Novo Nordisk (NVO) GLP-1 business: Ozempic, Wegovy, CagriSema

Key points

• In the first nine months of 2026, Novo reported adjusted sales of DKK 227.7 billion. Ozempic was DKK 88.9 billion, Wegovy injectable DKK 58.1 billion, the new Wegovy pill DKK 10.9 billion and insulin DKK 36.9 billion [1].
• The FDA approved the Wegovy pill on 22 December 2025, and Novo says it is launched in eight markets [1][7]. CagriSema was submitted to the FDA in December 2025; no approval was reported as of 4 November 2026 [1][9].
• Novo lists generics, compounding, pricing pressure and dependence on semaglutide among its own risks, and has announced a US list-price cut effective 1 January 2027 [1][3].
• This article reports what filings, regulators and the companies say. It makes no forecast and no recommendation.

What this article uses

Novo Nordisk A/S is Danish; its ADRs trade on the NYSE as NVO [1]. The latest interim report available on 2026-11-08 is the nine-month report (Company Announcement No 65/2026, furnished on Form 6-K), dated 4 November 2026 [1]. The latest annual documents are the 2025 Form 20-F, filed 4 February 2026 [2], and the Annual Report 2025 filed with it [3]. Every Novo document cited is the SEC copy. Figures are in Danish kroner (DKK); we do not convert them.

Sales by product

Novo reports “adjusted” sales that exclude a one-off DKK 26.8 billion reversal of US 340B rebate provisions booked in the first quarter of 2026. Reported nine-month sales were DKK 254,506 million; adjusted sales were DKK 227,746 million [1]. The table uses adjusted figures for 2026 and reported figures for 2025, in DKK million.

Product	Q3 2026	9M 2026	9M growth at constant exchange rates	Full year 2025	Share of 9M adjusted sales (our arithmetic)
Ozempic (injectable)	29,706	88,906	-3%	127,089	39.0%
Wegovy (injectable)	20,407	58,126	+4%	79,106	25.5%
Wegovy pill	5,394	10,868	not applicable	not launched	4.8%
Ozempic pill / Rybelsus	4,938	14,738	-10%	22,093 (Rybelsus)	6.5%
Total insulin	12,265	36,851	-4%	53,137	16.2%
Total net sales	79,195	227,746	+2%	309,064	100%

Sources: [1] for 2026, [2][3] for 2025. Total obesity sales rose 20 percent in the nine months and total diabetes sales fell 5 percent [1].

Novo says third-quarter sales rose 1 percent in the US and 8 percent in International Operations, with obesity volume growth partly offset by lower realised prices [1]. US insulin sales fell 16 percent in the nine months, which Novo attributes to lost market share, a declining market and lower prices [1]. For 2025, Wegovy rose from DKK 58,206 million to DKK 79,106 million and total sales were up 6.4 percent as reported [3]. Novo’s 2026 guidance of -2 to +2 percent adjusted sales growth is the company’s expectation, not a result [1].

Oral Wegovy and the Ozempic pill

Novo announced FDA approval of the Wegovy pill (oral semaglutide) on 22 December 2025, for weight reduction and maintenance and for reducing major cardiovascular events [7]. Novo cited OASIS 4, a 64-week trial in 307 adults with obesity or overweight, with 16.6 percent mean weight loss if all participants adhered to treatment [7]. The US launch was on 5 January 2026 [1].

Third-quarter Wegovy pill sales were DKK 5,394 million, of which DKK 4,178 million in the US [1]. Novo says about 3.6 million US prescriptions were filled in the quarter and estimates its new-to-brand share at around 80 percent, and it calls this the strongest US GLP-1 volume launch ever [1]. We did not check those claims against third-party data. Per Novo, the pill is also approved in the UK and UAE (June 2026) and the EU (July 2026), and a China application has been submitted [1].

The Ozempic pill is an oral semaglutide for type 2 diabetes, reported together with Rybelsus [1][14]. Novo made it available nationwide in the US on 4 May 2026 and expects an FDA decision on a 25 mg strength in the fourth quarter of 2026 [1].

