Novo-Nordisk A/S (NVO)

Novo Nordisk, the Danish maker of Ozempic and Wegovy, reported second-quarter 2026 adjusted sales of DKK 78.5 billion on 4 August, up 7 percent at constant exchange rates, which set currency swings aside 1. Adjusted sales leave out one-time reversals of rebate provisions tied to the US 340B Drug Pricing Program, which brought no cash 1. The company then raised its 2026 outlook for adjusted sales growth to between 0 and minus 6 percent, from minus 4 to minus 12 percent 12.

Growth came from more patients rather than higher prices: GLP-1 volumes rose in both operating units while realised prices fell 1. The Wegovy pill, a daily weight-loss tablet launched in the US on 5 January, passed 265,000 weekly prescriptions in the week ending 17 July 1. Chief executive Mike Doustdar called the Wegovy family "a key growth driver" for 2026 1.

On 21 September the company set out its ambitions to 2030 in London, including more than five multi-blockbuster launches and revenue growth in line with large drug peers 4. In early October it said the FDA had extended its review of denecimig, a haemophilia A medicine, while a factory is fixed 7. The open question is the nine-month report due on 4 November 2026 1.

Novo Nordisk was formed in 1989 when two Danish insulin makers, Nordisk Gentofte and Novo Industri, merged 2. Their businesses began in 1923 and 1925, and from the start both made and sold insulin for diabetes 2. For decades diabetes was the core, and the company says it built that business "patient by patient, innovation by innovation" 3.

The turn came from semaglutide, a lab-made form of the hormone GLP-1, which stimulates insulin production and regulates appetite 3. Its chemists found it on their 217th attempt while building a once-weekly injection 3. Ozempic, its diabetes brand, launched in the US and Canada in February 2018 and became the company's best-selling product 2.

Obesity then turned a steady business into a boom; the company wrote that it was thrust "into an era of unprecedented growth that, frankly, surprised even us" 3. Obesity care sales rose from DKK 6 billion in 2019 to DKK 82 billion in 2025, led by Wegovy, semaglutide sold for weight management 31. Total sales more than doubled over the same stretch, to DKK 309 billion in 2025, a compound rate of 17 percent a year 3.

Reported sales grew 31.3 percent in 2023 and 25.0 percent in 2024, reaching DKK 290.4 billion 3. To keep up with demand it spent heavily on factories: purchases of property, plant and equipment rose from DKK 6.3 billion in 2021 to DKK 47.2 billion in 2024 3. Its headcount grew from 48,478 in 2021 to 77,349 in 2024 3.

In 2024 it bought three fill-finish sites, where medicine is filled into its final containers, for USD 11.7 billion, mainly with borrowed money 2. The sites came from Novo Holdings, its controlling shareholder, which bought the contract manufacturer Catalent in the same transaction 2.

Growth slowed sharply in 2025: sales rose 6.4 percent as reported to DKK 309.1 billion, and operating profit slipped 0.5 percent to DKK 127.7 billion 3. The annual report blames rising competition, which cost GLP-1 volume share in obesity and diabetes, and about DKK 8 billion of restructuring costs 23. In the US, a competing GLP-1 product overtook Wegovy in weekly prescriptions at the beginning of 2025 2.

Leadership changed too: Mike Doustdar, with the company since 1992, succeeded Lars Fruergaard Jørgensen as chief executive on 7 August 2025 2. A company-wide overhaul began on 10 September 2025 and let around 9,000 employees go, leaving 69,505 at year end 23. An extraordinary general meeting on 14 November 2025 elected Lars Rebien Sørensen chair of the board 2.

On 9 December 2025 it bought Akero Therapeutics for USD 4.7 billion in cash plus a right to up to USD 0.5 billion more on a US approval 2. The prize was efruxifermin, a late-stage medicine for MASH, a liver disease tied to obesity and diabetes 2.

Obesity: Wegovy and Saxenda

Wegovy is semaglutide for weight management, sold as a weekly injection and, since early 2026 in the US, as a daily pill 21. Obesity care adjusted sales were DKK 23.2 billion in the second quarter of 2026, up 16 percent at constant exchange rates 1. Abroad they rose 37 percent, while US sales of injectable Wegovy fell 22 percent on lower realised prices 1.

Self-paying US patients pay $149 to $299 a month for the pill, depending on dose 1. A stronger 7.2 mg weekly shot, Wegovy HD, launched across the US on 7 April 1. In trials the 7.2 mg dose gave 20.7 percent average weight loss and the pill 16.6 percent 1.

Saxenda, an older daily injection whose compound patent has expired everywhere, fell 47 percent in the quarter at constant exchange rates 12. Novo Nordisk and Eli Lilly hold the largest shares of the obesity medicine market, and several other drugmakers have candidates in development 2.

Diabetes: Ozempic, Rybelsus and insulin

Ozempic, the weekly semaglutide injection for type 2 diabetes, is the largest product, with 2025 sales of DKK 127.1 billion, up 10 percent at constant exchange rates 3. In the second quarter of 2026 it sold DKK 31.4 billion, and the tablet, Rybelsus, sold as Ozempic pill in the US, DKK 5.2 billion 1.

