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← GLP-1 Cross-Sector Effects

Updated

Novo Nordisk Q1 2026: Oral Wegovy Launch Beats Expectations, Pipeline Advances, and Margin Pressure

Novo Nordisk reported Q1 2026 results on May 6, with the oral Wegovy tablet emerging as the standout story, while pricing pressure and a falling stock price continue to weigh on sentiment.

Oral Wegovy: Strongest GLP-1 Volume Debut in US History

  • Oral Wegovy generated 2.26 billion Danish kroner in Q1 revenue, nearly double the Jefferies consensus of 1.16 billion
  • Prescriptions topped 1.3 million during the quarter and have exceeded 2 million since launch
  • Wegovy now accounts for 65% of all new oral GLP-1 prescriptions in the US
  • Weekly prescriptions surpassed 200,000 by mid-April
  • Amazon Pharmacy began offering oral Ozempic in ~3,000 cities, with plans to reach 4,500 by end of 2026

High-Dose Injectable Wegovy (STEP-UP Trial)

  • 7.2 mg dose produced ~21% average weight loss at 72 weeks (~23 kg)
  • 84% of lost mass was fat, only 10% muscle — MRI subgroup data
  • Early responders (~27% of patients) achieved ~28% weight loss
  • High-dose version already shipping; major US PBMs have added it to standard formularies
  • Directly challenges Zepbound's efficacy narrative

CagriSema — FDA Decision Expected Late 2026

  • Combination of cagrilintide + semaglutide under FDA review
  • REDEFINE-1 trial: 22.7% weight loss at 68 weeks; 91.9% achieved ≥5% reduction
  • REDEFINE-11 Phase 3 data expected H1 2027; higher-dose version entering Phase 3 H2 2026
  • REDEFINE-4 head-to-head vs. Zepbound seen as a potential catalyst

Amycretin — Third Pillar Under Development

  • Dual GLP-1/amylin receptor agonist
  • AMAZE-12 Phase 3 trial began recruiting May 18, 2026, targeting weight maintenance (a commercially underexplored niche)
  • Phase 1b/2a showed 22% weight reduction at 36 weeks (injectable); oral formulation showed 13.1% at 12 weeks

Financials & Guidance

  • Reported revenue $14.97 billion (boosted by one-time 340B reserve reversal)
  • Stripping special items, adjusted revenue fell ~4% (currency-adjusted)
  • US adjusted revenue fell 11% (currency-adjusted); international grew 6%
  • Adjusted gross margin contracted from 83.5% to 80.6%
  • Full-year guidance improved to -4% to -12% decline (from -5% to -13%)
  • Stock at ~€38.50, down ~35% over 12 months and ~45% below all-time high

India Patent Cliff

  • Semaglutide US patent expired March 2026 in India
  • 12+ local manufacturers launched copycats (Sun Pharma, Dr. Reddy's, Cipla, Zydus)
  • Novo cut Ozempic price 38% and Wegovy 48%; April sales still rose 40%

Sources