Novo Nordisk (NVO.US) Q2 results beat expectations and full-year guidance is raised, but concerns remain! Wegovy oral drug sales are weak, and the path to renewed growth is still uncertain

According to Zhitong Finance APP, although Novo Nordisk (NVO.US) reported better-than-expected second-quarter 2026 results and raised its full-year guidance, it did not address Wall Street’s most pressing question—whether the Danish pharmaceutical giant can find a clear path back to sustainable growth as competition intensifies in the weight-loss drug market.

The financial report shows that, at fixed exchange rates, Novo Nordisk's adjusted sales in the second quarter increased by 7% year-on-year to 78.488 billion Danish kroner (approximately $12.09 billion), beating the market consensus of $11.35 billion; adjusted operating profit rose 11% year-on-year to 33.389 billion Danish kroner, also topping market expectations.

In the second quarter, Wegovy injection revenue reached 19.48 billion Danish kroner. In the US, although sales volume continued to grow, revenue declined 22% year-on-year due to pricing factors. Ozempic revenue was 31.38 billion Danish kroner.

It is noteworthy that Wegovy oral drug, which attracted significant attention, reported second-quarter revenue of 3.22 billion Danish kroner, slightly below market expectations of 3.27 billion Danish kroner. While Novo Nordisk strives to regain obesity drug market share from Eli Lilly (LLY.US), the initial rapid growth of Wegovy oral drug had investors hoping for explosive growth. However, the latest results have raised concerns about the company’s long-term competitiveness.

Novo Nordisk CEO Mike Doustdar explained that the growing demand for Wegovy oral drug was offset by lower prices. He noted that since its launch in January this year, prescriptions for Wegovy oral drug have exceeded 5 million; for the week ended July 17, total prescriptions in the US exceeded 265,000. He also stated that the next market for Wegovy oral drug will be Germany, the largest pharmaceutical market in Europe.

In a statement, Mike Doustdar said: “The Wegovy product portfolio remains the key growth driver for Novo Nordisk in 2026. The rapid adoption of Wegovy oral drug in the US is a main driver. At the same time, early promotional performance outside the US is encouraging. The launch of higher-dose formulations of Wegovy will also further drive growth.”

At the same time, Novo Nordisk warned that its US business would face a decline in sales. The company attributed this to multiple factors, including: a slowdown in GLP-1 injection prescription trends, continued intensification of competition, the narrowing of Medicaid obesity drug coverage, and lower actual sales prices in the US market—partially due to the company’s “most favored nation” drug pricing agreement with the Trump administration.

Looking ahead, Novo Nordisk raised its full-year 2026 guidance. It now expects adjusted sales and operating profit, at fixed exchange rates, to decline by 6% to remain flat, an improvement from the previous forecast of declines between 4% and 12% for both metrics. Novo Nordisk said the improved outlook was mainly due to higher expectations for GLP-1 product sales growth.

However, the market was not excited about Novo Nordisk’s revised full-year outlook. Citi analysts commented, “Overall, nothing to get excited about.” Jefferies said that after the guidance upgrade, there is almost no further room for consensus sales expectations to move higher. Mizuho Securities healthcare strategist Jared Holz said the guidance increase was “clearly nothing to get excited about.” He highlighted that, relative to market expectations, the “lack of upside for Wegovy oral drug” would put pressure on the stock price.

Novo Nordisk is engaged in fierce competition with US rival Eli Lilly for market share in the weight-loss drug market. It is estimated that the obesity drug market will reach $120 billion annually by 2030. Eli Lilly has grabbed a leading market share with its Zepbound and Mounjaro injections. Novo Nordisk’s core moves to regain competitiveness include the launch of Wegovy oral drug and higher-dose injection formulations.

A sign of the intensifying battle between the two pharmaceutical giants is that Novo Nordisk filed a lawsuit against Eli Lilly on July 21, accusing the US company of misleading advertising regarding its Zepbound and Mounjaro injection drugs. Eli Lilly has denied the allegations.

In addition to the weaker sales momentum for existing weight-loss drugs compared to Eli Lilly's similar products, Novo Nordisk’s experimental drug CagriSema failed to achieve the same glycemic control outcome as Zepbound in a large-scale trial. This is the second time this year that the new drug failed to match Eli Lilly’s star product. Global Health Invest CEO Claus Henrik Johansen wrote that this is yet another "scratch on CagriSema’s shell."

Furthermore, Novo Nordisk has suffered major setbacks in the R&D pipeline for other drugs. Last Friday, the company announced that its cardiovascular drug candidate ziltivekimab failed to meet its primary endpoint in a large-scale late-stage clinical trial, failing to demonstrate risk reduction in major cardiovascular events. This failure highlights Novo Nordisk’s heavy reliance on its GLP-1 weight-loss business and adds further uncertainty to its future growth.