Novo’s Next-Gen Shot Falls Short vs Lilly — Stock Tumbles 16%

With input from the Wall Street Journal, CNBC, the Financial Times, Bloomberg, Reuters, and Forbes.

Monday ended up a bad day in Copenhagen for Novo Nordisk: its experimental obesity drug CagriSema failed to hit the trial’s key goal of being at least as good as Eli Lilly’s tirzepatide, and the market punished the news hard — shares plunged about 16%, sliding to their weakest level since June 2021.

Here’s the rundown in plain terms:

• The head-to-head trial at 84 weeks showed 23% average weight loss for patients on CagriSema versus 25.5% for those on tirzepatide. That shortfall meant Novo missed the non-inferiority test it was aiming to clear.
• Investors didn’t wait: Novo’s Copenhagen-listed shares fell roughly 16%, trading near 251 Danish kroner — the lowest since mid-2021. By contrast, Eli Lilly rallied on the news.
• Trial design raised eyebrows: the study was open-label (patients knew which drug they were getting), something Novo’s chief scientific officer, Martin Holst Lange, said could bias results toward a well-known marketed drug. That explanation hasn’t quieted skeptics.

Novo had hoped CagriSema — a combo of semaglutide plus cagrilintide — would reclaim ground lost to tirzepatide (the active ingredient behind Lilly’s blockbuster obesity and diabetes medicines). Instead, the result hands Lilly more momentum in a market that’s already shifting in its favor.

The miss comes at a fraught moment for Novo. The company is wrestling with tougher competition, pressure on US pricing, and the looming loss of exclusivity for its big sellers Wegovy and Ozempic in some markets. All of that makes getting the next winner right crucial.

Executives tried to cool nerves. CEO Mike Doustdar emphasized confidence in CagriSema’s potential, and the company said it plans additional testing — including higher-dose trials — to fully assess whether the combo can still deliver top-tier weight loss. Novo also pointed out the drug was generally safe in the trial, with mostly stomach-related side effects.

Analysts warned the commercial picture just got murkier. In a market where a few percentage points can decide who dominates, falling short against an incumbent blockbuster is a big deal. For investors, this isn’t just a clinical setback — it raises questions about future revenue and how quickly Novo can pivot.

Bottom line: CagriSema’s miss is more than a data point — it’s a reminder that the obesity drug race is brutal, margins are under pressure, and leadership can flip fast. Novo’s next moves (high-dose trials, pricing strategy, possible M&A) will be watched very closely.