A stock that has lost more than 70% of its value from the peak tends to invite hard questions, and Novo Nordisk A/S (NYSE:NVO) is now facing them from its own investors. Late September 2026 brought renewed pressure on the company to explain what comes after its weight-loss drug franchise, as analysts project Eli Lilly’s Zepbound will outsell Novo’s Wegovy by more than $7 billion this year.
Novo did raise its 2026 sales and profit growth guidance to a range of 0% to negative 6% at constant exchange rates from a prior negative 4% to negative 12%. The semaglutide patent timeline varies by country: generic competition began entering markets, including India in 2026, even though protection in major Western markets holds into the early 2030s.
For investors, the question isn’t whether Novo still has a valuable core business; it clearly does, but whether management can build a credible second act before that core business starts losing ground on multiple fronts at once.
Look Into: Novo Nordisk (NVO) Pulls the Plug on Two More Heart Drug Trials
Bull Case
Novo Nordisk A/S (NYSE:NVO) raised its 2026 sales and operating-profit growth outlook to a range of 0% to negative 6% at constant exchange rates, from negative 4% to negative 12%. The business still faces contraction. However, the higher range gives management more room to fund pipeline work and suggests that current operations have stabilized more than investors previously expected.
A share-price decline of more than 70% from the peak has already removed much of the valuation premium that Wegovy created. Novo does not need to regain its former dominance for the stock to improve. Clearer medium-term targets, stronger pill sales, or a credible acquisition could change expectations from a deeply pessimistic base.
CEO Mike Doustdar has already cut costs, ended weak programs, and pursued targeted acquisitions and partnerships. Novo has five oral candidates in development, expects pills could capture as much as half of the obesity market by 2030, and holds delivery-technology patents that extend into the mid-to-late 2030s. That oral strategy could differentiate the franchise beyond the injectable patent cycle while management builds a broader pipeline.
Bear Case
Novo Nordisk A/S (NYSE:NVO)’s pipeline has not yet produced the growth bridge that investors need. The company halted trials of heart drug ziltivekimab; CagriSema disappointed investors. Analysts describe the late-stage pipeline as sparse. Those setbacks make management more dependent on acquisitions or early-stage programs that carry additional cost and development risk.
Analysts expect Eli Lilly’s Zepbound sales to top Wegovy by more than $7 billion this year. With the obesity market potentially exceeding $100 billion by the early 2030s, every point of share that Novo loses carries a large opportunity cost. It also raises the amount of profit that smaller therapeutic areas must replace.
Semaglutide already faces generic competition in markets including India, Canada, and Brazil after 2026 patent expiries, even though protection lasts longer elsewhere. Those launches expose Novo to price erosion before the larger early-2030s patent cliff. It also gives investors an early test of how quickly cheaper copies can weaken branded sales and margins.
Hedge Fund Sentiment
Novo Nordisk A/S (NYSE:NVO)’s hedge fund count rose to 59 in the second quarter of 2026 from 55 in the first, with position value climbing to $2.00 billion from $1.79 billion, according to Insider Monkey’s database. Eli Lilly, its chief rival in the weight-loss category, saw a much sharper increase, with holders rising to 152 from 132 and position value jumping to $17.24 billion from $12.58 billion.
Conclusion
Novo’s improved guidance, oral-drug position, and depressed valuation give management room to rebuild expectations. However, Lilly’s widening lead, recent trial failures, and generic semaglutide launches in early-expiry markets make diversification urgent now rather than only in the next decade. Novo can find a second act. But investors need evidence that its oral portfolio, pipeline, and acquisitions can create material revenue before price pressure spreads to its largest markets.
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