NVO · Novo Nordisk A/S

Novo Nordisk’s Q1 2026 results reflect a pronounced dichotomy between reported and adjusted performance, driven entirely by the reversal of a USD 4.2 billion (DKK 26.8 billion) provision related to the US 340B Drug Pricing Program — a non-cash, non-recurring item explicitly excluded from adjusted metrics. On an adjusted basis, sales declined 4% at constant exchange rates (CER) to DKK 70,063 million, primarily due to lower realized prices across key products, especially Ozempic® and Rybelsus®, which saw adjusted sales declines of 8% and 15% at CER respectively. This pricing pressure was only partly offset by robust volume growth: Wegovy® injectable sales rose 12% at CER, Wegovy® pill generated DKK 2,256 million in its first quarter post-launch, and total Obesity care sales grew 22% at CER. Adjusted operating profit fell 6% at CER to DKK 32,858 million, with adjusted operating margin contracting to 46.9% from 49.9% in Q1 2025, underscoring margin sensitivity to price erosion despite volume gains. Notably, the company raised its full-year 2026 guidance — now expecting adjusted sales and operating profit growth in the range of -4% to -12% at CER — citing accelerating adoption of Wegovy® pill (over 2 million prescriptions since January), successful launches of Wegovy® HD and Awiqli®, and positive phase 3 data for etavopivat. Management emphasized that the strength of oral and high-dose GLP-1 offerings, combined with expanded access initiatives including the Medicare Part D pilot launching 1 July 2026 and upcoming list price reductions effective 1 January 2027, underpins confidence in sustained commercial momentum despite near-term pricing headwinds.