Ozempic Changed the Market. Now Novo Has to Change Itself.

What Novo’s cultural reset reveals about success, competition and the danger of becoming too comfortable with the model that made you win

For years Novo Nordisk had the kind of problem most companies would take without hesitation.

Demand was almost impossible to meet. Ozempic slipped the boundaries of medicine and became part of popular culture. Wegovy helped turn obesity treatment into one of the most valuable growth markets in healthcare. At one point the company was worth more than Denmark’s entire annual economic output.

Success on that scale creates a powerful illusion: that the organisation behind it must also be working unusually well.

Then the market starts moving.

Eli Lilly became a much more serious competitor. Zepbound gained ground. Oral treatments began changing expectations around convenience. Roche, Pfizer, Amgen, AstraZeneca and others moved into a market still expected to exceed $100 billion a year.

Novo had helped create the category. Now it was being forced to keep pace with the category it had shaped.

That is why this story matters beyond pharmaceuticals. It is not primarily about which drug wins the obesity market. It is about what happens inside an organisation when the very success that made it powerful begins to make it slower.

When success starts hiding the friction

Growth has a quiet way of making complexity easier to tolerate.

When demand is extraordinary, an extra approval layer does not feel dangerous. A slow decision can be absorbed. Another organisational layer can be added to solve a local problem without anyone asking what it does to the system as a whole.

Over time the organisation built to support growth becomes more complicated because of that growth.

Novo has acknowledged the problem itself. Rapid expansion increased costs and organisational complexity. The company has been restructuring in an effort to simplify decision-making and concentrate resources on its strongest opportunities in obesity and diabetes.

In 2025 Novo announced plans to eliminate around 9,000 roles. By September 2026 Reuters reported approximately 13,000 departures over the previous year.

The numbers matter. What sits behind them matters more.

Success is often treated as proof that the operating model works. Sometimes it is. But exceptional demand can also conceal the things that would be impossible to ignore in a harder market. Commercial habits survive because the product is selling anyway. Decisions take longer without immediately showing up in the results. Complexity becomes affordable.

Until competition makes it expensive.

Then what previously looked like stability begins to look like inertia.

The market Novo created is changing around it

Mike Doustdar became CEO in August 2025 as Novo faced a sharply different competitive environment. The company itself described the moment as one requiring greater “speed and ambition.”

That pressure is most visible in obesity.

Novo built its position through extraordinary science. But obesity treatment is increasingly behaving unlike the pharmaceutical markets of the past. People are not only discussing efficacy with doctors. They compare treatments, prices, convenience and availability. Many pay directly. Digital access matters. Brand experience matters.

At Novo’s latest Capital Markets Day the company said around half of Wegovy revenue now comes from self-pay customers.

That is not a minor commercial detail. It changes the nature of the contest.

Excellent science remains fundamental. Science alone is no longer the whole commercial proposition. Novo increasingly needs to understand not just the patient at the end of the healthcare system, but the person making choices inside a fast-moving consumer environment.

That requires a different organisation.

Enter The Novo Way

In September the company unveiled a broader reset.

Its everyday identity was shortened from Novo Nordisk to Novo. The legal company remains Novo Nordisk A/S. Alongside the new brand platform — Lasting Health Starts Now — came a refreshed cultural framework called The Novo Way.

It rests on four principles: customer obsession, competitiveness, clarity, and care and integrity.

There is nothing controversial about those words. Most leadership teams would claim them without hesitation.

The difficult work begins afterwards.

If “customer obsession” is real, it should change whose information reaches the top of the organisation and whose voice influences decisions.

If “clarity” is real, it cannot simply produce clearer presentations. It should result in fewer competing priorities and clearer choices about what the organisation will stop doing.

And competitiveness cannot become another way of telling people to run faster. It has to show up in where Novo places its capital, its best talent and management attention.

That is the point at which culture stops being language and becomes a way of making decisions.

The uncomfortable tension inside “customer obsession”

For Novo this cultural shift is more complicated than borrowing a fashionable management phrase.

The company comes from a deeply patient-centred healthcare tradition. That matters. Scientific rigour, safety and ethics are not constraints a pharmaceutical business should optimise away in the pursuit of speed.

Now Novo is deliberately adding a stronger consumer orientation.

Those two ideas are related. They are not identical.

A patient is not simply a customer. Medicine is not consumer electronics. A company cannot simply copy the playbook of retail or technology without thinking carefully about what would be lost.

That leaves Novo with a genuine organisational tension.

It needs to respond faster without becoming careless. It needs to understand consumers better without reducing healthcare to consumer marketing. It needs to simplify an organisation without simplifying away the expertise on which good medical decisions depend.

No slogan resolves those tensions. Culture is tested in how people handle them.

A new identity cannot do the organisational work

There is something almost too neat about shortening the name to Novo. “New” is built into the identity.

But naming a new chapter and operating differently inside it are two different things.

This is where cultural resets most often disappoint.

The vocabulary changes first. Employees hear a new set of behaviours. Customers see refreshed branding. Investors receive a revised strategy. Meanwhile the old approval chains remain. Incentives still reward yesterday’s priorities. Decision rights stay unclear. Managers continue protecting work that everyone privately knows no longer matters.

The organisation has announced the destination. Its operating system is still running the previous version.

Novo therefore has something harder to prove than whether people remember The Novo Way. It has to show that The Novo Way produces different choices.

Success may be harder to unlearn than failure

This is where the Novo story becomes relevant far beyond pharmaceuticals.

Transformation is relatively easy to explain when an organisation is obviously failing. Results fall. Customers leave. The existing model has lost credibility. Leaders have permission to say that something fundamental must change.

Success creates a different problem.

Novo developed extraordinarily successful products. It scaled around the world. It helped transform obesity treatment. And because those choices worked so well, the structures and behaviours surrounding them accumulated credibility too.

That is what makes successful organisations difficult to change.

People rarely defend a broken system by saying “This has clearly failed.”

They defend it by saying “This is how we became successful.”

And often they are right.

The difficult leadership question is whether something that helped create yesterday’s success is still appropriate for tomorrow’s market.

Novo is not trying to recover from irrelevance. It is trying to stop success from becoming inertia.

That may be the harder transformation.

Failure gives leaders an obvious reason to change.

Success requires them to make the case before everyone else feels the urgency.

The market will not wait

Novo does not have the luxury of treating this as a long internal culture programme.

Eli Lilly continues to gain ground. Other groups are advancing their own obesity treatments. Novo is developing the next generation of products, including CagriSema, while preparing for a future in which the economics of semaglutide will inevitably change.

At its latest Capital Markets Day the company said it is targeting more than five multi-blockbuster launches by 2030 and more than DKK 150 billion in risk-adjusted pipeline sales by 2035.

Investors responded cautiously. Shares fell as much as 9% after the presentation as questions remained around growth, pricing and Novo’s future beyond the current semaglutide franchise.

That reaction makes the cultural reset more than an internal exercise.

Novo does not need a culture that sounds more competitive. It needs an organisation capable of behaving differently before the market moves again.

That is ultimately why The Novo Way is worth watching.

Not because “customer obsession,” “clarity” or “competitiveness” are revolutionary ideas.

But because Novo now has to prove that an organisation shaped by enormous success can change while that success is still visible.

The culture that helps a company win one era is not automatically the culture that will help it win the next.

And sometimes the hardest moment to change is when the outside world still thinks you are winning.