Novo Nordisk CEO Unveils Aggressive Strategy to Reclaim GLP-1 Market Lead, Targets 2 Billion People

After a turbulent 2025 that saw its market lead in the lucrative GLP-1 obesity drug sector erode, Novo Nordisk is ready to fight back. At the recent J.P. Morgan Healthcare Conference in San Francisco, new CEO Maziar Mike Doustdar unveiled a comprehensive battle plan for 2026, acknowledging the Danish drugmaker’s recent struggles while projecting a confident path forward. Doustdar, who stepped into the leadership role last summer, reflected on what he termed the “curse of a leader”—the unenviable position of guiding a pioneering company through an increasingly competitive landscape.

Novo Nordisk was, for years, the undisputed trailblazer in the prescription obesity drug market, first with Saxenda and then with the blockbuster Wegovy (semaglutide). However, 2025 proved to be a challenging year, marked by a steep share-price decline and a significant loss of market share in the U.S. to its formidable rival, Eli Lilly. Beyond direct competition, Novo also grappled with the rapid proliferation of the U.S. compounding industry, which began mass-producing GLP-1s earlier in the decade, capitalizing on previous shortages of Wegovy and Lilly’s Zepbound. Doustdar didn’t shy away from admitting Novo’s “difficult 2025,” underscoring the urgent need for a strategic overhaul.

A Three-Pronged Strategy for Reassertion and Growth

To navigate this complex environment and regain its footing, Doustdar outlined three core priorities for Novo Nordisk in 2026. First is the acceleration of commercial execution, which involves bolstering new product launches and expanding direct-to-patient (DTP) sales channels. Second, the company aims to progress its robust pipeline of innovative treatments. Finally, Novo will focus on balancing financial discipline with strategic investments “where the investments are needed,” ensuring sustainable growth while adapting to market demands.

Doustdar highlighted a profound shift in the obesity treatment landscape, stating, “We have seen that, especially within the field of obesity, this acts a lot more as a consumer business than a traditional medication.” This insight forms a cornerstone of Novo’s renewed commercial strategy. Mastering this consumer-centric approach, particularly through DTP and cash-pay channels, is now a “high on our agenda.” This recognition stems from the fact that many patients, especially those seeking weight loss solutions, are actively engaged in their treatment choices and often willing to pay out-of-pocket for convenient access.

Expanding Access and Embracing Partnerships

A critical component of Novo’s course correction involves significantly expanding GLP-1 availability. Doustdar acknowledged that the rise of telehealth providers and compounding pharmacies was a direct response to a very real “access deficit” in recent years. To address this, Novo is not only leveraging its own DTP platform, NovoCare Pharmacy, but also forging strategic partnerships with a diverse array of players. These include healthcare technology companies like Ro and LifeMD, e-commerce giants such as Amazon, and established wellness brands like Weight Watchers. These collaborations are designed to make Novo’s GLP-1s more accessible to a broader patient population, catering to varied preferences and financial situations.

A significant development in this push for broader access is the recent launch of Novo’s once-daily Wegovy pill. This oral formulation is poised to be a game-changer, especially for the “many of them [who] don’t want an injection and are waiting for the pill,” as Doustdar noted at the J.P. Morgan conference, according to Pharmaphorum. While Eli Lilly is also developing its own oral GLP-1 drug, orforglipron, Novo has a crucial head start. Doustdar defended the Wegovy pill’s prospects, pointing to the 1.5 million people who successfully manage Novo’s oral GLP-1 diabetes drug Rybelsus, which also requires 30 minutes of fasting after dosing. He subtly highlighted a potential differentiator, noting that Lilly’s orforglipron trial protocols included restrictions around statin administration, a class of medication widely used by individuals with obesity, suggesting a potentially more complex regimen for Lilly’s offering.

Refocusing R&D: Back to the Company’s DNA

Beyond commercial tactics, Novo Nordisk is also recalibrating its research and development strategy. Doustdar emphasized a return to the company’s core “DNA”—a focused approach on diabetes and obesity. While Novo’s work in these areas has historically provided inroads into adjacent fields like chronic kidney disease, cardiovascular disease, and metabolic dysfunction-associated steatohepatitis, the company will now use diabetes and obesity as a “starting point” rather than “rushing in” to new indications. This strategic pivot is rooted in the belief that “we are really good when we focus,” signaling a more disciplined and targeted R&D effort.

This slightly scaled-back R&D focus is not a retreat but a strategic consolidation, driven by the immense unmet need that still exists within diabetes and obesity globally. According to a presentation prepared by Novo for JPM, only 7% of the more than 550 million people living with Type 1 or Type 2 diabetes receive a GLP-1. This figure plummets to a mere 2% when considering the more than 900 million people worldwide with obesity. “This is a very, very large unmet need where we and our competition today are only touching the surface when it comes to treatment of these individuals,” Doustdar asserted, according to BioSpace. He challenged the notion that the market is saturated, asking, “us and Lilly combined probably have 10 [million or] 15 million patients. What about the other 85 million? We need to get to them.”

Novo Nordisk’s strategic pivot under Maziar Mike Doustdar represents a clear acknowledgment of past missteps and a decisive move to reassert its leadership. By embracing a consumer-centric approach, aggressively expanding access through partnerships and oral medications, and returning to a focused R&D strategy, the company is not merely defending its territory but aiming to significantly broaden the entire GLP-1 market. This shift from a lone pioneer to a nimble, market-adaptive leader could redefine the landscape of metabolic disease treatment, ultimately benefiting millions of underserved patients worldwide.