Wegovy Pill Sales Hit $810M as Novo Nordisk Raises 2026 Outlook

A beat built on a pill

The Wegovy pill now accounts for most of Novo Nordisk's recovery. The Danish drugmaker reported third-quarter sales of 5.39 billion Danish crowns, about $810 million, for its oral obesity drug. Analysts in a company-compiled consensus had expected 4.62 billion. On the strength of that number, Novo raised its full-year 2026 forecast again.36 The company now expects adjusted sales and adjusted operating profit to land somewhere between a 2% decline and 2% growth at constant exchange rates. In August it had guided to anything from flat to a 6% drop.319

The headline figures came in ahead of expectations too. Adjusted sales reached 79.2 billion crowns, up 4% at constant currencies, against an analyst estimate of about 73.2 billion. Adjusted operating profit rose 27% to 31.72 billion crowns, where analysts had expected 28.39 billion.8 Free cash flow guidance went from 45–55 billion crowns to 60–70 billion.16 Copenhagen-listed shares rose 5.8% during the session, reaching 288 crowns.7

The quarter shows a company that has stopped shrinking. It does not yet show a company that has solved its problems. On the earnings call, Chief Executive Mike Doustdar said Novo has entered a "growth recovery phase."11 Speaking elsewhere, he cautioned that one data point does not make a turnaround.10 The second remark is the better summary of where things stand.

Where the reporting diverges

Outlets agree on the main numbers but not on some of the framing. Reuters-based coverage calls this the third guidance raise of 2026.34 Earnings-call summaries call it the second.1115 The difference comes from where you start counting. One analysis says Novo began the year forecasting a decline of 5% to 13%, narrowed that in August, and has now raised it again. On that view, the midpoint has gone from a 9% contraction to a flat year.14 However the raises are counted, the outlook has improved a great deal since January.

The pill's quarter-on-quarter growth is also reported differently. Most coverage gives a 53% increase over the second quarter.26 One independent analysis puts second-quarter pill revenue at 3.22 billion crowns, which would make the jump closer to 68%.14 Estimates of the size of the beat range from 17% to about 20%, depending on which consensus figure is used.710 None of these differences changes the conclusion: the pill beat expectations by a wide margin.

The reported profit picture is less flattering than the adjusted one. Novo says the 27% rise in adjusted operating profit benefited from an easy comparison, because the year-earlier quarter carried 9 billion crowns of restructuring costs. Reported operating profit actually fell 9% at constant currencies. That decline reflects 8.7 billion crowns of non-cash impairments, split between the drug candidate ziltivekimab and a downsizing of Novo's manufacturing network.19

Lower prices, more patients

For anyone following drug prices, this quarter matters because it tests a simple idea: drugmakers can cut prices sharply and still grow if volume rises enough. Novo's results suggest that is starting to happen in obesity drugs.

US prices for obesity drugs have dropped quickly. Under a November 2025 agreement with the White House, the federal TrumpRx portal lists the starting dose of the Wegovy pill at $149 a month, against a list price of about $1,349. Starter fills of the Wegovy and Ozempic pens are listed at $199. Eli Lilly's Zepbound vials are listed from $299.2427 Novo has also said it will cut US list prices for Wegovy and Ozempic to $675 from January 1, 2027. That is a reduction of about 50% for Wegovy and 35% for Ozempic, and the company expects it to affect 2027 cash flow.326

The biggest single boost came from Medicare. The GLP-1 Bridge pilot started on July 1. It caps out-of-pocket costs at $50 a month for eligible seniors and runs until the end of 2027.7 Novo's US head said the program was largely responsible for a roughly 20% quarter-on-quarter rise in Wegovy pill volumes. He also said the wider US obesity drug category was roughly flat from May to October without it.8 That detail deserves more attention than it has received. In this reading, the US growth was created mainly by government policy, not by consumers spontaneously buying more, and the extra demand will end when the pilot ends.

Novo is open about the cost. It says lower US prices, driven by spending on market access and amplified by its most-favored-nation pricing agreement with the administration, are built into its forecast.13 Management estimated price erosion on Wegovy at 30% to 35% in the quarter, at the high end of its range. It said the agreed pricing path is already reflected and no further negative impact is expected.17 As a result, the company still expects full-year sales growth in international markets and a decline in the US.19

The injectable problem

The pill is offsetting weakness elsewhere in the business. US sales of injectable Wegovy fell 13% at constant currencies. Combined US Wegovy sales, including the pill, rose 21%.8 Diabetes sales dropped 5%, led by a 10% fall in US GLP-1 diabetes sales. Novo attributed that to lower volumes and wholesaler inventory movements.3 Obesity sales overall grew 22% to 26.1 billion crowns.3

The pill is still small in absolute terms, at about 6% of expected Wegovy sales.2 Investors care about it because of where it sits in the prescribing pipeline. Novo estimates the pill takes about 80% of new-to-brand US prescriptions in the oral obesity segment, across insurance, cash-pay and telehealth channels.8 Doustdar said about half of the remaining fifth come from Novo's own injectable Wegovy. The rest come from rival drugs and pharmacy-made copies of Wegovy.4 Abroad, Novo reports about 90% of the UK oral obesity market and 80% in the UAE. It sold roughly 100,000 packs in Germany in six weeks, mostly to people who had not used a GLP-1 drug before.4

The rollout is also moving faster. Novo now expects the pill to be available in more than 20 countries by mid-2027, earlier than its previous end-2027 target. It credits higher manufacturing output and faster regulatory approvals.6

Lilly still leads the larger market

The rivalry with Eli Lilly has two sides. Lilly raised its own outlook the week before, on strong demand for its injectables.8 Doustdar said Novo's data matches Lilly's estimate that about seven in ten Medicare seniors choose Lilly's drugs. Of those who choose a pill, he said, eight in ten pick Novo's.3 One Novo shareholder put it this way: Lilly leads in injectables, while Novo has the advantage in pills.4

That advantage may not last. Lilly's oral drug Foundayo is competing for new patients. Indirect trial comparisons point to about 16.6% weight loss for the Wegovy pill versus about 12.4% for Foundayo. Foundayo can be taken without the 30-minute morning fast the Wegovy pill requires. Without a head-to-head trial, the efficacy comparison remains uncertain.7 There are also signs of a slowdown. Doustdar said pill prescriptions had leveled off in recent weeks. He blamed seasonality and said Novo hopes for a pickup over the holidays.3 Citi kept a neutral rating, citing uncertain weight-loss drug pricing and the lack of a clear successor to Wegovy.10

What comes next

The next phase depends on new drugs and on how pricing plays out. Novo is preparing a US launch of CagriSema in early 2027, pending approval.3 In the REIMAGINE 5 trial, CagriSema produced 12.4% weight loss, compared with 9.1% for a 5 mg dose of tirzepatide.13 Management did not give 2027 guidance. It listed both supports and headwinds. The supports are continued pill uptake, a full year of the Bridge program, and new launches. The headwinds are patent expiries in international markets, including China, and a less favorable pricing comparison.15 Chief Financial Officer Karsten Munk Knudsen is leaving after 27 years and will be succeeded by Luigi La Corte, adding another change at the top.711

Novo is back on its feet. Its shares are still down more than 70% from their peak, and the recovery leans heavily on one product and one federal pilot program.611 One analysis calls 2026 a "reset year." It argues that once this year's price cuts are part of the comparison base, more volume should translate more directly into revenue growth.14 That argument is reasonable. Novo still has to show that pill growth continues without the Medicare boost and holds up once Foundayo is fully competing.