This post was originally published on here
The Danish pharmaceutical giant Novo Nordisk, led by new CEO Maziar Mike Doustdar, is spearheading a radical transformation of its long-term research and development strategy.
The company is moving ‘beyond the scale’ to reposition its flagship GLP-1 molecules, such as semaglutide, as comprehensive treatments for MASH (liver disease), chronic kidney disease, and cardiovascular health, rather than just weight-loss aids.
Following a challenging year that saw its market capitalisation drop by nearly $400 billion from its mid-2024 peak, the pharma firm received a critical boost on 22 December 2025 with the FDA approval of the first once-daily Wegovy pill (25 mg oral semaglutide).
While the strategic pivot was detailed at recent investor briefings in Copenhagen, the primary battlefield remains the United States, where Novo is fighting to reclaim market share from its arch-rival, Eli Lilly.
The pharmaceutical titan’s vision of becoming a ‘health-span’ company has created a significant divide between the laboratory and the stock exchange.
Scientists are increasingly hopeful as new data from the OASIS 4 and FLOW trials suggest that semaglutide offers profound benefits for the heart and kidneys that occur independently of weight loss. However, Wall Street remain ‘wary,’ with the stock trading at a forward price-to-earnings ratio of just 14.2x, roughly half its historical average. This cooling of investor sentiment reflects a growing impatience with Novo’s heavy capital expenditure, which reached 65 billion DKK (£7.4 billion) in 2025 to expand production and de-risk supply chains against a rising tide of ‘copycat’ competitors.
The Scientific Shift: From Vanity to Vitality
[embedded content]
For the medical community, Novo Nordisk’s evolution represents a turning point in how chronic diseases are managed.
The recent filing for CagriSema, a combination of semaglutide and cagrilintide, aims for weight reductions of over 22 per cent (23.1% in recent REDEFINE 1 trials), but its actual value lies in its potential to ‘reset’ metabolic health.
Researchers are particularly buoyed by the company’s expansion into self-replicating RNA (srRNA) and cell therapies to treat heart failure and atherosclerosis. By targeting the ‘root causes’ of metabolic dysfunction rather than just the symptoms of obesity, Novo is attempting to create a moat of ‘essential’ medicines that are harder for insurers to deny than lifestyle-focused treatments. This scientific ambition, however, requires long-term clinical trials that do not always align with the quarterly demands of institutional shareholders.
Wall Street’s Scepticism and the ‘Lilly Premium’
[embedded content]
The primary source of friction on Wall Street is the widening valuation gap between Novo and Eli Lilly, the latter of which currently commands a significant premium due to the superior weight-loss efficacy of its dual-action drug, Zepbound (tirzepatide).
While Novo has successfully launched its oral Wegovy pill, beating Lilly’s orforglipron to market by several months, investors are concerned about the ‘concentration risk’ of a portfolio where 74 per cent of revenue stems from a single molecule family.
TD Cowen and Morningstar have noted that while the new pill format could unlock a $3.65 billion market by 2030, the company’s profit margins are under pressure from Medicare price negotiations set for 2027. This ‘policy risk’ has led some fund managers to treat Novo as a ‘value play’ rather than the high-growth ‘tech-like’ stock it was in 2023.
For many on the trading floor, the ‘future vision’ of treating Alzheimer’s and liver disease is a welcome prospect, but it cannot come at the expense of defending the core obesity franchise.
A 2026 Comeback in the Making?
Despite the ‘bruising year’ of sliding shares, there are signs that Novo Nordisk’s strategic patience may soon pay off.
The launch of the Wegovy pill in early January 2026 is expected to flip the narrative from ‘pricing headwinds’ to ‘renewed volume growth.’
The company’s October 2025 acquisition of Akero Therapeutics for $5.2 billion, along with its push into the Chinese market, suggests a firm aggressively diversifying its geographic and therapeutic footprint.
As Mike Doustdar settles into his role, the goal is clear: to prove that Novo Nordisk is more than just an ‘Ozempic company.’
If the high-dose 7.2 mg injectable, currently under expedited FDA review, matches Lilly’s efficacy, the ‘Wall Street patience’ being tested may turn into a significant relief rally, rewarding those who backed the scientists’ long-term vision.
