Novo Nordisk vs Eli Lilly: Which Pharma Giant Will Outperform This Year?
Novo Nordisk Cuts 2026 Outlook, While Eli Lilly Prepares for Earnings
Novo Nordisk has significantly reduced its 2026 forecast after failing to meet 2025 expectations. Meanwhile, Eli Lilly is preparing for earnings, with a focus on potential Medicare benefits and its oral obesity pill. Analysts are leaning towards Eli Lilly due to better upside and ratings, despite the early success of Novo’s oral Wegovy pill.
Over the past year, Novo Nordisk’s stock has dropped nearly 40%, while Eli Lilly has seen an increase of about 25%. This contrast highlights the shifting dynamics in the obesity drug market as both companies prepare for their upcoming earnings reports.
Novo Shares Plunge After Guidance Cut
On Tuesday, Novo Nordisk shares fell by 15% following a warning that fiscal 2026 adjusted sales could decline between 5% and 13%, with adjusted operating profit potentially dropping by as much as 13%. The company cited pricing pressure, increased competition, and patent expirations for the active ingredient in Wegovy and Ozempic in some markets outside the U.S.
This outlook came after Novo’s 2025 results missed expectations. The company reported net sales of DKK 309.06 billion ($48.9 billion), up 6% year-over-year but below estimates of DKK 346.97 billion. Diluted earnings per share (EPS) rose to DKK 23.03 but fell short of expectations of DKK 23.4, while operating profit slipped 1% to DKK 127.66 billion.
Eli Lilly Expected to Report Strong Results
In contrast, Eli Lilly is expected to report quarterly revenue of $17.94 billion, up from $17.60 billion in the previous quarter. EBITDA is anticipated to reach $8.43 billion, with GAAP EPS rising to $7.04 from $6.21, according to Koyfin analysts. Despite a slight decrease in EBIT, the numbers suggest strong performance.
Wall Street Favors Eli Lilly Over Novo Nordisk
Wall Street currently favors Eli Lilly over Novo Nordisk based on analyst targets and ratings. Novo Nordisk shares closed at $50.3 in the U.S. and DKK 367.80 on the Copenhagen exchange. Koyfin data shows a 12-month average price target of DKK 401.91, indicating about 9.3% upside from the last close. Analyst ratings on Novo include one ‘Strong Buy’, ten ‘Buy’, nine ‘Hold’, and two ‘Sell’ from 22 analysts.
Eli Lilly shares closed at $1,003.46. Koyfin data shows a 12-month average price target of $1,150, implying about 14.6% upside from current levels. Analyst ratings on Lilly include four ‘Strong Buy’, 17 ‘Buy’, seven ‘Hold’, zero ‘Sell’, and one ‘Strong Sell’ from 29 analysts.
GLP-1 Pill vs Injection Race
Novo holds a first-mover advantage in oral obesity drugs after the FDA approved the Wegovy pill in December, with a launch last month. Reuters reported that the pill recorded 18,410 U.S. prescriptions in its first full week, outperforming Novo’s injectable Wegovy and Lilly’s Zepbound. Novo stated that over 170,000 patients have started the pill so far, with more than 80% being new to GLP-1 treatments.
Novo also announced that its next-generation obesity drug CagriSema delivered greater weight loss and blood sugar reduction than Wegovy in a late-stage diabetes trial.
Lilly is intensifying competition in injectable weight-loss drugs, with UBS stating that its tirzepatide-based treatment Zepbound is already a leading therapy in the class, increasing pressure on Novo’s Wegovy franchise. The company is awaiting FDA approval for its oral obesity drug Orforglipron, expected by April, with a full launch planned for the second quarter. Unlike Novo’s pill, Lilly’s oral drug does not require fasting, a feature UBS analysts highlighted as a potential competitive advantage.
Expanding Beyond Obesity
Lilly continues to expand its portfolio beyond obesity through acquisitions and partnerships, including the acquisition of Ventyx Biosciences, research collaborations with Seamless Therapeutics and Nimbus Therapeutics, and AI-focused partnerships with NVIDIA, Revvity, and Schrodinger.
Policy Headwinds and Tailwinds
Novo mentioned alongside its earnings update that lower realized prices, partly due to U.S. government efforts to control drug costs, will impact near-term results. Medicare discounts for Ozempic and Wegovy, announced last year, are set to take effect in 2027.
Lilly’s management has taken a more optimistic stance. CEO Dave Ricks said last week that Medicare coverage for obesity drugs, expected later this year, could increase access and reduce out-of-pocket costs in the second half. This optimism comes as the Centers for Medicare & Medicaid Services reported a proposed 0.09% average increase in Medicare Advantage payments for 2027, resulting in over $700 million in additional funding. Cantor Fitzgerald warned that this update could pressure healthcare insurers, citing limited incremental funding and greater political influence over rate-setting.
Retail Sentiment on Bisakimia
On Bisakimia, retail sentiment was ‘bullish’ for both stocks, with message volume ‘extremely high’ for Novo Nordisk and ‘normal’ for Eli Lilly. Novo message volumes surged nearly 2,900% over the past year, while Lilly message volumes more than doubled over the same period.
One user expects Novo Nordisk’s shares to rise if Eli Lilly’s results are disappointing. Another user expressed concern about Novo Nordisk’s outlook, warning that once Eli Lilly secures FDA approval for its oral obesity pill and gains traction, Novo’s shares could face further downside.
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