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GLP-1 earnings · 2026 · accounting beneath the growth.

The quarter behind the headline

Novo Nordisk reported 32% Q1 sales growth at constant exchange rates; excluding its 340B provision release, adjusted sales fell 4%.

From dismissal to recognition

Novo’s filings say a 340B panel dismissed University of Washington Medical Center and Harborview Medical Center’s Petition 231220-22 on 4 December 2025. With no timely reconsideration request, the decision became final and effective on 20 January 2026.

On 3 February—14 days later—Novo said the constrained revenue was highly probable not to reverse, triggering the full Q1 release. HRSA independently confirms the no-overcharge outcome and records no reconsideration request; the finality date and provision amount are issuer-sourced.

The Q1 2026 release

Provision held: USD 4.2B
Released in Q1: DKK 26.8B
Cash impact: None
Finality to results: 14 days

Reported → adjusted

Operating margin: 61.6% → 46.9%
US Operations: DKK 62.145B (+51% CER) → DKK 35.385B (−11%)
Diluted EPS: DKK 10.91 (+67%) → DKK 6.63 (−3%)
Adjustment basis: Excludes the full 340B release
US decline driver: Lower realised prices, partly offset by volume

The adjusted-versus-non-adjusted gap stayed broadly constant at 8–9 percentage points across all three updates. That means the May and August upgrades came from a stronger adjusted operating outlook—not an expanding benefit from the 340B release.

February introduced non-IFRS guidance excluding the 340B reversal. Novo also removed USD 400 million of reversal from the adjusted 2025 comparison base.