A mixture image shows an injection pen of Zepbound, Eli Lilly’s weight reduction drug, and boxes of Wegovy, made by Novo Nordisk.
Hollie Adams | Reuters
The appetite for blockbuster weight reduction and diabetes drugs is way from satisfied.Â
From fresh competition to recent uses, the market is quickly vaulting right into a recent stage of growth. But aspects including insurance coverage, pricing, copycat drugs and the event of latest pills will ultimately determine how far the treatments will reach.
Eli Lilly and Novo Nordisk are still the dominant players, as demand for his or her weekly injections shows few signs of slowing. Eli Lilly has pulled ahead out there, saying during its third-quarter earnings call on Thursday that it gained share for the fifth consecutive quarter and that its drugs account for nearly 6 out of 10 prescriptions throughout the injectable obesity and diabetes class.
But each firms are focused on ramping up supply, testing recent uses for his or her medicines and bringing the subsequent wave of obesity drugs to patients, including more convenient pills.Â
Behind them is a slate of drugmakers – from biotech upstarts to pharma giants – racing to win a slice of what some analysts expect may very well be a roughly $100 billion market by the tip of the last decade. There could also be loads of room for brand new entrants: McKinsey projects that 25 million to 50 million U.S. patients could use GLP-1s by 2030.Â
Nearly every major pharmaceutical company has bet on obesity drugs, often through deals with smaller developers, including businesses based in China. While some experimental drugs are further along than others, all are likely years away from hitting the market, and their competitive potential will rely on future data showing their effectiveness and the way well patients tolerate them.
As competition heats up, many patients are still struggling to access the drugs. Some insurers, including Medicare, don’t cover GLP-1s for obesity, which might cost roughly $1,000 monthly before rebates.
Eli Lilly and Novo Nordisk have rolled out discount programs for cash-paying patients to shut the gap, and more employers are offering coverage as GLP-1s prove their added health advantages like treating obstructive sleep apnea and chronic kidney disease in addition to slashing cardiovascular risks.
Still, some patients proceed to make use of cheaper, copycat versions of branded treatments – though those alternatives are restricted in lots of cases. While Novo Nordisk and Eli Lilly’s drugs are not any longer in shortage, each corporations are cracking down on pharmacies, medspas and other suppliers that mass-produce and market cheaper compounded GLP-1s.
While recent competitors and lower-cost pills could allow drugs to succeed in more patients, access will largely rely on how corporations like Novo Nordisk and Eli Lilly decide to price their drugs within the years ahead.
Here’s what to know in regards to the state of the booming weight reduction drug market.Â
Novo Nordisk scrambles to catch as much as Lilly
David Ricks, chief executive officer of Eli Lilly & Co., during a news conference at Generation Park in Houston, Texas, US, on Tuesday, Sept. 23, 2025.
Mark Felix | Bloomberg | Getty Images
Eli Lilly has taken the lead within the injectable GLP-1 market. Once the frontrunner, Novo Nordisk lost ground, particularly within the U.S., after supply chain issues, Eli Lilly’s emergence and the spread of compounded options.
Eli Lilly eclipsed its Danish rival for the primary time in May, when it secured 53% of the market through the first quarter. In August, Eli Lilly said its share rose to 57% through the second quarter. Â
TD Cowen analyst Michael Nedelcovych said that is largely because Eli Lilly’s injections are superior to Novo Nordisk’s drugs when it comes to safety and efficacy. Eli Lilly’s diabetes drug Mounjaro is viewed as a greater treatment than Novo Nordisk’s Ozempic, he noted. Real-world data and a head-to-head clinical trial have shown that Eli Lilly’s obesity injection Zepbound results in more weight reduction than Novo Nordisk’s Wegovy.
“It’s higher efficacy, and at the least anecdotally in real-world practices, it’s higher tolerability,” Nedelcovych said. “In our business, that is often all that is required for share gains, and I believe we’re seeing that play out in a short time.”Â
Investors have unloaded Novo Nordisk’s stock, which has fallen almost 40% this 12 months. Novo Nordisk cut its profit and sales forecast in July, saying compounded drugs had cut into Wegovy’s market. The corporate had already lowered its 2025 outlook in May.
