Novo Nordisk just woke up and chose violence… against its own shareholders.

The stock’s down nearly 9% after the company revealed that its big, new Alzheimer’s moonshot… well… didn’t make it past the launch pad. The EVOKE and EVOKE+ trials (the ones analysts already warned were long shots and Novo itself called a “lottery ticket”) officially scratched off to reveal a big fat “try again.” And the market did not clap. Novo sank to a four-year low before the opening bell even rang.

So what happened? The whole thesis was rooted in one hope… maybe semaglutide, the active ingredient in Ozempic and Wegovy (the same stuff allegedly powering the new Wicked movie red carpet) could also slow cognitive decline in early Alzheimer’s patients. 

And to be fair, this was peak pharma hopium. The drug improved some biomarkers, which is cute and all, but improving biomarkers without improving actual symptoms is like putting premium gas in a car with a blown engine. The trials needed to slow cognitive decline by at least 20%. They didn’t. Not even close.

(Source: CNBC)

Novo’s brand new CEO, Mike Doustdar, is probably wondering if there’s a return policy for his job. He took over in August and immediately got hit with slowing GLP-1 sales, a sliding stock price, and mass layoffs… and now this very public embarrassment. 

He tried to spin it by reminding everyone that semaglutide still works miracles for diabetes and obesity, which is true, but it still doesn’t hide the fact that he sh*t the bed.

The part that stings even more is who benefits from Novo’s failure… Eli Lilly. While Novo was trying to prove that its weight-loss megadrug could also be the next big Alzheimer’s breakthrough, Lilly already has an approved Alzheimer’s treatment that actually slows cognitive decline. It’s complicated, it has serious side effects, but it works. And while Novo regroups, Lilly’s already laying the groundwork for an oral GLP-1 pill in 2026, thanks to a research department that’s become the envy of the industry.

Novo somehow took a mile-long head start and turned it into a foot race. They owned the GLP-1 world before anyone else even showed up, and now Lilly’s Zepbound is walking in, taking market share, and making it look easy.

The Alzheimer’s setback hurts because the scale of the opportunity was (as Trump would say) YUGE. Analysts estimated only a 10% chance of success, which in hindsight feels generous. The trials spanned more than 3,800 patients aged 55 to 85… the biggest effort yet to test whether an oral form of semaglutide could slow early Alzheimer’s. The response wasn’t catastrophic, just underwhelming. The biomarkers suggested something was happening, but the clinical outcomes never actually changed.

So where does Novo go from here? Probably right back to the business that’s already carrying the entire company. Ozempic remains a license to print money, Wegovy demand is still overwhelming production lines, and semaglutide is still the molecule every competitor wishes they’d discovered first. One failed trial isn’t changing that.

But the dream of GLP-1s cracking Alzheimer’s (the trillion-dollar frontier, the holy grail of unmet medical need) that dream goes back into the vault next to 3D TVs and Google Glass. And with Lilly preparing to roll out an oral GLP-1 by 2026, Novo’s margin for error in this arms race just got a lot smaller.

At the time of publishing this article, Stocks.News holds positions in Google as mentioned in the article.