(Bloomberg) -- Maziar Mike Doustdar spent more than three decades quietly climbing the ranks of Novo Nordisk A/S, from office clerk through logistics and marketing roles to head of international operations. Now the relatively unknown insider is moving into the spotlight with a daunting task: revive a once high-flying drugmaker from a steep descent that’s wiped out two-thirds of its value in the past year.

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Doustdar has pledged to work quickly, and there were hints on Tuesday that part of his response may involve cutbacks and job reductions. He said he would look at “realigning the cost base,” though he didn’t offer any details.

Doustdar’s appointment as Novo’s new chief executive officer was announced alongside a stark reminder of the challenges ahead, particularly in the US, the biggest market for obesity treatments.

The Danish firm, based just north of Copenhagen, cut its earnings outlook as its blockbuster weight-loss drug Wegovy continues to cede ground to archrival Eli Lilly & Co., whose competing treatment has gained momentum in the US market and beyond.

The 54-year-old inherits a global powerhouse facing a critical point after being beset with supply shortfalls, drug pipeline failures and sharp competition that’s shaken investor confidence in its prospects.

Questions have already emerged on whether Doustdar — who has helmed Novo’s non-US operations in recent years — is the right leader, given the company’s headwinds are particularly linked to the US. He pushed back against any doubts on a call on Tuesday, defending his track record.

The US is “more than half of our business and we don’t just sit there running our own area, but we support the CEO,” he said. “So I’ve sat in this executive management team for more than 10 years and I know enough of the US business.”

The past year has marked a sharp reversal of fortune for Novo, which became a household name for jump-starting the booming obesity drug market with its GLP-1 medicines. But it’s failed to keep up with runaway demand and misjudged the speed and scale of competition, including a shadow market of copycat compounds.

Mixed trial data and heightened political scrutiny over pricing have further shaken investor confidence. The stock’s slump from its June 2024 peak has erased more than $400 billion from Novo, dethroning it as Europe’s most valuable company. That ultimately cost its former CEO, Lars Fruergaard Jorgensen, his job in May.

After the cut to the outlook, the shares fell almost 30% at one point on Tuesday. They closed down 23%, the biggest one-day drop on record.

“I don’t like it,” Doustdar said of the share-price moves. He added that “setbacks don’t define companies. Our response does.”

Novo is also hugely important to Denmark. The company has doubled its headcount over the past decade to more than 77,000 people, and just under a half of them work in its home country.

In many ways, the drugmaker’s influence in Denmark is outsized: for a time last year, its market value topped the size of the economy, its tax bill helps fund the government’s increased defense spending and booming drug exports have forced the central bank to keep interest rates low.

On Tuesday, Novo Chair Helge Lund described Doustdar as a “natural challenger,” saying he “has a bias for speed, for pace and for action.”

The new CEO is an Austrian national, who was born in Iran and raised in the US. He joined Novo in 1992 in Vienna.

He ran with the idea of speed when speaking to investors on Tuesday.

“We will sharpen our focus and move faster,” Doustdar said. “We will operate more efficiently. We will advance our pipeline and keep pushing the boundaries of innovation, and we will invest to accelerate growth and deliver shareholder value. That is my promise to you.”

--With assistance from Lisa Pham and Christian Wienberg.

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