Novo Nordisk just made a move that rattled Wall Street. The company slashed U.S. prices for Wegovy and warned investors that sales and profits could drop by as much as 13% this year. Shares plunged hard, wiping nearly $50 billion off its market value in a single trading session.

CEO Mike Doustdar called the financial hit “painful but necessary,” framing it as an investment in the company’s future. Instead of chasing short-term earnings, Novo Nordisk is betting on something bigger: long-term control of the U.S. weight loss market.

Price Cuts That Shocked the Market

David / Unsplash / In early February 2026, Novo Nordisk stunned investors with weaker guidance. The company had enjoyed years of double-digit growth driven by booming demand for GLP-1 drugs.

That streak is now broken!

The sharp shift followed a Most Favored Nation pricing deal with the Trump administration in November 2025. Under that agreement, Novo secured a three-year exemption from threatened tariffs. In exchange, it agreed to slash the monthly price of Wegovy from about $1,350 to $350 through the TrumpRx government portal.

That price cut was dramatic. It turned a high-end specialty drug into something far more accessible for everyday Americans. It also marked the first time Medicare and Medicaid expanded coverage for obesity medications, with beneficiaries paying a $50 copay toward a government-negotiated price of $245.

The Real Pressure Comes From the Market

Government policy played a role, but Novo’s finance chief made it clear that market forces are even more intense. CFO Karsten Munk Knudsen told Reuters that rising rebate demands from insurers and the shift toward self-pay patients have created stronger pressure than the MFN deal itself.

Insurers have pushed hard for bigger discounts, squeezing revenue per prescription. At the same time, more patients are paying out of pocket, often through telehealth services that bypass traditional insurance channels. Novo had to respond or risk losing ground.

The company moved quickly. In November 2025, it began selling Wegovy injections for $349 a month to cash-paying patients. It also introduced a limited-time offer of $199 per month for the first two months of therapy for new self-pay users, valid through March 31, 2026.

Then came the oral version of Wegovy, the first FDA-approved GLP-1 pill for weight loss. Novo launched lower doses at $149 per month for self-pay patients, with prices set to rise to $199 in April. That pricing undercut expectations and aimed straight at consumers who had hesitated at higher costs.

These discounts clearly reduce revenue per prescription. However, Novo is betting that lower prices will unlock a much larger pool of patients who were previously priced out.

Betting on Volume Over Margin

Hab / Unsplash / The strategy is simple but risky. Sell more at a lower price and make up the difference in volume.

Doustdar argues that expanded manufacturing to meet rising demand still counts as real growth, even if top-line revenue temporarily dips.

Early numbers suggest that the volume play might work. Weekly prescriptions for oral Wegovy hit about 50,000 by late January 2026. That figure exceeded standard market tracking estimates, partly because many cash-pay sales flow through channels that are harder to measure.

Around 90% of oral Wegovy sales in the United States are cash-pay. Novo has partnered with telehealth platforms such as WeightWatchers, Ro, and LifeMD to reach these patients directly. These partnerships allow fast onboarding, online consultations, and direct-to-home delivery.

Novo’s aggressive pricing move faces fierce competition from Eli Lilly, whose obesity drug Zepbound has gained ground in U.S. prescription volumes. Lilly has also issued a more optimistic financial outlook, which has impressed investors.