Lilly Outpaces Novo Nordisk in Obesity Drug Market: 2026 Outlook
- The battle for dominance in the rapidly expanding obesity drug market is intensifying, with Eli Lilly surging ahead of Novo Nordisk despite both companies facing pricing pressures.
- Eli Lilly projected Wednesday that its 2026 sales would reach $80 billion to $83 billion, exceeding analyst expectations of $77.62 billion.
- Both companies are navigating a landscape impacted by landmark deals struck with the U.S.
The battle for dominance in the rapidly expanding obesity drug market is intensifying, with Eli Lilly surging ahead of Novo Nordisk despite both companies facing pricing pressures. While Novo Nordisk is bracing for a sales decline in , Eli Lilly anticipates another year of robust revenue growth, fueled by the effectiveness of its medications and a strategic approach to market access.
Diverging Outlooks
Eli Lilly projected that its sales would reach $80 billion to $83 billion, exceeding analyst expectations of $77.62 billion. This forecast represents a -over- sales increase of 25%, according to the company. In contrast, Novo Nordisk warned on that it expects a sales and profit decrease of 5% to 13% in , citing falling prices in the U.S. And the expiration of patent exclusivity for its key drugs in China, Brazil, and Canada.
Both companies are navigating a landscape impacted by landmark deals struck with the U.S. Government in to lower the costs of obesity and diabetes drugs. These “most favored nation” agreements, along with recent efforts to reduce direct-to-consumer prices, are expected to reduce revenue but potentially increase prescription volumes. However, Lilly appears better positioned to offset these pricing headwinds.
According to Leerink Partners analyst David Risinger, the divergence in performance was “accentuated” this week, with Novo Nordisk guiding below consensus expectations and Eli Lilly exceeding them. Risinger stated that this outcome “solidified an investor’s mind that Lilly is going to be the dominant player in obesity going forward.”
The Role of Zepbound and Mounjaro
Lilly’s positive outlook is underpinned by strong demand for its obesity drug, Zepbound, and its diabetes counterpart, Mounjaro. The company also anticipates the launch of its oral obesity pill, orforglipron, in the second quarter of , pending U.S. Approval. Eli Lilly CEO David Ricks noted in a interview that approximately 20 million to 25 million patients are currently using medications from both companies, but emphasized the “gigantic” potential of the broader obesity market.
The success of tirzepatide, the active ingredient in Zepbound and Mounjaro, is a key differentiator. Risinger highlighted that tirzepatide is “superior” in both effectiveness and tolerability compared to semaglutide, the ingredient in Novo Nordisk’s Wegovy and Ozempic. This assessment is supported by clinical trial data from , which demonstrated that Zepbound leads to greater weight loss than Wegovy. Prescription trends also indicate a preference among prescribers for Lilly’s drugs.
Lilly also benefits from stronger patent protection for tirzepatide, which is expected to remain in effect through the latter half of the s in major markets. Novo Nordisk, faces patent expirations in several international markets, posing a challenge to its future growth.
The Pill Battle
The introduction of oral medications is poised to be a pivotal moment in the obesity drug market. Novo Nordisk launched its oral Wegovy pill earlier in , achieving 50,000 weekly prescriptions within three weeks of its release. However, investors are keenly awaiting the launch of Lilly’s orforglipron to see how the competitive landscape will shift.
Novo Nordisk CEO Mike Doustdar expressed confidence in his company’s ability to compete, citing clinical trial data indicating that Wegovy’s pill promotes comparable weight loss to its injectable form – around 15%. Lilly’s pill, based on available data, appears to be slightly less effective.
Risinger suggests that Lilly’s pill could gain an advantage due to its convenience. Orforglipron is a small-molecule drug that is more easily absorbed by the body and does not require the dietary restrictions associated with Novo Nordisk’s pill, which requires patients to limit water intake and delay eating for 30 minutes after consumption. While Novo Nordisk maintains that these requirements will not hinder uptake, Risinger believes that Lilly’s pill could achieve greater global sales as a result.
The coming year will be crucial as both Eli Lilly and Novo Nordisk navigate pricing pressures, patent challenges, and the evolving landscape of oral obesity medications. Currently, Eli Lilly appears to be gaining momentum, positioning itself as a potential leader in this increasingly important market.