Novo Nordisk's Pill Revenue Faces a Critical Quarter

A significant price increase for Novo Nordisk's Wegovy pill coincides with growing Wall Street skepticism over the drug's near-term revenue potential. On April 15, the monthly cost for the 4-milligram dose rose from $149 to $199, a move timed as many patients who started on the lowest dose earlier this year are now titrating up. However, analysts warn that a lopsided prescription mix may undermine the financial benefit.

BMO Capital Markets crystallized these concerns by cutting its price target on Novo Nordisk shares from $45 to $36, maintaining a "Market Perform" rating. The issue is one of volume versus value. While an estimated 721,000 prescriptions for the oral Wegovy were written in the first quarter, roughly 450,000 were for the cheapest 1.5-milligram starter dose. Consequently, BMO forecasts first-quarter 2026 revenue from the pill at just 881 million Danish kroner (DKK), a figure that would miss the consensus estimate of 1.001 billion DKK by approximately 12%.

The stock has already priced in substantial pessimism. Shares recently traded at 33.97 euros, reflecting a year-to-date decline of around 40%. The stock trades more than 23% below its 200-day moving average, and a Relative Strength Index (RSI) reading of 19.5 indicates a deeply oversold condition.

Amid this pressure, Novo Nordisk's management is deploying capital to support the equity. A share repurchase program of up to 3.8 billion DKK is underway and runs until May 4. By April 10, the company had already bought back approximately 11 million B-shares at an average price of 257.56 DKK.

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The company is also pursuing strategic initiatives to bolster its long-term pipeline. It recently announced a partnership with OpenAI to leverage artificial intelligence for drug discovery and supply chain optimization, though financial terms were not disclosed. This follows a similar move by rival Eli Lilly, which in March sealed an AI deal with Insilico Medicine worth up to $2.75 billion.

The competitive landscape remains fierce. Eli Lilly has also partnered with Amazon Pharmacy to offer same-day delivery for its new GLP-1 drug, Foundayo. Novo Nordisk itself suffered a recent setback when its combination drug CagriSema underperformed against Lilly's Zepbound in a head-to-head study.

Looking ahead, the company's own guidance points to a challenging period. Management anticipates a currency-adjusted sales and operating profit decline of 5% to 13% for 2026, which would mark the first annual drop in 25 years. The upcoming first-quarter results in May will provide a crucial test, with investor focus squarely on the Wegovy pill's sales figure. A miss against consensus could pressure the stock further, testing key support levels despite its technically oversold status.

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Further out, pivotal events include the mid-2026 start of Medicare Part D coverage for obesity medications in the US, which is expected to dramatically expand patient access. A US Food and Drug Administration (FDA) decision on the CagriSema combination drug is anticipated around the turn of the year 2026/2027.

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