“The ultimate defense in our industry is innovation,” says CFO Karsten Munk Knudsen in an exclusive interview with Fortune.
As the global race for dominance in the weight-loss drug market intensifies, Novo Nordisk, the Danish pharmaceutical titan behind blockbuster treatments like Ozempic and Wegovy, finds itself under growing scrutiny from investors, regulators, and competitors alike. Despite record-breaking sales and soaring profits, the company is facing a new wave of stock downgrades, legal challenges, and rising competition — all threatening to disrupt its meteoric rise.
Yet in an exclusive interview with Fortune, CFO Karsten Munk Knudsen made one thing clear: Novo Nordisk is not standing still.
“The ultimate defense in our industry is innovation,” Knudsen said, emphasizing that the company’s continued success depends on staying ahead scientifically, technologically, and strategically.
The statement underscores Novo Nordisk’s long-term playbook: to secure its leadership not just by selling drugs, but by redefining the future of obesity treatment through relentless R&D, global expansion, and ethical resilience.
The Weight-Loss Revolution Novo Nordisk Created
For decades, Novo Nordisk was best known for its dominance in diabetes care. That changed with the launch of Ozempicand later Wegovy, two semaglutide-based drugs that revolutionized obesity management. Marketed for weight loss, Wegovy triggered a global phenomenon — sparking waiting lists, shortages, and even cultural debates about body image and access to treatment.
By 2024, sales from these two drugs alone accounted for more than half of Novo Nordisk’s total revenue, turning the company into Europe’s most valuable firm, briefly surpassing even luxury giant LVMH.
But with success came complications. Supply constraints, safety concerns, price criticisms, and a wave of class-action lawsuits alleging side effects such as severe gastrointestinal issues all began to test Novo’s resilience. Wall Street analysts warned of valuation risk, arguing that the company’s market capitalization — which surged past $600 billion — might not be sustainable amid growing competition from Eli Lilly’s Mounjaro (tirzepatide) and a pipeline of new GLP-1 contenders.
The Financial Pressure: Downgrades and Investor Anxiety
In recent months, several major investment banks issued stock downgrades for Novo Nordisk, citing stretched valuations and an overheated market. Analysts pointed to signs of slowing growth in key markets like the U.S. and Europe, where reimbursement and insurance challenges have limited access for lower-income patients.
Some institutional investors also voiced concerns about the company’s ability to maintain high profit margins as it scales manufacturing and faces potential pricing pressure from governments and insurers demanding affordability.
Knudsen, however, remains calm in the face of investor anxiety.
“Markets will fluctuate. Valuations will come and go. What matters is that we continue to innovate and deliver real outcomes for patients,” he told Fortune.
To him, the antidote to market volatility is not financial engineering — but scientific leadership.
Innovation as the “Ultimate Defense”
Knudsen’s emphasis on innovation reflects Novo Nordisk’s deep-rooted philosophy. The company invests heavily in R&D — more than 14% of annual revenue, among the highest ratios in the global pharmaceutical sector.
This investment is now being channeled into:
- Next-generation GLP-1 and GIP/GLP-1 combinations designed for even greater efficacy and fewer side effects.
- Oral formulations of semaglutide to make weight-loss therapy more accessible.
- New delivery mechanisms, including weekly or monthly injectables with longer-lasting effects.
- Metabolic disease research that extends beyond obesity, targeting cardiovascular health, liver disease (NASH), and kidney disorders.
Knudsen calls this a “pipeline of defense” — a strategy to maintain Novo’s leadership not through legal or marketing maneuvers, but through scientific superiority that competitors will find difficult to replicate.
“Our competitors will always come. That’s inevitable. But if you are five years ahead in your science, you’re in control of your destiny,” Knudsen said.
Navigating Legal Storms and Public Scrutiny
Alongside financial challenges, Novo Nordisk faces an escalating legal battle over alleged side effects linked to its GLP-1 drugs. Multiple lawsuits filed in the U.S. and Europe accuse the company of failing to adequately warn patients about the risks of intestinal obstruction and other complications.
Knudsen did not comment directly on ongoing litigation but stressed the company’s commitment to transparency and patient safety.
“Every medicine carries risks. What matters is that we communicate those risks clearly, work with regulators, and continuously improve based on real-world evidence,” he said.
Behind the scenes, Novo Nordisk’s legal and compliance teams have ramped up efforts to preempt further lawsuits by tightening clinical data reporting and launching global safety awareness campaigns for healthcare professionals.
Despite the legal noise, Knudsen insists that such scrutiny is “part of being a market leader.” In his view, credibility and scientific rigor are Novo’s real defense mechanisms against both lawsuits and reputational risk.
Competition Heats Up: Eli Lilly and the Race for Market Share
While Novo Nordisk currently dominates the obesity drug market, the rise of Eli Lilly’s Mounjaro (tirzepatide) and Zepbound has intensified competition. Analysts forecast that the global anti-obesity market could surpass $150 billion by 2030, but market share could swing dramatically depending on efficacy, pricing, and accessibility.
Eli Lilly has positioned its treatments as slightly more potent in terms of weight loss percentage, while other biotech firms are exploring multi-hormone combination drugs and oral therapies that could challenge Novo’s injectable dominance.
Knudsen acknowledges the competition but views it as validation of the company’s pioneering role.
“We welcome competition — it pushes the entire field forward,” he said. “Our focus is on being the innovator everyone else is trying to catch.”
Novo Nordisk has also invested heavily in manufacturing capacity, committing billions of dollars to new facilities in Denmark, France, and the U.S. to address the global shortage of Wegovy and Ozempic. This expansion aims to secure the company’s supply chain and sustain leadership even as demand skyrockets.
Balancing Growth and Responsibility
Despite being one of the most profitable companies in Europe, Novo Nordisk has faced criticism for high drug prices, which have made its weight-loss therapies unaffordable for millions. Knudsen acknowledged this concern but defended the company’s pricing strategy as a balance between innovation and sustainability.
“We are constantly investing back into R&D. Without that reinvestment, there would be no next generation of therapies,” he said.
To mitigate criticism, Novo Nordisk has expanded access programs in lower-income countries and partnered with public health organizations to promote equitable treatment for diabetes and obesity patients.
Still, public sentiment remains divided — especially as social media fuels both enthusiasm and backlash around “miracle weight-loss drugs.”
The Future: From Weight Loss to Total Metabolic Health
Knudsen’s long-term vision for Novo Nordisk extends beyond weight loss. The company is increasingly focused on the broader category of metabolic health, aiming to address interconnected diseases that stem from obesity — including cardiovascular conditions, fatty liver disease, and certain cancers.
“Obesity is just the beginning,” Knudsen said. “The same science can transform how we treat other metabolic disorders. That’s the next frontier.”
Novo Nordisk’s research division is now exploring gene-based therapies, regenerative medicine, and AI-powered drug discovery — technologies that could once again redefine how chronic diseases are treated.
Conclusion
Novo Nordisk stands at a defining crossroads. The company’s extraordinary success with Ozempic and Wegovy has placed it at the pinnacle of the pharmaceutical industry, but also under intense global scrutiny. Stock downgrades, lawsuits, and fierce competition have challenged the company’s resilience — yet its leadership remains steadfast in its conviction that innovation is the only true safeguard.
As CFO Karsten Munk Knudsen told Fortune, the path forward lies not in defensive corporate maneuvers but in bold scientific ambition.
“The ultimate defense in our industry is innovation. If we continue to innovate, everything else will take care of itself.”
For Novo Nordisk, the message is clear: its future—and its defense of the weight-loss crown—will be won not in courtrooms or markets, but in laboratories.