CagriSema

CagriSema combines cagrilintide and semaglutide. Novo submitted it to the FDA for weight management in December 2025, on the REDEFINE 1 and 2 trials, and said in February 2026 that a decision was anticipated by late 2026 [9]. In the 4 November report the CEO says Novo is “preparing for the US launch of CagriSema in early 2027, subject to regulatory approval” [1]. The report’s milestone table did not give a decision date we could read unambiguously, and we found no approval.

Announced results, all sponsor-reported:

• REDEFINE 4 (809 adults with obesity, 84 weeks, open-label) compared CagriSema with tirzepatide 15 mg: 23.0 percent against 25.5 percent weight loss if all adhered. It missed its non-inferiority primary endpoint [9].
• REDEFINE 9: 21 percent weight loss at week 68 [1].
• REIMAGINE 5 (type 2 diabetes): 12.4 percent against 9.1 percent for tirzepatide 5 mg at week 60, with non-inferior HbA1c reduction [1].

Novo has also applied in China [1]. For the pipeline, see CagriSema and Novo’s pipeline.

Approval status

Product	Status as of 2026-11-08	Source
Wegovy injection	FDA label: cardiovascular event reduction in adults with established disease and obesity or overweight; weight reduction and maintenance in adults and patients aged 12 and older with obesity, or adults with overweight plus a weight-related condition; MASH with moderate to advanced fibrosis (accelerated approval)	[12]
Wegovy HD (7.2 mg)	FDA approved 19 March 2026 under the Commissioner’s National Priority Voucher pilot; US launch 7 April	[1][8]
Wegovy pill	FDA approved 22 December 2025	[7][12]
Ozempic injection	FDA label: type 2 diabetes, cardiovascular risk reduction, chronic kidney disease outcomes	[13]
Ozempic / Rybelsus tablets	FDA label: type 2 diabetes, cardiovascular risk reduction	[14]
CagriSema	Submitted to FDA December 2025; no approval reported	[1][9]

All three semaglutide labels carry a boxed warning about thyroid C-cell tumours seen in rodents [12][13][14]. These are prescription medicines. Novo reports EU and UK approvals of the Wegovy pill and a 7.2 mg single-dose pen in mid-2026 [1]. We did not check the EMA, MHRA or BfArM registers.

Restructuring and leadership

• CEO. Maziar Mike Doustdar became president and CEO on 7 August 2025, succeeding Lars Fruergaard Jørgensen [5].
• Workforce. On 10 September 2025 Novo announced a transformation cutting about 9,000 of 78,400 positions, with about DKK 8 billion of annualised savings by the end of 2026 and about DKK 8 billion of one-off costs [4]. The 20-F says it was largely completed by the end of 2025 [2].
• Board. An extraordinary general meeting on 14 November 2025 elected Lars Rebien Sørensen chair [2].
• Manufacturing. Nine-month reported operating profit includes DKK 4.1 billion of non-cash impairment for “right-sizing of manufacturing network” [1].
• CFO. On 4 November 2026 Novo said CFO Karsten Munk Knudsen will leave at the end of December 2026, succeeded by Luigi La Corte of Galderma [1].

Pricing and direct-to-patient sales

In the third quarter about 35 percent of roughly 4.1 million US Wegovy injectable prescriptions were self-pay, and about 55,000 subscriptions were active under a plan for self-pay patients [1].

The NovoCare Wegovy page, read on 2026-11-08 and undated, lists these self-pay prices [15]:

• Wegovy pill: $149 a month at the lowest strength, $199 at the next, $299 for the two highest.
• Wegovy injection: $199 a month for two fills for new patients through 31 December 2026, then $349; Wegovy HD $399.
• A “$25” offer applies only with commercial insurance, with a $100 monthly savings limit.

