Novo Nordisk’s Washington Shuffle and Teen Pill Progress Mask a Grim Market Reality

The Danish drugmaker is fighting on multiple fronts — and losing ground on most of them. While Novo Nordisk celebrates a clinical win for its first oral GLP-1 therapy in adolescents, the company is simultaneously dismantling its longtime lobbying partnership in Washington, slashing its 2026 revenue forecast, and watching its stock crater to near-historic lows.

The contradictions are stark. On one hand, the PIONEER study delivered the data needed to push an oral semaglutide pill toward regulatory approval for children and adolescents with type 2 diabetes. After six months, young patients saw their long-term blood sugar drop by 0.83 percentage points more than those on placebo. Novo Nordisk plans to file for US and European approval in the second half of 2026, betting that a tablet — easier for teenagers to swallow than an injection — will give it an edge over Eli Lilly’s more potent injectable rival.

On the other hand, the financial picture is deteriorating fast. For the full year 2026, Novo Nordisk now expects currency-adjusted revenue to fall by between five and 13 percent. The culprit: brutal price negotiations under Medicare, compounded by fresh competition from Amazon’s direct-to-consumer GLP-1 program. To survive the squeeze, the company is undergoing a restructuring that will cost roughly 8 billion Danish kroner.

That restructuring extends to the company’s political apparatus. As of February 1, 2026, Novo Nordisk ended its long-standing contract with Public Strategies Washington Inc., a firm that had focused exclusively on securing Medicare and Medicaid reimbursement for obesity drugs like Wegovy. The move is not a retreat — the company still spends over $8 million annually on lobbying, spread across more than a dozen outside firms and an in-house team that alone reported $1.3 million in Q1 2026 spending. But it is a recalibration. Newly added to the roster is S-3 Group LLC, a firm with deep ties to Republican leadership, while incumbents like Nickles Group, Checkmate Government Relations, and Ballard Partners remain on the payroll.

The political calculus explains the shift. The Biden administration had proposed a rule mandating Medicare and Medicaid coverage for obesity medications. The Trump administration scrapped that in April 2025, replacing it with the voluntary BALANCE model — a demonstration program offering limited GLP-1 access to Medicare beneficiaries starting July 2026 and running through December 2031. That is not a permanent legislative fix. Meanwhile, a Senate HELP committee hearing in mid-April 2026 put insulin pricing and biosimilar competition under the microscope, both areas where Novo Nordisk is directly exposed.

Should investors sell immediately? Or is it worth buying Novo Nordisk?

Adding to the pressure, semaglutide — the active ingredient in Ozempic and Wegovy — was selected for Medicare price negotiation under the Inflation Reduction Act in 2025. The negotiated price is set to take effect in 2027. Novo Nordisk has challenged the IRA provisions in court, so far without success.

The stock is reflecting the uncertainty. Shares closed Thursday at €32.97, down roughly 27 percent year-to-date and more than 53 percent below their 52-week high. The relative strength index has plunged to 17.8, deep in oversold territory. The distance to the 200-day moving average now exceeds 23 percent — a stark contrast to the record highs of last summer.

Yet the company continues to deploy capital. A share buyback program running through early May 2026 allows for repurchases of up to 3.8 billion Danish kroner, part of a broader 12-month program totaling up to 15 billion kroner. By mid-April, Novo Nordisk had already spent roughly 3.1 billion kroner on buybacks. The cash is flowing — but the political and competitive uncertainty remains.

All eyes now turn to May 6, when Novo Nordisk reports full quarterly results. Management will need to explain the weak outlook in detail. Longer term, the pipeline offers some hope: around the turn of the year, the FDA is expected to rule on CagriSema, the company’s closely watched successor drug. For now, though, the story is one of a company scrambling to hold its ground — in the clinic, in Washington, and on the trading floor.