Novo Nordisk’s Oral Push Marks a Sales Milestone as Trial Setbacks and Rival Pressure Keep the Spotlight on the Pipeline

Novo Nordisk is getting one piece of good news that is easy to count: Wegovy has now passed five million prescriptions since launch. The Danish drugmaker said on Thursday that the oral weight-loss treatment logged more than 265,000 weekly prescriptions in the week to July 17 and remained the leading prescription obesity medicine in the US by new patient starts. The rollout outside the United States is also said to be progressing encouragingly, helped by the introduction of the higher-dose Wegovy HD at 7.2 milligrams.

That commercial progress has landed alongside a far rougher readout from the laboratory. Novo Nordisk’s experimental CagriSema failed in the REDEFINE-4 study to show non-inferiority versus Eli Lilly’s tirzepatide, including under both ideal conditions with perfect treatment adherence and a more real-world scenario. Separately, the company’s phase 3 ZEUS trial of Ziltivekimab in patients with atherosclerosis, kidney disease and elevated inflammation reached its biological target but did not reduce major cardiovascular events versus placebo.

The stock has reflected that push and pull. Novo Nordisk shares closed on Friday at EUR 40.99, up 2.69 percent on the day, but still 25.27 percent below the 52-week high of EUR 54.86. The same closing level also sits exactly at the 50-day average, underscoring how little directional conviction the market currently shows. Since the start of the year, the shares are down 6.88 percent.

Investor nerves have been fed not just by the clinical setbacks, but by the sense that Eli Lilly is increasingly dictating the tempo in the GLP-1 market. Lilly posted strong second-quarter growth across the group, powered by Mounjaro and Zepbound, and also lifted its full-year outlook. Novo Nordisk, by contrast, delivered a raised annual forecast last Tuesday, only to see the mood darken again after disappointing study results last Thursday. Citi has since cut its target price for Novo Nordisk to 310 Danish kroner from 330, while BMO Capital raised its target to $47 and kept its “Market Perform” rating. Several other major houses have maintained broadly neutral views after the quarterly results.

On the legal front, Novo Nordisk secured a different kind of win. A district court in the Netherlands issued a preliminary injunction on Wednesday against the pharmacy Ceban Ziekenhuisfarmacie, which had been distributing a compounded semaglutide nasal spray. Reuters reported that the court found a breach of Novo Nordisk’s supplementary protection certificate for semaglutide and ordered Ceban to remove product listings, disclose supply-chain information and cover the company’s legal costs.

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In the US, Novo Nordisk also faced and then overcame another challenge. A federal judge rejected an antitrust complaint brought by Strive Specialties, which had accused Novo Nordisk and Eli Lilly of using exclusive telehealth partnerships to block access to compounded copies. The court ruled that compounded medicines and branded drugs do not belong to the same market.

The company is also pruning its own research portfolio. It has stopped development of Monlunabant for portfolio reasons after Ziltivekimab missed its main endpoint in ZEUS. Two other cardiovascular studies of Ziltivekimab, HERMES and ARTEMIS, are continuing, with results expected in the first half of 2027.

Even as some programs falter, Novo Nordisk is still buying back stock. Since the repurchase programme began, the company has acquired around 27.1 million B shares and now holds just under 1.0 percent of share capital as treasury stock. The buyback is worth up to 15 billion Danish kroner over 12 months, a sign that management still sees value in the business despite the volatility.

The rivalry with Eli Lilly remains the defining backdrop. Novo Nordisk has now shown that Wegovy can continue to draw prescriptions at scale, but the next set of CagriSema data and the company’s fight to defend its position in court will matter just as much. For investors, the story is no longer about a monopoly-like lead in obesity drugs. It is about whether Novo Nordisk can keep pace in a market that has become a two-horse race.