Intense Market Competition: Novo Nordisk faces significant and increasing competition, particularly in the diabetes and obesity treatment markets, from existing pharmaceutical companies and new market entrants developing similar or superior therapeutic alternatives.

Drug Pricing and Reimbursement Pressure: The company is exposed to ongoing global pressure on drug prices from governments, insurers, and pharmacy benefit managers, which could lead to reduced revenue and profitability if pricing negotiations become more challenging or unfavorable.

Regulatory Approval Challenges: The successful development and commercialization of new pharmaceutical products are highly dependent on obtaining and maintaining regulatory approvals, and delays or failures in this process can significantly impact future revenue streams and R&D returns.