Novo Nordisk A/S (NOVO:CA) Q1 2026 Earnings Call Transcript
Access earnings results, analyst expectations, report, slides, earnings call, and transcript.
Overview
The earnings call reveals mixed sentiments: strong product uptake and successful launches contrast with challenges like U.S. price erosion and supply limitations. Despite positive product feedback and strategic international expansion, the negative growth outlook for U.S. operations and expected decline in sales and operating profit are concerning. The Q&A highlights potential risks with patent expirations and competition. Overall, the sentiment is balanced with both positive developments and significant challenges, leading to a neutral outlook.
Key Financial Performance
Adjusted Sales Decreased by 4% year-over-year, driven by lower realized prices, partly offset by GLP-1 volume growth and market expansion.
U.S. Operations Sales Decreased by 11% year-over-year, partially offset by international operations growth of 6%.
GLP-1 Sales in Diabetes Decreased by 11% year-over-year, mainly driven by U.S. operations.
Obesity Care Sales Increased by 22% year-over-year, driven by both operating units. International operations grew by 44%, and U.S. operations grew by 9%.
Research and Development and Commercial Investments Invested about DKK 22 billion in the first quarter of 2026.
Shareholder Returns Returned nearly DKK 38 billion to shareholders through dividends and share buybacks.
Reported Sales Increased by 32% year-over-year, reaching DKK 96.8 billion. Adjusted sales declined by 4% due to exceptional and nonrecurring effects.
Adjusted Gross Margin Decreased to 80.6% from 83.5% in 2025, reflecting lower realized prices, one-time costs, and negative currency impact, partially offset by positive product mix from increased GLP-1 sales.
Adjusted Operating Profit Decreased by 6% year-over-year at CER, reflecting lower sales and gross profit combined with continued investments in R&D and commercial activities.
Full-Time Employees Decreased by almost 10,000 employees compared to 12 months ago, with the total number of employees around 68,000.
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Operating Highlights
Wegovy pill: Launched in the U.S. with over 1 million users in 16 weeks. It is the only oral peptide for obesity treatment and has shown record-breaking uptake.
Wegovy High-Dose (7.2 mg): Approved in the U.S., U.K., EU, and Brazil. Demonstrated 20.7% mean weight loss in trials with similar discontinuation rates as lower doses.
Etavopivat: Met co-primary endpoints in Phase III HIBISCUS trial for sickle cell disease, reducing VOC events by 27% and improving hemoglobin response.
UBT251: Phase II trials in China showed 19.7% weight loss in obesity and 2.16% A1c reduction in diabetes. Global trials planned for 2026 and 2027.
Obesity care sales: International operations grew by 44% to DKK 9.2 billion, driven by volume growth and market expansion, despite price reductions in China.
Wegovy franchise: Achieved 65% NBRx market share in the branded anti-obesity medication space.
R&D and commercial investments: Invested DKK 22 billion in Q1 2026 for research and development and commercial initiatives.
Employee reduction: Reduced workforce by 10,000 employees compared to 12 months ago as part of cost-saving measures.
Pipeline advancements: Initiated over 10 clinical trials and received 6 regulatory approvals in Q1 2026.
Savings reinvestment: Reinvested DKK 8 billion of savings from 2025 transformation into growth opportunities.
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Risk or Challenges
Sales and Profit Decline: Adjusted sales decreased by 4% in the first quarter of 2026, driven by lower realized prices. Adjusted operating profit also decreased by 6%, reflecting lower sales and gross profit.
U.S. Operations Performance: U.S. operations experienced an 11% decrease in sales, driven by lower realized prices and competition.
Market Competition: Intensifying competition in the GLP-1 product market, particularly in the U.S., is impacting sales and market share.
Regulatory and Pricing Challenges: Negative impacts from reduced obesity medication coverage in Medicaid and the Most-Favored-Nations agreement with the U.S. administration are affecting pricing and profitability.
Supply Chain and Cost Pressures: Lower gross margins due to onetime costs, negative currency impacts, and lower realized prices are pressuring profitability.
Patent Expiry: The compound patent expiry of the semaglutide molecule in certain markets is expected to negatively impact sales.
Employee Reductions: The company reduced its workforce by 10,000 employees compared to 12 months ago, which may pose operational challenges.
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Guidance & Outlook
2026 Adjusted Sales Growth: Expected to be between -4% and -12% at CER, driven by increased expectations for GLP-1 product sales and market expansion in obesity. However, negative impacts include compound patent expiry of semaglutide in certain markets and reduced obesity medication coverage in Medicaid.
