Novo's Wegovy Pill Beat Expectations Ahead of a Deep US Price Cut
The oral obesity drug cleared the Street in Q3 and Novo raised guidance. The same morning it confirmed deep 2027 US list-price cuts, the trade-off at the heart of its recovery.
Novo Nordisk posted a stronger third quarter than analysts had modeled, then spent the same morning explaining why it will give a large slice of that pricing power back. The Danish drugmaker's new Wegovy pill ran well ahead of the Street's sketch, and management raised full-year guidance for adjusted sales and adjusted operating profit. In the same set of remarks, Novo confirmed it will cut US list prices for specified Wegovy and Ozempic doses to a flat $675 starting 1 January 2027. Volume is returning. Novo is now paying for that volume with a deep concession, just as Eli Lilly's competing oral pill continues to scale.
Shares rose as much as 6% in early trading, CNBC reported. That move tracked the oral product more than the print as a whole. Analysts had expected Wegovy pill sales of about DKK 4.5 billion in the quarter. Novo recorded DKK 5,394 million after launching the tablet in the United States, the UAE, the UK and Germany. The pill is now in eight markets. The broader Wegovy franchise still holds more than 50% of the US branded obesity market by new patient starts, and Novo estimates the pill's new-to-brand share in the United States at around 80%. Injectable Wegovy contributed DKK 20,407 million of third-quarter sales. Ozempic contributed DKK 29,706 million.
The adjusted line carried the beat
Net sales for the third quarter were DKK 79,195 million, up 4% at constant exchange rates, according to the company's filing with the US Securities and Exchange Commission. Adjusted operating profit rose 27% at constant rates to DKK 31,720 million, the figure Novo put in the headline of its earnings release. Reported operating profit told a different story. It fell 9% at constant rates to DKK 23,011 million after DKK 8.7 billion of non-cash impairment charges, DKK 4.6 billion tied to ziltivekimab and DKK 4.1 billion tied to manufacturing network right-sizing. The beat that lifted the stock sits on the adjusted line.
On that adjusted basis, Novo raised its 2026 outlook. Adjusted sales growth is now expected at -2% to +2% at constant rates, and adjusted operating profit growth is now in the same -2% to +2% band. The company had previously guided both metrics to roughly negative 6% to flat. Chief executive Mike Doustdar said, "We delivered a stronger-than-expected third quarter and are raising our full-year outlook for adjusted sales and adjusted operating profit." He also said a turnaround cannot be established on one quarter.
List prices fall in January
The more durable number in the pack is the 2027 list-price reset. Effective 1 January 2027, Novo will lower the US wholesale acquisition cost of specified Wegovy and Ozempic doses to $675, a cut of about 50% for Wegovy and about 35% for Ozempic. Management framed the move as enhancing affordability and said it is expected to affect cash flow in 2027. Free cash flow that year is still expected at DKK 60-70 billion.
The concession is the price of defending share. Lilly raised its own outlook last week on the strength of Mounjaro and Zepbound. Lilly's oral candidate, Foundayo, missed estimates in its latest quarter even as the chief financial officer said prescriptions doubled. Novo is buying volume with a lower US sticker while that rival oral product is still finding its footing, and while Novo waits on the next injectable combination.
CagriSema is the product Novo is buying time for
CagriSema, Novo's combination of semaglutide and cagrilintide, delivered 21% weight loss at week 68 in the REDEFINE 9 obesity trial. In the REIMAGINE 5 diabetes and obesity trial it delivered 12.4% weight loss versus 9.1% for tirzepatide 5mg at week 60. Novo is preparing for a US launch of CagriSema in early 2027, subject to regulatory approval. Until that product is on the market, the company is trading list price to keep Wegovy in front of new patients.
Citi maintained a neutral rating, citing uncertainty over near-term, mid-term and long-term weight-loss pricing and the lack of a clear Wegovy successor. That is analyst commentary, not a company forecast, but it names the same tension the quarter put on the table. Oral Wegovy is running ahead of the models. The US price cut is a real transfer of economics to patients and payers. Reported profit still fell. Adjusted profit, and the guidance attached to it, recovered. Doustdar's caution is the right closer. One strong quarter, even one with a pill that beat, does not yet prove the franchise has turned.
