The internal and external challenges faced by the weight loss giant Novo Nordisk are intensifying

On February 24, industry sources reported that Novo Nordisk announced that starting January 1, 2027, the list price of its weight loss drug (semaglutide) in the U.S. market will be reduced by 50%, with the monthly fee lowered to $675.

On February 23, after the European stock market opened, Novo Nordisk’s stock price plummeted sharply, dropping over 15% during trading and hitting its lowest level since June 2021. As of the close on February 24, its stock price was $38.59 per share, down 2.62%, with a total market capitalization of $171.6 billion.

In terms of news, head-to-head clinical trial results for Novo Nordisk’s next-generation weight loss drug CagriSema, compared directly with Eli Lilly’s weight loss drug Tirzepatide, showed that over 84 weeks, CagriSema achieved a 23% weight loss, which is less effective than Eli Lilly’s Tirzepatide, which achieved a 25.5% weight loss.

Stock Price Impact

CagriSema was once highly anticipated, with Novo Nordisk positioning it as a more potent successor to semaglutide, and expecting 60% of future growth to come from it. The release of the latest head-to-head data suggests this hope may be dashed. However, Novo Nordisk stated that it plans to conduct higher-dose clinical trials later this year.

The underperformance of the new product development directly affected Novo Nordisk’s stock price. In June 2024, the company’s market value soared to a record high of $650 billion, making it the most valuable listed company in Europe. At that time, its market cap surpassed German software giant SAP and also exceeded LVMH, ASML, and other European industry leaders, widely regarded as the “European new market cap king.”

Subsequently, due to the disappointing clinical trial results of the next-generation weight loss drug CagriSema, better performance of Eli Lilly’s Tirzepatide, and market concerns over the growth prospects of GLP-1 drugs, Novo Nordisk’s stock price continued to decline, and its market value shrank significantly. By February 2026, the company’s market cap had evaporated over $470 billion from its peak, falling below $180 billion, with the stock price returning to pre-2021 semaglutide listing levels.

In contrast, Eli Lilly’s stock price unexpectedly gained momentum, with its market cap approaching $1 trillion again. Lilly expects demand for Tirzepatide as a weight loss drug to continue growing rapidly through 2026. The company also plans to launch an oral weight loss drug, orforglipron, in the second quarter of this year. This will further intensify competition with Novo Nordisk’s already approved oral semaglutide.

Amid multiple adverse factors, Novo Nordisk issued its 2026 performance guidance on February 23, projecting a 5% to 13% decline in full-year sales at constant exchange rates, marking the company’s first annual sales decline in nine years.

J.P. Morgan analysts stated that the clinical trial results of CagriSema falling short of expectations are a significant setback for Novo Nordisk, potentially dampening demand for CagriSema, weakening long-term sales outlook, and making it difficult for the company to regain market share in the rapidly growing weight management market.

CagriSema combines the mimetic pancreatic hormone component Cagrilintide and GLP-1 semaglutide, administered once weekly. J.P. Morgan’s Jefferies analysts noted: “What’s truly troubling is that Novo Nordisk’s valuation heavily depends on CagriSema, which, like semaglutide, faces technical development challenges. The trial failure, combined with commercialization uncertainties from competition, makes it hard for long-term investors to feel secure.”

Patent Cliff Approaching

Novo Nordisk began research on semaglutide as early as 2012, and it was only approved in the U.S. for adult obesity in 2021. Once approved, the explosive weight loss market surged. However, shortly after reaching the “pharmaceutical king” position, a bigger crisis loomed. In China, the core patent for semaglutide’s molecule will expire in 2026, allowing many low-cost generics to enter the market.

March 20, 2026, marks the expiration date of the core patent for semaglutide in China. Industry experts believe that for Novo Nordisk, the patent expiry may be more damaging than the trial failure of CagriSema.

With the global obesity population continuing to rise, the weight loss drug market shows enormous growth potential. According to forecasts, by 2030, the global market for weight loss drugs could exceed $150 billion, intensifying industry competition.

In the domestic market, over ten Chinese pharmaceutical companies, including Jiyuan Gene, Livzon Group (000513), Huadong Medicine (000963), Qilu Pharmaceutical, and Chia Tai Tianqing, have had applications for generic semaglutide accepted, with more than ten in Phase III clinical trials. Once the patent cliff passes, domestically produced semaglutide will flood the hospital market at prices of a few hundred yuan or even lower.