2026 Adjusted Operating Profit Growth: Expected to be between -4% and -12% at CER, reflecting updated sales outlook and continued investments in R&D and commercial activities.
Wegovy Pill Uptake: Uptake is reflected in the outlook based on assumptions related to market penetration, potential negative impact on injectable obesity medication growth, and channel mix.
International Operations Outlook: Growth trends include continued volume penetration from GLP-1 treatments and market expansion, mainly within obesity. Negative impacts include price reductions in China and patent expiry of semaglutide.
U.S. Operations Outlook: Outlook based on current prescription trends for injectable GLP-1 portfolio, intensifying competition, and reduced obesity medication coverage in Medicaid. Lower realized prices linked to market access investments and Most-Favored-Nations agreement are assumed.
CagriSema Launch: Decision in the U.S. expected by the end of 2026, with a potential launch in 2027.
Wegovy FlexTouch Decision: Decision in the U.S. anticipated in 2026.
Wegovy Pill and High-Dose Launches: Wegovy pill and high-dose (7.2 mg) launched in the U.S. Wegovy pill is expected to drive market penetration with new patients and healthcare providers. High-dose Wegovy is expected to deliver greater weight loss with a 20.7% mean weight loss observed in trials.
Zenagamtide Trials: Phase III trials initiated for zenagamtide in obesity and related conditions. Additional trials expected in 2026, including AMAZE 9 and AMBITION programs.
Etavopivat Regulatory Submission: First regulatory submission for Etavopivat in sickle cell disease planned for Q4 2026.
UBT251 Trials: Global Phase Ib/IIa trial for obesity initiated, with results expected in 2027. Phase II trial for type 2 diabetes to start in Q2 2026.
Ziltivekimab Phase III Results: First readout from ZEUS Phase III trial in atherosclerotic cardiovascular disease and chronic kidney disease expected in Q3 2026.
Denecimig Regulatory Decisions: Regulatory decisions in the U.S. and EU for denecimig (Mim8) for hemophilia A expected in 2026.
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Shareholder Return Plan
Dividends: Novo Nordisk returned nearly DKK 38 billion to shareholders through dividends and share buybacks in the first quarter of 2026.
Share Buybacks: Novo Nordisk returned nearly DKK 38 billion to shareholders through dividends and share buybacks in the first quarter of 2026.
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Key Q&A
Q:What might be causing the drop-off in patients transitioning from 4 mg to 9 mg doses of oral Wegovy?
A:Management stated that titration is happening as expected and comparable to injectable Wegovy. They are pleased with the progress and see continued uptake of higher doses week-over-week.
Q:How is the supply of oral Wegovy and how many international markets can be sustained?
A:Management acknowledged that supply is not unlimited but highlighted record uptake in the U.S. They announced launches in the first markets outside the U.S. this year and plan a gradual international rollout.
Q:Why is SG&A at its lowest absolute number in several quarters despite a product launch?
A:Management explained that a one-off legal provision adjustment favorably impacted SG&A by over $100 million. They emphasized disciplined spending, fewer employees, and leveraging telehealth partnerships for scalability.
Q:Will there be any changes to oral Wegovy pricing, and how does it impact the price mix across the business?
A:Management stated that the current price is in the 'sweet spot' with strong volume uptake. They foresee potential price reductions in the long term as volume increases but believe the current pricing is appropriate for now.
Q:What is driving the success of the oral Wegovy launch, and what feedback has been received from patients?
A:Management attributed success to the product's efficacy (17% weight loss) and the attractiveness of the limited-time offer pricing. They believe the price elasticity is favorable and the product is well-received.
Q:Why were SG&A and R&D costs low in the quarter, and what is the expected trend?
A:SG&A was impacted by a one-off legal adjustment, and R&D costs were slightly lower than expected. Management plans to increase R&D investment in the coming quarters to support pipeline growth.
Q:What differentiates the next-generation GLP-1 product, and what changes has the new management member implemented?
A:Management did not provide specific details on the next-gen GLP-1 product but mentioned potential differentiation in efficacy, tolerability, and dosing frequency. The new management member highlighted opportunities to integrate market access, sales, and regulatory strategies.
Q:What is the impact of U.S. price erosion on Ozempic and the guidance for the rest of the year?
A:Management reported a continuation of 10-15% price erosion for Ozempic in the U.S. They increased confidence in their guidance, raising sales and operating profit ranges by 1 percentage point.
Q:What is the largest opportunity among Ziltivekimab trials, and how will Novo defend Wegovy IP in the U.S.?
