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NVO's Ozempic Outshines LLY's Mounjaro in Lowering Cardiovascular Risk

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Key Takeaways

  • Novo's study found Ozempic 2 mg users had a 6% lower observed MACE risk than Mounjaro switchers.
  • In 720 days, 36.9% of patients escalated Ozempic to 2 mg, while 5.7% switched to Mounjaro.
  • The findings show an association, not proof and the analysis did not evaluate safety outcomes.

Novo (NVO - Free Report) announced new real-world data from the COMPETE SWITCH Cardiovascular (CV) study comparing treatment strategies in adults with type II diabetes (T2D) who were already receiving a 1-mg dose of Ozempic (semaglutide) injection.

The analysis found that patients who increased their Ozempic dose had a lower observed risk of major adverse cardiovascular events (MACE) than those who switched to Lilly’s (LLY - Free Report) Mounjaro (tirzepatide).

Ozempic and Mounjaro are competing therapies in the U.S. diabetes market.

Ozempic is a once-weekly GLP-1 receptor agonist developed by Novo. It is approved with diet and exercise to improve blood-sugar control and to lower the risk of major cardiovascular events, including heart attack, stroke and cardiovascular death, in adults with T2D and established cardiovascular disease. It is also approved for adults with T2D and chronic kidney disease to reduce the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death.

Meanwhile, Lilly’s Mounjaro is approved, in combination with diet and exercise, to improve blood-sugar control in patients aged 10 years and older with T2D. In August 2026, it also gained approval to reduce the risk of MACE in adults with T2D who are at high cardiovascular risk.

Year to date, shares of Novo have lost 22.2% against the industry’s 14.9% growth.

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NVO’s Treatment Patterns Observed in COMPETE SWITCH CV Study

Novo conducted the COMPETE SWITCH CV study to assess real-world treatment patterns and compare outcomes in patients who intensified Ozempic to 2 mg versus those who switched to Mounjaro.

Within 365 days, 67.2% remained on Ozempic 1 mg, 29.2% increased their dose to 2 mg, and 3.6% switched to Mounjaro. By 720 days of follow-up, 57.4% remained on semaglutide 1 mg, while 36.9% had escalated to 2 mg and 5.7% had switched to Mounjaro.

After adjustment for between-group differences, patients who increased their dose to Ozempic 2 mg had a statistically significant 6% lower risk of MACE than those who switched to Mounjaro, including doses of up to 15 mg. A subset of patients with available HbA1c or weight data showed similar findings. MACE included all-cause death, heart attack and stroke.

For Novo, the findings provided additional real-world evidence supporting continued use of higher-dose Ozempic among appropriate patients who require treatment intensification.

However, the study showed an association, not proof, that Ozempic 2 mg directly reduces cardiovascular risk more than Mounjaro. Importantly, safety outcomes were not evaluated in this analysis.

NVO's Zacks Rank & Stocks to Consider

Novo currently carries a Zacks Rank #3 (Hold).

Some better-ranked stocks in the biotech sector are Precigen (PGEN - Free Report) and AC Immune (ACIU - Free Report) , currently sporting a Zacks Rank #1 each. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

Over the past 60 days, estimates for Precigen’s 2026 bottom line have improved from a loss of 2 cents to earnings per share of 24 cents. Over the same period, earnings estimates for 2027 have risen from 25 cents to 73 cents. PGEN shares have gained 92.6% year to date.

Precigen’s earnings beat estimates in three of the trailing four quarters and missed in the remaining one, with the average surprise being 108.96%.

Over the past 60 days, estimates for AC Immune’s 2026 loss per share have narrowed from 84 cents to 60 cents. Over the same period, earnings estimates for 2027 remained unchanged at 17 cents per share. ACIU shares have lost 17.2% year to date.

AC Immune’s earnings beat estimates in each of the trailing four quarters, with the average surprise being 33.25%.

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