Why Is Novo Nordisk Stock Down 13% Premarket? Trial Fails to Match Eli Lilly

Novo Nordisk (NVO) shares are tumbling in premarket trading on Monday, February 23, 2026, after the Danish pharmaceutical giant disclosed that its next-generation obesity drug CagriSema failed to match the weight-loss efficacy of Eli Lilly’s tirzepatide in a direct head-to-head clinical trial. The disappointing result marks another setback for Novo Nordisk as it battles to defend its position in the highly competitive and fast-growing obesity treatment market.

Coming on top of a brutal 2025 in which NVO shares already shed roughly 49%, the fresh trial failure is intensifying investor concerns about the company’s ability to compete with Lilly’s Zepbound going forward.

CagriSema Misses Primary Endpoint

In a statement released Monday morning, Novo Nordisk confirmed that CagriSema did not meet the primary endpoint of the REDEFINE 4 trial, an open-label head-to-head study designed to demonstrate that CagriSema was at least as effective as Eli Lilly’s tirzepatide in reducing body weight.

According to Bloomberg, participants on a standard dose of CagriSema achieved 20.2% weight loss after 84 weeks, while Reuters reported a 23% figure for the broader trial cohort – both falling short of tirzepatide’s 25.5% reduction. The trial had originally been initiated at a time when Novo Nordisk expected CagriSema could actually outperform Zepbound, according to UBS analyst Colin White, making the miss all the more striking.

CagriSema was viewed as a cornerstone of Novo Nordisk’s long-term competitive strategy. The drug combines semaglutide, the active ingredient in Wegovy and Ozempic, with a compound that mimics the gut hormone amylin, a mechanism designed to push weight-loss results beyond what semaglutide alone can deliver.

However, the drug has now posted mixed results across multiple studies, including a prior large obesity trial that also failed to hit Novo’s internal weight-loss targets. Novo said additional trials are ongoing to explore higher-dose combinations and the drug’s fuller potential.

The market reaction was swift and severe. Copenhagen-listed shares of Novo Nordisk fell roughly 11–13% by mid-morning European trading, while Eli Lilly shares surged as much as 4.2% in U.S. premarket trading, briefly touching $1,049.94. The divergence underscores the shifting competitive landscape in the GLP-1 and obesity drug space, where clinical efficacy data increasingly drives market share expectations.

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NVO Stock Brief: Premarket Price and Key Metrics

As of the premarket session on February 23, 2026 at 5:27 AM EST, NVO was trading at $40.99, down $6.43 or 13.56% from the prior session’s closing price of $47.42. The stock had already closed down 2.13% on Friday, February 20, reflecting broader pressure on the name heading into the weekend.

With the premarket move, NVO has now fallen approximately 44.68% over the past year and 7.42% year-to-date, dramatically underperforming its benchmark, the OMX Copenhagen 25 Index, which is down just 3.40% over the same one-year period.

Despite the sharp decline, some valuation metrics suggest the stock may be approaching value territory. NVO currently trades at a trailing P/E of just 12.96 and carries a forward dividend yield of 3.92%, with an ex-dividend date of March 30, 2026. The 52-week range spans $43.08 to $93.80, meaning the stock is now trading near multi-year lows.

The consensus analyst price target sits at $53.98, implying meaningful upside from current levels, and the most recent analyst action, an Outperform initiation by CICC in January 2026 with a $73.50 price target, reflects that some on Wall Street see the selloff as overdone.

Novo Nordisk does retain significant financial strengths: a profit margin of 33%, return on equity of over 60%, and Q4 FY25 EPS of $6.04 that beat the $5.90 estimate. The company is also undergoing a leadership refresh, with Lars Rebien Sorensen installed as board chairman and two drug industry veterans nominated to the board.

Whether these operational and governance changes can translate into a credible competitive response to Eli Lilly, particularly as patents on Wegovy and Ozempic approach expiration, remains the central question for investors weighing the stock at these depressed levels.

Disclaimer: The author does not hold or have a position in any securities discussed in the article. All stock prices were quoted at the time of writing.