The competition in the weight loss drug market is intensifying. Recently, Eli Lilly announced plans to invest over $3.5 billion (about 24.3 billion RMB) to build a new manufacturing base for injectable drugs and devices in Lehigh Valley, Pennsylvania.

Besides Lilly, since 2026, many Chinese pharmaceutical companies have accelerated their layout in weight loss drugs. For example, on January 30, CSPC Pharmaceutical Group announced a strategic R&D and licensing agreement with AstraZeneca. The partnership will leverage CSPC’s proprietary sustained-release drug delivery platform and peptide drug AI discovery platform to jointly develop innovative long-acting peptide drugs, with a potential total value of up to $18.5 billion.

Under the agreement, AstraZeneca will obtain exclusive global rights to CSPC’s monthly injectable weight management product portfolio, including a project, SYH2082, already in clinical trials, and three other preclinical projects with different mechanisms.

On January 30, Borui Medicine disclosed and updated several innovative weight loss pipelines at the preclinical and PCC stages. The new pipelines include oral and long-acting injectable formulations based on the Amylin pathway, as well as key directions such as lean body mass preservation and fat tissue metabolism regulation, including oral peptide BGM1812, long-acting selective amylin receptor agonist BGM1962, MSTN cyclic peptide injections for maintaining lean mass, and ALK7-targeted siRNA projects with ultra-low frequency dosing potential.

On January 28, Hengrui Medicine (600276) announced that its subsidiary Shengdi Medicine received approval from the National Medical Products Administration for its innovative oral small-molecule GLP-1 receptor agonist HRS-7535 tablets, allowing Phase III clinical trials for the treatment of chronic kidney disease. HRS-7535 is a new oral small-molecule GLP-1R agonist, with no similar products currently on the market globally.

Price War Has Begun

With competitors emerging, the “price war” for semaglutide has fully erupted, with discounts approaching 50%. Some e-commerce platforms offer even lower prices with subsidies, and domestic generics are about to enter the market, further intensifying competition.

It is reported that Novo Nordisk has proactively applied to lower the online listed price of its weight loss version of semaglutide (brand name: Wegovy) in Sichuan Province. The 2.27mg/ml×3ml specification was reduced from 1,893.67 yuan to 987.48 yuan; the 3.2mg/ml×3ml specification from 2,463 yuan to 1,284.36 yuan, effectively halving the hospital listing price.

Online platforms like Meituan and JD Health offer even lower actual transaction prices after subsidies. For example, Wegovy’s same specification has been sold for as low as 921 yuan on some platforms, and the blood sugar-lowering version, Ozempic, has also seen discounts of over 14%.

Financial reports show that in 2025, Novo Nordisk China’s revenue was 18.658 billion Danish kroner (about $2.83 billion), a 5% increase year-over-year. Among these, the full-year sales of semaglutide in China were approximately 6.815 billion Danish kroner (about $1.079 billion): the blood sugar injection Ozempic contributed 5.399 billion Danish kroner, and the weight loss version Wegovy contributed 796 million Danish kroner (a 314% increase year-over-year).

Industry analysts say this performance is more like a “pre-retreat charge.” Over the next two years, the prices of single-target GLP-1 drugs like semaglutide may face an “avalanche”; after mass generic entry, prices could drop to about one-third of the original brand-name drug.

It is worth noting that Eli Lilly’s Tirzepatide (a dual-target drug), a major competitor to semaglutide, is also reducing prices simultaneously. After inclusion in the national insurance, Tirzepatide’s in-hospital price has dropped by over 80%, with the lowest single-dose price down to 81 yuan; e-commerce platforms are offering “80% off” promotions, with pre-sale prices for 10mg doses as low as 450 yuan, further intensifying market competition.

Moreover, the GLP-1 market is no longer just a contest between Novo Nordisk and Lilly. Global pharmaceutical giants like Roche, AstraZeneca, Merck, Amgen, and Pfizer are actively entering the obesity treatment field through acquisitions of biotech companies. A comprehensive market competition landscape is forming, and for Novo Nordisk, rebirth will not be easy.