A:Management sees high potential across all Ziltivekimab trials but acknowledges high risk due to first-in-class status. They intend to defend all patents in court if challenged.
Q:What is the long-term outlook for semaglutide pricing and manufacturing efficiency?
A:Management believes they are highly competitive in manufacturing efficiency and scale. They expect pricing dynamics to vary by market and do not see India as a proxy for other markets.
Q:What is the impact of generic semaglutide in Canada, and how does Novo view rare diseases as a growth area?
A:Management expects a low single-digit impact at the group level from Canadian generics and is prepared with savings cards and optionality. They see rare diseases as a strategic growth area.
Q:What feedback has been received on the Foundayo launch, and what is the dosing protocol for the AMAZE program?
A:Management reported positive feedback on Foundayo, emphasizing its efficacy and lower likelihood of discontinuation due to adverse events. The AMAZE program incorporates flexible dosing to help patients achieve full weight loss potential.
Q:What is the inventory impact on Wegovy pill sales, and why was the CagriSema co-formulation terminated?
A:Approximately $150 million of Wegovy pill sales were related to pipeline filling. The CagriSema co-formulation was terminated due to no production need, not technical issues.
Q:How will Novo reenergize the GLP-1 franchise in diabetes, and when will there be more visibility on tri-agonist profiles?
A:Novo plans to focus on efficacy and cardiovascular benefits in the U.S. and leverage high-dose launches and new products internationally. More data on tri-agonist profiles is expected next year.
Q:What is the approach to the ex-U.S. oral Wegovy launch and pricing levels?
A:Management plans to launch in select key markets with a strong focus, leveraging the halo effect from the U.S. launch. Pricing levels will depend on market dynamics.
Q:Review of Unclear Management Responses
A:Management avoided providing specific details on the next-generation GLP-1 product, stating only that it may have one or more differentiating traits. They also did not elaborate on the specific traits of the tri-agonist products, deferring further insights to future data releases.
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Earnings Word Cloud
The most frequently occurring keywords in this quarter's earning call
CER sale
EVP
Emil
GLP volume
HIBISCUS
High Dose
III trial
Member slide
Phase II
Phase III
UBT
VOC
VOCs
cell disease
competitiveness
dose device
endpoint
health
hemoglobin response
investment opportunity
line result
market expansion
milligram dose
obesity Phase
patient pill
placebo
safety tolerability
standard care
top
trial Etavopivat
trial result
trial zenagamtide
type diabetes
usage
user
zenagamtide people
NVO Transcript
Novo Nordisk A/S (NOVO:CA) Q1 2026 Earnings Call Transcript
Unknown5-6
The earnings call reveals mixed sentiments: strong product uptake and successful launches contrast with challenges like U.S. price erosion and supply limitations. Despite positive product feedback and strategic international expansion, the negative growth outlook for U.S. operations and expected decline in sales and operating profit are concerning. The Q&A highlights potential risks with patent expirations and competition. Overall, the sentiment is balanced with both positive developments and significant challenges, leading to a neutral outlook.
Novo Nordisk A/S (NOVO:CA) Q4 2025 Earnings Call Transcript
Unknown2-5
The earnings call summary indicates a mixed outlook. While there are positive elements such as a 16% increase in Wegovy sales and optimistic guidance for Wegovy pill demand, there are also concerns about declining U.S. sales and significant restructuring costs. The Q&A reveals uncertainties in volume uplift and market dynamics, particularly in the obesity sector. These mixed signals, along with stable but not exceptional financial metrics, suggest a neutral sentiment, expecting minimal stock price movement in the short term.
Novo Nordisk A/S (NVO) Q3 2025 Earnings Call Transcript
Unknown11-5
The earnings call reveals several concerns: lowered sales and profit growth outlooks, market share loss in the GLP-1 market, and challenges in the U.S. obesity market. Despite some optimistic guidance and strategic initiatives, the lowered growth expectations and uncertainties in regulatory approvals and market dynamics create a negative sentiment, likely leading to a stock price decline of -2% to -8%.
Novo Nordisk A/S (NVO) Q2 2025 Earnings Call Transcript
Positive8-6
The earnings call reflects strong financial performance with an 18% sales growth and 20% operating profit increase. The company's strategic initiatives, such as partnerships and market expansions, are promising. While there are some uncertainties in litigation and pricing strategies, management's confidence in growth, particularly in China, and the launch of new products like oral Wegovy, supports a positive outlook. The guidance suggests continued strong performance, and there's optimism in overcoming challenges like LOE impacts. Overall, the sentiment is positive, with potential for stock price appreciation.
NVO Slides
NVO Report
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