Shares in Novo Nordisk A/S (NYSE:NVO) fell sharply after the maker of Wegovy reported fourth-quarter results and issued a downbeat sales outlook for 2026, catching investors off guard.
The company said it expects adjusted sales growth in 2026—excluding revenue linked to the reversal of 340B provisions—to range between -5% and -13% at constant exchange rates. This compares with sales growth of 10% in 2025.
Management attributed the weaker outlook to a combination of factors, including lower pricing tied to the U.S. “Most Favoured Nations” agreement, patent expiries for the semaglutide molecule in certain international markets, and rising competitive pressures.
Novo Nordisk shares ended 14.6% lower in New York trading, while the stock dropped roughly 16% on the Copenhagen exchange on Wednesday.
The midpoint of the 2026 sales guidance came in around 8% below market expectations, according to BofA analyst Sachin Jain. Morgan Stanley analyst Thibault Boutherin said the “2026 guide surprised to the downside, confirming our concerns on U.S. prices and mix.”
“Our new forecasts are at the top end of the new guidance, but we see downside risks if our volume growth assumptions do not materialise,” Boutherin added.
For 2025, Novo reported sales growth of 6% in Danish kroner and 10% at constant exchange rates, reaching DKK 309.1 billion. Operating profit for the year declined 1% in Danish kroner but rose 6% at constant exchange rates to DKK 127.7 billion. Excluding the impact of a company-wide transformation programme, operating profit would have increased by 6% in Danish kroner and 13% at constant exchange rates.
Sales from U.S. operations rose 3% in Danish kroner, or 8% at constant exchange rates, in 2025, while international operations delivered growth of 10% in Danish kroner, or 14% at constant exchange rates.
Novo Nordisk also announced that Dave Moore, head of U.S. operations, will step down for personal reasons, with Jamey Millar named as his successor.
“Pricing concessions weigh on the topline in 2026 as Novo looks for volumes to flow through,” said BMO Capital analyst Evan David Seigerman after the results.
“Following Trump MFN deals and new needed efforts to maintain access in the obesity market, Novo now faces extensive pricing headwinds in the US. While early signs of growth exist for the Wegovy pill, concessions for injectable GLP-1s are clearly impacting the topline offsetting gains in the oral market.”
The update from Novo Nordisk also weighed on shares of U.S. rival Eli Lilly and Company (NYSE:LLY), which closed 3.9% lower.