Weak Earnings Follow Downward Guidance Revision
Novo Nordisk shares traded lower in premarket action Wednesday after the pharmaceutical company missed Wall Street expectations on both revenue and earnings in the second quarter. Revenue came in at $11.95 billion, narrowly missing the $11.97 billion forecast. Earnings per share reached $0.93, just short of the $0.95 projected by analysts. This follows a recent downward revision of full-year sales growth guidance, from a range of 13%–21% to 8%–14%.
Sales rose 16% year-over-year, driven by continued demand for the company’s GLP-1 based drugs Ozempic and Wegovy, which together generated $7.9 billion in revenue—approximately two-thirds of total quarterly sales.
Mounting Legal Actions Against Compounded Semaglutide
A significant drag on performance comes from the proliferation of unauthorized compounded versions of semaglutide, the active ingredient in Ozempic and Wegovy. On Tuesday, Novo announced 14 new lawsuits targeting these knockoff producers, bringing its legal tally to 132 cases across 40 U.S. states. Outgoing CEO Lars Jørgensen estimated over 1 million patients are using non-FDA-approved semaglutide, mostly sourced from unregulated channels abroad.
Jørgensen emphasized the risks of unregulated use and its impact on Novo’s growth, despite the company having enjoyed a first-mover advantage in the GLP-1 market. “We’re talking about more than 1 million people using unauthorized semaglutide knockoffs,” he said, underlining that many of these are produced without proper quality controls.
Competitive and Political Pressures Intensify
Beyond legal challenges, Novo faces stiff competition from Eli Lilly, which now accounts for about 60% of new prescriptions in the GLP-1 space. While Novo secured a formulary deal with CVS to be the exclusive weight-loss drug provider, it hasn’t translated into dominant market share.
Another looming concern is the impact of Medicare drug price negotiations, which will likely affect Ozempic and other flagship treatments in the coming year. The pricing environment grew more complex after a recent letter from President Donald Trump demanded that 17 pharmaceutical companies, including Novo, match their lowest international prices for drugs provided to Medicaid recipients.
NovoCare Shows Modest Adoption Amid Policy Scrutiny
While Novo did not directly respond to Trump’s demand for broader direct-to-consumer price reductions, Jørgensen stated that Medicaid already receives some of the lowest global pricing, even lower than in European markets. He also cited NovoCare—Novo’s direct-to-consumer platform—as a step toward affordability. Since launching in March, NovoCare has reached a 10% market penetration rate.
Despite Novo’s blockbuster products and long-term potential in metabolic diseases, the company faces a turbulent near-term outlook shaped by regulatory scrutiny, legal battles, and rising competitive threats.
