Novo Nordisk Lost 9pp GLP-1 Market Share in 12 Months. Is -66% Oversold?

Twelve months ago, Novo Nordisk was the undisputed king of the GLP-1 market. Ozempic and Wegovy were cultural phenomena. The stock was at all-time highs. Then Eli Lilly showed up with Mounjaro and Zepbound, and everything changed.

Today, Novo has lost 9 percentage points of global market share. The stock has fallen 40-66% from its June 2024 peak. Weekly Wegovy prescriptions are declining. And four separate regulatory pressures are converging: IRA pricing (effective January 2027), tariff-driven price concessions, over 1 million patients on compounded alternatives, and 235+ product liability lawsuits.

Is this a company in crisis, or a market overreaction to a managed transition?

This is a summary of our full NVO analysis →

What Our Analysis Revealed

We ran three analytical lenses on Novo Nordisk: Gravy Gauge (is revenue durable?), Regulatory Reader (what regulatory risks are material?), and Moat Mapper (is the competitive advantage defensible?). Here's what we found:

1. The Gravy Train Isn't Dead — It's Just Contested

The GLP-1 market is still massive and growing. Obesity is an epidemic. Diabetes isn't going away. The underlying demand is structural, not cyclical.

What's ending is Novo's monopoly on that market. They're transitioning from dominant market leader to one half of a duopoly. That's a significant change — it means lower pricing power, more competitive pressure, and smaller margins. But it's not the same as the business model collapsing.

2. Four Regulatory Pressures — But No Kill Shot

The regulatory picture is complicated but not catastrophic. Here's what's hitting simultaneously:

• IRA Pricing (Jan 2027): Medicare negotiated prices locked in. Management guides "low single digit" global impact.
• Tariff Exemption: NVO secured a 3-year exemption from 15% tariffs in exchange for US price cuts. Cost already in pricing guidance.
• Compounding Gray Market: Over 1 million US patients on compounded GLP-1s despite FDA action.
• 235+ Lawsuits: Product liability claims. Not class certified (yet). Manageable unless that changes.

None of these individually is existential. But converging simultaneously? That's unusual for a pharmaceutical company. The cumulative effect is margin compression, not revenue elimination.

3. CagriSema is the Swing Catalyst

Everything comes down to CagriSema REDEFINE 4 data, expected Q1 2026. This next-generation combo drug (GLP-1 + amylin) is Novo's best shot at restoring competitive differentiation.

Oral Wegovy (approved December 2025) provides a temporary first-mover advantage in the oral GLP-1 space. But Lilly's orforglipron is expected Q2 2026 — that's an advantage measured in months, not years.

What to Watch

The next 6 months will determine whether Novo stabilizes as a strong #2 or continues eroding. Here are the key triggers:

Bottom Line

Novo Nordisk isn't broken — but the monopoly era is over. The company is transitioning from dominant market leader to one half of a contested duopoly with Eli Lilly. That transition comes with real headwinds: regulatory pressure, competitive erosion, and leadership uncertainty.

The 40-66% stock decline may be an overreaction if CagriSema delivers differentiated efficacy. Or it may be justified if competitive erosion accelerates. The answer arrives in Q1 2026.

Our classification: HIGHER_SCRUTINY. Not avoid, not standard diligence — this is a company that requires careful monitoring through a critical transition period.