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Novo Nordisk is under growing pressure to show how it can build its next phase of growth beyond Wegovy as chief executive Mike Doustdar sets out the company’s updated strategy at its Capital Markets Day in London.
The Danish drugmaker transformed its financial profile after launching Wegovy in 2021. Sales reached DKK309 billion in 2025, more than double their 2019 level, while obesity-care revenue increased from DKK6 billion to DKK82 billion over the same period. That expansion has also increased investor attention on how Novo will sustain growth as competition intensifies and patent protection for semaglutide begins to expire in major markets in the early 2030s.
The immediate competitive pressure comes from Eli Lilly. Novo’s shares have fallen more than 70% from their peak, while Lilly has gained ground in obesity treatment with Zepbound and its wider portfolio. Investors cited by Reuters are seeking clearer medium-term targets, stronger business development and evidence that Novo can create significant new sources of revenue beyond its current semaglutide franchise.
Doustdar has already begun reshaping the organisation. Novo announced a global workforce reduction of around 9,000 positions under a transformation programme expected to generate approximately DKK8 billion in annualised savings from 2026 onwards, with resources redirected towards growth opportunities in obesity and diabetes.
The company has also introduced a simplified “Novo” brand and updated corporate culture under what it calls “The Novo Way”. The changes form part of Doustdar’s effort to make the business more customer-focused, competitive and faster-moving as the obesity market becomes increasingly consumer-driven. Novo said its Capital Markets Day on 21 September would provide a detailed overview of the updated corporate strategy, R&D pipeline, operations and performance.
Novo still has substantial momentum in obesity care. In its second-quarter update, the company said total weekly U.S. prescriptions for the Wegovy pill exceeded 265,000 in the week ending 17 July. Higher-dose Wegovy products and additional international launches are also expanding the franchise.
The strategic pressure is being intensified by setbacks elsewhere in the pipeline. Novo’s ZEUS phase 3 cardiovascular trial found that ziltivekimab did not reduce the risk of major adverse cardiovascular events compared with placebo despite showing the expected biological activity.
CagriSema has also produced mixed results. In the REDEFINE 4 phase 3 obesity trial, the treatment achieved 23% weight loss after 84 weeks but did not meet its primary endpoint of demonstrating non-inferiority to tirzepatide 15 mg. Novo is continuing the programme, including additional trials and development of higher-dose combinations.
Attention is therefore shifting towards the next generation of medicines. Zenagamtide, also known as amycretin, has advanced into phase 3 development after phase 2 data showed significant reductions in blood sugar and weight in adults with type 2 diabetes. Novo is developing the treatment in separate programmes for diabetes and obesity.
The wider question for Doustdar is how aggressively Novo should broaden its portfolio. Investors and analysts cited by Reuters have called for greater use of acquisitions and external innovation alongside internal R&D, with cardiovascular and rare diseases among the areas identified as potential sources of future growth.
Novo is also expanding its use of external AI partnerships to accelerate research. On 16 September, it announced a collaboration with Anthropic that will apply Claude and other AI tools to drug discovery, scientific reasoning and software engineering. The agreement forms part of Novo’s stated ambition to become a more AI-driven healthcare company.
The Capital Markets Day is therefore an important leadership test for Doustdar. Novo’s core obesity and diabetes businesses remain substantial, but investors are seeking evidence that the company can combine stronger commercial execution with new medicines, disciplined business development and a broader pipeline capable of supporting growth as semaglutide approaches its patent cliff.
The credibility of that strategy will depend increasingly on execution: maintaining momentum in Wegovy, converting next-generation candidates such as zenagamtide into commercial products, rebuilding confidence in the pipeline and demonstrating that external partnerships and acquisitions can add meaningful growth alongside Novo’s existing franchises.
Image credit: News Øresund – Johan Wessman