Novo Nordisk sold 5.39 billion Danish crowns (about $810 million) of its Wegovy pill in the third quarter, about 17% more than analysts expected and 53% more than the quarter before. On the back of it, Novo raised its 2026 outlook for the third time this year.
If you've followed Novo over the past two years, this is a change of tone. The shares are still down more than 70% from their peak. So it's worth looking at what the pill actually changes, and what it doesn't.
Why a pill matters more than another injection
Novo's first wave of growth came from weekly injections. A daily pill opens the door to people who would rather not inject, and it competes head to head with Eli Lilly's own pill, Foundayo. Right now Novo is winning that race: it estimates its pill holds about 80% of new-to-brand prescriptions in the US.
Chief executive Mike Doustdar said Novo has "been able to hold the baton." He also admitted the company needs to "watch them," as Lilly works to reverse the trend. Lilly's pill is taking a growing share of new prescriptions, and Lilly raised its own outlook last week.
Beats on sales, profit and guidance: the numbers
The pill wasn't the only surprise. Adjusted sales reached 79.20 billion crowns, about 8% above forecasts of 73.22 billion. Adjusted operating profit came in at 31.72 billion, up 27% from a year earlier at constant exchange rates and well ahead of the 28.39 billion expected.
The new 2026 outlook calls for sales and operating profit to range from a 2% decline to 2% growth, at constant exchange rates. The old range ran from flat to a 6% decline. In plain terms: Novo went from expecting a shrinking year to expecting a roughly flat one.
Investors liked it, but not without limits. The shares rose as much as 6.6% early on Wednesday, then settled to a gain of about 1.9% by mid-morning in London.
The risk: Lilly is catching up where it counts
New prescriptions are the scoreboard. Novo leads today, but Lilly's share of new patients is rising, and those are the patients that decide next year's sales.
"Raised" still means roughly flat. The best case in the new guidance is 2% growth.
A change at the top of finance. CFO Karsten Munk Knudsen leaves at the end of December; Luigi La Corte from Galderma takes over.
What to watch next
The number that matters now is the pill's share of new US prescriptions. If Novo holds most of the market while Lilly pushes, the upgrades could keep coming. If that share slips, this quarter may look like a high point.
The fade from a 6.6% jump to under 2% says it all: investors believe the pill is working. They're just not sure yet that it's enough to win.
Sources: Reuters via Euronext (4 Nov).