Novo Nordisk raised its full-year outlook for the third time this year on Nov. 4 after its Wegovy weight-loss pill outsold forecasts, but the Danish drugmaker's sales in China fell 5% and its Asia-Pacific region shrank 7% in the third quarter, as price cuts on Wegovy in China and weaker demand elsewhere in Asia offset strong growth in Europe.

For investors in Asia the split matters. Novo's recovery story rests on the U.S. and Europe, where its new pill and higher-dose injections are gaining patients. In Asia, the company is selling more obesity medicine at lower prices and losing ground in diabetes, and its two newest obesity products are not expected to clear China's regulator until 2028.

Novo Nordisk outlook range moves up

Novo now expects 2026 adjusted sales and adjusted operating profit each to land somewhere between a 2% decline and 2% growth at constant exchange rates, according to its financial report. The previous guidance was flat to a 6% fall, Reuters reported. The company said the change came mainly from higher expectations for GLP-1 drug sales in both its U.S. and international units.

Third-quarter adjusted sales rose 4% at constant exchange rates to 79.2 billion Danish kroner. Adjusted operating profit climbed 27% to 31.72 billion kroner, helped by a soft comparison: a year earlier the company booked 9 billion kroner of restructuring costs. Reported operating profit fell 9% at constant rates after 8.7 billion kroner of impairment charges, including 4.6 billion kroner on the experimental heart drug ziltivekimab and 4.1 billion kroner tied to shrinking its manufacturing network.

Analysts had expected adjusted sales of 73.22 billion kroner and adjusted operating profit of 28.39 billion kroner, according to Reuters. Wegovy pill sales of 5.39 billion kroner, about $810 million, beat a consensus of 4.62 billion. The U.S. accounted for about 4.18 billion kroner of that and international markets for about 1.22 billion, Reuters said.

Chief Executive Mike Doustdar said in the report that "growth was led by our obesity portfolio." The shares rose as much as 6.6% in Copenhagen trading on Nov. 4 and were up 4.2% in the afternoon, on course for their biggest daily gain since June 19, Reuters reported. Markus Manns, a portfolio manager at Union Investment, told the news agency that competition in obesity drugs is likely to get tougher.

China and Asia-Pacific lag Europe

Novo's International Operations unit grew sales 8% at constant rates to 37.3 billion kroner in the quarter. Almost all of that came from Region EUCAN (Europe and Canada), where sales jumped 18% to 19.9 billion kroner and obesity sales rose 47%.

Asia went the other way. Region China sales fell 5% at constant rates to 5.03 billion kroner, and Region APAC fell 7% to 5.04 billion kroner. Together the two regions made up about 13% of group sales in the quarter.

The company said lower realized Wegovy prices were concentrated in China, following list price cuts in late 2025. China obesity sales still rose 162% at constant rates, but from a small base, to 326 million kroner. In GLP-1 diabetes drugs, which include Ozempic, China sales dropped 36% to 1.44 billion kroner. Insulin was the bright spot: China insulin sales rose 17% to 2.93 billion kroner.

In APAC, obesity sales fell 22% at constant rates to 1.54 billion kroner in the quarter. Over nine months the region's total sales were still up 2%, while China's were down 2%.

The same pressure on prices has hit other European drugmakers in China. AstraZeneca reported last month that its China revenue slipped 3% in nine months after mandatory price cuts on older medicines.

Regulatory clock in China runs to 2028

Novo used the quarter to file two obesity treatments with China's Center for Drug Evaluation. It submitted oral semaglutide 25 mg, the active ingredient in the Wegovy pill, and expects that review to finish around the turn of 2027 into 2028. It also filed CagriSema, its next-generation injectable, with a decision expected in the first half of 2028.

Outside China, the pill is rolling out quickly. By the end of the third quarter it was on sale in the U.S., the United Arab Emirates, Britain and Germany, and later launches in Mexico, Spain, France and Poland took the total to eight markets. Novo also plans more than 30 launches of its higher-dose Wegovy 7.2 mg pen across International Operations this year.

Cash generation stays strong. Free cash flow reached 83.8 billion kroner in the first nine months, up from 71.1 billion a year earlier, and Novo returned 61.9 billion kroner to shareholders through dividends and buybacks. As of Nov. 2 it had repurchased shares worth about 11.56 billion kroner under a program of up to 15 billion kroner that runs until early February.

The next test for the U.S. side is a Food and Drug Administration decision on the 25 mg dose of the Ozempic pill, which Novo expects in the fourth quarter. The company is preparing a U.S. launch of CagriSema in early 2027, subject to approval.