In Canada, where semaglutide lost exclusivity, prices fell while volumes held broadly stable 1. Insulin, the original business, brought in DKK 12.9 billion in the quarter, and in the US it lost share in a shrinking market 1. The company's global diabetes value share fell 3.6 points in 2025 to 30.1 percent, with Eli Lilly its main rival 32.

Rare disease

Rare disease medicines sold DKK 19.6 billion in 2025, up 9 percent at constant exchange rates 3. They include NovoSeven and Alhemo for bleeding disorders and Norditropin and Sogroya for growth disorders 1. Denecimig, an antibody injected under the skin monthly, fortnightly or weekly for haemophilia A, won a positive EU committee opinion on 17 September under the name Frehemgo 6.

Plants and supply

Its major plants are in Denmark, the United States, France, China and Brazil, and the active ingredients are made mainly at Kalundborg, Denmark 2. The Kalundborg site has 168,300 square metres of production area 2. Sites in Bloomington, Indiana, Anagni, Italy and Brussels, Belgium also do contract manufacturing work 2.

Spending on plant and equipment was DKK 24.0 billion in the first half of 2026, against DKK 28.1 billion a year earlier, mostly for ingredient and fill-finish capacity 1.

People

Mike Doustdar, who joined as an office clerk in Vienna in 1992, is chief executive 2. Karsten Munk Knudsen is finance chief and Martin Holst Lange runs research and development 2. Lars Rebien Sørensen signed the 2025 annual report as chair 3.

The company employed about 66,700 people in August 2026, down from 77,349 at the end of 2024 123.

Problems: prices, patents and lawsuits

Prices are the main pressure: under a November 2025 deal with the US government, semaglutide medicines get wider Medicare and Medicaid access at lower cost 1. A Medicare negotiated price for Ozempic, Rybelsus and Wegovy takes effect in 2027, and the Supreme Court ended the company's challenge to that law on 18 May 2026 21.

Cipla in the US and Sandoz in Europe are challenging semaglutide patents, and the company sued Eli Lilly on 21 July 2026 over its comparative advertising 1. It also faces US class actions over an IT security incident disclosed on 11 June 2026 1. Its ZEUS heart trial of ziltivekimab missed its main goal 1.

Unapproved compounded copies of its GLP-1 medicines continued in the US after the shortages ended, and the company says it is working to stop them 2.

The umbrella, in words

Its main brands include Wegovy, Ozempic, Rybelsus, Saxenda, Tresiba, NovoRapid, NovoSeven and Norditropin 2. Among the wholly owned companies its annual report lists are Novo Nordisk Inc., Akero Therapeutics, Catalent Indiana, Dicerna Pharmaceuticals and Emisphere Technologies, all in the US 3.

Novo Holdings, owned by the Novo Nordisk Foundation, owns all the A shares and 5.24 percent of the B shares, 77.28 percent of the votes in all (computed) 2. Each A share carries 100 votes and each B share 10, and the foundation's articles forbid selling the A shares 3.

It owned 7.82 percent of Innate Pharma, a French biotech, at the end of 2025, and none by 29 May 2026, by its own Schedule 13G filings 910. Its Tianjin, China plants stand on land leased for another 28 and 32 years 2. Novonesis and Catalent share its controlling owner, and the companies trade services 2.

For 2026 the company expects adjusted sales and adjusted operating profit to change by between 0 and minus 6 percent at constant exchange rates 1. It expects capital spending of about DKK 55 billion and free cash flow of DKK 45 to 55 billion 1. It says the ZEUS failure may bring a non-cash impairment charge in the third quarter 1.

Nine-month results are due on 4 November 2026 and the full-year report on 3 February 2027 1. The company expects US decisions in the fourth quarter of 2026 on CagriSema, a weight-management injection it filed in 2025, and on a 25 mg Ozempic pill 13. An FDA decision on adding liver-disease data to the Wegovy pill label is expected in the first quarter of 2027 1.

The company expects to launch Frehemgo in the first European countries in the fourth quarter of 2026 6. Pending the FDA, it aims to launch denecimig in the US in the first half of 2027 7.

Further out, a high-dose CagriSema trial is expected to read out in the first half of 2028 and a zenagamtide heart failure trial in the second half of 2029 1.

The company is building a DKK 49.6 billion ingredient plant at Kalundborg, expected fully operational in 2029 2. A DKK 27.0 billion expansion at Clayton, North Carolina, is also expected to be fully operational in 2029 2.

From 1 January 2027 the company plans to lower US list prices of Wegovy and Ozempic to $675, cuts of about 50 and 35 percent 1. It expects the change to affect its 2027 cash flow 1.

At its Capital Markets Day the company set ambitions to 2030 from a 2026 base: revenue growth in line with large peers, a broadly stable operating margin and more than 60 million patients served 4. It also aims for more than DKK 150 billion of risk-adjusted pipeline sales in 2035, and says these ambitions are not guidance 4.

Under a buyback of up to DKK 15 billion over 12 months from 4 February 2026, it had bought back DKK 11.2 billion of B shares by 23 October 8.