For most of 2026, the dominant story on Novo Nordisk was one of retreat: a next-generation drug that disappointed in head-to-head trials, an injectable Wegovy losing ground to Eli Lilly’s Zepbound, and a list price cut so steep it prompted a Goldman Sachs downgrade. NVO shares had already fallen roughly 70% from their late-June 2024 high of $148.15 by mid-year. The company everyone assumed was losing the obesity price war just reported its strongest beat in several quarters.
Q3 adjusted net sales came in at DKK 79.2 billion, up 6% year-over-year, surpassing analysts’ estimates of DKK 73.65 billion. Revenue beat consensus by 8%, adjusted operating profit by 12%, and Wegovy pill sales by 17%. Adjusted earnings per share fell 12% year-over-year to DKK 5.79, but topped the Wall Street consensus of DKK 4.80. Shares climbed as much as 6.6% in early trading.
The Pill Is Doing the Heavy Lifting
The Wegovy pill numbers deserve particular attention. Sales increased 22% at constant currencies, with Wegovy pill revenue reaching DKK 5.394 billion, about 53% above Q2 and comfortably above the DKK 4.62 billion consensus. The pill is now large enough to offset weakness in established products.
Injectable Wegovy lost ground in the US, where sales fell 13%, but taken together, the Wegovy products grew 21% in the US. By the end of Q3, the Wegovy pill had launched in the US, UAE, UK and Germany. More recently, launches in four additional countries brought the total to eight markets. The pill is expected to be available in more than 20 markets in 2027.
Guidance Has Moved Sharply
The scale of the guidance revision is what matters most to long-term investors. Novo initially expected adjusted sales and operating profit to decline 5 to 13% this year. The midpoint of that guidance is now 30% higher.
The company now sees adjusted revenue and operating profit growth between negative 2% and 2% at constant exchange rates, up from the previous guidance of negative 6% to flat, which itself was raised in August.
Novo also raised its free cash flow forecast to 60 billion to 70 billion crowns, against the previous 45 billion to 55 billion and a consensus of about 45 billion, according to Jefferies. Jefferies noted the new guidance suggests consensus forecasts could rise by about 3 percentage points at the midpoint for both adjusted sales and profit.
The Bull and Bear in One Quarter
The bear case has not vanished. The company plans to cut the US wholesale acquisition cost of Wegovy and Ozempic by about 50% and 35%, respectively, to $675 from January 1, 2027. That list price reset is real and will pressure realized revenues, particularly in the US, where injectable Wegovy is already ceding share to Lilly’s tirzepatide.
In 2027, Novo is set to bring CagriSema to market. In the REIMAGINE 5 trial, CagriSema delivered 12.4% weight loss in people with type 2 diabetes versus 9.1% for Lilly’s tirzepatide at a 5 mg dose. Novo is preparing to launch it in the US in early 2027, subject to approval. Whether that result at a higher dose against a higher Lilly dose holds up will determine how much of the market Novo can reclaim.
The valuation remains the most striking element of the story. Novo’s trailing P/E ratio stands at about 10.3x, indicating the stock trades at a substantial discount relative to its own recent history.
Three guidance raises in a single year from a company the market had written off as a price-war casualty is worth taking seriously. The pill is working. The question now is how much of that momentum survives January 2027.
