In the year of the weight-loss pill, Lilly still leads GLP-1s
Pill versions of GLP-1 drugs arrive in 2026, but analysts say Eli Lilly’s lead in obesity and diabetes treatment should hold for years.
Your neighbor says they lost 20 pounds at the gym. You know the real credit likely belongs to GLP-1 weight-loss drugs. In 2026, drugmakers Novo Nordisk and Eli Lilly will add pill versions to those blockbuster treatments.
Novo will be first to market with its recently approved Wegovy pill, followed around midyear by a yet-to-cleared pill from Lilly that’s currently called orforglipron. Still, Guggenheim analyst Seamus Fernandez thinks Lilly will continue to expand its lead in the category.
Lilly is up nearly 40% in 2025, as it is expected to have grown its sales of weight-loss and diabetes drugs by about 60%. Novo shares have fallen by roughly the same percentage; sales of weight-loss drugs probably grew 20%, but its total sales are expected to have grown only 5%. In a December note, Fernandez reiterated his Buy rating on Lilly and a Hold rating for Novo Nordisk.
“Even though Lilly has delivered another impressive year of stock performance in 2025, we simply cannot argue with the company’s superior overall execution capitalizing fully on the Pharma mega cycle of our lifetime," the Guggenheim analyst wrote.
Lilly will remain the U.S. leader in these drugs for years to come, says Fernandez. Current prescription data show a 47% share in the diabetes market for Lilly’s Mounjaro, versus 38% for Novo’s Ozempic. In obesity, Lilly’s Zepbound has a 64% share, versus 36% for Novo’s Wegovy.
Looking ahead, he sees Lilly growing its GLP-1 sales at a 16% compound rate for the next five years, while Novo grows at just 2%. He thinks Lilly’s pill will power past Novo’s, despite a later start, with the Lilly injectable line supplemented by a powerful new addition called retatrutide, and a complementary drug eloralintide that could be added for muscle-sparing weight loss.
Other companies will enter the category. Shares of Structure Therapeutics more than doubled in December when it reported 15% weight loss by patients in a Phase 2 trial of its pill, compared with 12% in studies of the Lilly pill. A pivotal Phase 3 trial may not start until late 2026, however, so Structure won’t be a competitor for several years.
Pills will be cheaper to produce and distribute than injectables. But side effects like nausea may be worse, and Novo’s pill must be taken on an empty stomach. Add the faster, deeper weight-loss achievable from shots and the KeyBanc Capital Markets analyst Paul Knight thinks that injectables will dominate weight loss for years. He follows companies that supply the autoinjectors used for the drugs.
“We think injectables will be the preferred delivery method for highest and fastest weight loss, and oral could supplement injectableswith maintenance dosing," Knight says.
Write to Bill Alpert at william.alpert@barrons.com
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