Novo Nordisk’s Pill Revolution: 3 Million Scripts in Five Months as Pipeline Awaits a Verdict
11.06.2026 - 17:33:37 | boerse-global.de
Novo Nordisk is fighting back against Eli Lilly’s market dominance with a two-pronged strategy that has already delivered one stunning commercial success — and could yet reshape its long-term outlook. The Danish drugmaker’s oral Wegovy tablet has crossed three million prescriptions in the United States just five months after launch, while early-stage data for a next-generation injectable candidate point to weight-loss effects that do not plateau.
The pill is reaching an entirely new audience. More than 80% of those prescriptions come from patients who had never used a GLP-1 therapy before, suggesting the oral formulation is expanding — not cannibalising — the obesity treatment market. At peak, a script was written every five seconds. The drug generated roughly $355 million in first-quarter revenue, and its logistical advantage — no refrigeration needed — makes it especially suited for hot climates. The United Arab Emirates became the first international market to launch the tablet, with more countries slated for the second half of 2026. A decision from the European Medicines Agency is still pending; the EMA cleared the high-dose Wegovy injection in May, but the oral version awaits final approval. Starting 1 July 2026, eligible Medicare beneficiaries will gain access to both Wegovy injections and tablets at a monthly copay of $50.
Behind the commercial momentum, Novo Nordisk is advancing a pipeline candidate that could eventually succeed its semaglutide franchise. Zenagamtide — also known as Amycretin — activates both GLP-1 and amylin receptors, a dual mechanism that sets it apart from existing GLP-1 agonists. In a Phase 2 dose-finding study involving 262 adults with type 2 diabetes inadequately controlled on metformin, the highest dose produced an average weight loss of 14.6% at 36 weeks. HbA1c fell by up to 1.71 percentage points, and 89% of participants reached the clinically relevant target of below 7%. Notably, weight loss showed no sign of plateauing at higher doses, hinting at further potential with extended use.
That profile contrasts with Eli Lilly’s oral candidate, which delivered a 12.4% average weight reduction in a similar study — though direct comparisons remain premature. Lilly’s Mounjaro overtook Novo Nordisk in global sales during the second quarter of 2025, intensifying the pressure on the Danish company to deliver both commercially and clinically.
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A broad Phase 3 programme is already underway for Zenagamtide in obesity, comprising multiple AMAZE trials. AMAZE 1 and 2 are pivotal studies running over 84 weeks in overweight patients, with and without type 2 diabetes. Additional arms address obesity combined with sleep apnoea (AMAZE 3 and 4), knee osteoarthritis (AMAZE 5 and 6), and weight maintenance after loss (AMAZE 12). For type 2 diabetes, a separate Phase 3 programme is expected to begin in the second half of 2026. First Phase 3 results are not anticipated before 2028.
The market has so far greeted the pipeline news with muted enthusiasm. Novo Nordisk’s shares rose 1.42% on the day of the Zenagamtide data to EUR 37.62, but that still leaves the stock roughly 46% below its 52-week high of EUR 70.13 set in June 2025. Year to date, the shares are down nearly 16%. Investors appear to need hard Phase 3 proof before re-rating the long-term earnings outlook.
Meanwhile, management is rewarding shareholders directly. A share buyback programme launched in February has already repurchased nearly DKK 5 billion worth of stock, within an overall envelope of up to DKK 15 billion. The programme is ongoing.
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The next key catalyst is the EMA verdict on the oral Wegovy tablet. A positive decision would allow Novo Nordisk to accelerate its international rollout and potentially widen its lead in oral GLP-1 treatments at a time when only 2% of severely obese people worldwide are using such medications. The company is betting that a combination of pill-based market expansion and a pipeline with no visible weight-loss ceiling can turn the tide. The first real test of that bet arrives in 2028.
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