Novo Nordisk Deploys Higher-Dose Wegovy and Real-World Data to Counter Eli Lilly, but Shares Stay Stuck

Novo Nordisk has stepped up its defence of the GLP-1 franchise with a one-two punch: US regulatory approval of a more potent Wegovy formulation and a large real-world analysis showing that Semaglutide can match Tirzepatid on blood sugar control while edging ahead on weight loss. Yet the market response has been muted, with the stock closing at €37.27 on Friday, down 1.01%, as investors weigh clinical progress against mounting pricing pressure and an expected revenue decline.

The US Food and Drug Administration has cleared Wegovy HD, a 7.2?mg dose of Semaglutide that delivered an average 19% weight loss over 17?months in clinical trials. That compares with roughly 16% for the standard 2.4?mg dose. The improvement comes at a cost: more than 70% of patients on the higher dose reported side effects such as nausea or vomiting, versus 60% in the lower?dose group. The pricing for Wegovy HD remains undisclosed, leaving a critical open question: will patients, physicians and payers accept the added burden for a moderate gain in efficacy?

Separately, Novo Nordisk presented the COMPETE SWITCH study at the American Diabetes Association’s annual meeting. Drawing on a US claims database covering January 2018 to September 2025, researchers tracked roughly 55,550 type?2 diabetes patients who either up?titrated from Semaglutide 1?mg to 2?mg or switched to Tirzepatid. After one year, 74.7% of the Semaglutide group achieved an HbA1c below 7%, compared with 75.1% on Tirzepatid — a statistical dead heat. On body weight, Semaglutide held an edge: 60.5% of patients lost at least 5% of their weight, versus 55.3% for Tirzepatid. Novo Nordisk itself cautioned that the analysis is based on administrative claims, not a controlled trial, so causality cannot be inferred.

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The ADA meeting also brought fresh data from the SELECT, STEP, ESSENCE and OASIS programmes. Semaglutide was linked to a 52% lower risk of obstructive sleep apnoea (hazard ratio 0.48) and a 42% reduction in asthma?related events (hazard ratio 0.58). Systolic blood pressure fell by 5.48?mmHg versus comparators, while ESSENCE results showed improvements in liver health and cardiometabolic risk factors out to 72 weeks. None of these indications are currently approved for Semaglutide, but the exploratory findings broaden its medical profile.

Beyond Wegovy, Novo Nordisk is advancing its pipeline. Phase?2 data for Zenagamtide (also known as Amycretin) showed a weight loss of up to 14.6% and an HbA1c reduction of up to 1.71 percentage points over 36 weeks. A Phase?3 programme in diabetes and obesity is slated to begin in the second half of 2026. Meanwhile, the company has struck a clinical supply agreement with Veru for the Phase?2b PLATEAU study, which will test Enobosarm combined with Wegovy in older obese patients to preserve muscle mass. Novo Nordisk will provide Wegovy free of charge and secures a first?negotiation right for future Enobosarm?GLP?1 combinations.

The stock’s performance reflects the headwinds. At €37.27, the shares are 47% below their 52?week high of €70.13. They trade above the 50?day moving average of €35.80 but well below the 200?day average of €41.66. Year?to?date the decline stands at 16.58%. In the first quarter of 2026, adjusted revenue fell 4% at constant exchange rates, even though obesity sales jumped 22%. For the full year, Novo Nordisk expects an adjusted revenue and operating profit decline of 4% to 12%, partly owing to a Most?Favoured?Nations agreement that takes effect in July.

Investors will now look to the next major catalyst: a regulatory decision on CagriSema, due in the fourth quarter of 2026. Until then, the investment case remains a sobering trade?off between a broadening clinical arsenal and an increasingly price?sensitive market.

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