Novo Nordisk is making headway on multiple fronts in the obesity market, but the stock’s trajectory tells a more cautious story. The Danish drugmaker closed Friday at €38.51, up nearly 12% over the past month, yet still nursing a year-to-date loss of almost 14%. That gap between clinical and commercial progress and investor sentiment reflects the intense price competition and looming patent expirations that continue to shadow the GLP-1 sector.
The company’s latest clinical ammunition came at the European Obesity Congress in Istanbul, where detailed results from the STEP-UP study landed with force. Patients taking the 7.2-milligram dose of Wegovy over 72 weeks shed an average of 21% of their body weight — roughly 23 kilograms for a typical participant. Crucially, MRI scans of a subgroup showed that 84% of that weight loss came from fat, while muscle mass declined by only 10%. A standardized sit-to-stand test confirmed that muscle strength was preserved, addressing one of the most persistent concerns around GLP-1 therapies. Novo Nordisk also highlighted a subset of high responders: 27% of patients on the high dose lost at least 15% of their weight within 24 weeks, and that group went on to achieve nearly 28% weight loss by week 72.
The high-dose version of Wegovy directly targets Eli Lilly’s Zepbound, which has been viewed as the efficacy leader with average weight loss above 20%. Novo Nordisk’s data now narrows that gap, and the formulation is already in the hands of US patients — major pharmacy benefit managers have added it to their standard formularies.
Meanwhile, the oral tablet version of Wegovy is reshaping the revenue mix. In the first quarter, roughly 1.3 million prescriptions for the pill were written in the US, accelerating what the company calls a rapid market penetration. Patients increasingly prefer the non-injectable option, and telemedicine partnerships now handle about one-fifth of all Wegovy sales in key markets.
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That demand has prompted management to lift its full-year guidance. The expected currency-adjusted revenue decline has been narrowed to a range of 4% to 12%, with a similar tightening for operating profit. Reported first-quarter revenue surged 32% to 96.8 billion Danish kroner, though that figure was inflated by the reversal of a multibillion-kroner provision. On an adjusted currency-neutral basis, sales actually slipped 4% — still at the upper end of the prior outlook.
Operating pressures remain visible beneath the top line. Adjusted US sales in the first quarter fell 11% on a currency-adjusted basis, while international business grew 6%. The competitive pricing war in the US diabetes and obesity segments is the main drag, but strong demand for Wegovy is providing a partial offset.
Shareholders are benefiting from the robust cash flow. Novo Nordisk returned nearly 38 billion kroner through dividends and buybacks in the first quarter and has launched a new repurchase program worth up to 15 billion kroner. The pipeline is also advancing: the company plans to file for approval of the experimental drug Etavopivat in the fourth quarter.
Longer-term risks, however, are not dissipating. Patents are expiring in markets such as China and Canada, where generic manufacturers are preparing to enter. The stock remains far from its 52-week high of around €70, and the combination of US price pressure and Asian patent cliffs continues to cap any sustained rally. Novo Nordisk will lay out its long-term financial strategy and next-generation product plans on September 20-21 at its Capital Markets Day — a session that investors will watch closely for signs of how the company intends to defend its obesity franchise.
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