Novo Nordisk Shares Plunge as 2026 Guidance Signals Pricing Headwinds

The sell-off stems from a forecast indicating that adjusted sales and operating profit could decline between 5% and 13% this year at constant exchange rates. This outlook is notably steeper than the 2.1% sales dip analysts had anticipated. According to Sydbank senior analyst Soren Lontoft Hansen, the company is bracing for stronger headwinds in 2026, primarily driven by a recent deal with the U.S. government to lower prices for its blockbuster obesity treatments in exchange for expanded patient access and tariff exemptions.

Pricing Pressure and Patent Risks

Beyond government-mandated price cuts, Novo Nordisk is defending its market share against Eli Lilly and a proliferation of low-cost compounded versions of its drugs. The company estimated that over 1 million Americans are currently using these unbranded alternatives, which remain on the market despite branded versions no longer being on the FDA shortage list. Additionally, the manufacturer faces imminent patent expirations for the active ingredients in Ozempic and Wegovy in China, Brazil, and Canada, further threatening its long-term revenue streams.

The pessimistic outlook arrived alongside otherwise robust fourth-quarter performance. Wegovy sales climbed 17% to 21.86 billion Danish kroner ($3.46 billion), while Ozempic revenue edged up to 31.83 billion kroner, both exceeding market estimates. The company also reported a net profit of 26.89 billion kroner, beating the FactSet consensus. To reassure shareholders, Novo Nordisk proposed a total 2025 dividend of 11.70 kroner per share and announced a new 15 billion kroner share buyback program.

A bright spot in the report was the U.S. debut of the Wegovy weight-loss pill, which CEO Mike Doustdar noted has already reached 170,000 patients in its first month. To navigate the shifting landscape, the company confirmed a leadership shakeup: Jamey Millar, formerly of UnitedHealth Group, will take over the U.S. business, while Merck veteran Hong Chow will lead product strategy starting mid-February.