NVO Q4 Earnings & Sales Beat Estimates, Stock Down on Poor 2026 View

Novo Nordisk A/S NVO reported adjusted fourth-quarter 2025 earnings of $1 per American Depositary Receipt (ADR), which beat the Zacks Consensus Estimate of 90 cents. The company had reported adjusted earnings of 98 cents per ADR in the year-ago quarter.

Revenues of $12.34 billion declined 8% year over year in the Danish kroner (DKK) and 2% at the constant exchange rate (CER) in the reported quarter, driven by lower-than-expected Diabetes and Obesity Care sales, as GLP-1 product sales momentum slowed amid an intensifying competitive landscape. However, total revenues beat the Zacks Consensus Estimate of $12.08 billion.

Despite the fourth-quarter earnings beat, Novo Nordisk’s shares slumped 14.6% on Tuesday and continued to decline in the pre-market hours as investors were disappointed by its poor sales and operating profit outlook for 2026. All growth rates mentioned below are on a year-over-year basis and at CER.

NVO’s Q4 Results in Detail

Novo Nordisk operates under two segments: Diabetes and Obesity Care, and Rare disease.

The Diabetes and Obesity Care segment reported sales of DKK 73.8 billion in the quarter under review, representing a 2% decline. In Diabetes Care, fast-acting insulin Fiasp’s revenues were up 154%. NovoRapid revenues declined 24% and Human insulin revenues also decreased 24%. Premix insulin (Ryzodeg and NovoMix) revenues decreased 6%. Sales of long-acting insulins (Tresiba, Xultophy, Levemir and Awiqli) declined 4% in the fourth quarter.

Ozempic, which had earlier witnessed a strong launch and solid uptake, recorded sales of DKK 31.83 billion for the quarter, up 1%. Rybelsus recorded sales of DKK 5.30 billion for the quarter, down 19%. Victoza sales recorded DKK 0.4 billion during the reported quarter.

Obesity Care (Saxenda and Wegovy) sales were up 11% to DKK 22.45 billion. Wegovy’s sales growth rate continues to slow, with fourth-quarter sales reaching DKK 21.86 billion, up 17%, as growth was impacted by the availability of illegal compounded versions in Novo Nordisk’s largest obesity market, the United States, as well as increased competition from Eli Lilly LLY.

In the past six months, Novo Nordisk shares have gained 6.5% compared with the industry’s 24.8% growth.

Sales in the Rare disease segment were flat at DKK 5.35 billion in the fourth quarter of 2025. Sales of rare blood disorder products were DKK 3.02 billion, down 5%. Sales of hemophilia A products were flat. Sales of hemophilia B products increased 1%. Sales of NovoSeven declined 13% to DKK 1.80 billion. Sales of Novo Nordisk’s rare endocrine disorder products gained 2% to DKK 1.83 billion.

Sales and distribution costs declined 9% in the reported quarter to DKK 15.89 billion. This decrease was due to U.S. operations, which were affected by a reduction in a legal provision during the fourth quarter of 2025 and savings related to the company-wide restructuring during the third quarter of 2025.

Research and development (R&D) costs shot up 9% to DKK 14.65 billion. R&D expenses rose due to higher spending on late-stage clinical studies and research activities mainly related to the Obesity and Diabetes portfolio.

NVO’s 2025 Results

Sales for the year were $46.81 billion, representing growth of 6% in DKK and 10% at CER from the year-ago quarter’s figures. The total sales figure missed the Zacks Consensus Estimate of $48.03 billion.

For the full year, Novo Nordisk reported adjusted earnings of $3.96 per ADR, surpassing the Zacks Consensus Estimate of $3.58.

NVO’s 2026 Outlook Disappoints Investors

Novo Nordisk’s 2026 guidance fell well short of market expectations, triggering a sharp negative reaction in the stock. While headline sales and operating profit will benefit from a one-off $4.2 billion reversal of 340B drug rebate provisions in the United States, management chose to exclude this impact from its newly introduced non-IFRS “adjusted” metrics. As a result, the reported outlook strips out a material accounting uplift, revealing a far weaker underlying growth trajectory than investors had anticipated.

