Novo Nordisk delivered stronger earnings and improved its 2026 outlook, yet its shares fell as investors focused on Wegovy’s performance, another CagriSema disappointment and the widening commercial gap with Eli Lilly.
August 5, 2026
Novo Nordisk shares declined more than 4% in Copenhagen on Wednesday, extending the negative reaction that pushed its U.S.-listed shares down approximately 6% after the Danish pharmaceutical company released its second-quarter results.
At first sight, that reaction appears surprising. Novo reported higher adjusted sales, exceeded operating-profit expectations and raised its full-year guidance.
The problem was not the quarter in isolation. Investors had been positioning for a more decisive recovery, particularly from the new Wegovy pill. The actual results were good—but several closely watched indicators failed to clear the increasingly high bar set by the market.
Novo Nordisk’s second-quarter results at a glance
| Metric | Q2 2026 result |
|---|---|
| Net sales | DKK 78.49 billion |
| Reported sales growth at constant exchange rates | 3% |
| Adjusted sales growth at constant exchange rates | 7% |
| Reported operating profit | DKK 27.06 billion |
| Adjusted operating profit | DKK 33.39 billion |
| Adjusted operating-profit growth | 11% |
| Wegovy pill sales | DKK 3.22 billion |
| Previous 2026 sales guidance | -12% to -4% |
| New 2026 sales guidance | -6% to 0% |
| New operating-profit guidance | -6% to 0% |
The company’s adjusted operating profit of DKK 33.39 billion was well above the DKK 28.74 billion average estimate in Novo’s analyst survey.
Reported operating profit nevertheless declined 16% at constant exchange rates. The difference between the reported and adjusted figures largely reflected DKK 6.3 billion of non-cash impairment charges related to pipeline assets, including DKK 4 billion associated with monlunabant.
Novo’s official second-quarter announcement provides the complete financial results.
Guidance improved—but still points to a difficult year
Novo now expects adjusted sales and adjusted operating profit to range between a 6% decline and zero growth at constant exchange rates in 2026.
That is a meaningful improvement from its previous forecast:
| Outlook | Previous guidance | New guidance |
|---|---|---|
| Adjusted sales growth | -12% to -4% | -6% to 0% |
| Adjusted operating-profit growth | -12% to -4% | -6% to 0% |
The revised outlook reflects stronger GLP-1 sales, improving demand outside the United States and early uptake of Novo’s oral Wegovy treatment.
However, the new forecast still allows for a full-year decline. It does not yet signal a return to the sustained double-digit growth rates that previously supported Novo’s premium valuation.
This helps explain the negative market reaction: investors had already anticipated an upgrade following encouraging prescription data. Raising guidance confirmed that operating conditions were improving, but it did not prove that Novo had fully restored its former growth trajectory.
Wegovy sales remain under pressure
Novo’s Wegovy franchise continues to be one of the most important assets in the global obesity market. The product portfolio now includes the original injection, a higher-dose 7.2 mg version and the new daily pill.
The company said the overall Wegovy franchise remained the market leader in new patient starts among branded U.S. obesity treatments. Weekly prescriptions for the pill exceeded 265,000 in the week ending July 17, while more than five million prescriptions had been filled since launch.
International expansion is also accelerating. The pill has been introduced in the United States, the United Kingdom and the United Arab Emirates, with Germany and other European markets expected to follow.
Nevertheless, investors identified softness in U.S. injectable Wegovy sales. The injection has lost substantial ground to Eli Lilly’s Zepbound, whose U.S. prescriptions have recently been more than twice those of injectable Wegovy.
That erosion matters because the injectable market remains considerably larger than the oral segment. Strong pill adoption can partly offset lost injection share, but Novo must demonstrate that the pill adds new patients rather than merely shifting existing users from one Wegovy format to another.
The Wegovy pill was successful—but not successful enough
Quarterly sales of the Wegovy pill reached DKK 3.22 billion, equivalent to approximately $497 million. That was slightly below the DKK 3.3 billion analysts had expected.
The miss was small in absolute terms. It nevertheless carried disproportionate importance because the pill has become the central element of Novo’s recovery narrative.