As competition mounts, data on Novo Nordisk’s experimental medicines also underwhelmed Wall Street and raised concerns in regards to the growth of its drug portfolio beyond Wegovy and Ozempic.Â
In a note in September, BMO Capital Markets analyst Evan Seigerman said the corporate raised expectations too high for its next-generation obesity drug CagriSema, was slow to launch direct-to-consumer sales of its popular drugs and had a “tepid initial response” to compounders selling copycat treatments.Â
What’s more, Medicare is negotiating the worth of Novo Nordisk’s semaglutide – the lively ingredient in Ozempic, Wegovy and the corporate’s diabetes pill Rybelsus – effective in 2027, which could further cut into revenue. Eli Lilly’s tirzepatide, the lively ingredient in Mounjaro and Zepbound, likely won’t be subject to cost discussions until the tip of the last decade.Â
Novo Nordisk is betting its recent CEO, Mike Doustdar, will help it regain its footing. He took the helm in late July after the board ousted former top executive Lars Fruergaard Jorgensen.Â
Doustdar is not wasting any time to make changes: Novo Nordisk in September announced plans to chop around 9,000 roles, or roughly 11.5% of its global workforce.
There remains to be turbulence on the pharmaceutical giant. On Tuesday, Novo Nordisk said several board members will step down after clashing with the controlling shareholder, the Novo Nordisk Foundation, on the makeup of the board.
The compounding issueÂ
Novo Nordisk still faces one other major challenge: the persistence of cheaper, compounded versions of semaglutide.Â
The corporate for now “is certainly rather more vulnerable” to competition from copycats than Eli Lilly is, largely because most of them contain or claim to be semaglutide, said Cowen’s Nedelcovych. He added that Novo Nordisk is “already on its back foot” out there, so it may well’t afford to lose more share.
Patients flocked to compounded GLP-1s when branded injections were briefly supply during the last two years, or not covered by their insurance.
Compounding is a practice where pharmacies mix ingredients of a drug to create a specialized version tailored to a patient’s specific needs, resembling those with allergies to certain ingredients. When a branded drug is briefly supply, pharmacies are allowed to make larger quantities of compounded versions to assist fill the gap.
A view shows a Novo Nordisk sign outside its office in Bagsvaerd, on the outskirts of Copenhagen, Denmark, on July 14, 2025.
Tom Little | Reuters
But Novo Nordisk and Eli Lilly have each invested billions to extend manufacturing capability for his or her injections, which has already began to repay.Â
The FDA declared an end to the shortages of tirzepatide and semaglutide during the last 12 months. Those decisions legally barred compounding pharmacies from making and selling copycats of those drugs by deadlines that passed earlier this 12 months, except in rare cases where it’s medically obligatory.Â
Novo Nordisk in June said some mass, so-called 503B compounding pharmacies have scaled back production, but accused others — including those tied to Hims & Hers — of continuous to sell the drugs under the “false guise” of personalization. In August, Novo Nordisk executives noted that around 1 million U.S. patients are taking compounded GLP-1s.
The problem also plagues Eli Lilly. While the FDA regulates 503B pharmacies, most 503A sites fall under state oversight. Nedelcovych likened shutting them right down to “a case of whack-a-mole.” Eli Lilly and Novo Nordisk’s lawsuits against telehealth corporations, pharmacies and others since 2023 have consumed time and resources, with mixed legal outcomes.
The FDA also doesn’t seem like taking an aggressive stance on compounded GLP-1s: The agency in September published a “green list” of imported GLP-1 drug ingredients deemed protected to let into the country.Â
Insurance coverage remains to be spotty
Limited insurance coverage for GLP-1s is obstructing out patients who cannot afford their roughly $1,000 monthly price tags. That access gap has turn out to be a political and company flashpoint, with pressure mounting on employers and the federal government to expand coverage.
Many health plans, including Medicare, cover GLP-1s for the treatment of diabetes but not obesity. Medicaid coverage of obesity drugs is sparse and varies by state, in keeping with health policy research organization KFF.Â
Coverage for GLP-1s for obesity has ticked up barely: A May survey of greater than 300 corporations by the International Foundation of Worker Profit Plans, or IFEBP, found that 36% provided coverage for GLP-1s for each weight reduction and diabetes, up from 34% in 2024.Â
Still, many employers and health plans remain hesitant because of high costs. In 2025, weight-loss GLP-1s accounted for a mean of 10.5% of total annual claims amongst employers, up from 8.9% in 2024 and 6.9% in 2023, IFEBP found.
“If employers weren’t already on board before, they’re still waiting,” said Julie Stich, vice chairman of content at IFEBP. “The price issue remains to be a serious, major issue for them.”
