly, Novo isn’t resting on its laurels with semaglutide. Next up for Novo is CagriSema, a next-generation injectable weight loss candidate with an anticipated launch in early 2027. The drug combines semaglutide with the long-acting amylin cagrilintide.
To support the case for next-in-line asset CagriSema, Novo revealed new head-to-head data with Lilly’s tirzepatide on Monday.
In the Phase 3 REIMAGINE 5 study, a 1.0 mg/1.0 mg dose of CagriSema bested 5 mg of tirzepatide, eliciting 12.4% weight loss vs. 9.1% for Eli Lilly’s drug in adults with type 2 diabetes (T2D) at 60 weeks, according to a Monday Novo release based on efficacy estimands. Reductions in average blood sugar levels, as measured by the HbA1c test, were comparable at 1.71% for CagriSema vs. 1.67% for tirzepatide.
“REIMAGINE 5 results are encouraging for CagriSema positioning in diabetes, but approval remains more distant,” BMO Capital Markets wrote in a note to investors on Monday. Moreover, the analysts continued, “given tirzepatide has already been proven superior to higher strength CagriSema in obesity, we view superiority of CagriSema at a lower dose as less impactful in T2D.”
In March 2025, CagriSema delivered lower-than-expected weight loss results with 15.7% of body weight dropped at 68 weeks in patients with overweight or obesity and type 2 diabetes—notably lower than the 22.9% weight reduction elicited by a 15-mg dose of tirzepatide in the Phase 3 SURMOUNT-1 trial of adults with obesity or overweight and prediabetes.
Given the prior readouts, an FDA approval for the dual agonist in T2D “continues to be gated by REDEFINE 3 outcomes data expected in 2H27, positioning for a potential launch in 2028,” BMO added.
Meanwhile, in the REDEFINE 9 trial, the same dose of CagriSema led to 21% weight loss at week 68 in adults with overweight or obesity, Novo also announced Monday.
Across the new readouts, Novo’s next-gen weight loss candidate was well-tolerated overall, “with a safety profile consistent with previous studies,” according to the company.
Editor’s note: Heather McKenzie contributed to this article.
