Novo Nordisk A/S has encountered a turbulent 2025, marked by a continuous decline in its stock price, intensifying market competition, and internal disagreements that led to the collective departure of board members. Indications at the start of this year suggest the company's difficulties are far from over.

Last Wednesday, the pioneer in the weight-loss drug sector issued disappointing sales and profit forecasts, causing its stock to plummet nearly 20%. The following day, U.S. telehealth company Hims & Hers announced the launch of a generic version of Novo Nordisk's Wegovy, priced significantly lower than the original, dealing another heavy blow to the Danish firm.

Although Meihao Health stated last Saturday that it would stop selling the discounted generic drug after "constructive communication" with industry stakeholders, providing temporary relief for Novo Nordisk, the incident still highlights the severe challenges the company currently faces.

The launch of the generic version had angered the Danish pharmaceutical company, with Novo Nordisk even threatening legal action. Prior to this, Novo Nordisk had announced last Wednesday that it expects its net sales to decline by up to 13% this year, a pessimistic forecast that exceeded even the most bearish analyst predictions.

Mike Doustdar, who became CEO of Novo Nordisk last August, has been grappling with finding new growth areas for the company, whose Ozempic and Wegovy are global blockbuster drugs. Facing a stock price that has fallen more than 50% over the past year, he has warned that further declines are possible.

Markus Manns, a senior portfolio manager and healthcare expert at German asset manager Union Investment, stated, "I agree with the view that the company will face short-term pain." He called Novo Nordisk's earnings guidance "shocking."

He added, "With such guidance, it is very difficult to see where the end of these troubles lies."

Beyond pressure from the increasingly competitive weight-loss drug market, Novo Nordisk is also experiencing what Doustdar termed "unsustainable" price reductions in the United States, while patents for some of its core markets are nearing expiration.

The company, which once held the top spot in European market capitalization, ousted its former CEO last year due to disagreements with its majority shareholder, the Novo Nordisk Foundation, over how to curb slowing profit growth and the falling stock price, leading to a collective board departure. Novo Nordisk now risks falling further behind its U.S. rival Eli Lilly. Lilly announced this Wednesday that its 2026 sales would increase significantly from last year's $65 billion to at least $80 billion, causing its stock price to rise.

Novo Nordisk attributed the dismal guidance to what Doustdar called "unprecedented pricing pressure" in the U.S. market, its largest market. Drug pricing policies introduced by U.S. President Donald Trump will directly limit Novo Nordisk's pricing flexibility.

Under the terms of the Most Favored Nation agreement, drug prices in the U.S. market must align with the lowest prices for those drugs in other developed countries.

This means that for Novo Nordisk's semaglutide injectable and semaglutide weight-loss formulations, the monthly cost when purchased through Trump's new direct-to-consumer online platform, TrumpRx, will drop from at least $1,000 to $350.

The company will also reduce drug prices for patients covered by the two major government health insurance programs, Medicare and Medicaid.

Novo Nordisk's CFO, Karsten Munk Knudsen, stated that the new U.S. drug pricing model will impact company sales in two ways: revenue from consumers paying out-of-pocket and revenue from insurance reimbursements. However, the price cuts are also expected to boost sales volume.

He said, "As a company, we urgently need to demonstrate that price reductions in the cash-pay market can enable more patients to start using our products."

The slowdown in the U.S. market is just the tip of the iceberg for Novo Nordisk's troubles.

Due to the impending patent expirations for its semaglutide weight-loss and diabetes drugs in markets like Canada, Brazil, and India, Novo Nordisk expects its international sales growth to decline from approximately 10% in 2025 to mid-single digits this year. After patent expiration, generic drug manufacturers will be able to sell similar medications at lower prices.

Novo Nordisk had hoped that the oral version of its semaglutide weight-loss drug, launched in the U.S. this January, would boost performance. The lowest dose of this oral medication retails for $149, and approximately 170,000 consumers have already purchased it.

However, Meihao Health's attempt to launch a similar product retailing for just $49 per month tested this optimism. Meihao Health stated it remains "committed to supporting the millions of Americans who rely on us for safe, affordable, and personalized healthcare."

Although this competing product was ultimately withdrawn, it does not signal the end of Novo Nordisk's challenges.

Analysts at Jefferies warned last month that Novo Nordisk still faces numerous hurdles, including the continued entry of similar competing products and the risk of consumers switching from the higher-priced injectable semaglutide to the oral version.

Eli Lilly's weight-loss drug, orforglipron, is awaiting regulatory approval for market launch, although its efficacy and tolerability in clinical trials have been inferior to Novo Nordisk's oral drug.

Other major pharmaceutical companies like Pfizer and Roche are also preparing to launch weight-loss drugs, challenging both Novo Nordisk and Eli Lilly.

Investors have long criticized Novo Nordisk for having a weaker research and development pipeline compared to its peers and for its over-reliance on weight-loss and diabetes drugs, which contributed to over 90% of its sales in 2025.

Some analysts noted that after losing the bid last year to Pfizer for the acquisition of Metsera, a biotech company focused on obesity, Novo Nordisk urgently needs to acquire new assets to bolster its pipeline; the analyst also pointed out that business development capability is a significant weakness for the company.

Knudsen mentioned that Novo Nordisk aims to add a glucagon-like peptide-1 (GLP-1) drug requiring only monthly administration to its portfolio; current similar drugs typically require daily or weekly dosing.

Novo Nordisk also announced two further changes in its senior leadership team, with the heads of its U.S. operations and its Product & Portfolio Strategy departing.

The company has hired Jamey Millar from Optum, a subsidiary of UnitedHealth Group, to lead its U.S. business unit.

Optum is one of the world's largest pharmacy benefit managers, key intermediaries in the pharmaceutical industry. Novo Nordisk hopes that Millar's experience in this field, along with his over thirty years of experience at GSK and Procter & Gamble, will benefit the company's development.

However, analysts at UBS stated that frequent changes in senior management "do not inspire confidence in the company's strategic direction."