These are company prices on one date and can change [15]. From Novo’s reports:

• Effective 1 January 2027, Novo will cut the US list price of Wegovy and Ozempic to $675, which it describes as reductions of about 50 and 35 percent. It expects an effect on 2027 cash flow [1].
• Medicare Part D obesity coverage through the Bridge programme began on 1 July 2026 [1].
• Novo ties lower realised prices to its “Most Favoured Nations” agreement with the US administration [1].

For context see GLP-1 pricing and direct-to-consumer in 2026.

Competition from Lilly

Novo’s 20-F names Eli Lilly as the other most significant company in the diabetes, obesity and GLP-1 markets. It says a competing product overtook Wegovy in US weekly obesity prescriptions in early 2025 and Ozempic in type 2 diabetes during 2025, and that Novo lost volume share in both [2]. The Annual Report puts Novo at “close to 43%” of global GLP-1 volume [3]. The nine-month report says the Wegovy franchise has more than 50 percent of new patient starts among US branded obesity medicines [1]. Novo’s CagriSema trials use Lilly’s tirzepatide as comparator. For Lilly’s side see Eli Lilly’s GLP-1 business; for share data see Lilly vs Novo Nordisk: GLP-1 market share.

Hims & Hers

On 9 March 2026 Hims announced an agreement with Novo to bring Ozempic and Wegovy, including pills, to its platform. Hims said it would stop advertising compounded GLP-1s, offer compounded semaglutide “on a limited scale”, and that Novo was dismissing its lawsuit without prejudice [16].

Hims’s second-quarter 10-Q describes that suit: Novo sued in Delaware on 9 February 2026 alleging infringement of US Patent 8,129,343 and dismissed it on 9 March, reserving the right to refile. It also describes a securities class action about “the business relationship” with Novo for 29 April to 22 June 2025, which Hims does not consider a probable loss [17].

Novo’s reports of 6 May and 4 August 2026 said Hims & Hers was “expected to come online soon” for its Wegovy subscription [10][11]. The 4 November report names no telehealth partner [1]. We found no Novo statement that Hims is live, and no primary statement on why a 2025 collaboration ended. See Hims & Hers and compounded GLP-1s.

Risks and unknowns

These are Novo’s own disclosures unless noted.

• Concentration. The Annual Report cites “portfolio dependency with multiple brands relying on semaglutide” [3].
• Patents and generics. The US compound patent for Ozempic, Rybelsus and Wegovy expires in 2032; Novo lists 2026 for China and 2031 for Japan and Europe [2][3]. Generic makers have filed US challenges, and Novo settled with seven over Ozempic on confidential terms [2]. In Canada, loss of exclusivity lowered prices while Novo’s volumes stayed broadly stable [1].
• Compounding. Novo says compounding “has illicitly continued” after the US shortage ended [2]. In July 2025 it tied a lowered outlook partly to “persistent use of compounded GLP-1s” [6]. On 27 August 2026 the Fifth Circuit affirmed dismissal of compounders’ suit against the FDA; Novo expects no material effect [1]. A securities class action filed 1 August 2025 alleges Novo misled investors about the compounded market [3]. For the rules, see compounded GLP-1 and FDA rules.
• Pricing. Novo expects continued US pressure from rebates, Medicare and Medicaid exposure, and a negotiated Medicare price from 2027 [2].
• Product liability. Novo and Lilly face suits alleging gastrointestinal and other injuries from GLP-1 medicines, mostly in two multidistrict proceedings in Pennsylvania [3].
• Not verified. The CagriSema decision date, EMA, MHRA and BfArM status, third-party share data, and whether Hims is live.

Frequently asked questions

How much of Novo’s sales are Ozempic and Wegovy? In the first nine months of 2026, Ozempic injectable and Wegovy injectable were DKK 88,906 million and DKK 58,126 million of DKK 227,746 million adjusted sales, about 64.5 percent combined by our arithmetic [1].

Is the Wegovy pill approved? The FDA approved it on 22 December 2025 [7]. Novo reports UK, UAE and EU approvals in 2026 [1].

Is CagriSema approved? Not as of Novo’s 4 November 2026 report. It was submitted to the FDA in December 2025 [1][9].

