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Shares of Novo Nordisk plunged more than 16%, erasing the remaining gains driven by its blockbuster weight-loss drug Wegovy. The sharp decline followed disappointing trial results for its next-generation obesity treatment CagriSema, which underperformed a rival therapy from Eli Lilly. The drop pushed Novo’s valuation sharply lower, extending a massive fall from its 2024 peak when it was briefly worth over $650 billion.

Novo has now shed roughly $475 billion in market value, with its shares retreating to levels last seen before Wegovy’s 2021 launch transformed the company into Europe’s most valuable drugmaker. The stock was among the biggest decliners on Europe’s STOXX 600 index, while Eli Lilly shares gained in U.S. trading, reflecting investor confidence in its competing obesity treatments.

Analysts said the trial setback could dent long-term sales prospects for CagriSema and make it harder for Novo to regain market share in the rapidly expanding obesity drug sector. Growing competition, particularly from highly effective weight-loss therapies, has intensified pressure on the Danish drugmaker as investors reassess its growth outlook.

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Novo Nordisk’s newly launched Wegovy weight-loss pill has shown encouraging early uptake in the United States, according to analysts citing initial prescription data. About 3,071 retail prescriptions were filled in the first four days after the January 5 launch, offering a first glimpse of performance for the first oral GLP-1 weight-loss drug to reach the market. Following the news, Novo’s shares rose 6.5%, recovering from earlier declines and reaching their highest level since September.

The pill is a key part of Novo’s strategy to regain ground from U.S. rival Eli Lilly, as competition intensifies ahead of a potential FDA decision on Lilly’s experimental pill by April. Analysts caution that the early data is limited and that pricing pressures and insurance coverage changes could affect sales. However, UBS noted that if prescriptions exceed 400,000 in the first quarter, the launch would rival Lilly’s Zepbound and outperform the earlier rollout of Wegovy injections.

Novo is prioritizing the U.S. launch to avoid supply issues and is targeting cash-paying consumers through major pharmacies and telehealth platforms. Analysts estimate the pill could generate around $1 billion in sales this year if Novo capitalizes on its first-mover advantage. While injectable treatments are expected to remain dominant, experts say oral options could significantly expand the market by attracting patients seeking alternatives to needles.

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