Some plans are concerned that patients won’t stay on the drugs long run because of gastrointestinal negative effects, resembling nausea and vomiting, and will regain the load they lost, said John Crable, senior vice chairman of Corporate Synergies, a national insurance and worker advantages brokerage and consultancy. Employers, which might experience high turnover, are also hesitant to cover costly drugs for employees who may leave the corporate inside a couple of years, Crable added.
Crable added that recent direct-to-consumer programs from Eli Lilly and Novo Nordisk — which let patients pay money for treatments at lower than half their monthly list price — might also discourage employer coverage.
Stitch said employers even have questions on how oral obesity drugs, which may very well be available as soon as 2025, could affect demand and costs.
But she said coverage could still grow, especially as GLP-1s gain recent approvals for more chronic conditions. Wegovy is cleared for reducing cardiovascular risk and fatty liver disease, while Zepbound is approved for sleep apnea.
Novo Nordisk can be testing semaglutide in Alzheimer’s, with initial late-stage trial results expected this 12 months. If that study shows that GLP-1s reduce the chance of cognitive decline, “it will give a giant boost” to Novo Nordisk and Eli Lilly since it could encourage patients to remain on them longer, said Leerink Partners analyst David Risinger.
“You are paying for the GLP-1 drug with the hope that obesity or these other conditions will improve, in order that health-care costs for these individual employees will recuperate as you progress forward,” Stich said.
Some plans have also introduced cost controls, like BMI thresholds, to administer spending.
Stich added that broader Medicare coverage could eventually drive private insurers to follow suit. The Trump administration plans to pilot coverage of weight reduction drugs under Medicare and Medicaid, which could expand access to tens of millions of older Americans, the Washington Post reported in August.
All eyes are on pills
Malerapaso | Istock | Getty Images
While Novo Nordisk already sells an oral GLP-1 for diabetes, the corporate and Eli Lilly could soon bring pills specifically for weight reduction to patients.
Some experts and analysts imagine they may fundamentally shift the market, helping more patients access treatment and alleviating the provision shortfalls of existing injections. But others raise questions on how much of a task pills will play within the space on condition that some seem like less effective than injections and produce greater negative effects.
Novo Nordisk’s 25-milligram oral semaglutide could win approval for obesity by the tip of the 12 months, which might make it the primary needle-free alternative for weight reduction in the marketplace. The day by day pill appears to be barely more practical than a competing oral GLP-1 from Eli Lilly called orforglipron, based on data from separate phase three trials.Â
Still, Eli Lilly’s pill could have a couple of notable benefits. Each drugs work by mimicking the GLP-1 gut hormone to suppress appetite and regulate blood sugar. But while Novo Nordisk’s pill is a peptide medication, orforglipron is a small-molecule drug.
Which means Eli Lilly’s treatment is absorbed more easily within the body and doesn’t require dietary restrictions like Novo Nordisk’s does. Some analysts say orforglipron will even be easier to fabricate at scale than Novo Nordisk’s, which is crucial as demand for obesity and diabetes injections outpaces supply. In August, Eli Lilly CEO David Ricks told CNBC the company hopes to launch its pill globally “this time next 12 months.”Â
In an August note, Goldman Sachs analysts forecast day by day oral pills will capture 24% share — or around $22 billion — of the 2030 global weight reduction drug market, which they expect to be value $95 billion.Â
The Goldman analysts said they expect Eli Lilly’s pill to have a 60% share — or roughly $13.6 billion — of the marketplace for day by day oral treatments in 2030. They expect Novo Nordisk’s oral semaglutide to have a 21% share — or around $4 billion — of that segment. The remaining 19% slice will go to other emerging pills, the analysts said.
TD Cowen’s Nedelcovych said he has been “treading sort of cautiously” in his outlook for oral weight reduction drugs. He said that is partially because physician consultants and other experts imagine injections, that are more practical and easier to tolerate than pills, will dominate the marketplace for the foreseeable future.Â
Nedelcovych said the convenience of a once-daily pill will not be enough to persuade patients to change, since a few of them “really don’t mind” taking an injection once per week. Nedelcovych added that really fizzling out injections and switching to pills as a maintenance regimen “also doesn’t appear to make a ton of sense, once we ask physicians about it.”Â
He said if pills are less effective at promoting weight reduction, it raises concerns that patients who initially lose significant weight on an injection could gain some back after switching to an oral drug. A phase three study from Eli Lilly, which is studying orforglipron’s ability to keep up weight reduction, will bring more clarity on that issue.Â
Firms have said that pills could reach patients who don’t take injections because they’re afraid of needles. But Nedelcovych said the “fate of oral weight reduction therapies could really revolve” around one other category of individuals: patients who may benefit from weight reduction treatments but don’t take injections because they imagine they’re meant for those with serious diseases.
