Novo Nordisk’s Amazon Bet Can’t Hide the Core Contraction

The numbers coming out of Novo Nordisk’s first quarter look like a blockbuster at first glance. Revenue jumped 32% to 96.8 billion Danish kroner, and operating profit surged 65%. But peel back the veneer, and the Danish drugmaker is facing a very different reality. A one-time accounting windfall is masking an underlying business that is shrinking.

That windfall came from the reversal of a multi-billion-dollar reserve tied to US rebate programs, a non-cash item worth $4.2 billion that flattered the top line. Strip it out, and the picture darkens considerably. Adjusted revenue actually fell 4%, while adjusted operating profit declined 6%. The gross margin slipped to 80.6%, squeezed by relentless pricing pressure in the company’s most important market.

The US is the epicenter of the pain. Adjusted sales there dropped 11% as lower selling prices for diabetes drugs like Ozempic ate into volume gains. Chief Financial Officer Karsten Knudsen confirmed that Ozempic prices in the US are falling by 10% to 15% annually. The international business provided a partial offset, with obesity drug Wegovy posting 12% global sales growth and a 44% jump outside the US.

To combat the US pricing headwinds, Novo Nordisk is leaning hard into a new distribution channel. The company is expanding its partnership with Amazon, making Ozempic available through the tech giant’s pharmacy service. Patients with a prescription can get same-day delivery, with the cost as low as $25 for those with insurance coverage. Amazon plans to scale the service to roughly 4,500 locations by year-end. Self-pay patients, however, will face significantly higher out-of-pocket costs.

Should investors sell immediately? Or is it worth buying Novo Nordisk?

The management team has tweaked its full-year outlook, narrowing the expected decline in both revenue and operating profit to a range of 4% to 12%. That is a slight improvement from the prior forecast of minus 5% to minus 13%. Analysts are split on the move. Morgan Stanley views the lower end of the new range as conservative, while Jefferies sees the unchanged floor as a negative signal for the market.

CEO Mike Doustdar is banking on Wegovy to hold the line. The drug is currently capturing 65% of all new US prescriptions for GLP-1 therapies. The company is also preparing to launch the first oral version of Wegovy in international markets during the second half of 2026. A major data readout is just around the corner: Novo Nordisk will present 52 studies at the European Obesity Congress in Istanbul from May 12 to 15, offering a fresh look at the competitiveness of its pipeline.

The company is not sitting on its hands financially. It has completed the first tranche of a share buyback program, repurchasing nearly 15 million of its own shares for roughly 3.8 billion kroner. A new 15 billion kroner repurchase program is already underway. At the same time, Novo Nordisk is pouring about 55 billion kroner into expanding production capacity this year.

Novo Nordisk at a turning point? This analysis reveals what investors need to know now.

The stock has shown some signs of life recently, climbing nearly 9% over the past week to close at €39.09 on Friday. Over the past 30 days, the shares have recovered about 21%. But the longer-term trend remains deeply negative, with the stock still down roughly 33% over the past 12 months. The battle for market share with US rival Eli Lilly is far from over, and expiring patents are set to keep margins under pressure for the rest of the year.

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Novo Nordisk Stock: New Analysis - 9 May

Fresh Novo Nordisk information released. What's the impact for investors? Our latest independent report examines recent figures and market trends.

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