Novo Nordisk's Semaglutide Edges Out Tirzepatide on Heart Risk as Oral Wegovy Sheds Pounds in Real-World Test
Published on 10/02/2026 at 20:31 | Editorial boerse-global.de
Novo Nordisk has rolled out two separate sets of data that bolster the case for its semaglutide franchise, even as the Danish drugmaker's shares continue to languish near their lowest levels of the year. The findings — one comparing semaglutide head-to-head against a rival therapy, the other tracking patients who switched from injections to a daily pill — landed during a stretch in which investors have grown increasingly wary of the company's medium-term growth story.
The larger of the two analyses examined billing records from 636,525 adults with type 2 diabetes. Researchers set out to measure what happened when patients either raised their semaglutide dose to 2 milligrams or moved directly to tirzepatide, the competing treatment from Eli Lilly. The dose-escalation route came out ahead: it was tied to a statistically significant 6 percent lower risk of major cardiovascular events.
Novo Nordisk cautioned that safety endpoints fell outside the scope of this particular review. Even so, real-world evidence of this kind carries considerable weight in the industry, helping to defend market share among the physicians who write the prescriptions.
A Pill That Delivers Modest but Measurable Results
Separately, at the European Association for the Study of Diabetes annual meeting in Milan, Novo Nordisk unveiled its first real-world look at patients transitioning from GLP-1 injections to the oral form of Wegovy. The evaluation, conducted with U.S. telehealth platform Ro, followed 194 adults with overweight or obesity who had previously used injectables such as semaglutide or tirzepatide before switching to the once-daily tablet.
Over three months, participants lost an average of 4.1 percent of their body weight, or roughly 4.0 kilograms. About 41 percent of those tracked trimmed at least 5 percent of their starting weight. The share of patients with a body mass index of 30 or above fell from 87.1 percent to 65.5 percent during the observation window.
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The company was careful to flag the limits of the OCTANE analysis: it is an observational study with no control group and no randomization, meaning it cannot establish a causal link between the switch and the weight loss. Only individuals who took the medication for three months without a gap exceeding 30 days were included. Details on side effects or the exact dosages of prior injections were not disclosed.
Regulatory Timeline and Pricing Headwinds
The U.S. Food and Drug Administration cleared the oral version of Wegovy on December 22, 2025, with the product reaching U.S. pharmacies on January 5, 2026. In the Phase 3 OASIS 4 trial, a daily maintenance dose of 25 milligrams produced an average weight reduction of 13.6 percent over 64 weeks, against 2.2 percent for placebo. Patients must take the tablet on an empty stomach and then wait 30 minutes before eating.
Commercial pressures are mounting alongside the clinical updates. Novo Nordisk cut the price of Wegovy in Sweden by 20 percent effective October 1, aiming to curb treatment discontinuations driven by cost. According to media reports, the company has also filed a fresh reimbursement application there for specific high-risk patients.
Market Response Muted as Skepticism Persists
Trading reflected little enthusiasm for the news. Novo Nordisk shares changed hands at EUR 33.34, essentially flat with a gain of 0.05 percent. Since the start of the year, the stock has shed 24 percent, underscoring persistent investor doubts about intensifying competition in the obesity treatment arena.
Those concerns extend beyond day-to-day volatility. Following the company's capital markets day on September 21, Reuters reported that shareholders were taking a critical view of future pricing power and the acquisition strategy. Management laid out long-term ambitions — including the launch of more than five blockbuster medicines by 2030 and pipeline revenue exceeding DKK 150 billion by 2035 — but stopped short of providing concrete numerical growth targets for overall sales at the event.
Beyond its metabolic portfolio, Novo Nordisk is pressing ahead with diversification. Its denecimig-based therapy is intended for adults and children with hemophilia A, with first launches in European countries penciled in for the fourth quarter of 2026 and a broader EU rollout from early 2027. The move highlights efforts to build growth beyond GLP-1 treatments into rare diseases.
Additional data on the oral treatment is expected in November, when the Danish group presents at the ObesityWeek conference.
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