Novo's lack of a clear small-molecule strategy beyond peptides in the oral segment is likely to hamper its long-term growth, BMO added. The firm also flagged continued fallout from last year's supply disruptions of semaglutide, which may have pushed physicians to favor Lilly's tirzepatide more permanently. Novo's next catalysts, including Alzheimer's-related trials EVOKE and EVOKE+, could provide upside, but BMO described them as high risk and unlikely to shift sentiment meaningfully in the near term The stock is down roughly 34% so far this year despite the soaring demand for its GLP-1-based therapies, Wegovy and Ozempic. Related articles Novo Nordisk downgraded by BMO as Eli Lilly gains ground in weight-loss drug race U.S. shoppers spend $1.5 trillion a year.