Novo Nordisk A/S

Reported first-quarter sales were DKK 96.8 billion, up 32%. Adjusted sales declined 4%, and adjusted operating profit decreased 6% at CER. Adjusted gross margin was 80.6% versus 83.5% in 2025. The company said obesity care sales in international operations grew 44% to DKK 9.2 billion, while U.S. operations declined 11% and international operations grew 6% overall. For 2026, Novo Nordisk now expects adjusted sales growth of minus 4% to minus 12% at CER and adjusted operating profit growth of minus 4% to minus 12% at CER. The outlook assumes stronger GLP-1 product sales, continued competition in the U.S., reduced obesity medication coverage in Medicaid, lower realized prices from market access investments including the U.S. Most-Favored-Nations agreement, and assumptions around Wegovy pill uptake and potential cannibalization of injectable obesity growth.

Mike Doustdar framed 2026 as a year of competitiveness, pipeline progress and focused reinvestment. He highlighted that Novo Nordisk now serves more than 45 million people with obesity and diabetes, with more than 4 million using obesity treatments, and emphasized the company’s launch execution with the Wegovy pill and Wegovy HD. His tone was upbeat but disciplined: growth matters, but so does resource allocation, and he repeatedly tied current spending to future opportunities across obesity, diabetes and other therapy areas.

Karsten Knudsen said the quarter included a major mix of reported and adjusted figures, with reported sales up 32% to DKK 96.8 billion but adjusted sales down 4% because of lower realized prices and offsetting volume growth. He pointed to the adjusted gross margin decline to 80.6% from 83.5% as a result of pricing pressure, one-time costs and FX, partly offset by better GLP-1 mix. He also said the company is on track for DKK 8 billion of savings from the transformation program, had about 68,000 FTEs at quarter-end, and returned nearly DKK 38 billion to shareholders in the quarter. On spending, he noted the SG&A ratio for the full year is expected to be in the low 20s and that R&D investment should rise in coming quarters.

Analysts focused heavily on oral Wegovy demand, pricing and supply, SG&A and R&D phasing, Ozempic pricing erosion, and whether the lowered guidance floor reflected caution despite a solid quarter. Management said titration on oral Wegovy is proceeding as expected, self-pay remains the early mix, and supply is being scaled gradually for international rollout rather than unlimited expansion. On pricing, management said the current oral price is the “sweet spot” for now, though it remains dynamic over a much longer horizon. On costs, Karsten said Q1 SG&A was helped by a legal provision benefit of a little more than $100 million and that R&D was lighter than the full-year run rate, with more investment expected later in the year.