Novo Nordisk CEO on medicare coverage, new obesity pill, U.S. pricing pressure

Speakers

Mike Doustdar — CEO, Novo Nordisk

Summary

Novo Nordisk projects negative sales growth for 2026 due to significant pricing headwinds, specifically from opening up Medicare access, but expects volume growth to eventually compensate for this.
The "Wegovy Pill" is the centerpiece of their growth strategy, having launched 5 weeks ago with 246,000 patients already enrolled; it targets the "needle-phobic" demographic.
A major "War on Compounders" is underway. Novo has filed over 120 lawsuits (including against Hims & Hers) and asserts that with the shortage over, the legal loophole for mass compounding has closed.
In the oral GLP-1 market, Novo claims a significant efficacy advantage (16.6% weight loss) compared to the competitor's oral option (12.4%), alongside better gastrointestinal tolerability.

Trade Ideas

Ticker	Direction	Speaker	Thesis	Time
NVO	LONG	Mike Doustdar CEO, Novo Nordisk	"The pill has been the centerpiece of growth for us... We today have 246,000 people on the pill... Our pill and its clinical trial has shown 16.6% weight loss. Our competitors pill has 12.4% weight loss." While Novo lags in injectable efficacy currently, they have a distinct "moat" in the oral market. The pill opens a massive Total Addressable Market (TAM) of needle-phobic patients that the competitor (Lilly) cannot serve as effectively due to lower efficacy and higher discontinuation rates (10.4% vs 3.6%). Additionally, the upcoming 7.2mg injectable dose will match the competitor's 21% weight loss, neutralizing the main disadvantage. Long NVO as a volume play. The pricing pressure is a known short-term headwind, but the oral platform provides a durable competitive advantage in 2026. Medicare volume uptake is slower than expected; pricing headwinds compress margins more than volume expands them.	0:00
HIMS	SHORT	Mike Doustdar CEO, Novo Nordisk	"We sued hims and hers obviously over their compounded semaglutide... We really don't understand why it continued. And I certainly don't understand why it's still here. When the prices of the original product and the knockoff version has become very, very similar." The regulatory arbitrage trade for compounding pharmacies is ending. Novo asserts the "shortage" (the legal basis for compounding) is over. With the DOJ and FDA signaling support, and aggressive litigation (120+ cases), HIMS faces an existential threat to its high-margin compounded GLP-1 business line. Short/Avoid HIMS. The business model relies on a loophole that is actively being closed by the IP holders and regulators. Litigation drags on for years allowing HIMS to continue operating; another supply shortage re-opens the compounding window.	10:24
LLY	WATCH	Mike Doustdar CEO, Novo Nordisk	"Our competitor was able better than us to explain about their higher efficacy when it comes to magnitude of weight loss... Our competitor has 15mg of GLP-1 in their product, and that gives them 2,021% weight loss [vs NVO's 15-16%]." Novo's CEO admits Lilly currently has the superior injectable product regarding the metric patients care about most: weight loss percentage. This explains Lilly's 60% market share vs Novo's 40%. Until Novo's higher dosage (7.2mg) or CagriSema launches, Lilly retains the "best in class" injectable status. Watch. Lilly remains the efficacy leader in injectables, but faces stiff competition in the oral form factor. Novo's new high-dose products erode Lilly's efficacy advantage.	20:15