An indication with the corporate emblem sits exterior of the headquarters of Eli Lilly in Indianapolis, Indiana, on March 17, 2024.
Scott Olson | Getty Images
Eli Lilly‘s inventory continues to be recovering after the drugmaker released trial data earlier this month on its intently watched obesity pill that underwhelmed Wall Street.
In a key late-stage trial, Eli Lilly’s pill, orforglipron, induced much less weight reduction and had increased uncomfortable side effects than what analysts had been anticipating. The pill’s efficacy additionally appeared to return in barely beneath that of Novo Nordisk‘s oral semaglutide for obesity, which confirmed robust knowledge in a separate research.
Shares of Eli Lilly fell about 13% on the day the trial outcomes had been launched, though they’re up about 12% since then.
But some analysts say Eli Lilly’s every day pill, if accredited, may nonetheless be a viable competitor within the weight reduction drug area — even when it will seemingly be second to enter the market. It’s a extremely profitable space that’s anticipating extra handy choices that would ease the availability shortfalls and entry hurdles created by the expensive weekly injections at the moment dominating it.
Analysts observe that Eli Lilly’s pill may have just a few benefits over the every day oral model of Novo Nordisk’s weight reduction drug semaglutide, which is on observe 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 year,” CEO David Ricks informed CNBC in early August.
Both medicine work by mimicking a intestine hormone known as GLP-1 to suppress urge for food and regulate blood sugar. But whereas Novo Nordisk’s pill is a peptide treatment, orforglipron is a small-molecule drug.
That means Eli Lilly’s pill is absorbed extra simply within the physique and does not require dietary restrictions like Novo Nordisk’s does. Orforglipron will even be simpler to fabricate at scale, which is essential as demand for obesity and diabetes injections outpaces provide.
Neither firm has launched costs for its respective pill, however some analysts mentioned Eli Lilly’s drug may probably have a lower cost than Novo Nordisk’s pill. That could be a notable edge, as many well being plans within the U.S. nonetheless do not cowl obesity therapies.
“It’s a 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 manufacture oral semaglutide,” Leerink Partners analyst David Risinger mentioned in an interview.
“Whereas Lilly plans to blanket the world with orforglipron, and very quickly it will generate dramatically more sales,” he continued. “It can launch globally in an extraordinary manner with lower prices and with no food intake consideration.”
Goldman Sachs analysts appear to agree, primarily based on a observe in August. They forecast every day oral drugs will seize 24% share — or round $22 billion — of the 2030 international weight reduction drug market, which they anticipate to be price $95 billion.
The Goldman analysts mentioned they anticipate Eli Lilly’s pill to have a 60% share — or roughly $13.6 billion — of the every day oral phase of the market in 2030. They anticipate Novo Nordisk’s oral semaglutide to have a 21% share — or round $4 billion — of that phase. The remaining 19% slice will go to different rising drugs, the analysts mentioned.
The race to develop a extra handy obesity pill has been fraught, as corporations corresponding to Pfizer have needed to scrap earlier contenders and convey ahead new ones. Novo Nordisk and Eli Lilly are additionally exploring different experimental oral medicine, together with a slate of different corporations corresponding to Viking Therapeutics, Structure Therapeutics, AstraZeneca and Roche.
In an announcement, Novo Nordisk CEO Mike Doustar mentioned “we strongly believe in the efficacy” of the oral drug. The Danish firm added it will 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, mentioned it is laborious to crown a winner between Eli Lilly and Novo Nordisk with out figuring out how their respective drugs will be priced and whether or not insurance coverage will cowl them.
“I think both of the drugs are going to be gamechangers,” he mentioned. “When it comes to which company is going to win the game — cost is the biggest issue.”
Weight loss, aspect impact comparisons
It’s tough to straight evaluate the outcomes of separate medical trials, particularly as traders look forward to Eli Lilly and Novo Nordisk to launch the total knowledge from their section three research.
Eli Lilly’s ATTAIN-1 trial additionally adopted 3,000 sufferers, whereas Novo Nordisk’s OASIS 4 research evaluated a much smaller group of roughly 300. There are at the moment no research straight evaluating the 2 medicine, a Novo Nordisk spokesperson mentioned.
But Novo Nordisk’s oral semaglutide seems to trigger a larger degree of weight reduction than Eli Lilly’s pill primarily based on the obtainable knowledge, mentioned BMO Capital Markets analyst Evan Seigerman.
In the trial, the best dose of Eli Lilly’s pill helped sufferers lose 12.4% of their physique weight on common at 72 weeks. The pill’s weight reduction was 11.2% when analyzing all sufferers no matter discontinuations.
Wall Street had hoped Eli Lilly’s pill would generate weight lack of round 15%, the identical degree 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 exterior its workplace 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 sufferers lose as much as 16.6% of their weight on common at 64 weeks, in line with outcomes from the trial introduced at a medical convention in 2024. That weight reduction was 13.6% when the corporate analyzed all sufferers no matter whether or not they stopped the drug.
A Novo Nordisk spokesperson added that 20% of weight reduction was noticed in almost one-third of sufferers within the trial.
Still, the marginally decrease efficacy of Eli Lilly’s pill might not be vital sufficient to discourage sufferers from taking it.
“For many patients, 12% is a really great number,” mentioned Seigerman. “There’s definitely a market there” for orforglipron.
In a observe earlier this month, Bank of America analysts shared an identical sentiment.
“Yes, weight loss fell a bit short, but ask 100 prescribers whether this new data will really make a difference in who they’d put on orforglipron, and our belief is the vast majority would say, ‘not really,'” they wrote, referring to Eli Lilly’s trial knowledge.
