Novo Nordisk entered 2026 with the momentum of a historic year in more ways than one – but recent weeks have delivered more drama than most companies might expect over a decade.

The Danish drugmaker kicked off the year with the explosive launch of the first-ever GLP-1 pill for obesity. Its recent challenges have centered around protecting its market share in the blockbuster weight loss drug market, all while its stock price swings wildly.

This week, Novo sued upstart telehealth provider Hims & Hers for alleged patent infringement and received its own warning from the U.S. Food and Drug Administration for what the agency says is misleading claims in advertising. That all followed a 2026 outlook that disappointed investors and stood in stark contrast to its chief rival, Eli Lilly. 

While Lilly guided to 2026 sales growth of 25%, Novo forecast that sales and profits could decline as much as 13% this year. 

“Enough has occurred in the past week to occupy a few volumes,” said Deutsche Bank analyst Emmanuel Papadakis on Tuesday, as he — like many of his Wall Street peers — lowered his price target on the stock following the gloomy outlook.

The rapid news flow has given investors whiplash. So far in February, U.S.-listed Novo shares have traded across a spread ranging from $43.24 to $64.16, shedding as much as 14% in a single day only to gain 10% back in a later session. 

The latest developments add to a thorny situation for Novo as it risks being edged out by Lilly and the growing number of people taking cheaper compounded versions of semaglutide, which are unapproved copycats of Novo’s Wegovy jab.

CEO Mike Doustdar, who took the reins in August after the former CEO was ousted over misjudging the U.S. market and challenges there, has a plan to steer the company through what’s been described as a “show me” year. 

His agenda is extensive: cracking down on those compounded knock-offs, sustaining strong demand for its newly launched obesity pill, building prescription volumes in the U.S. and bringing new, next-generation obesity and diabetes treatments to market.  

In an interview with CNBC on Wednesday, Doustdar acknowledged the challenges ahead but said 2026 “is also a year of growth in many ways.” 

“We will have more patients this year than ever before, we will produce more than last year and years before that,” he said. 

Doustdar said around 246,000 patients are currently on the company’s Wegovy pill, which launched at the beginning of January and is already outpacing the early rollouts of existing GLP-1 injections.

“This, of course, tells me that while the investors are feeling a bit of a headwind on the pricing side and the whole business as you’re alluding to, they are hopefully getting convinced that over a period of time that would wash out and that growth will come,” Doustdar said. 

Novo has repeatedly cited compounding pharmacies as a key reason for its slowing sales growth. The company estimates 1.5 million Americans are currently taking the copycat weight loss drugs offered by Hims & Hers, as well as some wellness clinics and compounding pharmacies. 

Telehealth firms like Hims have profited massively from selling so-called compounded versions of injectable semaglutide under a regulatory loophole that allows other companies to sell copycats of the drugs if the branded medicines are in short supply. While branded semaglutide injections are no longer in short supply after a notable demand spike, the companies have continued to mass market cheaper versions directly to consumers, raising legal questions. 

“We understand why compounding, mass compounding, got started. It was on the back of a shortage. We really don’t understand why it continued,” Doustdar told CNBC on Wednesday, noting that Novo’s opposition has nothing to do with medically necessary compounding for individual cases. 

Hims last week announced plans to sell a compounded version of Novo’s newly launched Wegovy pill for roughly $100 less than Novo sells the branded version for, though it quickly backed down after Novo said it would sue over patent infringement and the FDA announced a broader crackdown on compounding. The agency also said it had referred Hims to the Department of Justice over potential violations. 

Novo moved to sue Hims on Monday over compounded versions of both injectable and oral semaglutide, adding to more than 130 lawsuits the drugmaker has filed against pharmacies, wellness clinics and other firms unlawfully marketing those copycats. 

“The news last Thursday about the pill… was seen as kind of the last straw for many people,” Rothschild & Co Redburn analyst Simon Baker told CNBC. 

From the point of view of U.S. regulators, removing cheaper drugs from the market at a time when the Trump administration has made lower drug prices for Americans a priority might not have been an easy sell, Baker said. 

But, “when we got the move on the pill, there was a realization that this has just gone a little bit too far,” he added. “You can’t have people launching knock-off versions of pills five weeks after the brand gets launched.”

“That would destroy the industry.”

If Novo can get the compounding issue under control, the company can potentially win back some market share and turn things around for sales projections, said BMO Capital Markets analyst Evan Seigerman. 

Doustdar called it “a very strong signal” that the government acknowledged the compounding fight with Hims and “articulated that very publicly. We welcome that.” 

Of course, a government crackdown on compounding wouldn’t clear the way for Novo alone. 

Lilly’s obesity drug Zepbound already enjoys significant market share, and the company is preparing to launch its own oral version. 

Novo’s guidance likely doesn’t include any reduction in the volume of compounded drugs on the market, as the FDA’s announcement of its “decisive steps” to restrict GLP-1 compounding came after the guidance was released. 

But the price sensitivity of consumers for weight loss drugs remains a big unknown, which makes greater volumes and more access points important. 

Novo is anticipating Medicare coverage for weight loss treatments, expected to begin later this year, to open up a 15 million-patient opportunity, Doustdar told CNBC. 

Around 67 million Americans are covered by Medicare, but “when you take a look at specifically our products and the target group, I think around 15 million people would be a good number to target,” Doustdar said. Though he said Medicare access to obesity treatments will open up gradually. 

Novo Nordisk CEO Mike Doustdar on Wednesday said the company is aiming to capture around 15 million new patients, at least initially, when Medicare starts covering obesity treatments for the first time later this year.

Around 67 million Americans are covered by Medicare, but “when you take a look at specifically our products and the target group, I think around 15 million people would be a good number to target,” he told CNBC in an interview. 

Medicare is slated to start covering obesity medicines for the first time later this year under the landmark “most favored nation” drug pricing deals that Novo and its chief rival Eli Lilly struck with President Donald Trump in November.

Health experts say the long-awaited coverage could broaden the market for the medicines and spur more private insurers to cover them. Some experts estimate that 20 million to 30 million Medicare patients are suffering from obesity and related conditions.

Doustdar said Medicare coverage, along with the launch of Novo’s new obesity pill and other factors, should help the company gradually boost prescription volumes and offset lower prices in the U.S. following that agreement with Trump. 

But he said he doesn’t expect Medicare access to obesity treatments to open up overnight. 

“Now, it would be great if we could find a way to get access very, very fast. But I think that would be a bit naive,” Doustdar said, pointing to the slow adoption seen among eligible patients with commercial insurance. 

It’s a slightly more conservative tone on the initial impact of Medicare coverage compared to Lilly, which has cited that coverage as a key tailwind to its guidance this year. Last week, Lilly said it expects Medicare coverage to come online by July. 

Meanwhile, Doustdar said Novo is in the midst of negotiations with the government on “exactly which month, which week that is going to be opening.”