Between Strong Results and a Cautious Outlook

Novo Nordisk, the Danish pharmaceutical giant listed in Copenhagen and New York, reported exceptionally strong results for the first half of 2025, marking double-digit growth in sales and profits. However, alongside these impressive top- and bottom-line numbers, the company revised its full-year growth outlook downward. The financial metrics are particularly robust, but so too are the emerging questions about the future pace of expansion for its flagship products, especially Wegovy and Ozempic in the obesity and diabetes markets. This review dives into Novo Nordisk’s H1 2025 report, the company’s key growth engines, market dynamics, and the strategic opportunities and risks that will define the rest of the year.

Quantitative Review: H1 2025 Delivers New Highs Across the Board

In the first half of 2025, Novo Nordisk recorded revenues of DKK 154.9 billion, up 16% year-over-year and 18% at constant exchange rates (CER). Operating profit soared to DKK 72.2 billion, a 25% increase (29% at CER), while net profit reached DKK 55.5 billion, up 22%. Diluted earnings per share rose 23% to DKK 12.49. The diabetes and obesity franchise remains the company’s main growth engine, jumping 16% to DKK 145.4 billion, with the obesity segment itself surging 56% to DKK 38.8 billion. The rare disease segment also grew 14% to DKK 9.5 billion.

Operationally, gross profit reached DKK 129.2 billion, reflecting a gross margin of 83.4%, a slight decrease due to efficiency expenditures and the acquisition of additional manufacturing facilities. Novo Nordisk’s return on equity strengthened further, reaching 34.9%. Free cash flow, while still strong at DKK 33.6 billion, declined compared to last year as the company increased capital investments and supply chain spending.

Segment Analysis: Obesity and Diabetes Lead, While Insulin Stagnates

Segmental analysis highlights obesity as the most powerful driver, growing 56% in local currency and 58% in CER, mainly due to Wegovy’s global rollout—a 75% sales increase to DKK 36.9 billion. In contrast, Saxenda sales dropped 51% to DKK 1.9 billion, as the market shifts decisively toward newer, weekly injectable therapies.

In diabetes, GLP-1 products—led by Ozempic and Rybelsus—grew 8% to DKK 77.9 billion. Ozempic alone rose 14% to DKK 64.5 billion, consolidating its role as the franchise flagship. However, insulin products stagnated, with total sales up only 3% at DKK 27.7 billion, and several lines declining further.

The rare disease division continued its positive momentum, with rare endocrine disorder treatments rising 48% to DKK 2.7 billion. Geographically, the U.S. remains the core growth engine, with sales of DKK 87.3 billion (16% up), but the contribution from international markets is expanding even faster at 19% growth in CER.

Strategy, Innovation, and Investment—Novo’s Relentless Drive

Novo Nordisk continues to invest aggressively in its future, with a focus on pharmaceutical innovation and bold strategic moves. The company is advancing the next generation of obesity drugs, including the amycretin platform (injectable and oral), now in phase 3 trials. Ozempic is undergoing regulatory review for use in peripheral artery disease, and trials are progressing for high-dose Wegovy and collaborations with U.S. biotech firms.

The company is also entering cardiology, with late-stage clinical trials in MASH (liver disease) and heart failure, and has secured FDA approval for Alhemo, a therapy for hemophilia A and B. This pipeline diversification reflects Novo’s effort to build beyond its historic core and address the broader spectrum of metabolic and chronic diseases.

Updated Guidance: U.S. Market Headwinds and Slower Growth

Despite stellar H1 performance, Novo Nordisk revised its full-year guidance downward, projecting 8–14% revenue growth (previously 13–21%) and 10–16% operating profit growth (previously 16–24%). Currency effects are expected to shave off 3–5 percentage points from these figures.

The main reason for the cautious outlook is a sharp deceleration expected in the U.S. market in H2 2025. Headwinds include increased use of compounded (generic) GLP-1s, slower-than-expected penetration of Wegovy into U.S. insurance markets, and intensifying competition from Eli Lilly’s tirzepatide. Supply and distribution constraints are also limiting sales outside the U.S., particularly in Europe and China.

Risk Management and Returns: Navigating the Challenges

Novo Nordisk faces several headwinds in H2 2025: U.S. market slowdown, mounting competition from generics and new therapies, supply constraints, regulatory risks (especially around the 340B discount program in the U.S.), and continued cost pressures in R&D and supply chain. At the same time, the company enjoys exceptional market positioning, gold-standard products, and a robust pipeline that should enable it to maintain leadership in years ahead.

Operationally, the company is pursuing efficiency measures, maintaining double-digit operating growth, and building its global presence while managing FX challenges. In the obesity space, Novo notes a substantial unmet need: of over a billion people worldwide with obesity, only a tiny fraction receive pharmaceutical treatment.

ESG Analysis: Business Growth with Social and Environmental Responsibility

Novo Nordisk emphasizes its ESG agenda in the report. Alongside expanding treatment to over 45 million patients worldwide, the company saw a 31% rise in carbon emissions, mainly due to new manufacturing sites and increased production. Novo aims for net zero emissions by 2045, reducing plastic waste per patient and maintaining gender diversity (43% women in senior management, up from 41%).

Leadership Transition and Strategic Realignment

In August 2025, a new CEO, Mike Daoustarr, will take over from longtime leader Lars Fruergaard Jørgensen, marking a new era for the company. At the same time, Martin Holst Lange will integrate R&D and product development units. These changes could usher in fresh management perspective and innovation but may also require adjustment in a fiercely competitive market.

Market Trends and Strategic Opportunities for H2 2025

While the U.S. remains Novo Nordisk’s revenue engine, growth in Asia, Europe, and emerging markets is accelerating. The launch of new drugs in cardiovascular, liver, and rare disease segments could drive substantial future growth. However, the pace of obesity treatment uptake and the complex U.S. environment will continue to shape quarterly performance.

Conclusion: Balancing Growth, Innovation, and Caution

Novo Nordisk’s H1 2025 report shows robust sales and profit growth, driven by innovation in obesity and diabetes treatments. Yet, the company is not blind to challenges—a slower U.S. market, fierce competition, and regulatory pressures loom. The ability to innovate, grow in new markets, and manage costs will be critical for Novo Nordisk to sustain its leadership in global biopharmaceuticals through the rest of 2025 and beyond. The downward revision of guidance may weigh on investor sentiment short-term, but the company’s long-term fundamentals remain strong.