Novo Nordisk Shares Slide After Trimming 2026 Sales Forecast Amid U.S. Pricing Pressures

Shares of Novo Nordisk A/S (NYSE:NVO) took a heavy hit after the pharmaceutical giant reported its fourth-quarter results alongside a sobering sales outlook for 2026. The company now anticipates adjusted sales to shrink by 5% to 13% at constant exchange rates, a sharp turnaround from the 10% growth recorded in 2025.

This dimmer forecast is largely linked to the impact of the U.S. Most Favoured Nations pricing agreement, looming patent expirations on the semaglutide molecule in some international markets, and intensifying competition. These factors combined are expected to chip away at revenue streams that have bolstered Novo's portfolio, particularly for its flagship obesity drug Wegovy.

In the immediate fallout, Novo's American-listed shares dropped nearly 15% in New York trading, with an even steeper decline of around 16% on the Copenhagen exchange. Analysts noted the 2026 guidance fell roughly 8% short of consensus predictions at the midpoint, raising fresh concerns about pricing pressures, especially in the U.S.

Sachin Jain of Bank of America flagged the sales warning as a setback, while Morgan Stanley's Thibault Boutherin underscored that the new forecasts, though near his firm's upper range, carry downside risks if expected volumes don't materialize. Pricing concessions related to the U.S. regulatory landscape and patent issues appear to be the driving forces behind this caution.

The year 2025 still managed to show growth, with sales climbing 6% in Danish kroner and 10% at constant exchange rates to DKK 309.1 billion. Operating profits experienced a mixed picture: down 1% in local currency but up 6% at CER, excluding transformation costs. The U.S. market, while growing, showed just a modest 3% sales increase in kroner, indicating the beginnings of the pressure ahead.

Executive changes also marked the report, with Dave Moore stepping down as Head of U.S. Operations. Jamey Millar is set to take the reins, signaling possible shifts in leadership to navigate the challenging market conditions.

Analyst Evan David Seigerman from BMO Capital highlighted how the pricing moves, driven in part by Trump-era MFN deals, are casting a shadow over Novo's topline despite early hope from Wegovy pills. The concessions necessary to maintain market access in injectable GLP-1s are hammering revenue growth, even as new product forms begin to gain traction.

The ripple effects of Novo Nordisk's revised outlook were felt beyond its own shares, knocking Eli Lilly and Company (NYSE:LLY) down about 4% as investors weighed the competitive impact.

With the pharmaceutical sector facing patent cliffs and pricing regulations reshaping key markets, the next months will reveal whether Novo Nordisk can stabilize its sales momentum or if this marks a more enduring shift in its growth story.