Novo Nordisk raises its 2026 outlook as Wegovy pill sales hit DKK 5.4 billion, but US sales are still falling

Novo Nordisk raised its full-year outlook on Wednesday after a third quarter that beat its own expectations, according to its financial report filed with the SEC. Adjusted sales growth for 2026 is now guided to -2% to +2% at constant exchange rates, up from -6% to 0% in August. Adjusted operating profit growth gets the same new range. As of 2:27 pm ET the company's U.S.-listed shares traded at $42.68, up 6.2% on the day, according to the Nasdaq quote feed.

What changed in the guidance

The floor rose four points and the ceiling two. The midpoint moves from a 3% decline to flat, for both sales and adjusted operating profit. Novo also tightened the currency drag: it now expects reported kroner growth to match constant-currency growth on sales, where in August it had flagged a drag of about one percentage point.

The cash numbers moved more than the headline. Free cash flow is now guided to DKK 60 to 70 billion, from DKK 45 to 55 billion, and capital spending to about DKK 50 billion, from DKK 55 billion. Novo said that reflects the better profit outlook, lower capital expenditure and working-capital improvements.

The number behind the number

Look at the free cash flow range against what Novo has already banked. In the first nine months it generated DKK 83.8 billion of free cash flow, which is already above the top of the full-year range. Mechanically, the guide implies fourth-quarter free cash flow of roughly negative DKK 14 to 24 billion. Novo says the nine-month figure was lifted by phasing of operating expenses and the timing of U.S. rebate and tax payments, so some of that cash is expected to flow back out. The filing does not break out the fourth-quarter amount, so treat our arithmetic as an implication, not a forecast from the company.

The quarter itself: net sales were DKK 79.2 billion, up 4% at constant rates. Adjusted operating profit was DKK 31.7 billion, up 27%, helped by an easy comparison with DKK 9 billion of company-wide restructuring costs booked in the third quarter of 2025. Reported operating profit actually fell 9% because of DKK 8.7 billion of non-cash impairments: DKK 4.6 billion on ziltivekimab, whose two phase 3 trials missed their primary endpoint, and DKK 4.1 billion on a smaller manufacturing network.

Obesity is carrying the company

Q3 2026, adjusted sales	DKK million	Growth, constant rates
Total obesity	26,146	+22%
Total diabetes	47,545	-5%
Wegovy pill	5,394	new product
Wegovy injectable	20,407	-2%
Ozempic injectable	29,706	-5%

The Wegovy pill's DKK 5.4 billion was about 6.8% of the quarter's sales, and the company says it is now launched in eight countries. Obesity is about a third of total sales (33%), diabetes about 60%. That mix matters: the faster-growing third is still smaller than the shrinking sixty percent, which is why the full-year range straddles zero rather than sitting comfortably above it.

The U.S. is still the soft spot

The raise is mainly an international story. U.S. Operations diabetes sales fell 11% to DKK 24.0 billion, while International Operations rose 2% to DKK 23.5 billion. Within the U.S., GLP-1 diabetes sales were down 10%, which Novo ties to lower volumes and wholesaler inventory movements, and insulin fell 13%, which it attributes to lost market share, a shrinking insulin market and lower realized prices. The company's guidance explicitly assumes sales growth in International Operations and a sales decline in U.S. Operations for the year.

Novo also says the Wegovy franchise holds more than 50% of new patient starts in the U.S. branded obesity market, and that weekly new-to-brand prescriptions for its Ozempic pill are up about 100% from where Rybelsus stood before launch. Separately, the filing says Novo will lower the list price of Wegovy injection from January 1, 2027, so the U.S. price line is a known headwind next year.

Who this touches

For traders, the shares came into the print a third below their January high, with a 52-week range of $35.12 to $64.16, so a guidance raise that still centers on flat growth is a repair, not a breakout. For employers and small-business owners who pay for health coverage, the pill's rollout and the 2027 list-price cut are the two things to watch in plan renewals, but Novo's report says nothing about what insurers or employers will pay, and we have no data on that yet. The company still has a pipeline event ahead: it says it is preparing a U.S. launch of CagriSema in early 2027, subject to regulatory approval.

Sources: Novo Nordisk Company Announcement No 65/2026 (Form 6-K, SEC EDGAR); Novo Nordisk filings on SEC EDGAR; share price via Nasdaq.com, delayed and read at 2:27 pm ET. Related: more stock coverage. This is market information, not investment advice.