An indication with the corporate logo sits outside of the headquarters of Eli Lilly in Indianapolis, Indiana, on March 17, 2024.
Scott Olson | Getty Images
Eli Lilly‘s stock continues to be recovering after the drugmaker released trial data earlier this month on its closely watched obesity pill that underwhelmed Wall Street.
In a key late-stage trial, Eli Lilly’s pill, orforglipron, caused less weight reduction and had higher unwanted side effects than what analysts were expecting. The pill’s efficacy also appeared to are available barely below that of Novo Nordisk‘s oral semaglutide for obesity, which showed strong data in a separate study.
Shares of Eli Lilly fell about 13% on the day the trial results were released, although they’re up about 12% since then.
But some analysts say Eli Lilly’s day by day pill, if approved, could still be a viable competitor in the load loss drug space — even when it’s going to likely be second to enter the market. It is a highly lucrative area that’s longing for more convenient options that would ease the availability shortfalls and access hurdles created by the pricey weekly injections currently dominating it.
Analysts note that Eli Lilly’s pill could have a number of benefits over the day by day oral version of Novo Nordisk’s weight reduction drug semaglutide, which is on the right track to turn into the first needle-free alternative for obesity to win approval within the U.S. later this yr. Eli Lilly hopes to launch its pill globally “this time next yr,” CEO David Ricks told CNBC in early August.
Each drugs work by mimicking a gut hormone called GLP-1 to suppress appetite and regulate blood sugar. But while Novo Nordisk’s pill is a peptide medication, orforglipron is a small-molecule drug.
Meaning Eli Lilly’s pill is absorbed more easily within the body and doesn’t require dietary restrictions like Novo Nordisk’s does. Orforglipron can even be easier to fabricate at scale, which is crucial as demand for obesity and diabetes injections outpaces supply.
Neither company has released prices for its respective pill, but some analysts said Eli Lilly’s drug could potentially have a lower cost than Novo Nordisk’s pill. That may be a notable edge, as many health plans within the U.S. still don’t cover obesity treatments.
“It’s just a little little bit of an apples and oranges comparison because Novo Nordisk could have difficulty manufacturing enough of the product, given the high cost and requirements to fabricate oral semaglutide,” Leerink Partners analyst David Risinger said in an interview.
“Whereas Lilly plans to blanket the world with orforglipron, and in a short time it’s going to generate dramatically more sales,” he continued. “It may well launch globally in a rare manner with lower prices and with no food intake consideration.”
Goldman Sachs analysts appear to agree, based on a note in August. They 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.
The Goldman analysts said they expect Eli Lilly’s pill to have a 60% share — or roughly $13.6 billion — of the day by day oral segment of the market 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.
The race to develop a more convenient obesity pill has been fraught, as firms reminiscent of Pfizer have needed to scrap previous contenders and convey forward recent ones. Novo Nordisk and Eli Lilly are also exploring other experimental oral drugs, together with a slate of other firms reminiscent of Viking Therapeutics, Structure Therapeutics, AstraZeneca and Roche.
In an announcement, Novo Nordisk CEO Mike Doustar said “we strongly consider within the efficacy” of the oral drug. The Danish company added it’s going to be “laser-focused on getting this product to patients without supply constraints” within the U.S.
Dr. Mihail “Misha” Zilbermint, director of endocrine hospitalists at Johns Hopkins Community Physicians, said it’s hard to crown a winner between Eli Lilly and Novo Nordisk without knowing how their respective pills will likely be priced and whether insurance will cover them.
“I feel each of the drugs are going to be gamechangers,” he said. “In the case of which company goes to win the sport — cost is the largest issue.”
Weight reduction, side effect comparisons
It’s difficult to directly compare the outcomes of separate clinical trials, especially as investors wait for Eli Lilly and Novo Nordisk to release the complete data from their phase three studies.
Eli Lilly’s ATTAIN-1 trial also followed 3,000 patients, while Novo Nordisk’s OASIS 4 study evaluated a much smaller group of roughly 300. There are currently no studies directly comparing the 2 drugs, a Novo Nordisk spokesperson said.
But Novo Nordisk’s oral semaglutide appears to cause a greater level of weight reduction than Eli Lilly’s pill based on the available data, said BMO Capital Markets analyst Evan Seigerman.
Within the trial, the best dose of Eli Lilly’s pill helped patients lose 12.4% of their body weight on average at 72 weeks. The pill’s weight reduction was 11.2% when analyzing all patients no matter discontinuations.
Wall Street had hoped Eli Lilly’s pill would generate weight reduction of around 15%, the identical level as Novo Nordisk’s blockbuster weight reduction injection Wegovy. Semaglutide is the lively ingredient in Wegovy and its diabetes counterpart Ozempic.
Novo Nordisk flags flutter outside its office in Bagsvaerd, on the outskirts of Copenhagen, Denmark, on July 14, 2025.
Tom Little | Reuters
Meanwhile, the 25-milligram dose of Novo Nordisk’s oral semaglutide helped patients lose as much as 16.6% of their weight on average at 64 weeks, in keeping with results from the trial presented at a medical conference in 2024. That weight reduction was 13.6% when the corporate analyzed all patients no matter whether or not they stopped the drug.
A Novo Nordisk spokesperson added that 20% of weight reduction was observed in nearly one-third of patients within the trial.
Still, the marginally lower efficacy of Eli Lilly’s pill might not be significant enough to discourage patients from taking it.
“For a lot of patients, 12% is a extremely great number,” said Seigerman. “There’s definitely a market there” for orforglipron.
