Novo Nordisk Capital Day reveals the next battle in the GLP-1 track

On September 21, Novo Nordisk brought investors to London to hear a story about 2035.

CEO Mike Doustdar spoke for nearly three hours: by 2030, launch more than 5 new drugs with "multi-blockbuster" potential; by 2035, the risk-adjusted pipeline sales will exceed 150 billion Danish kroner, equivalent to about 23 billion U.S. dollars; there will be at least 5 Phase III programs in the obesity and diabetes fields, and up to 5 Phase III programs in other therapeutic areas.

The story is fully fleshed out. The only problem is that what investors are asking about is 2027.

The market gave a very straightforward feedback. Novo Nordisk's Copenhagen-listed shares closed down 7.7% on that day, marking the worst single-day performance since February this year; they fell further the next day, with a cumulative decline of about 8% in two days. Its U.S. ADR closed down 7.92%. The company's share price has now retreated by more than 70% from its peak in mid-2024, and has fallen by a quarter since the beginning of the year.

A 2035-themed narrative was offset by the market's 2027-focused outlook.

01 "The Elephant in the Room"

Doustdar took the initiative to call out the "elephant in the room" on stage: The core compound patent of semaglutide in the United States will expire at the end of 2031, and generic drugs will enter the market in 2032. The U.S. market accounts for more than half of the company's total sales last year, and semaglutide alone contributed about 75% of its sales in 2026.

Putting these three figures together, it is not a difficult arithmetic problem for any investor: a single molecule (75% of sales), a single market (more than half of total revenue), and a single time point (2032). Three layers of huge pressure are all centered on that patent expiration date.

The market's pricing model for Novo Nordisk has changed.

Over the past two years, the market has applied the valuation logic of "GLP-1 penetration rate" to Novo Nordisk, believing that as long as the company captures the obesity treatment market, its growth rate is justified. Now, the logic has shifted to "discounted cash flow after the patent cliff": no one is asking how much your performance will rise next year, but only asking whether you have alternative cash flow to sustain the business before hitting that wall in 2032.

So the management's response direction is completely correct, but the market does not give any applause. Because there are five to nine years between the current strategic direction and the actual generation of cash flow, while the patent cliff is only six years away.

02 The Phrase "In Line With Peers" Is Worse Than Any Bad News

The problem ultimately lies in the height of the narrative.

For the revenue growth target from 2026 to 2030 given by the management, the wording used is "in line with industry peers". Translating this phrase, the implied annual compound growth rate is only 3% to 4% — the approximate range estimated by the sell-side institutions. In the past, the market was accustomed to Novo Nordisk's double-digit growth rate.

The key point is not the slowdown in growth. The slowdown was already priced in back in February when the company released its "first-ever negative growth guidance in history". The critical issue is no upward revision. Investors came in with the expectation that "there should at least be a turnaround plan", but what they heard was "we are roughly on par with our peers", a resigned and self-restrained growth narrative.

A CAGR of just over 3% has long been factored into the market's pricing. The problem is never the slowdown itself, but the absence of any upward revision to the guidance.

A company that once made the whole of Europe look up to it is now actively positioning itself in the "industry average" coordinate system. This is equivalent to acknowledging a cruel fact: after semaglutide, Novo Nordisk does not have a second molecule that can define the track for the time being.

03 The Race Between Options and the Patent Cliff

Looking at Novo Nordisk's solutions openly, every step it takes is at the right point:

CagriSema will be launched early next year, the single-agent cagrilintide and high-dose CagriSema are scheduled for 2028, followed by zenagamtide later; the company strengthens its business through mergers and acquisitions, promotes the oralization of its products, expands its production capacity tenfold, targets to reach 60 million patients by 2030, and makes the self-pay channel cover 50% of all Wegovy product lines.

However, a close look at each of these cards shows that they are all "options", not "actual cash flow".

In the key Phase III head-to-head trial of CagriSema, it achieved a 23.0% weight loss result, which lost to tirzepatide's 25.5% and failed to meet the non-inferiority standard. It lost the first battle on the battlefield where it was supposed to prove its strength the most. In the second quarter, Novo Nordisk's share in the obesity drug market has dropped to 39%, while Eli Lilly has taken 61% of the market; Zepbound is expected to generate more than 7 billion U.S. dollars in sales than Wegovy this year.

In other words, the next growth driver that Novo Nordisk shows to the market cannot outperform the existing leading product that its rival already holds. And time waits for no one: it takes five to nine years for an option to turn into actual cash flow, while the patent cliff is only six years away. Six years is exactly the time span for semaglutide to go from its peak to patent expiration.

04 This Set of Data Reveals the Next War of the Entire Track

What really caught the attention of investors is not the financial report, but this set of proportion data: the self-pay channel accounts for 50% of all Wegovy product lines, and the self-pay demand for oral tablets accounts for 90%.

It shows that the GLP-1 market has quietly split into two pricing systems. One relies on commercial insurance reimbursement, constrained by PBM (Pharmacy Benefit Management) and MFN (Most Favored Nation) clauses, so its price is suppressed institutionally; the other adopts cash self-payment, bypassing insurance and PBM, and the pricing power returns to pharmaceutical manufacturers again.

The transfer of pricing power is the most profound subtext of this whole story.

When the moat of molecular innovation is leveled in 2032, the party that first gets the oral product self-pay flywheel running — low price, easy prescription, no reliance on insurance approval — will be able to rebuild a moat that no one can break before the patent expires. This is why Novo Nordisk stated its ambition so clearly: at least 5 oral assets will enter clinical trials before the end of this year.

From the perspective of the whole industry, the competition in the GLP-1 track is shifting from "who has a better molecule" to "who has a more robust distribution and payment structure". Eli Lilly has stronger molecules, while Novo Nordisk bets on a wider channel coverage. This is the final battle for pricing power unfolding in the countdown to the patent cliff.

And the market's current judgment on Novo Nordisk is as follows: no matter how complete the 2035 roadmap you draw is, it cannot block the crack that appears in 2027. The CEO said "We need to work harder, and we will". After hearing that, investors voted with their feet.

The next six years are the most valuable asset for this company right now, and will also become its most valuable liability.

This article is from the WeChat official account "YiYao", author: Wang Zhe, published with authorization from 36Kr.