Shares of Danish pharmaceutical giant Novo Nordisk A/S (NVO) tumbled 22% Tuesday after the company slashed its 2025 outlook and announced a CEO change, sending shockwaves through a range of ETFs tied to weight-loss drugs.
Novo, best known for pioneering GLP-1 drugs like Ozempic and Wegovy, now expects sales to grow 8% to 14% this year, down from a prior range of 13% to 21%. Operating profit guidance was similarly lowered to 10% to 16% from a previous estimate of 16% to 24%.
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The stock is now down 66% from its mid-2024 highs, erasing hundreds of billions in market cap and pressuring several ETFs with heavy exposure to the once high-flying name.
Novo is the top holding in the Roundhill GLP-1 & Weight Loss ETF (OZEM), with a 17% weighting. It also makes up 11% of the Amplify Weight Loss Drug & Treatment ETF (THNR) and 8% of the VanEck Pharmaceutical ETF (PPH). A leveraged ETF tied directly to the stock, the Defiance Daily Target 2X Long NVO ETF (NVOX), fell more than 40% on the day.
Thematic ETFs tied to the GLP-1 boom have been hit hard by Novo’s collapse. OZEM fell more than 5% on Tuesday, while THNR dropped 3%. Traditional pharma ETFs like PPH also declined, though to a lesser extent. The leveraged NVOX ETF posted one of the steepest declines in the entire ETF universe.
For a full list of ETFs that hold Novo Nordisk, check out etf.com’s Novo Nordisk stock page.
In a press release, Novo Nordisk attributed the lowered guidance in part to persistent use of compounded GLP-1 drugs—custom-made knockoffs that some clinics continue to sell even after the FDA ended its temporary allowance for such practices in May.
“Despite the expiry of the FDA grace period for mass compounding on 22 May 2025, unsafe and unlawful mass compounding has continued,” the company said. “Multiple entities continue to market and sell compounded GLP-1s under the false guise of ‘personalisation’ … exposing patients to the significant risks posed by knockoff ‘semaglutide’ drugs made with illicit or inauthentic foreign active pharmaceutical ingredients.”
Novo has launched litigation and is calling on regulators to crack down more aggressively, but the damage is already being felt. The easy availability of cheaper compounded alternatives is undercutting demand for Wegovy and Ozempic, especially in the U.S., where insurers remain reluctant to cover the pricey branded versions.
At the same time, Novo is also facing growing competitive pressure from Eli Lilly and Co. (LLY), which has seen blockbuster success with its GLP-1 drug Zepbound. Some studies suggest Zepbound may be more effective than Wegovy, giving Lilly the edge both clinically and commercially.
