Novo Nordisk Forecasts 2026 Sales Drop as Lilly Projects $83B

Novo Nordisk has forecast that 2026 sales will fall between 5% and 13%, ending years of double-digit growth, while rival Eli Lilly projects 2026 sales of $80bn to $83bn, up from $65bn last year.

Novo Nordisk's guidance shock

Denmark-based Novo Nordisk, the manufacturer of Ozempic, Wegovy and Rybelsus, saw its share price plummet 17% on the day the forecast was issued, erasing all gains for the year. Over the prior year, the stock had lost nearly 50% of its value.

Total 2025 sales grew 10% to 309bn Danish kroner (£36.6bn), with profit before tax rising 3% to 130.5bn kroner. Chief executive Mike Doustdar, who succeeded Lars Fruergaard Jørgensen in August, described the 2026 outlook as reflecting "a year of unprecedented pricing pressure".

Lilly's contrasting trajectory

Eli Lilly, maker of Mounjaro and Zepbound, last year became the first pharmaceutical company worldwide to hit a $1tn valuation. Its 2026 sales guidance of $80bn to $83bn represents a 45% increase over 2025. Lilly shares rose 9.5% by lunchtime US time on the day of the announcements.

The BMJ reported that tirzepatide products from Eli Lilly "are growing fast in market share and are projected to overtake semaglutide as the leading GLP-1 drug within the next few years, though semaglutide still holds the largest overall proportion at the time of writing".

Canadian pricing dynamics

Novo Nordisk's semaglutide patent lapsed in Canada after the company did not pay the C$250 annual patent maintenance fee since 2018, and a separate regulation expired on 5 January 2026. Novo Nordisk told the BMJ in an email that "all intellectual property decisions are carefully considered at the global level".

Novo will keep semaglutide patent protection in Europe and Japan until 2033, and in the US until 2032. The BBC reported that Novo Nordisk has stated the Canadian generics situation "is a localized situation based on our specific patent timelines and regulatory environment and does not reflect the situation in the United States, where exclusivity remains intact".

Response strategies in Canada

According to Mina Tadrous, a pharmacist who studies drug policy at the University of Toronto, Novo Nordisk "is offering brand name cards-discount cards issued directly by a drug manufacturer-to cover the difference in cost, and an advertising campaign in Canada now encourages patients to ask for brand name Ozempic".

Tadrous told the BMJ: "Once we hit three on the market the pricing framework will allow them to be substantially cheaper," adding that out-of-pocket costs should drop to around 35% of the brand name price, bringing them to around C$100 per month. Current listed pharmacy pricing tracked on GLP1Prices.ca shows Ozempic ranging from C$86.40 to C$663, and Wegovy from C$270 to C$550.

Pipeline pressures

Novo's Wegovy oral formulation reached 50,000 US prescriptions a week by late January after launching earlier that month, priced between $149 and $299 a month for cash payers depending on the dose. Finance chief Karsten Knudsen described the launch as a "fantastic update". Lilly is expected to launch its own oral GLP-1 in the spring, subject to regulatory approval, with plans to limit higher doses to $399 a month for repeat cash buyers.

For Canadians tracking generic timelines, our generic semaglutide tracker, insurance coverage checker and FAQ are updated as filings advance.

This article is for informational purposes only and does not constitute medical advice.

Sources

• Wegovy and Ozempic maker forecasts sharp drop in ...
• Ozempic generic approved in Canada after Novo Nordisk ...
• Why Canadians can now get cheaper generic Ozempic