Key Takeaways
- Shares of Novo Nordisk plummeted 15% following disappointing results from CagriSema’s comparative trial against Eli Lilly’s tirzepatide.
- Trial participants using CagriSema achieved 23% weight reduction compared to 25.5% with tirzepatide — falling short of the non-inferiority benchmark.
- NVO shares reached their lowest valuation since June 2021, marking a nearly 50% decline over twelve months.
- Company leadership maintains optimism about CagriSema’s prospects as a pioneering GLP-1/amylin combination therapy.
- Shares of Eli Lilly climbed 3.1% during premarket hours following the announcement.
Novo Nordisk faced significant market turbulence on Monday following the disclosure that its experimental obesity treatment CagriSema underperformed in a direct comparison against Eli Lilly’s tirzepatide during clinical testing.
The disappointing outcome pushed shares to their weakest position in nearly four years.
Clinical trial data spanning 84 weeks demonstrated that CagriSema users experienced a 23% reduction in body weight. By contrast, participants receiving tirzepatide — the compound behind Lilly’s Mounjaro and Zepbound brands — achieved a 25.5% weight decrease.
This differential proved sufficient to prevent CagriSema from meeting its critical objective: demonstrating non-inferiority when compared to tirzepatide.
The study utilized an open-label format, where subjects were aware of their assigned treatment. Novo’s Chief Scientific Officer Martin Holst Lange acknowledged that such protocols can create inherent bias favoring established medications over investigational compounds.
Lange expressed astonishment at the 25.5% efficacy figure for tirzepatide, noting that Lilly’s previous research indicated approximately 20.2% weight reduction over a 72-week period.
Leadership Maintains Confidence
Undeterred by the setback, CEO Mike Doustdar defended the compound’s prospects. “We strongly believe that CagriSema has, right now, the best weight efficacy than any product currently in the market,” he stated.
The pharmaceutical giant submitted CagriSema for FDA review in the final months of last year, with regulatory feedback anticipated by late 2026. Doustdar projected market entry in early next year with what he described as superior weight-loss labeling compared to existing options.
The organization is evaluating supplementary clinical investigations, including higher-dose formulations, to optimize the therapy’s performance.
CagriSema represents a dual-action approach, pairing semaglutide — found in Ozempic and Wegovy — with cagrilintide, an investigational appetite-regulating hormone. The company has marketed it as the inaugural GLP-1/amylin combination for obesity management.
Mounting Challenges for Danish Pharma Giant
This development represents the latest in a series of disappointments. When Novo initially unveiled CagriSema’s late-stage findings in December 2024, shares plunged 21%, erasing approximately $100 billion in market capitalization.
Over the trailing twelve months, NVO has surrendered roughly half its market value.
Earlier in March, the company projected revenue and earnings contractions ranging from 5% to 13% for 2026. Management cited intensifying competitive pressures, declining U.S. pricing, and impending patent cliff challenges for Wegovy and Ozempic in certain jurisdictions.
Jefferies analyst Michael Leuchten observed that CagriSema’s market positioning has become “increasingly unclear” after Monday’s revelations. He projected the drug could represent 15% to 25% of Novo’s total revenue by 2030 and emphasized “the pressing need for M&A,” estimating potential acquisition spending of up to $35 billion throughout this year.
In contrast, Eli Lilly shares advanced 3.1% during Monday’s premarket session.
Novo’s Copenhagen-traded shares declined 14% to 259 Danish kroner during European trading hours.
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