On an adjusted basis, Novo Nordisk expects both sales and operating profit to decline by 5-13% at CER in 2026, with further downside when translated into DKK due to adverse FX movements. Even on a non-adjusted basis, the mid-point of guidance implies negative sales growth (-1%) and only modest operating profit growth (11%), underscoring how heavily the statutory numbers rely on non-recurring accounting benefits rather than core business momentum. The shift to adjusted reporting, though framed as a transparency measure, effectively highlighted the absence of sustainable growth drivers in the near term.

Operationally, the outlook reflects diverging regional trends but mounting pressure overall. International Operations are expected to grow volumes as GLP-1 adoption expands, particularly in obesity, supported by broader Wegovy roll-outs and the planned introduction of a higher 7.2 mg dose. However, these gains are offset by intensifying competition, pricing pressure and the loss of semaglutide exclusivity in certain markets. In the United States, expectations are weaker, driven by slowing prescription trends, rising competition, reduced Medicaid obesity coverage, and lower realized prices due to access initiatives and the MFN agreement with the U.S. administration.

Profitability is further constrained by stepped-up investment plans. Novo Nordisk signaled continued heavy spending on R&D to advance its obesity and diabetes pipeline, including costs related to the Akero Therapeutics acquisition, alongside elevated commercial investments to defend and expand the GLP-1 franchise. With no repeat of favorable U.S. gross-to-net adjustments seen in 2025, margins are set to compress. Taken together, the combination of declining adjusted growth, structural pricing headwinds, and rising investment intensity explains the sharp sell-off in the stock.

Novo Nordisk A/S Price, Consensus and EPS Surprise

Novo Nordisk A/S price-consensus-eps-surprise-chart | Novo Nordisk A/S Quote

Our Take on NVO Stock

Novo Nordisk delivered a modest fourth-quarter earnings beat, but the market reaction underscores that near-term fundamentals matter more than backward-looking results. The sell-off reflects investor disappointment with slowing core momentum across the diabetes and obesity franchises, ongoing pricing pressure, and rising investment intensity. While cost discipline in selling and distribution offered some relief, elevated R&D spending and weaker-than-expected underlying demand trends continue to weigh on sentiment. Against this backdrop, investors’ confidence in the durability of near-term growth is eroding.

The bigger concern lies in management’s 2026 outlook, which fell sharply short of expectations. Excluding one-off accounting benefits, guidance points to a meaningful contraction in sales and operating profit, revealing a softer core trajectory than investors had anticipated. Structural headwinds, like slowing U.S. prescription trends, pressure from access initiatives and pricing agreements, adverse FX, and intensifying competition, are expected to offset international volume growth. With margins likely to compress amid sustained R&D and commercial investments, the outlook suggests limited earnings visibility over the next year.

Competitive dynamics further tilt the risk-reward balance unfavorably. Eli Lilly continues to gain share in diabetes and obesity through stronger efficacy perceptions and sharper execution, raising doubts about Novo Nordisk’s ability to defend its early-mover advantage. Although the launch of oral Wegovy offers differentiation, history suggests that superior late entrants can still dominate, potentially limiting the long-term impact of this catalyst. Taken together — muted 2026 guidance, pricing and margin pressure, and a crowded GLP-1 landscape — the near-term setup for NVO remains challenging, warranting caution until clearer evidence of a re-acceleration emerges.

NVO’s Zacks Rank & Stocks to Consider

Novo Nordisk currently carries a Zacks Rank #4 (Sell).

Some better-ranked stocks in the biotech sector are Alkermes ALKS and Immunocore IMCR, each sporting a Zacks Rank #1 (Strong Buy) at present. You can see the complete list of today’s Zacks #1 Rank stocks here.

Over the past 60 days, 2026 EPS estimates for Alkermes have increased from $1.54 to $1.91. Shares of ALKS have gained 29.7% over the past six months.

Alkermes’ earnings beat estimates in three of the trailing four quarters, missing on the remaining occasion, with the average surprise being 4.58%.

Over the past 60 days, estimates for Immunocore’s loss per share for 2026 have narrowed from 97 cents to 90 cents. IMCR stock has lost 1.3% over the past six months.

Immunocore’s earnings beat estimates in three of the trailing four quarters and missed in the remaining quarter, with the average surprise being 53.96%.

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This article originally published on Zacks Investment Research (zacks.com).

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