Novo Nordisk rolls out oral semaglutide as Ozempic in US pharmacies, facing revenue decline, pricing pressure, and fierce rivalry from Eli Lilly.
The Danish drugmaker is rolling out its blockbuster GLP-1 therapy in pill form across the United States, betting that brand recognition can revive momentum ahead of what analysts expect to be a bruising quarterly update. Novo Nordisk confirmed that more than 70,000 US pharmacies now stock the oral version of semaglutide, replacing the Rybelsus label with the far more familiar Ozempic nameplate.
Pricing has been calibrated to drive volume. Insured patients can pick up a three-month supply for as little as $25, while uninsured buyers face a monthly tab ranging from $149 to $299 depending on dosage. The company has also struck partnerships with discount platforms such as GoodRx and WW International’s Med+ program to widen access and bypass some of the friction that typically comes with insurance reimbursement.
Early prescription data offers a glimpse of the pill’s potential. When the oral version of Wegovy launched in a comparable week, it generated 18,410 prescriptions. By contrast, Eli Lilly’s newly introduced Foundayo managed just 3,707 scripts in its second week on the market. That gap underscores Novo’s head start in the oral GLP-1 space — for now.
Still, the launch arrives at an awkward moment. Novo Nordisk is scheduled to report first-quarter results on Wednesday, and the consensus is grim. Analysts project an eight percent drop in revenue year-over-year, with earnings per share forecast to slide roughly 16 percent. Management has already warned of declining sales volumes, and Morningstar has flagged the risk of US semaglutide prices falling more than 20 percent in 2026 as Medicare Part D renegotiations take effect.
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The competitive landscape is shifting fast. Eli Lilly posted 56 percent revenue growth in the first quarter and raised its full-year guidance to a range of $82 billion to $85 billion. Lilly now commands 60.1 percent of the combined US obesity and diabetes market, versus Novo’s 39.4 percent. Foundayo also carries a practical edge: it can be taken without restrictions on food or drink, a direct challenge to Novo’s oral semaglutide, which requires stricter adherence to dosing rules.
Wall Street is divided on what comes next. Citi has downgraded the stock, and Bernstein initiated coverage with an underperform rating, warning that pricing pressure and thinning margins could make Novo a value trap. But a competing view emerged on CNBC’s Fast Money in late April, where analysts argued that Novo — down roughly 68 percent from its mid-2024 peak — offers a more attractive risk-reward profile than Lilly. The stock trades at about 12 times earnings, compared with Lilly’s 26 times. Optimists point to a projected free cash flow yield above 6.5 percent in 2027, plus a dividend yield near four percent.
Novo has been buying back shares to cushion the fall. The company recently repurchased 3.44 billion Danish kroner worth of equity as part of a 15 billion kroner program that remains active. Options market activity suggests some investors are betting on a positive surprise: nearly 78 percent of recent contracts were calls.
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Shares climbed more than four percent on Monday to €37.52, though the stock remains down roughly 16 percent year-to-date. The forward price-to-earnings ratio of 12 is historically cheap for Novo, and the Wegovy pill is already generating about 113,000 weekly prescriptions.
Wednesday’s earnings call will be pivotal. Investors want clarity on how Medicare Part D pricing talks will hit margins, whether Foundayo has begun to erode Wegovy prescriptions, and whether the oral Ozempic rollout can meaningfully offset the headwinds. Novo has also filed for FDA approval of a higher-dose 25-milligram version of the pill, signaling that the pipeline remains active even as the present quarter looks painful.
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