Novo (NVO Quick QuoteNVO - Free Report) shares have fallen 11.1% over the past month, with the Capital Markets Day in London on Sept. 21 emerging as the main source of investor disappointment. The market wanted a clear near-term plan: how Novo would stabilize a shrinking top line, defend its position against Eli Lilly (LLY Quick QuoteLLY - Free Report) and restore confidence in its growth path.

Instead, management emphasized where it wants to be by 2030 and beyond. Targets include launching more than five multi-blockbuster drugs by 2030, generating over DKK 150 billion in risk-adjusted pipeline sales in 2035 and serving more than 60 million patients. Novo aims for 2026–30 revenue growth in line with industry peers, including Eli Lilly, and a broadly stable operating margin, while stating that these ambitions do not constitute guidance. Beyond a stated focus on stabilizing revenues, it offered no quantified near-term outlook. For a company that once commanded a premium growth profile, a peer-level growth goal and a long runway, rather than near-term proof points, left investors unconvinced.

The reaction also reflects already fragile sentiment, largely because of Lilly. LLY’s Zepbound continues to gain ground in injectable obesity, while its newly launched oral drug, Foundayo, challenges NVO’s Wegovy pill. Lilly has also secured broader coverage from major pharmacy benefit managers, including CVS Caremark, and the Medicare GLP-1 Bridge program offers identical reimbursement for Lilly’s therapies and Novo’s, removing any coverage edge for Wegovy. The contest is shifting to clinical differentiation, where Novo’s CagriSema, the follow-up to Wegovy, failed to show non-inferiority to Lilly’s Zepbound on weight loss in the phase III REDEFINE 4 study.

Other factors have added to the pressure. Lower realized prices pushed U.S. adjusted sales down 4% at constant exchange rates in the first half of 2026. Even after the guidance raise, Novo still expects 2026 adjusted sales and operating profit to range from flat to a 6% decline at constant exchange rates. The ZEUS phase III study of ziltivekimab, in patients with atherosclerotic cardiovascular disease, chronic kidney disease and inflammation, failed to reduce major adverse cardiovascular events, raising questions about pipeline depth beyond obesity and diabetes. Morgan Stanley’s downgrade to “Underweight” cited muted medium-term growth and the semaglutide patent cliff, a real risk given that semaglutide products made up roughly 75.5% of adjusted first-half 2026 sales. To better assess the stock’s investment appeal, let us weigh Novo’s long-term opportunities against these near-term challenges.

Semaglutide Franchise Remains NVO’s Top-Line Backbone

As Ozempic, Wegovy and Rybelsus remain Novo’s primary top-line drivers, the company is pursuing broader indications and new formulations to sustain revenues and extend the commercial potential of the semaglutide franchise. Wegovy is approved not only for obesity but also to reduce the risk of major cardiovascular events in certain adults with obesity or overweight and established cardiovascular disease. The company has also secured approvals for higher-dose Wegovy injections in the United States and Europe. At the same time, oral Wegovy for weight management is approved in the United States and the EU.

Novo is similarly seeking to expand semaglutide’s reach in diabetes. Ozempic is indicated to reduce the risk of kidney disease progression and cardiovascular death in certain type II diabetes (T2D) patients, while the company is pursuing additional label expansions. Rybelsus is approved for cardiovascular-risk reduction in T2D patients in the United States and Europe, and the launch of oral Ozempic for adults with T2D further expands Novo’s oral GLP-1 offering. Positive late-stage data in pediatric T2D and potential label-expansion filings for Rybelsus and oral Ozempic could provide additional avenues to broaden the franchise and support revenue growth.

NVO’s Competition Heating Up in the Obesity Space

The obesity space has drawn much of the spotlight over the past year because of the sizeable and still underpenetrated market opportunity. Smaller biotech firms, such as Viking Therapeutics (VKTX Quick QuoteVKTX - Free Report) and Structure Therapeutics (GPCR Quick QuoteGPCR - Free Report) , are also advancing GLP-1–based therapies to challenge the incumbents. Viking Therapeutics’ dual GIPR/GLP-1 RA, VK2735, is being developed in both oral and subcutaneous formulations for the treatment of obesity. Last month, Viking reported positive top-line results from a subcutaneous maintenance study, with patients maintaining up to 97% of their prior weight loss on every-other-week dosing and up to 90% on monthly dosing over the 12-week maintenance period. Viking plans to advance oral VK2735 into phase III development for obesity in the fourth quarter of 2026.

