Even as Novo Nordisk A/S shares tumbled 6.10% to $66.15 on November 4, 2025, following disappointing Alzheimer’s trial results for its blockbuster drug Ozempic, Florent Cespedes, a senior equity analyst at Bernstein SocGen Group, stood firm — upgrading his price target to DKK540 ($72.40), calling the sell-off an overreaction. The news, first reported by The Wall Street Journal and Investor’s Business Daily, sent shockwaves through healthcare investors. But Cespedes wasn’t just looking at one failed trial. He was betting on the bigger picture: obesity, oral semaglutide, and a bold acquisition move that could redefine Novo Nordisk’s future.
Failed Trial, Strong Fundamentals
Ozempic’s failure to slow cognitive decline in a Phase 2 Alzheimer’s trial was undeniably a blow. The drug, already a $20 billion-a-year revenue engine for weight loss and type 2 diabetes, had been hyped as a potential neuroprotective agent. Investors had hoped it could expand into the $100 billion neurodegenerative market. But the data didn’t support it — and the market punished the company accordingly.
Yet, just one day later, on November 5, 2025, Novo Nordisk reported Q3 earnings that told a different story. Earnings per share came in at $1.02 — blowing past the $0.77 consensus by 32%. Net margin held steady at 35.6%, and return on equity soared to 78.64%. Revenue, however, missed expectations at $11.74 billion versus the $11.98 billion forecast. That’s the paradox: profitability is stronger than ever, but growth expectations are being reset.
The Metsera Gambit
On the same day as the Alzheimer’s setback, Novo Nordisk announced an updated, "superior" unsolicited acquisition proposal for Metsera, Inc., a U.S.-based biotech firm with early-stage peptide programs targeting incretin and non-incretin pathways. The move isn’t about replacing Ozempic — it’s about building the next generation.
Metsera’s pipeline, still in preclinical and Phase 1 stages, offers novel mechanisms that could complement Novo’s existing GLP-1 platform. The Danish company isn’t just chasing blockbuster drugs anymore. It’s assembling a toolbox — peptides that could work in tandem with semaglutide, or even replace it in patients who develop tolerance. "This isn’t a hedge," said one unnamed executive familiar with the talks. "It’s a bridge to the next decade."
Analyst Divide: Hold vs. Buy
The market’s reaction reflects a deep split. According to MarketBeat data cited by HSBC, the consensus among 20 analysts is a tepid "Hold," with an average price target of $59.20. That includes 10 Hold ratings, 3 Sell, and only 7 Buy or Strong Buy calls.
But the outliers are loud. Florent Cespedes isn’t alone. Rajesh Kumar at HSBC upgraded Novo to "Buy" on October 1, 2025, citing improved reimbursement channels and pipeline value. TD Cowen’s Michael Nedelcovych still sees $105 upside — a 59% jump from current levels.
What’s driving their optimism? Oral semaglutide. While Ozempic is injectable, Novo’s oral version — taken daily — is gaining traction in Europe and is now rolling out in the U.S. It’s cheaper to produce, easier for patients to use, and could capture a broader demographic, including older adults wary of needles. Sales projections for next quarter: $12.36 billion, with a high-end forecast of $12.97 billion.
The Eli Lilly Shadow
Novo’s biggest threat isn’t just clinical setbacks — it’s competition. Eli Lilly is surging, thanks to its oral drug Orforglipron and a favorable new Medicare reimbursement deal brokered by the White House. Bernstein raised Lilly’s price target to $1,300, projecting Orforglipron sales of $1.8 billion in 2026 — nearly triple the $550 million consensus. Morgan Stanley and Truist Securities have followed suit, lifting their targets to $1,290 and $1,182 respectively.
The White House deal gives Lilly a critical head start in accessing Medicare beneficiaries — a demographic Novo has struggled to penetrate. "Lilly got the timing right," noted a former FDA official. "Novo’s strength is in Europe and private payers. But in the U.S., the government’s the biggest payer. And they’re favoring Lilly’s launch cadence."
What Comes Next?
Novo Nordisk’s next move will be critical. The company plans to file for FDA approval of its oral semaglutide in the U.S. by Q2 2026. If approved, it could capture 15–20% of the obesity market by 2027, according to J.P. Morgan’s modeling. Meanwhile, Metsera’s pipeline — though early — could yield its first clinical data by late 2027.
Investors should watch two things: First, whether Novo can negotiate a separate Medicare deal — perhaps by leveraging its existing diabetes footprint. Second, whether Metsera’s non-incretin peptides show promise in early trials. If one of those compounds reduces appetite without GI side effects, it could be a game-changer.
For now, the market is punishing Novo for one misstep. But the company’s fundamentals — cash flow, margins, R&D discipline — remain among the best in pharma. The question isn’t whether Ozempic works for Alzheimer’s. It’s whether Novo can build the next drug before Lilly owns the market.
Frequently Asked Questions
Why did Novo Nordisk’s stock drop despite strong earnings?
The drop was driven by investor disappointment over Ozempic’s failure in an Alzheimer’s trial, which had raised hopes for a major new market. Even though Q3 earnings beat on EPS and profitability, the market prioritized growth potential over current performance. Revenue slightly missed estimates, reinforcing fears that Novo’s reliance on GLP-1 drugs may be peaking.
How does the Metsera acquisition change Novo Nordisk’s long-term strategy?
The acquisition signals a shift from purely leveraging GLP-1 agonists to diversifying into novel peptide mechanisms. Metsera’s non-incretin programs could lead to drugs that work differently than semaglutide — potentially with fewer side effects or broader applications in metabolic and neurodegenerative diseases. It’s a hedge against future competition and patent cliffs.
Why is Eli Lilly gaining ground despite Novo’s dominance in sales?
Eli Lilly benefits from a White House-backed Medicare reimbursement deal that prioritizes its oral obesity drug Orforglipron, giving it faster access to the 65+ demographic — a key growth segment. Novo’s drugs are still largely covered under private insurance. Without similar public payer access, Novo’s U.S. market expansion is constrained, even as it leads in global sales.
What’s the significance of Florent Cespedes’ DKK540 price target?
DKK540 ($72.40) is 9% above current prices and far above the $59.20 analyst consensus. It reflects confidence in Novo’s ability to monetize oral semaglutide and absorb short-term pipeline risks. Cespedes sees Novo as a structural winner in obesity care, not just a temporary blockbuster play. His target implies strong growth beyond 2026, assuming Metsera’s pipeline delivers.
Are there any risks to Novo Nordisk’s bullish outlook?
Yes. If Metsera’s pipeline fails in clinical trials, or if Orforglipron’s U.S. uptake exceeds projections, Novo could lose its pricing power. Regulatory delays in oral semaglutide approval, or new generic competition, could also pressure margins. The company’s high valuation leaves little room for error — one more clinical misstep could trigger another sharp sell-off.
How does this situation compare to past pharmaceutical setbacks?
It’s similar to Roche’s failed Alzheimer’s drug trials in the 2010s — investors initially punished the stock, but Roche rebounded by doubling down on oncology. Novo’s advantage is its cash flow and proven commercial engine. Unlike Roche, Novo doesn’t need a miracle drug to survive — it just needs to execute on its existing strengths while quietly building the next one.
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