Novo Nordisk raises 2026 guidance as Wegovy pill tops 5m prescriptions
Novo Nordisk has raised its full-year guidance for 2026 after reporting adjusted operating profit of DKK 33,389 million for Q2, an 11% increase at constant exchange rates (CER). The Danish pharmaceutical giant credited accelerating GLP-1 prescription volumes and favourable US rebate adjustments for the improvement, lifting both its adjusted sales and adjusted operating profit growth expectations to a range of 0% to -6% at CER, an upgrade on the prior guidance range.
Adjusted net sales for the quarter rose 7% at CER to DKK 78,488 million. Reported figures looked weaker: reported operating profit fell 16% at CER, dragged down by a DKK 6.3 billion non-cash impairment charge on intangible pipeline assets, of which DKK 4.0 billion related to monlunabant, the company's cannabinoid receptor-1 inverse agonist obesity candidate. The reported figures were also unfavourably compared against a DKK 2.6 billion US 340B Drug Pricing Program rebate provision reversal booked in Q2 2025.
Wegovy franchise momentum
The oral semaglutide pill formulation of Wegovy has been the standout commercial story of the quarter. Weekly total prescriptions in the US exceeded 265,000 for the week ending 17 July, and cumulative prescriptions have surpassed five million since launch. Mike Doustdar, president and chief executive of Novo Nordisk, said the Wegovy product portfolio "remains a key growth driver," pointing to the pill's rapid US adoption alongside encouraging early uptake in markets outside the US.
Geographical expansion is continuing. The Wegovy pill launched in the UAE in June and the UK in July. The higher-dose Wegovy HD formulation (7.2 mg) launched in the US in April, while the 7.2 mg single-dose pen launched in the UK in June. The European Medicines Agency granted approval in July for both the 7.2 mg single-dose pen, based on STEP UP data showing up to 20.7% mean weight loss, and the oral pill, based on OASIS 4 data showing up to 16.6% mean weight loss. The EU 7.2 mg pen roll-out is planned for the second half of 2026.
Not all pipeline news was positive. The ZEUS Phase 3 cardiovascular outcomes trial of ziltivekimab, Novo Nordisk's anti-inflammatory interleukin-6 ligand antibody, did not meet its primary endpoint, representing a setback for the company's efforts to diversify beyond the GLP-1 franchise.
Competitive context and market landscape
Novo Nordisk's GLP-1 franchise is engaged in a two-horse race with Eli Lilly, whose tirzepatide products Mounjaro and Zepbound have eroded Novo's share in the US obesity and diabetes segments over the past 18 months. The competitive intensity is likely to intensify further as oral GLP-1 entrants from several mid-tier biotechs and large pharma groups approach late-stage readouts through 2026 and 2027. Novo's emphasis on the breadth of its Wegovy portfolio, spanning injection, high-dose pen, and now an approved oral formulation, reflects a strategy of defending market leadership through dosing convenience and geographic reach rather than efficacy differentiation alone.
The failure of ziltivekimab to meet its primary endpoint in ZEUS also narrows Novo's diversification story in cardiovascular disease, a segment it had identified as a major second pillar alongside metabolic disease. Investors will scrutinise the Q2 earnings call on 5 August for detail on the magnitude of the ZEUS miss and whether any post-hoc signals justify continued development in a subset population.