Some traders raised issues in regards to the uncomfortable side effects and discontinuation charges within the trial of Eli Lilly’s pill. But Seigerman mentioned the drug’s tolerability knowledge — how effectively sufferers tolerate it — seems to be comparatively consistent with that of Novo Nordisk’s oral semaglutide.
About 10.3% of sufferers who took the best dose of Eli Lilly’s pill — 36 milligrams — discontinued remedy as a result of uncomfortable side effects, in contrast with round 2.6% of those that took a placebo.
Those uncomfortable side effects had been primarily gastrointestinal, corresponding to nausea and vomiting, and delicate to average in severity. An estimated 24% of those that took the best dose of Eli Lilly’s pill reported vomiting, whereas 33.7% had nausea.
Leerink’s Risinger mentioned he’s watching to see how persistent these gastrointestinal points are as soon as Eli Lilly presents the total knowledge.
The uncomfortable side effects within the trial on Novo Nordisk’s pill had been largely gastrointestinal-related: 30.9% of those that took oral semaglutide reported vomiting and 46.6% reported nausea, in line with the trial outcomes.
Johns Hopkins’ Zilbermint mentioned it is tough for him to determine which one has a greater security and tolerability profile primarily based on the obtainable knowledge.
Meanwhile, Seigerman pointed to a distinct issue “that will also matter a lot”: dietary necessities.
Food necessities, manufacturing, value
Unlike Eli Lilly’s pill, sufferers must take Novo Nordisk’s oral semaglutide within the morning on an empty abdomen with not more than 4 ounces of plain water. They’re instructed to attend half-hour earlier than consuming, consuming or taking different oral medicines.
Seigerman mentioned that may very well be a hurdle for some sufferers.
For instance, “if you’re a parent with kids and you have to take this drug and wait half an hour before you can drink your coffee, you’re going to drive yourself crazy, especially if you have to take this every day,” he mentioned. “I try to think about the real-world use of these drugs in a market like this. It’s going to matter.”
Leerink’s Risinger mentioned oral semaglutide will even be “extremely expensive to manufacture” since it’s a peptide treatment, and “is likely going to have to be priced higher than orforlipgron.”
A Novo Nordisk spokesperson mentioned the pill will be made largely within the U.S., and the corporate is worked up in regards to the potential the pill “provides millions of Americans living with obesity.”
“Currently, all typical launch readiness activities [for the pill] are fully underway and building momentum,” the spokesperson mentioned. They added that over the previous decade, the corporate has invested $24 billion within the U.S. to broaden manufacturing capability and gasoline analysis and improvement. That contains investments geared toward rising manufacturing of lively pharmaceutical elements and capability for the ultimate phases of manufacturing for each present and future injectable and oral merchandise.
Small molecules are chemically easier and simpler to provide at scale, making them usually cheaper for corporations to formulate. But it’s nonetheless unclear how Eli Lilly will value orforglipron.
During an earnings name in August, Eli Lilly’s Ricks mentioned the pricing will be primarily based on the worth orforglipron brings, contemplating health-care financial savings and the comorbidities it may tackle.
In the observe earlier this month, Goldman Sachs analysts mentioned they anticipate the pill to be “priced at parity” to Eli Lilly’s tirzepatide, the lively ingredient within the firm’s obesity injection Zepbound and diabetes counterpart Mounjaro, which record for simply over $1,000 for a month’s provide.
“They should be cheaper than injections because they are easier to produce. But it does not mean they will be cheaper,” Johns Hopkins’ Zilbermint mentioned. “We just don’t know — for example, we don’t know how much went into research and development.”
Seigerman mentioned commercialization methods will even be key when the drugs compete in the marketplace.
He questioned whether or not Novo Nordisk will lean into the deal it just lately struck with CVS‘s pharmacy profit supervisor, Caremark. Under the deal, Caremark began to prioritize Novo Nordisk’s Wegovy on its commonplace formularies on July 1, making that weekly injection the popular GLP-1 drug for obesity over Zepbound.
But it’s unclear whether or not oral semaglutide may obtain an identical preferential standing.
Seigerman additionally questioned whether or not Eli Lilly will supply orforglipron via its direct-to-consumer pharmacy, LillyDirect. That providing bypasses insurers and pharmacy profit managers, permitting sufferers to straight buy Zepbound and a few of Eli Lilly’s different medicine from the corporate.
Seigerman mentioned he expects “a lot of nuances in the go-to-market campaign for these drugs,” including “that’s going to matter.”
Other opponents path behind
Other obesity drugs are in earlier phases of improvement, making it tough to straight evaluate them to the medicine from Eli Lilly and Novo Nordisk with out longer and bigger trials.
But up to now, some specialists suppose they pale as compared.
For instance, Viking Therapeutics on Tuesday released mid-stage trial data that disappointed traders, sending its inventory down as a lot as 40%.
Jared Holz, Mizuho well being care fairness strategist, mentioned in an electronic mail Tuesday that the outcomes on Viking’s drug “look inferior” to these of Eli Lilly’s pill “on almost all metrics.”
Viking’s once-daily pill helped sufferers lose as much as 12.2% of their weight at round three months, with no plateau, which implies sufferers may lose much more in a longer-term research.
Holz pointed to the excessive charge of sufferers who discontinued Viking’s drug for any cause over 13 weeks, which was round 28%. Meanwhile, round 1 / 4 of individuals discontinued Eli Lilly’s pill, orforglipron, for any cause over 72 weeks.
That’s “a much longer trial and therefore [Lilly] looks far better head-to-head,” Holz mentioned.