In a note earlier this month, Bank of America analysts shared an identical sentiment.
“Yes, weight reduction fell a bit short, but ask 100 prescribers whether this recent data will really make a difference in who they’d placed on orforglipron, and our belief is the overwhelming majority would say, ‘not likely,'” they wrote, referring to Eli Lilly’s trial data.
Some investors raised concerns concerning the unwanted side effects and discontinuation rates within the trial of Eli Lilly’s pill. But Seigerman said the drug’s tolerability data — how well patients tolerate it — appears to be relatively consistent with that of Novo Nordisk’s oral semaglutide.
About 10.3% of patients who took the best dose of Eli Lilly’s pill — 36 milligrams — discontinued treatment resulting from unwanted side effects, compared with around 2.6% of those that took a placebo.
Those unwanted side effects were mainly gastrointestinal, reminiscent of nausea and vomiting, and mild to moderate in severity. An estimated 24% of those that took the best dose of Eli Lilly’s pill reported vomiting, while 33.7% had nausea.
Leerink’s Risinger said he’s watching to see how persistent those gastrointestinal issues are once Eli Lilly presents the complete data.
The unwanted side effects within the trial on Novo Nordisk’s pill were mostly gastrointestinal-related: 30.9% of those that took oral semaglutide reported vomiting and 46.6% reported nausea, in keeping with the trial results.
Johns Hopkins’ Zilbermint said it’s difficult for him to make a decision which one has a greater safety and tolerability profile based on the available data.
Meanwhile, Seigerman pointed to a special factor “that can even matter lots”: dietary requirements.
Food requirements, manufacturing, price
Unlike Eli Lilly’s pill, patients must take Novo Nordisk’s oral semaglutide within the morning on an empty stomach with not more than 4 ounces of plain water. They’re instructed to attend half-hour before eating, drinking or taking other oral medicines.
Seigerman said that might be a hurdle for some patients.
For instance, “in the event you’re a parent with kids and you will have to take this drug and wait half an hour before you possibly can drink your coffee, you are going to drive yourself crazy, especially if you will have to take this every single day,” he said. “I attempt to think concerning the real-world use of those drugs in a market like this. It is going to matter.”
Leerink’s Risinger said oral semaglutide can even be “extremely expensive to fabricate” because it is a peptide medication, and “is probably going going to should be priced higher than orforlipgron.”
A Novo Nordisk spokesperson said the pill will likely be made mostly within the U.S., and the corporate is worked up concerning the potential the pill “provides hundreds of thousands of Americans living with obesity.”
“Currently, all typical launch readiness activities [for the pill] are fully underway and constructing momentum,” the spokesperson said. They added that over the past decade, the corporate has invested $24 billion within the U.S. to expand manufacturing capability and fuel research and development. That features investments geared toward increasing manufacturing of lively pharmaceutical ingredients and capability for the ultimate stages of production for each current and future injectable and oral products.
Small molecules are chemically simpler and easier to supply at scale, making them generally cheaper for firms to formulate. But it surely continues to be unclear how Eli Lilly will price orforglipron.
During an earnings call in August, Eli Lilly’s Ricks said the pricing will likely be based on the worth orforglipron brings, considering health-care savings and the comorbidities it will probably address.
Within the note earlier this month, Goldman Sachs analysts said they expect the pill to be “priced at parity” to Eli Lilly’s tirzepatide, the lively ingredient in the corporate’s obesity injection Zepbound and diabetes counterpart Mounjaro, which list for just over $1,000 for a month’s supply.
“They must be cheaper than injections because they’re easier to supply. But it surely doesn’t mean they will likely be cheaper,” Johns Hopkins’ Zilbermint said. “We just do not know — for instance, we do not understand how much went into research and development.”
Seigerman said commercialization strategies can even be key when the pills compete in the marketplace.
He questioned whether Novo Nordisk will lean into the deal it recently struck with CVS‘s pharmacy profit manager, Caremark. Under the deal, Caremark began to prioritize Novo Nordisk’s Wegovy on its standard formularies on July 1, making that weekly injection the popular GLP-1 drug for obesity over Zepbound.
But it surely is unclear whether oral semaglutide could receive an identical preferential status.
Seigerman also questioned whether Eli Lilly will offer orforglipron through its direct-to-consumer pharmacy, LillyDirect. That offering bypasses insurers and pharmacy profit managers, allowing patients to directly purchase Zepbound and a few of Eli Lilly’s other drugs from the corporate.
Seigerman said he expects “loads of nuances within the go-to-market campaign for these drugs,” adding “that is going to matter.”
Other competitors trail behind
Other obesity pills are in earlier stages of development, making it difficult to directly compare them to the drugs from Eli Lilly and Novo Nordisk without longer and bigger trials.
But thus far, some experts think they pale compared.
For instance, Viking Therapeutics on Tuesday released mid-stage trial data that disillusioned investors, sending its stock down as much as 40%.
Jared Holz, Mizuho health care equity strategist, said in an email Tuesday that the outcomes on Viking’s drug “look inferior” to those of Eli Lilly’s pill “on just about all metrics.”
Viking’s once-daily pill helped patients lose as much as 12.2% of their weight at around three months, with no plateau, which suggests patients could lose much more in a longer-term study.
Holz pointed to the high rate of patients who discontinued Viking’s drug for any reason over 13 weeks, which was around 28%. Meanwhile, around 1 / 4 of individuals discontinued Eli Lilly’s pill, orforglipron, for any reason over 72 weeks.
That is “a for much longer trial and due to this fact [Lilly] looks much better head-to-head,” Holz said.