“They’re really just invisible to the marketplace immediately,” he said. “But they may have different views about an oral therapy, which may very well be considered more like a vitamin so that they could be more amenable to taking that.”Â
The query top of mind for health experts is how corporations will price the pills.Â
“If it wasn’t for the undeniable fact that they might be made more cheaply, I would not care” about pills, said Dr. Caroline Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital.
The direct-to-consumer platforms from Eli Lilly and Novo Nordisk offer Zepbound and Wegovy for roughly $500 a month. She said less effective pills with more negative effects may have to be priced lower than that if corporations want health-care providers to prescribe them first over injections.Â
Competition is creeping upÂ
It’s still unclear who can be the subsequent viable player to enter the load loss drug space. Many experimental drugs from other corporations may not reach patients until the tip of the last decade.Â
Still, some drugmakers have made strides during the last 12 months and a half, inking deals with obesity biotechs or releasing promising data on experimental treatments. Several corporations are attempting to drive innovation with recent drugs that promote weight reduction in a different way, are taken less often or preserve muscle mass, amongst other changes.Â
Some investors are wanting to see a drug that promotes much more weight reduction than Wegovy and Zepbound, which has hit those corporations’ stocks when their treatments don’t meet lofty expectations in clinical trials. But some health experts say many patients needn’t lose greater than 20% of their weight.Â
“I’m not even in search of greater weight reduction anymore. What’s unsuitable with 16% and 22% weight reduction? Nothing, right?” said Apovian, referring to the degrees of weight reduction seen with some existing and experimental drugs.Â
Apovian said she is in search of treatments that focus on recent gut hormones, which could address patients who may not shed pounds on GLP-1s. She pointed to drugs targeting amylin analogs – an emerging type of weight reduction treatment that mimics a hormone co-secreted with insulin within the pancreas to suppress appetite and reduce food intake.
Several drugmakers, including Novo Nordisk and Eli Lilly, are betting on amylin analogs as a part of the subsequent wave of obesity treatments
Other experts have said that a super competitor would promote weight reduction while being easier to tolerate than existing injections. That is because many individuals discontinue those injections – and should not experience the total health advantages – because of gastrointestinal negative effects resembling nausea and vomiting.Â
Without late-stage trial data on any of the brand new competitors, it’s too early to say who will have the ability to deal with that issue.
The Amgen logo is displayed outside Amgen headquarters on May 17, 2023 in Thousand Oaks, California.
Mario Tama | Getty Images
Some drugs are much closer to answering that query than others.Â
For instance, Amgen in March said it has began two critical late-stage trials for its experimental weight reduction injection MariTide, which is designed to be taken monthly and even less often and promotes weight reduction in a different way from competitors.Â
In a mid-stage study, patients with obesity taking MariTide lost as much as 16.2% of their weight in a single 12 months when analyzing all participants no matter discontinuations, or as much as 19.9% when only analyzing those that stayed on the treatment. But patients experienced a high rate of negative effects and discontinuations within the trial.Â
Those results support the corporate’s decision to make use of a slower dosing schedule over eight weeks to make the drug more tolerable in phase three studies.Â
Some pharmaceutical corporations have turned to China for his or her obesity bets. For instance, Merck in December snagged the rights to an early-stage experimental GLP-1 pill from Chinese drugmaker Hansoh Pharma, in a deal value as much as $2 billion.Â
That acquisition and other smaller players raised questions on the fate of public U.S.-based obesity biotechs resembling Viking Therapeutics, which were once seen as hot takeover targets. Some analysts argue that their experimental drugs, most of that are still in mid-stage development, haven’t differentiated themselves enough from existing treatments.Â
“Unless and until these molecules show that they really are differentiated in phase three, I do not think there’s really a reason for given pharma to put out a big transaction to achieve access to it,” said TD Cowen’s Nedelcovych.Â
He said the “clearest path forward” for U.S.-based obesity biotechs is probably going inking partnerships with larger firms to develop and commercialize their drugs.
But Nedelcovych noted that “there really aren’t too many large pharmas who aren’t already spoken for at this point.”