Investors had hoped that rapid prescription growth would translate into an earnings beat large enough to justify another upward revision to market forecasts. Instead, sales were broadly in line with expectations.
Some of the shortfall may be temporary. Wholesalers were reportedly reducing inventory during the quarter, while prescription data do not always translate immediately into recognized pharmaceutical revenue.
Pricing is another concern. Novo has used competitive cash-pay offers and discounts to build market share. These measures can accelerate patient adoption but reduce revenue per prescription.
The pill has captured around 90% of the still-young U.S. oral obesity market. Its commercial position is therefore strong. But the market wanted evidence that Novo was not merely leading the oral category—it wanted the company to outperform the sales trajectory already reflected in analysts’ models.
CagriSema delivers another disappointment
The most important long-term concern came from CagriSema, Novo’s experimental combination of semaglutide and the amylin analogue cagrilintide.
Novo has positioned CagriSema as a potential next-generation successor to Wegovy. The treatment is strategically important because semaglutide patent protection will begin expiring in major markets early in the next decade.
In a 68-week head-to-head study involving patients with type 2 diabetes, CagriSema matched Eli Lilly’s tirzepatide on weight loss but failed to demonstrate superiority in blood-sugar control.
Technically, meeting a non-inferiority target can support regulatory and commercial objectives. From an investment perspective, however, the result failed to establish a clear competitive advantage over Lilly’s Mounjaro.
That distinction is crucial. Investors are not valuing CagriSema simply as another effective obesity treatment. They expect it to become a differentiated successor capable of restoring Novo’s scientific leadership.
The latest data followed an earlier disappointment in which CagriSema produced approximately 23% weight loss but did not establish the decisive advantage over tirzepatide that some investors had anticipated.
Novo still plans to launch CagriSema in 2027. Yet the product may have to compete through pricing, access and patient-specific advantages rather than clearly superior overall efficacy.
Pipeline concerns extend beyond obesity
CagriSema is not Novo’s only pipeline concern.
The company recently announced that ziltivekimab, an experimental cardiovascular medicine, failed to reduce the risk of major cardiovascular events in a Phase 3 study. Novo also recorded impairment charges involving other development assets.
These setbacks have intensified questions about the company’s ability to diversify beyond diabetes and obesity.
CEO Mike Doustdar said Novo needs “more shots at goal” and must accelerate research following the recent failures. Management intends to streamline development, pursue bolt-on acquisitions and disclose additional early-stage projects at its September Capital Markets Day.
The strategy is rational, but acquisitions introduce their own risks. Attractive obesity, metabolic and cardiovascular assets command high prices, and externally acquired drugs still face clinical and regulatory uncertainty.
For investors, the issue is no longer whether Novo has a pipeline. It is whether that pipeline contains a product capable of replacing semaglutide’s long-term economic contribution.
Eli Lilly widens the commercial gap
The contrast with Eli Lilly made Novo’s results look less impressive.
Lilly reported second-quarter revenue growth of 48%, with Mounjaro sales increasing 91% to $9.94 billion and Zepbound generating $4.93 billion. The two products produced nearly $14.9 billion of quarterly revenue.
Novo’s entire diabetes and obesity portfolio generated approximately $9.16 billion during the same period.
Lilly also raised its 2026 revenue outlook to between $85 billion and $87 billion, while adjusted earnings of $8.38 per share comfortably exceeded expectations. Lilly shares rose more than 7% at one stage as Novo’s Copenhagen-listed shares declined.
The comparison highlights the different growth profiles:
- Lilly is benefiting from accelerating tirzepatide volumes in the United States and internationally.
- Novo is managing pressure on injectable Wegovy while relying on its new pill to stabilize market share.
- Lilly’s current products appear to hold an efficacy advantage in many investors’ minds.
- Novo’s intended next-generation response, CagriSema, has not yet demonstrated a decisive clinical edge.
Novo is not being pushed out of the obesity market. The market is expected to exceed $100 billion annually in the United States alone by 2030, leaving room for several large products. But Novo is increasingly being valued as the challenger rather than the undisputed leader. Reuters explains how the Wegovy pill and CagriSema shaped the reaction.