Does Novo work with Hims & Hers? A March 2026 Hims announcement describes a Novo agreement [16]. Novo’s later reports said Hims was “expected to come online soon” and the latest names no partner [10][11][1].

Sources

1. Novo Nordisk A/S, Form 6-K, Company Announcement No 65/2026, “Financial report for the period 1 January 2026 to 30 September 2026” (2026-11-04). https://www.sec.gov/Archives/edgar/data/353278/000162828026069805/caq32026.htm
2. Novo Nordisk A/S, Form 20-F for the year ended 31 December 2025 (filed 2026-02-04). https://www.sec.gov/Archives/edgar/data/353278/000035327826000012/nvo-20251231.htm
3. Novo Nordisk A/S, Annual Report 2025, filed in the same SEC accession as the 20-F (2026-02-04). https://www.sec.gov/Archives/edgar/data/353278/000035327826000012/nvo-20251231_d2.htm
4. Novo Nordisk A/S, Form 6-K, “Novo Nordisk to streamline operations and reinvest for growth” (2025-09-10). https://www.sec.gov/Archives/edgar/data/353278/000117184325005809/f6k_091025.htm
5. Novo Nordisk A/S, Form 6-K, “Maziar Mike Doustdar appointed as president and chief executive officer” (2025-07-29). https://www.sec.gov/Archives/edgar/data/353278/000117184325004761/f6k_072925.htm
6. Novo Nordisk A/S, Form 6-K, “Novo Nordisk lowers sales and operating profit outlook for 2025” (2025-07-29). https://www.sec.gov/Archives/edgar/data/353278/000117184325004760/f6k_072925.htm
7. Novo Nordisk A/S, Form 6-K, announcement of FDA approval of the Wegovy pill (announced 2025-12-22, filed 2025-12-23). https://www.sec.gov/Archives/edgar/data/353278/000117184325008080/f6k_122225.htm
8. Novo Nordisk A/S, Form 6-K, announcement of FDA approval of Wegovy HD (announced 2026-03-19, filed 2026-03-20). https://www.sec.gov/Archives/edgar/data/353278/000117184326001813/f6k_031926.htm
9. Novo Nordisk A/S, Form 6-K, REDEFINE 4 headline results (2026-02-23). https://www.sec.gov/Archives/edgar/data/353278/000117184326000996/f6k_022326.htm
10. Novo Nordisk A/S, Form 6-K, Company Announcement No 30/2026, financial report for the first three months of 2026 (2026-05-06). https://www.sec.gov/Archives/edgar/data/353278/000035327826000018/caq12026.htm
11. Novo Nordisk A/S, Form 6-K, Company Announcement No 48/2026, financial report for the first six months of 2026 (2026-08-04). https://www.sec.gov/Archives/edgar/data/353278/000035327826000023/caq22026.htm
12. DailyMed (NLM), Wegovy (semaglutide) injection and tablets prescribing information, label version published 2026-06-30. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
13. DailyMed (NLM), Ozempic (semaglutide) injection prescribing information, label version published 2026-06-10. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=adec4fd2-6858-4c99-91d4-531f5f2a2d79
14. DailyMed (NLM), Ozempic and Rybelsus (oral semaglutide) tablets prescribing information, label version published 2026-08-19. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=27f15fac-7d98-4114-a2ec-92494a91da98
15. Novo Nordisk Inc., NovoCare Pharmacy Wegovy page (read 2026-11-08; page undated). https://www.novocare.com/delivery/wegovy.html
16. Hims & Hers Health, Inc., Form 8-K Exhibit 99.1, “Hims & Hers announces strategic shift for US weight loss business” (2026-03-09). https://www.sec.gov/Archives/edgar/data/1773751/000177375126000033/ex991pressrelease.htm
17. Hims & Hers Health, Inc., Form 10-Q for the quarter ended 30 June 2026 (filed 2026-08-10). https://www.sec.gov/Archives/edgar/data/1773751/000177375126000163/hims-20260630.htm

This article is information, not medical advice.

This is not investment advice.