Structure Therapeutics’ phase II ACCESS program on its orally administered small molecule GLP-1 RA, aleniglipron, demonstrated significant weight loss across all doses. Based on such encouraging results, Structure Therapeutics has initiated dosing patients in its late-stage ACCOMPLISHprogram to evaluate aleniglipron for chronic weight management.

NVO Expands Footprint in Rare Diseases and Liver Care

Beyond its GLP-1 portfolio, Novo is broadening its presence in rare diseases. Regulatory filings for denecimig (Mim8) in the United States and the EU are currently under review, potentially offering a more convenient once-weekly or monthly dosing option for hemophilia A. It has also secured U.S. and EU approvals for Alhemo to treat hemophilia A and B with or without inhibitors, with its prefilled subcutaneous pen designed to reduce reliance on intravenous infusions.

Additionally, Wegovy injectable is approved in the United States for noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) in adults with moderate-to-advanced liver fibrosis, along with certain other geographies. Meanwhile, Novo has submitted MASH data for the Wegovy pill to the FDA, with a decision expected in first-quarter 2027. Novo’s once-daily oral etavopivat remains a key late-stage rare-disease candidate for sickle cell disease, with the first regulatory filing expected in fourth-quarter 2026.

NVO Focuses on Next-Generation Drugs

Novo is also developing several next-generation obesity candidates in its pipeline, especially targeting the lucrative U.S. market. NVO has submitted a regulatory filing seeking approval of CagriSema injection, a follow-up drug to Wegovy, for obesity. A decision is expected in the fourth quarter. It is also gearing up to launch a dedicated late-stage program evaluating cagrilintide as a monotherapy for obesity.

Another key candidate for T2D and obesity is zenagamtide (formerly known as amycretin), a novel long-acting GLP-1 and amylin receptor agonist, in phase III. The company has also bolstered its pipeline through several major collaborations and acquisition deals. Beyond GLP-1s, Awiqli (once-weekly insulin icodec) is approved in the EU and several other countries for adults with Type 1 and Type 2 diabetes, as well as in the United States for T2D.

NVO’s Stock Price, Valuation & Estimates

Year to date, Novo shares have lost 24% against the industry’s 12.5% growth. The company has also underperformed the sector and the S&P 500 during the same time frame, as seen in the chart below.

NVO Stock Underperforms the Industry, Sector & the S&P 500

Image Source: Zacks Investment Research

Novo is trading at a discount to the industry, as seen in the chart below. Going by the price/earnings ratio, the company’s shares currently trade at 11.24 forward earnings, which is lower than 18.19 for the industry. The stock is trading much below its five-year mean of 28.98.

NVO Stock Valuation

Image Source: Zacks Investment Research

Earnings estimates for 2026 have increased from $3.39 per share to $3.53 per share over the past 60 days. During the same time frame, Novo’s 2027 earnings estimates have increased from $3.31 to $3.41.

NVO Estimate Movement

Image Source: Zacks Investment Research

Here’s How to Play NVO Stock

Novo, currently carrying a Zacks Rank #3 (Hold), faces a difficult near-term setup. The Capital Markets Day offered long-term ambitions but no quantified near-term outlook, leaving investors without visibility on when growth will stabilize. Intensifying competition from Eli Lilly, with Zepbound gaining ground and Foundayo challenging the Wegovy pill, is compounding the problem. Lower realized prices are pressuring U.S. sales, and the company still expects 2026 adjusted sales and operating profit to range from flat to a 6% decline. Heavy dependence on semaglutide, which made up roughly 75.5% of adjusted first-half 2026 sales, and pipeline setbacks such as the ZEUS failure and CagriSema’s miss against Lilly’s Zepbound add to the risk. Short-term investors may be better off staying clear of NVO stock until there are clearer signs of stabilization in pricing, market share and growth. You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

For long-term investors, holding existing positions remains reasonable. Novo has a broad cardiometabolic pipeline, an established obesity franchise and exposure to a still underpenetrated global market. Its oral GLP-1s, next-generation candidates such as CagriSema and zenagamtide, and expansion into rare diseases and liver care offer growth avenues beyond semaglutide. Valuation provides some cushion. However, Novo must execute on its pipeline, defend its market position against Lilly and manage pricing pressure before its long-term growth story gains greater visibility.