The End of an Era? Novo Nordisk’s Sales Guidance Stumbles Amid Wegovy Headwinds

The Danish pharmaceutical giant Novo Nordisk (NVO) has been the poster child of the obesity drug boom, fueled by its blockbuster weight-loss treatments Wegovy and Ozempic. For years, the company repeatedly raised sales forecasts as demand surged, but 2025 is proving far less forgiving. Recent data and analyst warnings suggest the era of unchecked optimism for Novo’s growth trajectory may be ending—and investors are bracing for a reckoning.

The Plateauing Phenomenon

Wegovy’s meteoric rise has slowed. Despite Novo’s claims of boosting U.S. supplies to meet “booming demand,” weekly prescription data from IQVIA reveals stagnation: U.S. Wegovy scripts flatlined since mid-February 2025. Meanwhile, Eli Lilly’s rival drug Zepbound has surged, outpacing Wegovy by 128,000 prescriptions in the week ending April 11. This shift underscores a critical challenge: Novo’s dominance is no longer unassailable.

The FDA’s May 22 ban on compounded semaglutide—a cheaper alternative to Wegovy and Ozempic—adds further uncertainty. While Novo estimates 30% of U.S. semaglutide demand comes from these compounded versions, analysts doubt it can fully capture this market. Berenberg’s Kerry Holford argues affordability concerns and patient shifts to Zepbound will erode sales, even as compounded generics vanish.

Guidance Under Siege
Novo lowered its 2025 sales growth guidance to 16%–24% at constant exchange rates (CER) in February 2025, already a slowdown from 2024’s 26% growth. Now, that range faces its own reckoning. Bank of America analysts project a further cut to 14%–22%, the weakest since 2021, citing “sluggish” trends for Ozempic and Wegovy, currency headwinds, and rising costs. Barclays similarly reduced its Q1 estimates, noting flat U.S. prescription growth and inadequate volume gains.

The stock market has already priced in pessimism. Novo’s shares plummeted over 25% in March 2025—the worst monthly drop since July 2002—and hit a two-and-a-half-year low. Analysts at seven major firms have trimmed price targets since late March, reflecting investor anxiety over the company’s ability to defend its market share.

The Q1 Crossroads
The May 7 Q1 earnings report is a pivotal moment. Analysts expect sales to miss consensus estimates by 1%–2%, with Bank of America forecasting a full-year growth range below Novo’s original midpoint. Key metrics to watch:
- Wegovy’s U.S. prescription trends: Did they rebound after February’s stagnation?
- Zepbound’s momentum: How much market share has Lilly captured?
- Cost pressures: Did supply investments and marketing expenses eat into margins?

Long-Term Hurdles and Opportunities
While near-term risks are clear, Novo’s long-term prospects hinge on innovation and scale. The acquisition of three Catalent manufacturing sites—part of a $9 billion 2025 investment—aims to boost supply capacity by 2026. However, next-generation drugs like CagriSema face hurdles: its 22.7% weight-loss trial result missed earlier projections, and the FDA’s approval timeline remains uncertain.

Meanwhile, Lilly’s experimental pill orforglipron—recently shown to match Ozempic’s efficacy in diabetes trials—threatens to upend the market. If approved, it could bypass the need for injections altogether, a major competitive advantage.

Conclusion: A New Reality for Novo Nordisk
The writing is on the wall: Novo’s days of double-digit sales growth may be numbered. With Wegovy’s demand plateauing, Zepbound’s surge, and pipeline setbacks, the company’s 2025 guidance faces a high probability of further cuts. The May 7 earnings report will be the litmus test for whether management can justify its current outlook—or if a harsher reality demands a more modest path.

Investors should note:
- Valuation risks: Novo’s market cap has already shed $230 billion since December 2024, reflecting lost confidence.
- Competitive dynamics: Lilly’s pipeline and pricing power now rival Novo’s, eroding its pricing advantage.
- Supply chain bets: The $9 billion investment in manufacturing is a gamble—success hinges on winning back lost demand.

For now, the odds favor a guidance cut. As analyst Lukas Leu of Bellevue Asset Management put it, “The question is no longer if Novo will revise guidance, but how far it will retreat.” Until Wegovy’s growth resumes or next-gen drugs deliver, investors are right to be cautious.