Novo Nordisk is betting on the Wegovy pill to win beyond America

Novo Nordisk told CNBC how he is preparing to go “all in” on launching his Wegovy pill outside the US, as the battle for weight loss market dominance rages around the world.

“If we launch, we’ll all go in,” Novo’s Vice President for International Operations, Emil Kongshøj Larsen, told CNBC in an interview on Tuesday. “It’s a big opportunity.”

Novo announced last week that it expects to begin its first launch outside the US later this year, pending approval, after the pill continued to impress with unparalleled US uptake.

The American market accounts for more than half of the sales of Novo and its biggest competitor Eli Lilly. But companies are now increasingly looking to expand the market for weight loss drugs that have revolutionized the pharmaceutical landscape in recent years.

Larsen wouldn’t name specific countries where Novo might launch the Wegovy pill first, saying the drugmaker “will go full force,” highlighting factors such as patient interest in obesity treatment, how well-trained doctors are, and the availability of potential healthcare partners.

Larsen said that telehealth was one of the ways to increase access to patients, saying that, in Germany, “it has been slow for a long time, and suddenly, telehealth helps patients to receive treatment in a very convenient and respected way.”

While Eli Lilly expects sales to grow 28% in the middle of its guidance for this year, Novo has predicted a sharp decline in sales.

Novo raised its guidance slightly last week, but still expects profits and sales to fall between 4% and 12% in 2026, hurt by lower prices in the US and competition from generics in markets including India, Canada, Brazil, and China.

This is despite Novo gaining an early lead in oral weight loss drugs by launching the Wegovy pill in the US in January. Last week, Novo said total orders had reached more than 2 million, as sales far exceeded expectations in its first quarter despite the low price.

“We’re not going to have a better launch in a world that’s too young when it comes to social media, digital, emotions, etc.,” Larsen said, referring to the US launch. “It’s very exciting for our injection franchise as well, because it powers the Wegovy brand,” he added.

Nordea analysts said in a letter to clients that Wegovy is becoming the number one weight loss brand in the US, based on Google Trends data, which matches prescription trends.

Meanwhile, Lilly said on April 30, more than 20,000 people have started taking the rival pill Foundayo since it started at the beginning of that month.

According to analysts who closely track weekly US prescription data, Foundayo recorded significantly fewer prescriptions than the Wegovy pill in a comparable period, according to IQVIA data, which does not include all prescriptions, but gives market watchers an indication of demand.

Lilly CEO David Ricks told CNBC late last month that establishing Foundayo as a brand “will take time.” Foundayo uses a different active ingredient than Lilly’s blockbuster injections Mounjaro and Zepbound, while Novo’s Wegovy pill is an extension of the company’s equivalent injections.

“Our ramp is going to be a little different, because it’s a new product, a new molecule,” Ricks said. “This will be played in quarters, not days… ask people to beat the beat and get it out.”

Barclays analyst Emily Field noted last week that Oral Wegovy and Foundayo will target different patient categories, with the former having “injectable-like efficacy” and the latter perhaps being considered a “starter” for GLP-1.

Both Ricks and Novo CEO Mike Doustdar say the pills are expanding the market, rather than driving the need for injections.

The pill format is appealing to many patients, and “we believe [it] it will also be done in our part of the world,” Larsen told CNBC, referring to the former US markets.

Larsen said Wegovy’s “high-performance” pill means don’t worry if it’s launched behind the competition in certain markets.

Research has suggested that the pill results in more weight loss than Foundayo and has some cardiovascular benefits, but so far, no clinical trial has directly compared the two drugs.

Larsen said Novo expects “very strong uptake” of the Wegovy pill globally but not at the same curve as in the US.

He said the US does not compare well with other countries because the uptake will depend on the price difference compared to the injectable types.

“We’re not detailing our pricing approach yet, but you can say in the US, there’s a great product, but there’s also another price point compared to injectable therapy.”

He predicted that foreign sales may have “an optic curve that is probably a little more curved than the US curve.”

Sydbank analyst Soren Hansen told CNBC on Wednesday that the launch of Wegovy outside the US it may be “selective” and will reflect the company’s “ability to meet demand.” He highlighted major European markets such as the UK and Germany as potential launch markets, as well as Novo’s home country, Denmark.

Larsen told CNBC that Novo has seen the biggest increase in obesity GLP-1s from customers who pay cash, compared to those covered by national health plans or insurance.

“Even in social health care systems like Denmark, 99% of all patients pay out of pocket. We would not have thought that a few years ago, when we started obesity care,” he added.

In late April, Lilly CEO Ricks told CNBC that the international launch gave the company “a huge leeway.”

“There are a billion people in the world who could benefit from these medicines… we are currently reaching about 20 million, he said.

Lilly’s first-quarter revenue outside the US jumped 81% to $7.7 billion, driven by a 95% increase in volume. Revenue in the US rose 43% in the quarter to $12.1 billion. “It turns out that people like to lose weight all over the world,” Ricks said.

The policy of President Donald Trump called the price policy of the most popular drugs, where the prices of the US market are tied to the prices of a set of reference countries, has complicated the introduction of drugs for many pharmaceutical companies.

Novo’s Larsen said how European countries handle drug prices will not affect out-of-package launches.

“It is really important that European governments also accept that they pay for quality innovations that change public health, because otherwise investments and clinical trials, etc., will continue to go to the US or China, as we see now,” said Larsen.