Novo Nordisk’s quarterly beat and guidance increase did little to resolve Wall Street’s biggest concern: whether the Ozempic maker has a convincing path back to sustainable growth as competition from Eli Lilly intensifies.

Analysts said the better-than-expected quarter benefited from rebate adjustments and other temporary factors, obesity drug sales were broadly in line with expectations, and oral Wegovy slightly missed forecasts. 

At the same time, Novo reported another mixed clinical result for next-generation weight-loss drug CagriSema, reinforcing investor questions about the company’s longer-term pipeline.

“Overall nothing to inspire,” Citi analysts wrote, while Jefferies said the guidance increase left little room for consensus sales estimates to move higher.

The Danish drugmaker hiked its full-year guidance and said it now expects adjusted sales and operating profit to be down 6% to flat at constant exchange rates, an improvement from previous guidance of a decline of between 4% and 12% for both metrics.

Copenhagen-listed shares fell as much as 5% in morning trading before paring some losses to trade 3.4% lower. Novo’s American depositary receipts fell 6% in after-hours trading Tuesday after the quarterly report was published one day earlier than expected.

Novo is racing to restore investor confidence in its pipeline and ability to execute, especially in the challenging U.S. market, amid intense pressure from Eli Lilly’s rival medicines Zepbound and Mounjaro, which have rapidly gained market share despite being launched years after Novo’s.

Coming into Wednesday trading, the company’s Danish shares had fallen about 5% year-to-date and were down nearly 70% from their mid-2024 peak, even if they have recovered some ground this year following the successful launch of the Wegovy pill.

Novo said the improved outlook was driven by increased expectations for GLP-1 product sales and specifically its Wegovy product portfolio, which includes both an injectable and a pill. The pill has reached more than 5 million prescriptions since its launch, alongside encouraging early uptake in markets outside the U.S. and the rollout of a newly approved higher dose of injectable Wegovy, Novo said.

“I could see a future where actually this market is, to a large extent, a pill market,” Mike Doustdar told CNBC’s Carolin Roth on Wednesday, while stressing that the launch was only six months old.

“The fine detail is that [the] first 1 million prescriptions took us 11 weeks to do without any competitor in the market. This last 1 million prescriptions took us four weeks to do. While there’s a competitor out there trying really hard to take those prescriptions away from us, and we have not allowed that,” he said.

Eli Lilly launched its rival weight loss pill Foundayo in April, roughly four months after the Wegovy pill hit the U.S. market. It has seen slower initial uptake, and Lilly CEO David Ricks has previously told CNBC that it will take time to build the brand since it’s a new drug that doctors and patients don’t know.