Novo Nordisk CEO Mike Doustdar warned of tougher conditions in its international operations for 2026, citing rising competition after losing market exclusivity in several countries. Speaking at the J.P. Morgan Healthcare Conference, he said rivals are entering markets where Novo has long held dominant share, which will pressure near-term results despite strong long-term volume potential.

With operations in roughly 80 to 85 markets, Novo remains structurally positioned outside the United States. But the obesity market is shifting as cross-border and online sales make access easier for competitors. Doustdar said the company must adapt to this new reality, particularly as its international portfolio faces exclusivity expirations that open the door to cheaper alternatives.

To defend its position, Novo plans capacity expansion, higher-dose formulations, and new products. The company specifically cited growing competition from Lilly in several regions. The challenge underscores a broader trend: blockbuster drugs eventually face global copycats, and Novo’s playbook will test whether manufacturing scale and product upgrades can hold ground against aggressive rivals.