Investors revised expectations before the results
Share-price reactions depend on the difference between actual results and expectations—not simply on whether sales or profits increased.
Novo’s shares had recovered approximately 30% from their March low before the earnings announcement. That rebound reflected growing optimism surrounding the Wegovy pill and expectations that management would raise its guidance.
As a result, the earnings upgrade was partially priced in.
The pill’s minor sales miss, softer injectable performance and disappointing CagriSema data forced investors to revise the more optimistic assumptions that had driven the recovery.
The reaction therefore followed a familiar pattern:
- Prescription data created expectations of a strong oral-Wegovy beat.
- Novo shares recovered in anticipation of better earnings and guidance.
- Management raised its outlook as expected.
- The pill delivered only broadly in-line revenue.
- CagriSema added a new reason to question long-term growth.
- Investors took profits and reduced their expectations.
The guidance upgrade was positive, but it did not provide enough incremental information to offset the pipeline concerns.
Is Novo Nordisk now undervalued?
Novo’s valuation has changed dramatically since its 2024 peak, when the company temporarily became Europe’s most valuable listed business.
Its Copenhagen-listed shares remain at less than one-third of that record level. At around $44 for the U.S. ADR, Novo had a market capitalization of approximately $201 billion following the latest decline.
Current valuation indicators include:
| Valuation metric | Approximate level |
|---|---|
| Trailing price-to-earnings ratio | 11 times |
| Forward price-to-earnings ratio | 13–14 times |
| Price-to-sales ratio | Approximately 4 times |
| EV/EBITDA | Approximately 8 times |
| Price-to-free-cash-flow | Approximately 17 times |
These multiples are far below those assigned to Eli Lilly. Lilly trades at approximately 27–34 times forward earnings and has a market capitalization above $1 trillion.
Novo’s forward P/E is also below the broader pharmaceutical-industry median. S&P Global Market Intelligence figures compiled by StockAnalysis show the scale of the valuation reset.
The discount could represent an opportunity if oral Wegovy continues growing, U.S. pricing stabilizes and CagriSema achieves meaningful commercial success. Novo remains highly profitable, retains global manufacturing capacity and holds one of the strongest metabolic-disease franchises in the industry.
But the low multiple also reflects genuine risks:
- declining U.S. sales;
- lost injectable market share;
- lower realized prices;
- dependence on semaglutide;
- disappointing late-stage trials;
- and uncertainty about growth after patent expiration.
Novo is therefore no longer priced as a high-growth pharmaceutical leader. It is increasingly valued as a mature company attempting to prove that its decline is temporary.
What investors should watch next
The most important indicators for the second half of 2026 will be:
- weekly and quarterly Wegovy pill prescriptions;
- revenue per prescription and the effect of cash-pay discounts;
- the performance of injectable Wegovy and the 7.2 mg version;
- U.S. sales trends following Medicare access changes;
- international launches of the Wegovy pill;
- regulatory and commercial plans for CagriSema;
- new pipeline disclosures at the September Capital Markets Day;
- and any acquisitions intended to strengthen research and development.
The bottom line
Novo Nordisk’s results were stronger than the share-price reaction suggests. Adjusted operating profit beat expectations, the Wegovy pill is gaining patients rapidly and management substantially improved its 2026 outlook.
Investors nevertheless looked beyond the headline numbers.
The Wegovy pill produced slightly less revenue than expected, injectable Wegovy remains under competitive pressure, and CagriSema again failed to demonstrate the clear superiority needed to restore confidence in Novo’s next generation of obesity treatments. Eli Lilly’s much faster growth amplified those concerns.
After its substantial correction, Novo’s valuation is no longer demanding. The shares could recover if management proves that oral Wegovy can deliver sustainable growth and that the pipeline is stronger than recent trial results suggest.
For now, however, the market is treating the guidance upgrade as evidence of stabilization—not yet evidence of a full turnaround.
This article is for informational purposes only and does not constitute investment advice.
