Novo Nordisk’s dilemmas and that fine line between science and marketing
The Danish pharmaceutical group is grappling with a strategic crisis, amid market challenges and cultural change within the pharmaceutical sector
When presenting the 2026 figures a few weeks ago, Chief Executive Mike Doustdar described it as the need for better “commercial execution” and the ability to reach customers in “new ways”. A call to action that actually conceals something deeper: the urgency, for Novo Nordisk to change its identity – not just its strategy – in the face of the most difficult challenge in its recent history.
The Danish group – and with it a significant part of the European pharmaceutical industry – is discovering just how a best-selling drug can spiral out of control, becoming a social phenomenon even before it is recognised as an excellent therapeutic product. And how much this calls into question a culture rooted in scientific rigour, regulatory prudence and a mediated relationship with doctors.
Novo Nordisk has seen around 70% of its market value evaporate since its mid-2024 peak, crushed in the battle against obesity by Eli Lilly: faster, more aggressive. The first results of 2026 have triggered a partial recovery, although the gap from the highs remains huge and the strategic challenge remains intact. In the pharmaceutical sector, as in many others, it is the US market that crowns – and rewards – the global champions, and Novo has two of the most powerful drugs of the last thirty years in its portfolio: Ozempic and Wegovy, produced originally developed for diabetes and obesity but which soon became something quite different.
Doustdar himself acknowledged this: the phenomenon whereby one patient tells another about a ‘fantastic medicine’ and the latter goes out to obtain it, bypassing – at least in part – the medical prescription, had never before occurred on this scale. It is a landscape in which the demand for healthcare no longer arises solely in the doctor’s surgery, within an orderly chain of diagnosis, prescription and treatment. It arises from a late-night scroll through social media, from a celebrity’s endorsement, from a ‘before and after’ photograph, and from the algorithm that leads the pharmaceutical industry to compete in the very same mental space where consumers’ desires, hopes and aspirations take shape.
Eli Lilly operates in this arena with ease. Not because it has better medicines, but because it is accustomed to a dynamic forged over decades of direct-to-consumer pharmaceutical advertising, which was liberalised in the United States in 1997 and has since reshaped the relationship between patients, doctors and brands. It also knows that the obesity market is not merely about treatment: it taps into megatrends that have now become crucial — longevity, self-management as a form of individual responsibility, image control as a public issue, and wellness tech.
